Childhood emotional and physical maltreatment and borderline personality disorder features in adolescence: A dual-model examination of mediation and moderation via secure and insecure attachment

Abstract

Background & objective: Childhood maltreatment is an antecedent of borderline personality disorder, yet the mechanisms and boundary conditions of this link in adolescence remain unclear. We simultaneously tested whether secure, anxious, and avoidant attachment mediate the association between emotional and physical maltreatment and borderline personality features (BPF), and whether the same attachment dimensions moderate those associations. Method: Six-hundred and nine Italian adolescents (Mage =16.88 years) completed the Childhood Trauma Questionnaire, Attachment Style Questionnaire, and Borderline Personality Inventory. We estimated a four-step mediation sequence and a two-step moderation model. Results: Emotional maltreatment was indirectly associated with higher BPF through higher attachment anxiety (β =0.11), higher avoidance (β =0.03), and lower confidence (β =0.05); the combined indirect effect was β =0.19. Physical maltreatment showed no comparable indirect associations via attachment but was directly associated with BPF (β =0.20). The mediation model accounted for 42% of variance in BPF. In the moderation model (43% explained variance), the maltreatment–BPF association was stronger at higher confidence (for both emotional and physical maltreatment) and weaker at higher avoidance (for emotional maltreatment). Conclusions: Findings suggest distinct patterns of association between emotional and physical maltreatment and adolescent BPF: emotional maltreatment was associated with BPF primarily through attachment-related pathways, whereas physical maltreatment was directly associated with BPF. Moreover, attachment security was not uniformly protective: higher confidence was linked to stronger maltreatment–BPF associations, whereas higher avoidance was linked to weaker associations. These results support maltreatment-specific, attachment-informed screening and intervention strategies in adolescence.