Associations between Childhood Trauma and Epistemic Trust, Attachment, Mentalizing, and Symptoms of Borderline Personality Disorder

Introduction: The construct of epistemic trust (ET) has gained wide acceptance and support in the field, although there is little empirical evidence to substantiate the theoretical assumed model. Studies of the assessment of ET were conducted in community samples only and the mediating role of attachment and mentalizing in addition to ET was not investigated. This study examines the theoretical assumed relationships between ET and attachment and mentalizing as well as the mediating role of attachment, mentalizing and ET in the association between childhood adversity and borderline personality disorder (BPD) in a heterogeneous sample containing also patients. Methods: The associations between ET and attachment, mentalizing, childhood maltreatment and BPD were explored in a sample of 245 participants, including subjects from the community as well as patients diagnosed with anxiety and personality disorders from two clinical samples. Multiple mediation analysis was performed to explore the mediating role of attachment (ECR-R), mentalizing (RFQ), and ET within the relationship between childhood trauma (CTQ-SF) and BPD (MSI-BPD). Results: Strong relationships between ET and attachment and mentalizing were found indicating that lower degrees of cET are associated with insecure attachment and lower reflective functioning. Attachment, mentalizing, and ET together accounted for 75% of the mediation between childhood adversity and BPD. Hypomentalizing and anxious attachment accounted for the largest share of the mediation. Conclusion: Our findings provide preliminary evidence for the theoretical supposed model of ET and suggest relevance of ET in the mediation between childhood adversity and PDs, although the role of ET seems smaller than assumed by recent theories.