The Influence of Attachment Styles on the Development of Post-Traumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD): A Comprehensive Review

Abstract

Attachment patterns possess a substantial role in the emergence of Post-Traumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD), especially in those who were subject to childhood abuse. This extensive review compiles data from 45 literature investigating the impact of attachment insecurity on PTSD and BPD symptoms. Attachment anxiety and avoidance appear to aggravate emotional dysregulation, dissociation, and interpersonal problems, making them more vulnerable to both conditions. Mentalizing impairments, self-compassion, and neurobiological changes such as increased amygdala activation mediate these connections. Furthermore, the overlap between PTSD, BPD, and attachment-related disorders makes differentiated diagnosis difficult. According to meta-analytic data, secure attachment is a protective factor, whereas insecure attachment enhances the association between early trauma and psychopathology. These findings emphasise the need of attachment-informed therapies in trauma recovery and personality disorder therapy.