The Effects of Mentalization-Based Therapy and Attachment-Based Therapy on Positive and Negative Affect Regulation in Individuals with Borderline Personality Disorder

Shekarian Yazd, Fatemeh; Safarian Toosi, Mohammadreza; Seirafi, Mohammadreza

doi:10.22087/ijac.2025.563746.1084

The Effects of Mentalization-Based Therapy and Attachment-Based Therapy on Positive and Negative Affect Regulation in Individuals with Borderline Personality Disorder

Document Type : Research

Authors

Fatemeh Shekarian Yazd ¹

Mohammadreza Safarian Toosi ²

Mohammadreza Seirafi ³

¹ Health Psychology, Kish International Branch, Islamic Azad University, Kish, Iran.

² Department of Educational Sciences and Educational Management, Mashhad Branch, Islamic Azad University, Mashhad, Iran

³ Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.

10.22087/ijac.2025.563746.1084

Abstract

This study compared mentalization-based therapy (MBT) and attachment-based therapy (ABT) for positive and negative affect in individuals with borderline personality disorder (BPD). A quasi-experimental pretest-posttest-follow-up design included 45 participants aged 18-35 years with BPD, randomly assigned to MBT (n=15), ABT (n=15), or a control condition (n=15). The interventions comprised 10 weekly two-hour sessions delivered by trained therapists. The Borderline Symptom List and Positive and Negative Affect Schedule assessed outcomes at pre-test, post-test, and 2-month follow-up. Mixed-model analysis of variance revealed significant main effects of time on positive affect (F=703.44, p<0.001) and negative affect (F=1422.68, p<0.001). The time × group interactions were significant for both outcomes (positive affect: η²ₚ = 0.84; negative affect: η²ₚ = 0.85), with large effect sizes. Both MBT and ABT significantly improved positive and negative affect relative to the control condition. Importantly, MBT demonstrated superior effectiveness in enhancing positive affect. Treatment gains were maintained during the 2-month follow-up period. Both MBT and ABT effectively improve affect regulation in BPD through distinct mechanistic pathways: MBT via enhanced mentalizing capacity and ABT via improved relational security. MBT's superiority in positive affect suggests a particular clinical benefit for subjective well-being. Despite these promising findings, the modest sample size limits the statistical power and generalizability of the results. Larger multicenter randomized controlled trials are recommended to confirm these findings and establish optimal treatment strategies for individuals with BPD.

Keywords

Borderline Personality Disorder

Psychotherapy

Affect

Emotions

Therapeutic Intervention

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