Emotion word repertoire in the adult attachment interview is linked to reduced suicide attempts in patients with borderline personality disorder

Abstract

BackgroundThis study explored the association between emotion word repertoire (EWR), attachment, reflective functioning and personality organization (PO) and suicidal behavior in borderline personality disorder (BPD) patients. MethodsThe current study performed a secondary data analysis from a randomized control trial for BPD patients (all female; n = 87; age: m = 27; SD = 7.42). EWR was assessed via machine-scoring transcripts of Adult Attachment Interviews (AAI) for affective words using the VETA electronic scoring software for the Levels of Emotional Awareness Scale (LEAS). Generated scores were related to impairments in PO (Structured Interview for Personality Organization; STIPO), attachment organization (AAI) and mentalization (Reflective Functioning Scale), general symptom severity (Brief Symptom Inventory; BSI-53), self-harm and suicidal behavior. Independent effects of the investigated predictors were studied using Bayesian path analysis. ResultsCorrected for education, findings in Bayesian path analysis suggest an independent negative association between EWR and suicide attempts (BE = −.32; 95 % CI [-.51, −.12]) and positive associations of deficits in PO with psychiatric symptoms (BE = .23; 95 % CI [.01, .44]) as well as suicide attempts (BE = .30; 95 % CI [.08, .49]). DiscussionThe findings underscore the potential role of high EWR and PO as a protective factor for suicidal behavior in individuals with BPD.