The Experiences in Close Relationship Scale (ECR)-short form: reliability, validity, and factor structure

An investigation of Jezebel stereotype awareness, gendered racial identity and sexual beliefs and behaviours among Black adult women

Evidence suggests that the intersectional nature of Black women's race and gender identities influence their awareness of sexual scripts such as the hypersexual, Jezebel stereotype. This study examined the role of the Jezebel stereotype and Black women's identity beliefs on their sexual beliefs and behaviours. Specifically, we investigated the role of gendered racial identity beliefs on the relationship between Jezebel stereotype awareness and Black women's sexual behaviours (sexual assertiveness, sexual satisfaction, sexual guilt and attachment avoidance in relationships). A diverse national sample of Black women completed measures of gendered racial identity beliefs, Jezebel stereotype awareness and sexual behaviours. Black women who felt more positively connected to their Black woman identity reported greater sexual assertiveness and satisfaction. Consistent with past research, more awareness of the Jezebel stereotype was associated with higher sexual guilt and attachment avoidance. We discuss the enduring legacy of the Jezebel stereotype in relation to Black women's gendered racial identity beliefs, as well as the importance of promoting positive sexual beliefs and a sense of sexual agency among Black women in the USA.

Cross-Lagged Associations of Insecure Attachment Style, Alcohol Use, and Sexual Behavior During Emerging Adulthood

Insecure romantic attachment style has been associated with greater substance use and higher risk sexual behavior, but the temporal nature of these associations is not well-understood. This study examined whether having a more insecure attachment style was associated with greater engagement in higher-risk sexual behavior over time and, if so, whether this was mediated by more frequent alcohol use. We used three annual waves of survey data from a diverse California cohort (N = 2371) who were assessed from ages 19 to 21-22 years. Separate cross-lagged models examined temporal associations of insecure romantic attachment style (anxious and avoidant), past month alcohol use frequency, and sexual behavior (number of sex partners, condomless sex with casual and steady partners). Attachment anxiety was not directly associated with sexual behavior. Rather, a consistent pattern across waves showed that greater attachment anxiety was associated with more frequent alcohol use at the next wave, which, in turn, was associated with having more sex partners and condomless sex with casual and steady partners one year later. In contrast, greater attachment avoidance was directly associated with having fewer sex partners, and its associations with condomless sex differed across partner type and assessment waves. Attachment avoidance was unrelated to alcohol use frequency. Results indicated that both anxious and avoidant attachment styles were associated with higher-risk sexual behavior, but in different ways and through different mechanisms. Future research may want to examine whether the effectiveness of sexual risk reduction programs for young people is enhanced by discussing attachment style and tailoring the curriculum accordingly.

The sexual wholeness model: An initial evaluation with two samples

Based upon the psychological needs delimited in self-determination theory, we created the sexual wholeness model to encapsulate the different dimensions (physical, emotional, and meaning) that create couple sexuality. We evaluated the model with data from two national samples (Sample 1, n = 610; Sample 2, n = 884), by examining the association between sexual, relationship, and life satisfaction, and attachment with the different elements of the sexual wholeness model using harmonious sexual passion as an intermediate variable. The emotional dimension had the strongest associations in both samples with harmonious sexual passion and all other outcomes except attachment. The physical dimension of sexuality had a surprisingly strong association with attachment and sexual satisfaction. In addition, couples' self-evaluation of the degree of sexual wholeness in their relationship was strongly associated with harmonious passion and all other outcomes, providing another level of validity to the dimensions of the model and the potential utility for using this model to assist in couple therapy.

Mothers’ Attachment Representations and Children’s Brain Structure

Ample research demonstrates that parents’ experience-based mental representations of attachment—cognitive models of close relationships—relate to their children’s social-emotional development. However, no research to date has examined how parents’ attachment representations relate to another crucial domain of children’s development: brain development. The present study is the first to integrate the separate literatures on attachment and developmental social cognitive neuroscience to examine the link between mothers’ attachment representations and 3- to 8-year-old children’s brain structure. We hypothesized that mothers’ attachment representations would relate to individual differences in children’s brain structures involved in stress regulation—specifically, amygdala and hippocampal volumes—in part via mothers’ responses to children’s distress. We assessed 52 mothers’ attachment representations (secure base script knowledge on the Attachment Script Assessment and self-reported attachment avoidance and anxiety on the Experiences in Close Relationships scale) and children’s brain structure. Mothers’ secure base script knowledge was significantly related to children’s smaller left amygdala volume but was unrelated to hippocampal volume; we found no indirect links via maternal responses to children’s distress. Exploratory analyses showed associations between mothers’ attachment representations and white matter and thalamus volumes. Together, these preliminary results suggest that mothers’ attachment representations may be linked to the development of children’s neural circuitry related to stress regulation.

Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia

BACKGROUND

Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD.

AIM

The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality.

METHODS

One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up.

OUTCOMES

(1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index.

RESULTS

Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition.

CLINICAL IMPLICATIONS

Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress.

STRENGTHS & LIMITATIONS

Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties.

CONCLUSION

Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity. V Charbonneau-Lefebvre, M-P Vaillancourt-Morel, NO Rosen, et al. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022;19:479-495.

How does attachment style affect psychosis? A systematic review of causal mechanisms and guide to future inquiry

PURPOSE

The link between attachment and psychosis is now well established, but less is known about the causal mechanisms underlying this relationship. This systematic review synthesises the studies that examine mediating mechanisms in the attachment and psychosis relationship, in both clinical and non-clinical samples.

METHOD

We conducted a database search (PsychINFO, MEDLINE, Web of Science) to identify all eligible studies irrespective of publication status, the language of article or article date. We assessed methodological quality and completed a narrative synthesis given the heterogeneity of studies to date.

RESULTS

We identified 17 papers, comprising 3,672 participants. The relationship between attachment and psychosis is mediated by four variables or groups of variables. There is good evidence for the causal role of affective factors (affective dysregulation and affective disturbances) and cognitive factors (e.g., self-beliefs and self-esteem and beliefs about symptoms). Affective factors differed by attachment style. Tentative evidence was found for the role of duration of untreated psychosis and baseline negative symptoms.

CONCLUSIONS

Cognitive and affective factors mediate the relationship between attachment style and psychosis. Whilst cognitive factors are routinely targeted in recommended psychological interventions for psychosis, affective factors and attachment style are less commonly considered. Psychological therapies may be improved by calibrating cognitive and affective interventions by attachment style, which should be subjected to experimental and then field studies to assess the impact on clinical and recovery outcomes.

PRACTITIONER POINTS

The relationship between attachment and psychosis is now well established, and studies have started to examine mediating mechanisms. Affective and cognitive factors mediate the attachment-psychosis relationship. Affective factors differ by attachment style. There is limited evidence for the duration of untreated psychosis and negative psychotic symptoms as mediating mechanisms, and research replication is needed. Cognitive factors are routinely targeted in recommended psychological therapies for psychosis, but affective factors and attachment style are less commonly considered. Research should be conducted into the effectiveness of psychological therapies which calibrate cognitive and affective interventions, according to attachment style.

"A Romanian Version of the Experiences in Close Relationship Scale – Short Form (ECR-S) Measure of Adult Attachment"

The present research objective is to adapt the 12-item Experiences in Close Relationship Scale – Short Form (ECR-S) on the Romanian population. This self-report scale is used to assess adult attachment, by two dimensions: Anxiety and Avoidance. The psychometric properties of the instrument were assessed in a cross-sectional approach, by examining the reliability (in terms of internal consistency, as well as test-retest reliability), factor structure, convergent and predictive validity, in a sample from general population. A total number of 440 participants, aged 18 to 71 years-old, filled out a socio-demographics data sheet, the ECR-S and the Patient Health Questionnaire-9 (PHQ-9). The incomplete questionnaires were removed, resulting in a final number of 421 participants for the analysis. Results indicated good internal consistency (Cronbach`s alpha coefficients 0.79, 0.73, McDonald`s omega coefficients 0.80, 0.74) and good test-retest reliability over 2-weeks period (Spearman coefficients 0.86, 0.74) for both subscales (Anxiety and Avoidance). The confirmatory analysis revealed a bifactorial structure, with 11 items. Results confirmed convergent and predictive validity. Influence of socio-demographic variables was also assessed. The results indicate that the Romanian version of ECR-S has good psychometric properties, being a suitable instrument for assessing adult attachment.

Is Infidelity Predictable? Using Explainable Machine Learning to Identify the Most Important Predictors of Infidelity

Infidelity can be a disruptive event in a romantic relationship with a devastating impact on both partners' well-being. Thus, there are benefits to identifying factors that can explain or predict infidelity, but prior research has not utilized methods that would provide the relative importance of each predictor. We used a machine learning algorithm, random forest (a type of interpretable highly non-linear decision tree), to predict in-person and online infidelity across two studies (one individual and one dyadic, N = 1,295). We also used a game theoretic explanation technique, Shapley values, which allowed us to estimate the effect size of each predictor variable on infidelity. The present study showed that infidelity was somewhat predictable overall and interpersonal factors such as relationship satisfaction, love, desire, and relationship length were the most predictive of online and in person infidelity. The results suggest that addressing relationship difficulties early in the relationship may help prevent infidelity.

Unraveling the Roles of Distrust, Suspicion of Infidelity, and Jealousy in Cyber Dating Abuse Perpetration: An Attachment Theory Perspective

People who are anxiously attached, distrustful and jealous of their partners, and suspect infidelity are more likely to use psychological dating violence. Is this also true for cyber dating abuse perpetration (CDAP)? This study investigated the prevalence of and gender differences in self-reported CDAP and whether trust, anticipated partner infidelity, and jealousy serially mediated the association between anxious attachment and CDAP in a sample of Turkish college students. College students (N = 390) completed the Cyber Dating Violence Inventory, Anxious Attachment subscale of the Experiences in Close Relationship Scale-Short Form, Dyadic Trust Scale, Cognitive Jealousy subscale of the Multidimensional Jealousy Scale, Partners' Intentions Towards Infidelity Scale, and a Demographic Information Form. A total of 67% of the sample used at least one cyber abusive behavior with their partner over the last 6 months. A multiple serial mediation model indicated that greater anxious attachment was related to more dyadic distrust, the anticipation of partner infidelity, and jealousy, and, in turn, to the use of cyber dating abuse. Overall, results show that the prevalence of CDAP is high and that attachment theory offers a promising framework for identifying predictors of CDAP in emerging adults. These findings have implications for research, intervention, and prevention of CDAP by identifying potential risk factors for perpetrating cyber abuse.

The FACAM study: protocol for a randomized controlled study of an early interdisciplinary intervention to support women in vulnerable positions through pregnancy and the first 5 years of motherhood

BACKGROUND

Inequality in health can have profound short- and long-term effects on a child's life. Infants develop in a responsive environment, and the relationship between mother and infant begins to develop during pregnancy. The mother's ability to bond with the fetus and newborn child may be challenged by mental health issues which can cause impaired functioning and poorer health outcomes. Families with complex problems need interdisciplinary interventions starting in early pregnancy to be prepared for motherhood and to ensure healthy child development. This study aims to examine the effects of an early and coordinated intervention (the Family Clinic and Municipality (FACAM) intervention) offered to vulnerable pregnant women during pregnancy and the child's first year of life on the mother-child relationship, maternal social functioning, mental health, reflective functioning, well-being, parental stress, and the development and well-being of the child.

METHODS

The study is a prospective randomized controlled trial where we will randomize 320 pregnant women enrolled to receive antenatal care at the family clinic at Odense University Hospital, to either FACAM intervention or usual care. The FACAM intervention consists of extra support by a health nurse or family therapist during pregnancy and until the child starts school. The intervention is most intensive in the first 12 months and also includes attachment-based support provided either individually or in groups. The participants are assessed at baseline, and when the infant is 3 and 12 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior (CIB) instrument. Secondary outcomes include prenatal parental reflective functioning, mental well-being, depressive symptoms, breastfeeding duration, maternal satisfaction, child development, parent competence, parental stress, and activities with the child.

DISCUSSION

The trial is expected to contribute knowledge about the effect of early coordinated support in antenatal and postnatal care for vulnerable pregnant women and their families.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03659721 . Registered on September 6, 2018.

Psychotherapist Trainees' Quality of Life: Patterns and Correlates

While psychotherapists are trained to improve their clients' quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was used at the outset of trainings to assess trainees' professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees' lives could be characterized as fortunate or happy (i.e., experiencing great life satisfaction and not much stress), whereas 14.3% could be characterized as clearly distressed or troubled (i.e., experiencing great life stress and not much satisfaction). The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees' life quality when it may be deficient, such as those on a societal level (e.g., availability of low-cost student loans), training program level (e.g., promoting supportive supervision, positive between-trainee relationships and group collaboration), and individual level (e.g., personal therapy and learning self-care), in order to promote effective learning and therapy practice.

Can Emotion Dysregulation Explain the Association Between Attachment Insecurities and Teen Dating Violence Perpetration?

Attachment theory provides important insight regarding the etiology of teen dating violence perpetration (TDV-P). Attachment insecurities have been associated with TDV-P, but the mechanisms underlying this association remain unclear. Furthermore, as of now, studies have failed to explore whether the relation between attachment insecurities and TDV-P varied according to its forms (i.e., psychological, physical or sexual) or to the perpetrator's gender. This study aimed to investigate if emotion dysregulation mediates the association between attachment insecurities and different forms of TDV-P among girls and boys. Adolescents (M_age = 16 years; n = 3,214; 60% girls) were recruited from a one-stage stratified cluster sample of 34 high schools in Quebec, Canada. Path analyses with probit regression models were conducted separately for girls and boys. Attachment anxiety and avoidance were associated with more emotion dysregulation. Emotion dysregulation was, in turn, associated with higher probabilities of physical TDV-P in girls and psychological TDV-P in girls and boys. Surprisingly, emotion dysregulation was not associated with sexual TDV-P. Attachment anxiety remained directly related to higher probabilities of perpetrating all forms of TDV. These findings support the hypotheses set forth by attachment theory and highlight the utility of this theory to understand and potentially prevent TDV-P. Practitioners should more specifically address adolescents' attachment anxiety, as it seems more related to TDV-P. Finally, this study underscores the necessity of considering gender and specific forms of TDV-P to understand the association between attachment insecurities, emotion dysregulation, and TDV-P.

Validation of the International Trauma Interview (ITI) for the Clinical Assessment of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) in a Lithuanian Sample

BACKGROUND

The 11^th revision of the International Classification of Diseases (ICD-11) includes a new diagnosis of complex posttraumatic stress disorder (CPTSD). The International Trauma Interview (ITI) is a novel clinician-administered diagnostic interview for the assessment of ICD-11 PTSD and CPTSD.

OBJECTIVE

The aim of this study was to evaluate the psychometric properties of the ITI in a Lithuanian sample in relation to interrater agreement, latent structure, internal reliability, as well as convergent and discriminant validity.

METHOD

In total, 103 adults with a history of various traumatic experiences participated in the study. The sample was predominantly female (83.5%), with a mean age of 32.64 years (SD = 9.36). For the assessment of ICD-11 PTSD and CPTSD, the ITI and the self-report International Trauma Questionnaire (ITQ) were used. Mental health indicators, such as depression, anxiety, and dissociation, were measured using self-report questionnaires. The latent structure of the ITI was evaluated using confirmatory factor analysis (CFA). In order to test the convergent and discriminant validity of the ITI we conducted a structural equation model (SEM).

RESULTS

Overall, based on the ITI, 18.4% of participants fulfilled diagnostic criteria for PTSD and 21.4% for CPTSD. A second-order two-factor CFA model of the ITI PTSD and disturbances in self-organization (DSO) symptoms demonstrated a good fit. The associations with various mental health indicators supported the convergent and discriminant validity of the ITI. The clinician-administered ITI and self-report ITQ had poor to moderate diagnostic agreement across different symptom clusters.

CONCLUSION

The ITI is a reliable and valid tool for assessing and diagnosing ICD-11 PTSD and CPTSD.

Activating the attachment system modulates neural responses to threat in refugees with PTSD

Social attachment systems are disrupted for refugees through trauma and forced displacement. This study tested how the attachment system mitigates neural responses to threat in refugees with posttraumatic stress disorder (PTSD). Refugees with PTSD (N = 28) and refugee trauma-exposed controls (N = 22) viewed threat-related stimuli primed by attachment cues during a functional magnetic resonance imaging scan. Group differences and the moderating effects of avoidant or anxious attachment style and grief related to separation from family on brain activity and connectivity patterns were examined. Separation grief was associated with increased amygdala but decreased ventromedial prefrontal cortical (VMPFC) activity to the attachment prime and decreased VMPFC and hippocampal activity to attachment primed threat in the PTSD (vs trauma-exposed control) group. Avoidant attachment style was connected with increased dorsal frontoparietal attention regional activity to attachment prime cues in the PTSD group. Anxious attachment style was associated with reduced left amygdala connectivity with left medial prefrontal regions to attachment primed threat in the PTSD group. Separation grief appears to reduce attachment buffering of threat reactivity in refugees with PTSD, while avoidant and anxious attachment style modulated attentional and prefrontal regulatory mechanisms in PTSD, respectively. Considering social attachments in refugees could be important to post-trauma recovery, based within changes in key emotion regulation brain systems.

Predictors of acculturation attitude of international students in China

This study investigates international students' acculturation attitude preference and the influence factors (i.e., gender, duration in China, host and English proficiency, adult attachment style and social ties) on each acculturation attitude (i.e, integration, assimilation, separation and marginalization attitude) in China. A group of 229 international students within China responded online. Results from cluster analysis based on process model of acculturation revealed that, integration was the most prevalent acculturation attitude of international students in China. Additionally, logistic regressions analysis indicated that duration in China was negatively associated with adoption of separation and marginalization attitude also higher level of English proficiency predicted the preference of marginalization attitude. However, Chinese proficiency was positively associated with integration attitude adoption, host ties were positively and significantly associated with adoption of assimilation and integration attitude, but negatively associated with the usage of marginalization attitude. Lastly, avoidance attachment was found negatively associating with the integration attitude. This study provides valuable insights for international student education policymakers to assist international students in order to adapt to a new environment quickly and effectively.

Longitudinal associations between childhood sexual abuse-related PTSD symptoms and passive and active suicidal ideation among sexual minority men

BACKGROUND

Sexual minority men report high rates of childhood sexual abuse (CSA) and adulthood suicidality. However, mechanisms (e.g., PTSD symptoms) through which CSA might drive suicidality remain unknown.

OBJECTIVE

In a prospective cohort of sexual minority men, we examined: (1) associations between CSA and suicidal thoughts and behaviors; (2) prospective associations between CSA-related PTSD symptoms and suicidal ideation; and (3) interpersonal moderators of these associations.

PARTICIPANTS AND SETTING

Participants included 6305 sexual minority men (M_age = 33.2, SD = 11.5; 82.0% gay; 53.5% White) who completed baseline and one-year follow-up at-home online surveys.

METHODS

Bivariate analyses were used to assess baseline demographic and suicidality differences between CSA-exposed participants and non-CSA-exposed participants. Among CSA-exposed participants, multivariable logistic regression analyses were used to regress passive and active suicidal ideation at one-year follow-up on CSA-related PTSD symptoms at baseline. Interactions were examined between CSA-related PTSD symptoms and interpersonal difficulties.

RESULTS

CSA-exposed sexual minority men reported two-and-a-half times the odds of suicide attempt history compared to non-CSA-exposed men (95% CI = 2.15-2.88; p < 0.001). Among CSA-exposed sexual minority men, CSA-related PTSD symptoms were prospectively associated with passive suicidal ideation (adjusted odds ratio [aOR] = 1.38; 95% CI = 1.19; 1.61). Regardless of CSA-related PTSD symptom severity, those with lower social support and greater loneliness were at elevated risk of active suicidal ideation at one-year follow-up.

CONCLUSIONS

CSA-related PTSD symptom severity represents a psychological mechanism contributing to CSA-exposed sexual minority men's elevated suicide risk, particularly among those who lack social support and report loneliness.

Can Sensory- and Attachment-Informed Approaches Modify the Perception of Pain? An Experimental Study

Accumulating evidence linking pain with both attachment and sensory processing variables introduces the possibility that attachment- and sensory-informed strategies may modify pain experiences. The aim of this study was to investigate this proposition using an experimentally induced pain procedure. Pain perceptions of individuals using either a sensory-informed (weighted modality) or an attachment-informed (secure base priming) coping strategy were compared with those of individuals using no designated coping strategy. An independent measures experimental study design was used with a convenience sample of 272 pain-free adults. Experimental participants (n = 156) were randomly allocated to either an attachment (n = 75) or a sensory (n = 81) intervention group. Data from these participants were compared to those of 116 participants involved in an earlier cold pressor study in which no coping strategy was used. All participants completed the same sensory, attachment, and distress questionnaires and participated in the same cold pressor pain test. ANCOVAs revealed that participants in the sensory- and attachment-informed intervention groups reported significantly higher pain thresholds than the control group. Participants allocated to the sensory group also reported higher pain intensity scores than the control group. There were no significant differences in pain tolerance between the three groups after controlling for covariates. While further research is required, findings encourage further consideration of sensory- and attachment-informed strategies for people anticipating a painful experience.

Physiological Factors Linking Insecure Attachment to Psychopathology: A Systematic Review

Although many studies have documented associations between insecure attachment and psychopathology, attachment may not confer risk for psychopathology independently, but rather through its interaction with emotional, social, and biological factors. Understanding the variables through which attachment may lead to psychopathology is therefore important. Within this domain of research, the role of physiological factors is poorly investigated. What are the relevant domains and why, when, or for whom do they influence mental disorders relating to attachment? The current systematic review aims to answer these questions. Results reveal that physiological indices of emotional regulation play a role in explaining and/or determining the relationship between attachment and psychopathology. Specifically: (1) combined with insecure attachment, higher skin conductance level (SCL), lower cardiac slowing, and respiratory sinus arrhythmia modulation (RSA) contribute to different psychopathological indicators and behavioral/psychological dysfunctions, although the latter predicts a contradictory pattern of findings; (2) insecure-avoidant attachment is more consistently linked with stress and emotional dysregulation when combined with RSA, while anxious attachment confers risk of depressive symptoms when combined with SCL. We concluded our discussion of the results of seven studies by outlining a plan to move the field forward. We discuss the quality of the assessment, methodological limitations, and future directions, highlighting the need to extend the research to clinical samples.

Development and validation of the Relational Skills Inventory for Adolescents

INTRODUCTION

Dating violence prevention initiatives are intended, not only to reduce the occurrence of violent behaviors, but also to promote the development of positive dating relational skills starting in adolescence. However, despite the growing interest in examining adolescent relational skills in adolescents, no specific measure is yet available to assess post program gains relative to dating violence prevention and intervention. The current study addressed this important gap in dating relationships research by developing and validating a new measure of relational skills for adolescents.

METHODS

Exploratory and confirmatory factor analyses were conducted on two samples of French-speaking dating adolescents from Quebec, Canada (n₁= 384; n₂= 687).

RESULTS

Exploratory factor analysis revealed a three-factor structure reflecting constructs of Assertiveness, Support and Individuality (α = 0.69-0.81). Results also support evidence of convergent validity with related measures. The three-factor structure was cross-validated among a second sample (α = 0.74-0.79). Two-way ANCOVAs were also conducted to examine differences in levels of relational skills as a function of sex and previous dating violence perpetration. Results indicated that girls reported higher levels of assertiveness than boys, and that adolescents who reported the use of dating violence also reported lower levels of all relational skills.

CONCLUSION

The validation of the Relational Skills Inventory for Adolescents (RSI-A) will help researchers assess the effectiveness of interventions aimed at promoting the development of positive dating relationships during adolescence.

A tangled start: The link between childhood maltreatment, psychopathology, and relationships in adulthood

BACKGROUND

Adults with a history of childhood maltreatment are more likely to experience distrust, feel distant from others, and develop an insecure attachment style which may also affect relationship quality. Furthermore, childhood maltreatment has been linked to several mental health problems; including, depression, anxiety, and alcohol dependance severity, that are also known to relationship quality.

OBJECTIVE

The current study was designed to investigate to what extent childhood maltreatment is associated with adult insecure attachment and intimate relationships and whether this association is mediated by psychopathology.

PARTICIPANTS AND METHOD

In a study comprised of 2035 adults aged 18-65, we investigated whether childhood maltreatment was associated with insecure adult attachment styles and the quality of intimate relationships and whether this was mediated by depression, anxiety, and alcohol dependence severity (based on repeated assessments of the Inventory of Depressive Symptomatology-Self Report, Beck Anxiety Index, and Alcohol Use Disorders Identification Test respectively).

RESULTS

The path model showed an acceptable fit, RMSEA = 0.05, and suggested full mediation of the association of childhood maltreatment with quality of intimate relationships by depression severity and a) anxious attachment (β = -4.0 ∗ 10^-2; 95% CI = -5.5 ∗ 10^-2, -2.7 ∗ 10^-2) and b) avoidant attachment (β = -7.2 ∗ 10^-2; 95% CI = -9.6 ∗ 10^-2, -4.9 ∗ 10^-2). Anxiety and alcohol dependence severity were not significant mediators.

CONCLUSIONS

Childhood maltreatment is associated with a lower quality of intimate relationships, which is fully mediated by depression severity and insecure attachment styles.

It's not who you lose, it's who you are: Identity and symptom trajectory in prolonged grief

The death of a loved one has been associated with a range of emotional and cognitive impacts, with up to 10% of the bereaved population experiencing a prolonged grief reaction. Direct investigation of the role of self-identity in the maintenance of grief symptoms is limited and has not discriminated between relationship type. This longitudinal study investigated the differences in grief symptoms over time depending on relationship to the deceased person (partner or adult child), as well as the association between long-term grief symptoms and identity, attachment, and cognitive interdependence. Data from bereaved partners and adult children in The Aarhus Bereavement Study at two- and 18-months post-bereavement were included in this study. They completed questionnaires measuring their grief symptoms at both time points, a measure of attachment at Time 1, and measures of the interdependence of their pre- and post-loss identity with the deceased, their cognitive interdependence, and everyday memory retrieval failures at Time 4. Compared with adult children, bereaved partners experienced more intense grief symptoms at both time points. Regression analysis identified that over and above immediate grief symptoms, key predictors of prolonged grief symptoms were a merged post-bereavement identity with the deceased, younger age, and everyday memory retrieval difficulties. Relationship type and pre-bereavement identity contributed to initial but not prolonged grief symptoms. We discuss these findings in terms of the role of interdependence in prolonged grief.

The Link between Attachment Style and Self-Reported Olfactory Ability: A Preliminary Investigation

Individuals in healthy romantic relationships gain significant benefits to their psychological wellbeing and physiological health. Notably, the majority of relationship research has focused on how adult attachment influences these relationship outcomes while the role of olfaction remains an emerging research focus. The aim of the current study was to bring together these seemingly unrelated factors–attachment and olfaction–in an online quasi-experimental design. The participants were 401 undergraduate students, predominantly females, ranging in age from 17 to 70 years. Participants completed a battery of questionnaires that evaluated their attachment tendencies, olfactory ability and experiences in romantic relationships. Results indicated that attachment insecurity, across both attachment anxiety and avoidance, was associated with decreased olfactory functioning for females. These findings provide preliminary evidence that olfaction is related to romantic relationship maintenance and suggests that body odors could be fundamental for evoking the attachment system. These findings also elicit enticing new avenues of research which can assist psychologists to provide targeted treatments to individuals with olfactory deficits and insecure attachment tendencies.

Refining the Assessment of Entitlement in Romantic Relationships: The Sense of Relational Entitlement Scale-Revised (SRE-R)

Objective: A subjective sense of entitlement is strongly evoked in the context of romantic relationships. A pathological sense of entitlement results from believing a partner should fulfill all one’s needs and wishes (inflated) or that the expression of genuine needs is illegitimate (restricted). This study aimed to validate a revised, improved version of the Sense of Relational Entitlement scale entitled the Sense of Relational Entitlement scale—Revised (SRE-R). We hypothesized it would have good factor structure and convergent validity, and that attachment dimensions and relationship indices would predict both inflated and restricted subscales.

Method: The SRE-R was completed by 854 Israeli adults (8.3% males) aged 31.94 ± 8.02. A subset (n = 629) also completed measures of attachment (ECR-S) and 447 completed measures of relational authenticity, pathological concern, and relational obsessions and compulsions.

Results: CFA confirmed two factors, inflated and restricted sense of relational entitlement. Relational obsessive-compulsive symptoms and pathological concern predicted an inflated sense of entitlement, and attachment avoidance, pathological concern, and authenticity in relationships predicted a restricted sense of entitlement.

Discussion: The SRE-R is a valid and useful tool to assess sense of entitlement in romantic relationships and should be examined in diverse samples and cultures.

Prevalence of complex post-traumatic stress disorder in refugees and asylum seekers: systematic review

BACKGROUND

Refugees and asylum seekers often report having experienced numerous complex traumas. It is important to understand the prevalence of complex post-traumatic stress disorder (CPTSD), which can follow complex traumas.

AIMS

This systematic review aims to summarise the available literature reporting the prevalence in refugees and asylum seekers of three operationalised definitions of CPTSD: the ICD-11 diagnostic criteria, the ICD-10 criteria (for enduring personality change after catastrophic experience) and the DSM-IV criteria (for disorders of extreme stress not otherwise specified).

METHOD

Six electronic databases were searched for studies reporting the prevalence of CPTSD in adult refugee and/or asylum-seeking samples. Owing to heterogeneity between the studies, a narrative synthesis approach was used to summarise studies. Methodological quality was assessed using the Joanna Briggs Critical Appraisal Checklist for Prevalence Studies. This systematic review has been registered with PROSPERO (registration number CRD42020188422, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188422).

RESULTS

Systematic searches identified 15 eligible studies, with 10 examining treatment-seeking samples and five using population samples. CPTSD prevalence in treatment-seeking samples was between 16 and 38%. Prevalence in population samples ranged from 2.2 to 9.3% in four studies, with the fifth reporting a much higher estimate (50.9%).

CONCLUSIONS

This review highlights both the high prevalence of CPTSD in treatment samples and the lack of research aiming to establish prevalence of CPTSD in refugee and asylum-seeking populations. Understanding the prevalence of these disabling disorders has implications for policy and healthcare services for the appropriate promotion, planning and provision of suitable treatment and interventions for this highly traumatised population.

Neighborhood poverty, allostatic load, and changes in cellular aging in African American young adults: the moderating role of attachment

Attachment experiences are thought to contribute to physical health across the lifespan. Evidence suggests that attachment style may serve as a protective factor for individuals' physical health by mitigating the negative effects of social and environmental risk factors. In the present study, we evaluated how attachment styles may moderate the link between African American adolescents' exposure to neighborhood poverty and accelerated cellular aging in young adulthood. Analyses revealed that allostatic load at age 19 mediated the association between neighborhood poverty in adolescence and changes in cellular aging from age 20 to 27. Notably, attachment avoidance (but not attachment anxiety) moderated this association, such that allostatic load was only associated with faster cellular aging for individuals who were high in avoidance. These findings suggest that allostatic load may give rise to faster cellular aging, but these detrimental effects of allostatic load can be offset by young adults' effective use of attachment figures.

Development and validation of a 12-item version of the Barrett-Lennard Relationship Inventory (B-L RI:mini) using item response theory

The Barrett-Lennard Relationship Inventory (B-L RI; Barrett-Lennard, (2015). The Relationship Inventory A Complete Resource and Guide. http://nbn-resolving.de/urn:nbn:de:101:1-201602103917) is the most widely used measure of the facilitative conditions described by Carl Rogers as important for constructive personality development in his person-centered theory. At with 64 items it is however time consuming for participants to complete, and even in its shorter form, the B-L RI is 40-items long. In order to improve its utility, a mini form of the B-L RI was developed. In study 1, we used item response theory to select 12 out of the full 64 items to form the B-L RI:mini based on their discrimination, difficulty, information, and measurement invariance across the English (n = 298), Chinese (n = 658), and Spanish (n = 330) language versions of the inventory. In study 2 (N = 362), we validated the reliability and validity of the new 12-item measure. It was found that the B-L RI:mini showed excellent total internal consistency, temporal stability, and construct validity. According to the results of the study, the B-L RI:mini maintains optimal psychometric properties with a small number of items. This scale is recommended for use in further studies.

The Link from Child Abuse to Dissociation: The Roles of Adult Disorganized Attachment, Self-Concept Clarity, and Reflective Functioning

In this study of 624 adult participants from the general population (i.e., a community sample), we examine adult disorganized attachment, a construct that can now be measured on a self-report scale, and its linkage between child abuse to dissociation. Prior research has demonstrated that child abuse is positively associated with adult disorganized attachment, which in turn is linked to a variety of externalizing and internalizing behaviors (e.g., depression, anxiety) in adulthood. Based on the literature regarding self-concept, we further consider that having an integrated sense of self is crucial in examining how having an adult disorganized attachment could result in dissociative symptoms. We consider two measures representing an unintegrated sense of self - self-concept clarity and reflective functioning - and find that both play a role in moderating the mediating effects of adult disorganized attachment. Specifically, lower levels of clarity were associated with higher levels of dissociation in our sample, and reflective functioning played a more nuanced and complex role in examining moderated mediation in our sample. Overall, using moderated mediation analysis, we found support for our hypotheses.

Childhood adversity and attachment anxiety predict adult symptom severity and health anxiety

BACKGROUND

Childhood adversity is associated with somatization, including physical symptom burden and health anxiety. Attachment theory offers a developmental framework to understand adult somatization, as attachment phenomena are theoretically and empirically related to physiological regulation, affect regulation, and childhood adversity, all of which are relevant to somatization.

OBJECTIVE

The purpose of this study was to identify the pathways by which childhood adversity and attachment insecurity influence physical symptom burden and health anxiety in adults.

PARTICIPANTS AND SETTING

Three hundred and fifty-one family medicine patients from a teaching hospital in Toronto, Canada.

METHODS

A cross-sectional survey study was conducted to assess adverse childhood experiences, attachment insecurity, health anxiety and physical symptom severity in primary care patients. Path Analysis using structural equation modeling (AMOS V.26, IBM, 2019) was used to test the model in which childhood adversity, attachment anxiety, attachment avoidance, symptom severity interact to influence health anxiety.

RESULTS

The majority of the participants were white (66%), had completed post-secondary education (68%), and reported themselves to be in very good to excellent health (62%). Childhood adversity, attachment anxiety, attachment avoidance, health anxiety and symptom severity are all significantly correlated (ranges of r_s = 0.29 to 0.63). Childhood adversity has a significant indirect effect on health anxiety with attachment anxiety and symptom severity as serial mediators (β_indirect = 0.237, p = .001 and β_direct = 0.065, p = .244).

CONCLUSIONS

Overall, this model extends our understanding of the processes underlying adult somatization. Findings support that childhood adversity and attachment anxiety are predictors of symptom severity and health anxiety.

COVID-19 Related Traumatic Distress in Psychotherapy Patients during the Pandemic: The Role of Attachment, Working Alliance, and Therapeutic Agency

The early months of the COVID-19 pandemic have been a challenging time for many psychotherapy patients. To understand why certain patients were more resilient, we examined the role of patients' attachment anxiety and attachment avoidance, as well as collaborative therapy experiences (perceived working alliance and therapeutic agency) in their online sessions on their COVID-related traumatic distress over a three-month period. A total of 466 patients in online psychotherapy completed a survey during the first weeks of the pandemic, and 121 of those completed a follow-up survey three months later. Lower distress at follow-up was predicted by patients' lower attachment anxiety and higher therapeutic agency in their online sessions after controlling for baseline distress and time of survey completion. Higher working alliance predicted less distress at follow-up only for patients with high attachment anxiety. For patients with low attachment avoidance (i.e., more securely attached), higher therapeutic agency predicted less distress. These findings suggest that patients' attachment anxiety and therapeutic agency may play significant roles also in online therapy during COVID-19 in patient's experienced traumatic distress, and that working alliance and therapeutic agency may be differentially important for patients with different levels of attachment anxiety and avoidance.

Attachment anxiety predicts worse mental health outcomes during COVID-19: Evidence from two studies

COVID-19 has resulted in a mental health crisis across the globe. Understanding factors that may have increased individuals' risk of poor mental health outcomes is imperative. Individual differences in attachment styles have been shown to predict poorer mental health outcomes and insecure individuals struggle to cope with stressful situations. Therefore, we extended past research by examining whether higher attachment insecurity (anxiety and avoidance) predicted worse mental health over time during the COVID-19 pandemic. Study 1 examined mood and mood fluctuations daily over a week in the beginning of lockdown and depression and anxiety weekly over a five-week period (n = 200). Study 2 examined depression and anxiety before and during the pandemic (n = 100 couples). As predicted, individuals higher (vs. lower) in attachment anxiety, but not avoidance, reported greater depression and anxiety during the pandemic in both studies. Individuals lower in attachment anxiety experienced an improvement in mental health over time in Study 1 suggesting that more secure individuals may recover more quickly from the initial change in circumstances. Attachment styles did not significantly predict mood or mood fluctuations. Attachment anxiety is likely to be a risk factor for poor mental health outcomes during COVID-19.

The relationship sabotage scale: an evaluation of factor analyses and constructive validity

BACKGROUND

Some individuals are no longer entering romantic relationships, others move through relationships too quickly searching for "the one" and making quick assessments of their romantic partners, while others stay in their relationships but "check out" or do not work on their issues. These are conclusions from two studies: (1) an interview with psychologists who specialise in relationship therapy, and (2) an analysis of individuals' lived experiences of relationships. The concept of relationship sabotage can explain these phenomena. However, presently, there is no instrument to conceptualise and empirically measure how people continue to employ self-defeating attitudes and behaviors in (and out) of relationships to impede success, or withdraw effort, and justify failure.

METHODS AND RESULTS

A series of three studies (involving a total of 1365 English speaking individuals of diverse gender orientation, sexual orientation, and cultural background, with relationship sabotage experience) were conceptualized for the current project to fill the need for scale development and to build empirical evidence on the topic of self-sabotage in romantic relationships. The scale was developed over two studies using exploratory factor analysis and one-congeneric model analyses. The third study, using confirmatory factor analysis, confirmed the final structure for the Relationship Sabotage Scale (RSS), which contains 12 items and three factors: defensiveness, trust difficulty, and lack of relationship skills. Constructive validity analyses were also conducted.

CONCLUSION

The RSS is a brief scale that provides conclusive information about individual patterns in relationships. Findings using this scale can offer explanations regarding the reasons that individuals engage in destructive behaviours from one relationship to the next. Investigations should continue to test a model for sabotage in romantic relationships using the developed scale and other factors such as relationship diferences and insecure attachment. More specifically, this measure can be used to understand mediator constructs of relational outcomes within the attachment framework to explain relationship dissolution and work towards relationship maintenance.

Working toward anti-racist perspectives in attachment theory, research, and practice

Recent social movements have illuminated systemic inequities in U.S. society, including within the social sciences. Thus, it is essential that attachment researchers and practitioners engage in reflection and action to work toward anti-racist perspectives in the field. Our aims in this paper are (1) to share the generative conversations and debates that arose in preparing the Special Issue of Attachment & Human Development, "Attachment Perspectives on Race, Prejudice, and Anti-Racism"; and (2) to propose key considerations for working toward anti-racist perspectives in the field of attachment. We provide recommendations for enriching attachment theory (e.g. considering relations between caregivers' racial-ethnic socialization and secure base provision), research (e.g. increasing the representation of African American researchers and participants), and practice (e.g. advocating for policies that reduce systemic inequities in family supports). Finally, we suggest two relevant models integrating attachment theory with perspectives from Black youth development as guides for future research.

Pathways linking attachment and depressive symptoms for Black and White adolescents: do race and neighborhood racism matter?

Decades of evidence demonstrate that insecure attachment is associated with increased risk for depressive symptoms. Yet research has focused on predominantly White samples, with little attention to whether developmental pathways vary by social-contextual factors like racial identity and neighborhood racism. This study examines whether longitudinal links between attachment style and depressive symptoms differ for White and Black American adolescents or by exposure to neighborhood racism (N = 171, M_age at Time 1 = 14 years). Multigroup measured variable path analyses controlling for gender and household income revealed that attachment avoidance predicted relative increases in depressive symptoms for White adolescents, but not for Black adolescents. Links between attachment style and depressive symptoms did not differ based on exposure to neighborhood racism. Experiences of neighborhood racism were associated with greater attachment avoidance but not anxiety. Results highlight the importance of examining attachment in different socioecological contexts to illuminate the unique pathways characterizing Black youth development.

Exploring Locus-of-Hope: Relational Tendencies, Self-Esteem, Attachment, and Gender

BACKGROUND

As little research has been devoted to examining associations between the four locus-of-hope dimensions (internal, external-peer, external-family, and external-spiritual) and individual differences, the current study explores the correlations with individual-level individualist and collectivist relational tendencies, self-esteem, insecure attachment, and gender within a culturally diverse sample of university undergraduate students.

METHODS

questionnaires were completed by a culturally diverse sample of undergraduate students measuring locus-of-hope, individualist and collectivist relational tendencies, self-esteem, insecure attachment, and gender.

RESULTS

State and trait locus-of-hope were significantly correlated. Individualism showed positive correlations with internal and external-family locus-of-hope. Collectivism positively correlated with internal locus-of-hope and the three external locus-of-hope dimensions. Internal locus-of-hope was significantly predicted by self-esteem, relational self-esteem, individualism, and collectivism. External-spiritual locus-of-hope was not significantly predicted by the variables. External-family locus-of-hope was significantly predicted by relational self-esteem and collectivism and external-peer locus-of hope was significantly predicted by relational self-esteem, collectivism, and avoidant attachment style. No significant gender differences in locus-of-hope were found.

CONCLUSIONS

The results provide further understanding about the construct of locus-of-hope and provide a foundation for future research to continue exploring the role of locus-of-hope in the development and expression of self-esteem and attachment profiles.

Mindfulness and Sexual Mindfulness as Moderators Between Conflict Resolution and Sexual and Relationship Satisfaction

Mindfulness has shown positive links with conflict resolution. Additionally, couples skilled in conflict resolution report greater sexual and relationship satisfaction. However, no research has examined the moderating effect of mindfulness, specifically sexual mindfulness, between conflict resolution and sexual and relationship satisfaction. We used 1,627 couples from wave III of the Couple Relationships and Transition Experiences (CREATE) study. Sexual mindfulness moderated the association between conflict resolution and sexual satisfaction, even after controlling for attachment. Wives higher in sexual mindful awareness may rely less on conflict resolution for their sexual satisfaction. Karremans and colleagues' (2017) model of mindfulness and romantic relationships provides a framework for testing whether, when, and how mindfulness increases positive romantic relationship processes and outcomes. Under this framework, mindfulness may provide a mechanism to help couples achieve sexual and relationship satisfaction. Mindfulness and sexual mindfulness may provide a useful mechanism for therapists, educators, social workers, and couples to enhance satisfaction within the romantic and sexual relationship even without partner buy-in.

Maternal social support, depression and emotional availability in early mother-infant interaction: Findings from a pregnancy cohort

BACKGROUND

Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depression.

METHODS

210 women were followed from early pregnancy to six months postpartum within Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Mother-infant interactions within a standardised observation at six months postpartum were measured by the Emotional Availability (EA) Scales using total scores of the parental scales. In early and late pregnancy and at six months postpartum, mothers rated perceived maternal social support from a partner, family and friends using subscales of the Multidimensional Scale of Perceived Social Support. Depression was measured in early pregnancy and at six months postpartum using the Structured Clinical Interview for the DSM-IV-TR, with repeated measurement of depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS). Data was analysed using structural equation models.

RESULTS

There were significant interactions between depressive symptoms in early pregnancy and perceived maternal support from a partner (B = .18, 95% CI = 03, .31) and separately from family (B = .12, 95% CI = .03, .32) in predicting maternal emotional availability. No such interaction was found for support from friends. While partner and family support moderated the association between early depressive symptoms and emotional availability, there were no direct associations between maternal depressive disorder in early pregnancy and perceived support, and further, maternal depression was not a significant predictor of emotional availability.

LIMITATIONS

Future studies should consider extending measurement of the mother-infant relationship beyond the EA Scales, inclusion of a measure of maternal childhood trauma, and replicating our findings.

CONCLUSION

Maternal perception of partner and family support in the postpartum is a predictor of the association between early pregnancy depressive symptoms and maternal emotional availability.

Adult attachment and engagement with fictional characters

Adult attachment influences how people engage with stories, in terms of how immersed or transported they become into these narratives and the tendency to form close bonds with characters. This likely stems from the ability of stories and story characters to provide interpersonal intimacy without the threat of rejection. In Study 1, we expand on this work to examine how attachment relates to two previously uninvestigated aspects of character engagement: character identification and parasocial interactions. Taking a statistically conservative approach, controlling for broader traits, we demonstrate that the attachment dimensions of anxiety and avoidance differentially predict these forms of character engagement. A high-powered, pre-registered, Study 2 follows up on these results by examining the types of characters that are most appealing, based on one's attachment orientation. Together, these studies demonstrate that attachment plays an essential role in both how we engage with characters and the types of characters to whom we are attracted.

Social touch deprivation during COVID-19: effects on psychological wellbeing and craving interpersonal touch

Social touch has positive effects on social affiliation and stress alleviation. However, its ubiquitous presence in human life does not allow the study of social touch deprivation 'in the wild'. Nevertheless, COVID-19-related restrictions such as social distancing allowed the systematic study of the degree to which social distancing affects tactile experiences and mental health. In this study, 1746 participants completed an online survey to examine intimate, friendly and professional touch experiences during COVID-19-related restrictions, their impact on mental health and the extent to which touch deprivation results in craving touch. We found that intimate touch deprivation during COVID-19-related restrictions is associated with higher anxiety and greater loneliness even though this type of touch is still the most experienced during the pandemic. Moreover, intimate touch is reported as the type of touch most craved during this period, thus being more prominent as the days practising social distancing increase. However, our results also show that the degree to which individuals crave touch during this period depends on individual differences in attachment style: the more anxiously attached, the more touch is craved; with the reverse pattern for avoidantly attached. These findings point to the important role of interpersonal and particularly intimate touch in times of distress and uncertainty.

Compassionate Mind Training: An 8-week group for the general public

OBJECTIVES

There is an increasing interest in how compassion training, and in particular, the cultivation of self-compassion may be an important component in the reduction of distress and promotion of well-being. Compassion Focused Therapy (CFT) has shown promising results in this area, with positive outcome studies in a wide range of mental health problems. However, following the successful development of short mindfulness-based programmes (e.g., Mindfulness-based Stress Reduction and Mindfulness-based Cognitive Therapy) and compassion/self-compassion programmes (e.g., Mindful Self-Compassion) that can be accessed by the general public, we were keen to develop and research an 8-week Compassionate Mind Training (CMT) course, based on the CFT model.

DESIGN

Within-subjects pre-to-post-group comparison.

METHODS

Following an 8-week CMT groups, participants in the general population (n = 55) completed pre- and post-measures (with 22 of these also providing 3-month follow-up data) on self-compassion, compassion for others, compassion from others, attachment, self-criticism, positive emotion, well-being, and distress.

RESULTS

Significant increases in compassion, self-reassurance, social rank, positive emotions, and well-being were found, alongside reductions in self-criticism, attachment anxiety, and distress. Changes were maintained at 3-month follow-up. Change scores indicated the importance of increases in self-compassion and reductions in self-criticism in overall improvements in well-being and psychological distress.

CONCLUSIONS

Findings offer preliminary support for the usefulness of group CMT in community samples.

PRACTITIONER POINTS

Compassionate Mind Training (CMT) groups appear to be applicable and beneficial in community samples. CMT psychoeducation and practices appear to bring positive changes to a variety of psychological processes, including attachment, self-criticism, self-compassion, well-being, and distress. Further studies are required to investigate whether the mechanisms through which CMT is beneficial.