The effectiveness of emotion therapy on emotion regulation and attachment styles in women with borderline personality disorder

Document Type : Research Paper


1 PhD Student, Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

2 Faculty, Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran

3 professor in psychology


Introduction: The characteristics of patients with borderline personality disorder and its complex nature justify the need for new therapies. The aim of this study was to determine the effectiveness of emotion-based therapy on emotional regulation and attachment styles of women with borderline personality disorder.
Methods: The present study was a quasi-experimental with a pretest-posttest design with a control group and a two-month follow-up period. The statistical population of the study included women with borderline personality disorder who referred to medical centers in district one of Tehran. In this study, 30 people were selected as the research sample using available sampling method and were replaced in two groups using random method. The method was that all three groups first responded to the Emotion Regulation Questionnaire (Gross and John, 2003) and Attachment Styles (Hazen and Schiver, 1987). Emotion-focused treatment intervention was applied in 10 sessions for the experimental group. Thus, research data were collected and analyzed using repeated measures analysis of variance.
Results: The results showed that emotion-oriented treatment had a significant and lasting effect on improving emotional regulation and attachment styles in women with borderline personality disorder (p <0.001).
Conclusion: By improving emotional regulation and attachment styles through emotional therapy, the mental health of women with borderline personality disorder can be increased.


  1. Chalker SA, Carmel A, Atkins DC, Landes SJ, Kerbrat, AH, Comtois KA. Examining challenging behaviors
    of clients with borderline personality disorder. Behav Res Ther 2015; 75: 11-19. doi:
    2. Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD. [Prevalence, correlates, disability and
    comorbidity of DSM-IV borderline personality disorder results from the wave 2 national epidemiologic survey
    on alcohol and related conditions]. J Clin Psychiatr2008; 69: 533-45.
    3. Ganji M. Psychopathology according to the DSMV. 2th ed. Tehran Savalan Publication. 2014; P.231.
    4. Marwaha S, He Z, Broome M, Singh SP, Scott J, Eyden J. [How is affective instability defined and measured?
    A systematic review]. Psychol Med 2013; 44: 1793-808. doi: 10.1017/S0033291713002407.
    5. Kaplan, C., Tarlow, N., Stewart, J. G., Aguirre, B., Galen, G., & Auerbach, R. P. (2016). Borderline
    personality disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and suicidality.
    Comprehensive psychiatry, 71, 86-94.
    6. Moran, L. R., Kaplan, C., Aguirre, B., Galen, G., Stewart, J. G., Tarlow, N., & Auerbach, R. P. (2018).
    Treatment effects following residential dialectical behavior therapy for adolescents with borderline personality
    disorder. Evidence-based practice in child and adolescent mental health, 3(2), 117-128.
    7. Fernández-Dols, J. M., Carrera, P., & Crivelli, C. (2011). Facial behavior while experiencing sexual
    excitement. Journal of Nonverbal Behavior, 35(1), 63-71.
    8. Serafini, G., Canepa, G., Adavastro, G., Nebbia, J., Belvederi Murri, M., Erbuto, D., ... & Amore, M. (2017).
    The relationship between childhood maltreatment and non-suicidal self-injury: a systematic review. Frontiers
    in psychiatry, 8, 149.
    9. Sadock, E. (2015). Evaluation of psychological services for anxiety and depression provided in a universitybased primary care clinic. Virginia Commonwealth University.
    10. Mohebi, S., Shokri, O., Pourshahriar, H. Effect of Resilience Education on Cognitive Appraisals, Coping and
    Emotions. , 2018; 15(57): 83-99.
    11. Greenberg, L. S., & Goldman, R. N. (2019). Clinical handbook of emotion-focused therapy (pp. xiv-534).
    American Psychological Association.
    12. Foroughe M, Stillar A, Goldstein L, Dolhanty J, Goodcase ET, Lafrance A. Brief emotion focused family
    therapy: An intervention for parents of children and adolescents with mental health issues. Journal of marital
    and family therapy. 2019 Jul;45(3):410-30.
    13. Weisberg PJ, Dilts TE, Greenberg JA, Johnson KN, Pai H, Sladek C, Kratt C, Tyler SW, Ready A. Phenologybased classification of invasive annual grasses to the species level. Remote Sensing of Environment. 2021 Sep
    14. Wiesel I, Shahar B, Goldman RN, Bar‐Kalifa E. Accuracy and Bias in Vulnerability Perceptions of Partners
    Undergoing Emotion‐Focused Therapy for Couples. Family process. 2021 Jun;60(2):377-92.
    15. Shenal BV, Harrison DW, Demaree HA. The neuropsychology of depression: a literature review and
    preliminary model. Neuropsychology review. 2003 Mar;13(1):33-42.
    16. Glisenti, K., Strodl, E., King, R., & Greenberg, L. (2021). The feasibility of emotion-focused therapy for
    binge-eating disorder: a pilot randomised wait-list control trial. Journal of Eating Disorders, 9(1), 1-15.
    17. Mahmoudvandi Baher E, Falsafinejad M, Khodabakhshi koulaei A. The effectiveness of emotion group
    therapy on negative spontaneous hopes and thoughts of divorced women. Social health. 2018; 5 (1): 67-76.
    18. Pos AE, Greenberg LS. Organizing awareness and increasing emotion regulation: Revising chair work in
    emotion-focused therapy for borderline personality disorder. Journal of Personality Disorders. 2012
    19. Warwar SH, Links PS, Greenberg L, Bergmans Y. Emotion-focused principles for working with borderline
    personality disorder. Journal of Psychiatric Practice®. 2008 Mar 1;14(2):94-104.
    20. Hazan C, Shaver PR. Love and work: An attachment-theoretical perspective. Journal of Personality and social
    Psychology. 1990 Aug;59(2):270.
    21. Nazari Chegani, A., Behroozi, N., Hashemi Sheykh Shabani, S., Mehrabizadeh Honarmand, M. The
    Relationship of Attachment Styles with Depression and Life Satisfaction with Mediating Role of Social
    Support and Optimism in Female Students of SCU. Psychological Achievements, 2012; 19(2): 81-100.
    22. Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect,
    relationships, and well-being. Journal of personality and social psychology. 2003 Aug;85(2):348.
  2. 23. Bigdeli I, Najafy M, Rostami M. The Relation of Attachment Styles, Emotion Regulation, and Resilience to
    Well-being among Students of Medical Sciences . Iranian Journal of Medical Education. 2013; 13 (9) :721-729
    24. Greenman, P. S., Johnson, S. M., & Wiebe, S. (2019). Emotionally focused therapy for couples: At the heart of
    science and practice.
    25. Teo J, Chia JT. EEG-based excitement detection in immersive environments: An improved deep learning
    approach. InAIP Conference Proceedings 2018 Sep 26 (Vol. 2016, No. 1, p. 020145). AIP Publishing LLC.
    26. Plener PL, Bubalo N, Fladung AK, Ludolph AG, Lulé D. Prone to excitement: Adolescent females with nonsuicidal self-injury (NSSI) show altered cortical pattern to emotional and NSS-related material. Psychiatry
    Research: Neuroimaging. 2012 Aug 1;203(2-3):146-52.
    27. Wiebe SA, Elliott C, Johnson SM, Burgess Moser M, Dalgleish TL, Lafontaine MF, Tasca GA. Attachment
    change in emotionally focused couple therapy and sexual satisfaction outcomes in a two-year follow-up study.
    Journal of Couple & Relationship Therapy. 2019 Jan 2;18(1):1-21.