Attachment-related psychodynamics

Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect

STUDY QUESTION

Are attachment anxiety and avoidance dimensions in female and male partners in couples seeking infertility treatment associated with her and his infertility-related stress?

SUMMARY ANSWER

Attachment dimensions are significantly associated with several aspects of infertility stress in couples undergoing IVF treatment.

WHAT IS KNOWN AND WHAT THIS PAPER ADDS

Attachment dimensions of anxiety and avoidance (where highly anxious individuals fear rejection and are preoccupied with maintaining proximity to their partner and highly avoidant individuals are uncomfortable with intimacy and prefer to maintain distance from their partner) may influence the well being of individuals undergoing IVF/ICSI treatment. This study showed that one partner's attachment dimensions had a direct effect on the infertility-related stress of the other partner.

DESIGN

Cross-sectional study of consecutive couples before starting their first IVF/ICSI treatment in 2009-2011 at the ANDROS clinic in Palermo, Italy.

PARTICIPANTS AND SETTING

Three hundred and fifty-nine couples undergoing fertility treatments were invited to participate in the research. The final sample comprised 316 females and 316 males who filled out the psychological questionnaires (Experiences in Close Relationships; Fertility Problem Inventory; State scale of State-Trait Anxiety Inventory). The participants included patients who had a primary infertility diagnosis and were about to undergo their first IVF or ICSI treatment.

DATA ANALYSIS METHOD

Paired t-tests were used to examine gender differences on the study variables (attachment anxiety, attachment avoidance, infertility stress, state anxiety, etc.). Associations between infertility-related stress and the study variables were explored using hierarchical stepwise multivariate linear regression analyses.

MAIN RESULTS AND THE ROLE OF CHANCE

Attachment anxiety and attachment avoidance were significantly associated with global infertility stress in both women (β = 0.24, P < 0.01 and β = 0.27, P < 0.01) and men (β = 0.23, P < 0.01 and β = 0.37, P < 0.01). Regarding the cross-partner effects, men's infertility stress and relationship concerns were associated with their partners' attachment avoidance (β = 0.10 P < 0.05 and β = 0.12, P < 0.05); and the infertility stress of women and the scores for need of parenthood were associated with their partners' attachment anxiety (β = 0.14 P < 0.05 and β = 0.16, P < 0.05).

BIAS, CONFOUNDING AND OTHER REASONS FOR CAUTION

The study data are cross sectional, and specifically focus on associations between adult attachment style and infertility stress. Treating the data from couples as independent observations may be a limitation of the analysis. Potential moderators of such relationships (e.g. coping strategies, stress appraisal) are not included in this study.

STUDY FUNDING/COMPETING INTEREST(S)

This research was supported by funds provided by Centro Andros S.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study.

Changes in marital satisfaction across the transition to parenthood: the role of adult attachment orientations

This longitudinal study investigated marital satisfaction trajectories across the first 2 years of parenthood. Data were collected from new parents (couples) 6 weeks before the birth of their first child, and then at 6, 12, 18, and 24 months postpartum. Growth curve models revealed two key findings. First, for highly anxious individuals, satisfaction was lower or declined when they perceived their partners as less supportive and as behaving more negatively toward them. Second, for highly avoidant individuals, satisfaction was lower or declined when they perceived more work-family conflict and greater demands from their families. The findings suggest that attachment insecurities predict dissatisfaction in new parents primarily when stressors block the pursuit of important attachment goals.

Toward a multidimensional model of personality disorder diagnosis: implications for DSM-5

This article outlines a model of personality disorder (PD) diagnosis that combines clinically useful constructs from the Diagnostic and Statistical Manual of Mental Disorders (DSM) with assessment procedures that maximize reliability and clinical utility while minimizing problems associated with threshold-based PD classification. I begin by addressing limitations in the current DSM conceptualization of PDs: excessive comorbidity, use of arbitrary cutoffs to distinguish normal from pathological functioning, failure to capture variations in the adaptive value of PD symptoms, and inattention to situational influences that shape PD-related behaviors. The revisions proposed by the DSM-5 Personality and Personality Disorders Work Group help resolve some of these issues, but create new problems in other areas. A better solution would be to employ a multidimensional model of PD diagnosis in which clinicians (a) assign a single dimensional rating of overall level of personality dysfunction, (b) provide separate intensity and impairment ratings for each PD dimension, and (c) list those personality traits-including PD-related traits-that enhance adaptation and functioning. Preliminary evidence bearing on the multidimensional model is reviewed, and broader clinical and empirical implications of the model are discussed.

Adult attachment insecurities are associated with obsessive compulsive disorder

OBJECTIVES

Obsessive compulsive disorder (OCD) is one of the most disabling and highly prevalent anxiety disorders (ADs). Current cognitive models of OCD implicate views about the self and world in the maintenance of the disorder. However, little research has focused on issues that may lead to vulnerability to such views. In particular, a person's attachment insecurities (attachment anxiety, avoidance) may be important risk factors increasing the likelihood of such non-adaptive perceptions (Doron & Kyrios, 2005).

DESIGN

Participants meeting criteria for OCD were compared with cohorts meeting criteria for other ADs and healthy controls on a range of measures including adult attachment, OC symptoms, cognitions, and mood.

METHODS

Diagnosis of the clinical groups was established using the Anxiety Disorders Interview Schedule for DSM-IV (Brown, Di Nardo, & Barlow, 1994). The clinical relevance of attachment insecurities was ascertained by comparing their prevalence in an OCD sample (N = 30), an ADs sample (N = 20), and a community sample (N = 32).

RESULTS

Attachment anxiety was significantly higher in individuals with OCD, even when controlling for depression.

CONCLUSIONS

Addressing attachment anxiety in individuals presenting with OCD may be important for enhancing therapeutic outcomes. However, findings are based on cross-sectional data that preclude conclusions relating to causal influence.

Service user attachments to psychiatric key workers and teams

PURPOSE

The first aim of the study was to evaluate whether self-reported attachment styles of individuals with psychosis are consistent with their self-reported attachment in therapeutic relationships with both key workers and mental health teams. The second aim was to evaluate the level of concordance in attachment ratings given by different raters (self-report, key worker informant-report and team informant-report).

METHODS

Three self-report versions of the Psychosis Attachment Measure (PAM; attachment in general relationships, attachment towards key worker and attachment in relation to the mental health team) were administered to 24 individuals with a diagnosis of psychosis in psychiatric rehabilitation settings. Key worker and 'team' informant versions of the PAM were also completed.

RESULTS

There were strong, significant correlations among the three self-reported attachment measures. There was less consistent evidence of correlations between key worker ratings of attachment and self-report attachment ratings. The majority of the correlations between team ratings of attachment and self-report attachment were small and non-significant.

CONCLUSIONS

Strong correlations among the self-reported PAM scales suggest that self-reported attachment in specific therapeutic relationships is consistent with self-reported attachment in general relationships. The self-ratings were not consistently correlated with informant-ratings and team informant ratings were particularly poorly correlated with self-ratings. This suggests that it is vital that teams consult service users themselves when making decisions about their care.

Standoffish perhaps, but successful as well: evidence that avoidant attachment can be beneficial in professional tennis and computer science

Attachment-related avoidance and anxiety have repeatedly been associated with poorer adjustment in various social, emotional, and behavioral domains. We examined 2 domains in which avoidant individuals might be better equipped than their less avoidant peers to succeed and be satisfied--professional singles tennis and computer science. These fields may reward self-reliance, independence, and the ability to work without proximal social support from loved ones. In study 1, we followed 58 professional singles tennis players for 16 months and found that scores on attachment-related avoidance predicted a higher ranking, above and beyond the contributions of training and coping resources. In study 2, we sampled 100 students and found that those who scored higher on avoidance were happier with their choice of computer science as a career than those who scored lower on avoidance. Results are discussed in relation to the possible adaptive functions of certain personality characteristics often viewed as undesirable.

The relationship between loss of parents in the holocaust, intrusive memories, and distress among child survivors

The prevalence of intrusive memories of the Holocaust and their relationship to distress was examined among 272 child survivors in Israel. Using attachment theory as a conceptual framework, the authors also examined the effects of type of experience and loss of parents in the Holocaust, psychological resources, other life events, and sociodemographic characteristics on distress and symptomatic behavior. Eighty five percent of the participants reported suffering from intrusive memories. Structural equation modeling showed that survivors who lost one or both parents in the Holocaust suffered more distress because of more intrusive memories. These findings suggest that intrusive memories may be part of unfinished mourning processes related to the loss of parents in the Holocaust.

Adolescent attachment insecurity and parasympathetic functioning predict future loss adjustment

Losing a close relationship is highly stressful and a robust predictor of major depression in adolescents. The current study examined relationships between attachment insecurity, parasympathetic nervous system activity, indexed by respiratory sinus arrhythmia (RSA), and adolescent adjustment to the loss of a close social partner. Adolescents with more attachment anxiety to their mother at age 14 were more likely to report poorer adjustment to a subsequent loss than adolescents with less attachment anxiety. Attachment avoidance interacted with stress-induced changes in RSA to predict loss adjustment. Among adolescents with higher RSA in response to the stressor, those with more attachment avoidance reported better loss adjustment, whereas among adolescents with lower RSA in response to the stressor, those with more attachment avoidance reported poorer loss adjustment. In sum, the combination of attachment insecurity and stress-induced changes in RSA predicted how well adolescents adjusted to a loss.

"Shift-and-Persist" Strategies: Why Low Socioeconomic Status Isn't Always Bad for Health

Some individuals, despite facing recurrent, severe adversities in life such as low socioeconomic status (SES), are nonetheless able to maintain good physical health. This article explores why these individuals deviate from the expected association of low SES and poor health and outlines a "shift-and-persist" model to explain the psychobiological mechanisms involved. This model proposes that, in the midst of adversity, some children find role models who teach them to trust others, better regulate their emotions, and focus on their futures. Over a lifetime, these low-SES children develop an approach to life that prioritizes shifting oneself (accepting stress for what it is and adapting the self through reappraisals) in combination with persisting (enduring life with strength by holding on to meaning and optimism). This combination of shift-and-persist strategies mitigates sympathetic-nervous-system and hypothalamic-pituitary-adrenocortical responses to the barrage of stressors that low-SES individuals confront. This tendency vectors individuals off the trajectory to chronic disease by forestalling pathogenic sequelae of stress reactivity, like insulin resistance, high blood pressure, and systemic inflammation. We outline evidence for the model and argue that efforts to identify resilience-promoting processes are important in this economic climate, given limited resources for improving the financial circumstances of disadvantaged individuals.

Attachment models affect brain responses in areas related to emotions and empathy in nulliparous women

BACKGROUND

The attachment model, as assessed by means of the Adult Attachment Interview (AAI), is crucial for understanding emotion regulation and feelings of security in human interactions as well as for the construction of the caregiving system. The caregiving system is a set of representations about affiliative behaviors, guided by sensitivity and empathy, and is fully mature in young-adulthood. Here, we examine how different attachment models influence brain responses in areas related to empathy and emotions in young-adult subjects with secure and dismissing attachment models.

METHODS

By means of AAI, we selected 11 nulliparous young-adult females with a secure model and 12 with a dismissing model. Subjects underwent functional magnetic resonance, whereas imitating or observing and empathizing with infant facial expressions. Subjects were tested for alexithymia and reflective functioning.

RESULTS

Dismissing subjects activated motor, mirror, and limbic brain areas to a significantly greater extent, but deactivated the medial orbitofrontal cortex (mOFC) and the perigenual anterior cingulated cortex (pACC). During emotional faces, increased activity in dismissing women was seen in the right temporal pole. Furthermore, greater alexithymia was correlated with greater activity in the entorhinal cortex and greater deactivation in the pACC/mOFC.

CONCLUSIONS

These findings provide evidence of how the attachment model influences brain responses during a task eliciting attachment. In particular, hyperactivation of limbic and mirror areas may reflect emotional dysregulation of infantile experiences of rejection and lack of protection, whereas increased deactivation of fronto-medial areas may be the expression of the inhibition of attachment behaviors, which is a typical aspect of dismissing attachment.

Bindungsmuster von Cannabis- und Ecstasykonsumenten

Fragestellung: Frühere Studien haben einen Zusammenhang zwischen Opiatabhängigkeit und dem ängstlich-vermeidenden Bindungsmuster aufgezeigt. In dieser Studie soll explorativ untersucht werden, ob sich dieser Zusammenhang auch bei anderen Konsumentengruppen findet. Methode: Mit dem Bindungsinterview nach Bartholomew wurden die Bindungsmuster zweier Gruppen abhängig oder missbräuchlich Cannabis (N = 19) bzw. Ecstasy (N = 31) konsumierender Jungerwachsener untersucht, die einen möglichst „reinen“ Konsum der jeweiligen Substanz betrieben. Ergebnisse: Die Cannabisgruppe wies überwiegend abweisende und unerwartet häufig auch sichere Bindungsmuster auf. In der Ecstasygruppe traten alle Formen unsicherer Bindung gleich häufig, aber kaum sichere Bindungsmuster auf. Schlussfolgerungen: Die deutlichen Unterschiede zwischen den Gruppen sprechen gegen einen allgemeinen Zusammenhang eines einzelnen Bindungsmusters mit Substanzstörungen. In der Cannabisgruppe finden sich eine sichere und eine unsichere, überwiegend abweisende Untergruppe. Die Ergebnisse der Ecstasygruppe sprechen gegen einen einfachen Zusammenhang zwischen dem Konsum von Stimulanzien und einem anklammernd-aktivierendem Bindungsmuster, aber für eine deutliche klinische Auffälligkeit der Ecstasygruppe. Aufgrund des kleinen Stichprobe und des explorativen Charakters der Studie müssen die Ergebnisse an einem größeren Kollektiv repliziert werden.

Adult Attachment and Motivated Attention to Social Images: Attachment-Based Differences in Event-Related Brain Potentials to Emotional Images

Differences in adult attachment may concord with differences in social perception. The present study aimed to measure neural activity associated with the presentation of visual social stimuli. In an affective oddball paradigm, event-related brain potentials were recorded while participants viewed negative, positive, and neutral images of people and categorized them according to valence. Brain response amplitudes were examined across valence categories and across attachment groups. Results revealed differences between anxious and avoidant groups in "emotion bias." The avoidant group displayed a bias towards more neural activation in response to negative compared to positive images. The anxious group trended in the opposite direction. Results are discussed in terms of possible attachment-based differences in motivated attention to social stimuli.

An empirically derived approach to the latent structure of the Adult Attachment Interview: additional convergent and discriminant validity evidence

Building on studies examining the latent structure of attachment-related individual differences as assessed by the Adult Attachment Interview (AAI) via Principal Components Analysis, the current report further explores the validity of four AAI dimensions reported by Haydon, Roisman, and Burt (in press): dismissing states of mind, preoccupied states of mind, and inferred negative experience with maternal and paternal caregivers. Study 1 reports evidence of distinctive cognitive correlates of dismissing vs. preoccupied states of mind with reaction time in an attachment Stroop task and the valence of endorsed self-descriptors, respectively. Study 2 replicates prior meta-analytic findings of generally trivial convergence between state of mind dimensions and self-reported avoidance and anxiety (i.e., Roisman, Holland, Fortuna, Fraley, Clausell, & Clarke, 2007 ). Study 3 contrastively demonstrates moderate empirical overlap between inferred experience (but not state of mind) AAI scales and self-reported avoidance and anxiety when the latter were assessed at the level of specific caregivers. Taken together, these findings add to accumulating evidence that an empirically-driven approach to scaling adults on AAI dimensions (Haydon et al., in press; Roisman, Fraley, & Belsky, 2007 ) aids in identifying theoretically anticipated and distinctive affective, behavioral, and cognitive correlates of dismissing versus preoccupied states of mind.

Childhood trauma in obsessive compulsive disorder: the roles of alexithymia and attachment

OBJECTIVE

The aim of this study was to investigate the interrelationships between childhood trauma, attachment, alexithymia, and the severity of obsessive compulsive disorder (OCD) in a cohort of participants with OCD.

RATIONALE

There is a growing body of research linking traumatic experiences in childhood with the development of OCD. The mechanisms involved in this association are not yet clear.

METHODS

The sample was comprised of 82 people with OCD and 92 comparison participants. A cross-sectional design was used, utilizing internet-mediated administration of the Childhood Trauma Questionnaire - revised (CTQ-R); the Yale-Brown Obsessive Compulsive Scale - Self-Report (Y-BOCS-SR); the Experiences in Close Relationships Scale (ECR); and Toronto Alexithymia Scale (TAS-20). Partial least squares (PLS) analysis was used to determine significant paths between the constructs.

RESULTS

Results of PLS analysis supported all of the hypotheses made: there was a significant positive correlation between childhood trauma and attachment avoidance, which in turn was significantly positively associated with alexithymia. Alexithymia was significantly associated with the severity of OCD symptoms and the number of OCD symptoms. Mediational analysis showed that alexithymia significantly carried an influence from attachment avoidance to the severity of obsessions and the number of obsession symptoms.

CONCLUSIONS

There is a relationship between childhood trauma and OCD, however this relationship is not direct in nature but is influenced by peoples' past experiences with significant others and associated difficulties in emotional processing.

Distinct but overlapping neural networks subserve depression and insecure attachment

Insecure attachment has been linked to depression and to outcome in psychotherapy. The neural mechanisms subserving the relationship between attachment security and depression are not well understood. We have developed a method to examine attachment-related brain activity in depression. Twenty-eight women, half depressed, viewed images of their mother, a female friend, and female strangers during fMRI scanning. The effects of depression and insecure attachment were determined with whole-brain multiple linear regression of blood-oxygen-level-dependent response against subjects' Beck Depression Inventory and Adult Attachment Interview (AAI) coherence of mind scores. Interaction effects were analyzed with ANOVA. Activity associated with depression and with insecure attachment was found in the cortico-striato-thalamic circuits of affect regulation. For early attachment (mother-friend contrast), depression scores correlated with activation of cortical and sub-cortical components of these circuits, while attachment insecurity correlated with sub-cortical activity in the same circuitry. Depression and attachment insecurity correlated with both cortical and sub-cortical activities for mother-stranger, and areas of overlap and of enhancing interactions between depression and insecure attachment were found. For late attachment (friend-stranger contrast), only cortical effects were found. Depression and attachment insecurity may be subserved by similar but distinct components of affect regulating circuits. Their interactions may explain the greater difficulty of treating depression in insecurely attached patients and suggest a contributing role for insecure attachment in depression. Further, differential sub-cortical vs cortical encoding of early vs late attachment suggests a top-down model of late attachment, potentially relevant to psychotherapeutic outcome.

Anxious attachment and relationship processes: an interactionist perspective

Relationship processes in adult romantic relationships have been vastly studied under the aegis of attachment theory. Attachment theory is interactionist in nature, proposing that individual differences in levels of both attachment avoidance and anxiety predict an individual's thoughts, feelings, and behaviors in contexts that activate attachment concerns. A growing body of research is beginning to systematically test the conditions in which individual differences in attachment orientations both predict and fail to predict relationship processes. In this article, we focus on anxious attachment and review a program of research showing that the potentially destructive relationship processes typically observed in highly anxious individuals do not always appear in neutral or benign contexts, or when security needs are met. We argue that research needs to more thoroughly investigate the conditions that should, or should not, activate attachment concerns and thus result in links between individual differences in attachment orientations and relationship processes.

Applying interpersonal theories to the understanding of and therapy for auditory hallucinations: a review of the literature and directions for further research

Cognitive models of auditory hallucinations are being elaborated in an attempt to more fully understand the variables that determine the distress often experienced by hearers. There is a growing body of literature that aims to explore the relevance of the concept of 'relating' to the experience of auditory hallucinations. This review explored the relevance of interpersonal perspectives to both understandings of and therapy for auditory hallucinations. Eighteen papers were included, published between 1989 and 2010. Studies have utilised and are reviewed within three different theoretical perspectives: Benjamin's Structural Analysis of Social Behaviour; Gilbert's Social Rank Theory; and Birtchnell's Relating Theory. Qualitative studies have explored the nature of the person's relationships with their auditory hallucinations, and are also reviewed. Collectively, the studies suggest that the experience of auditory hallucinations can be understood within interpersonal frameworks, and the relationships that hearers develop with their hallucinations share many properties with interpersonal relationships within the social world. Two themes were prominent across studies: an understanding of the power of the hearer, relative to both auditory hallucinations and social relationships; and the broader influence of social factors that extends beyond power to encompass broader patterns of relating. Findings are considered with regard to clinical implications and future research.

Sleep architecture and sleep-related mentation in securely and insecurely attached people

Based on REM sleep's brain activation patterns and its participation in consolidation of emotional memories, we tested the hypothesis that measures of REM sleep architecture and REM sleep-related mentation would be associated with attachment orientation. After a habituation night in a sleep lab, a convenience sample of 64 healthy volunteers were awakened 10 minutes into a REM sleep episode and 10 minutes into a control NREM sleep episode in counterbalanced order, then asked to report a dream and to rate themselves and a significant other on a list of trait adjectives. Relative to participants classified as having secure attachment orientations, participants classified as anxious took less time to enter REM sleep and had a higher frequency of REM dreams with aggression and self-denigrating themes. There were no significant differences across attachment groups in other measures of sleep architecture or in post REM-sleep awakening ratings on PANAS subscales reflecting mood and alertness. Selected aspects of REM sleep architecture and mentation appeared to be associated with attachment orientation. We suggest that REM sleep plays a role in processing experiences and emotions related to attachment, and that certain features of sleep and dreaming reflect attachment orientations.

Different perspectives on the sex-attachment link: towards an emotion-motivational account

Although the link between sex and attachment was made decades ago (Hazan & Shaver, 1987), theories on sexual and attachment functioning have been developed in relative isolation. Recent efforts to integrate both literatures have been complicated by the fact that the sex-attachment link has been approached from very different perspectives, including biological, evolutionary, developmental, cognitive, and social psychology approaches. Also, at the empirical level, research on sex and attachment lacks overarching synthesis. This article gives an overview of the most important theoretical ideas and empirical insights on sex and attachment. It starts with describing general models that approach the sex-attachment link from an evolutionary and neurobiological perspective. Then, it summarizes theoretical and empirical ideas of attachment theory and describes how attachment style differences are manifested in intimate and sexual relationships. Research so far has been limited to studying the predicted link between sex and attachment in terms of broad descriptives, and it would benefit the literature to specify the processes and pathways that mediate the sex-attachment link. After a short discussion of the functional similarities between the sexual and the attachment systems, the article describes some specific--dynamical--models that focus on the emotional and cognitive-motivational processes through which attachment schemas influence sexual experiences. Such an emotion-motivational perspective on sex and attachment can help to organize theoretical ideas and empirical findings and eventually promote an integrative view on how attachment dynamics can interact with sexual experiences.

Attachment Anxiety, Verbal Immediacy, and Blood Pressure: Results from a Laboratory-Analogue Study Following Marital Separation

Marital separation and divorce increase risk for all-cause morbidity and mortality. Using a laboratory analogue paradigm, the present study examined attachment anxiety, language use, and blood pressure (BP) reactivity among 119 (n = 43 men, 76 women) recently separated adults who were asked to mentally reflect on their relationship history and separation experience. We created a language use composite of verbal immediacy from participants' stream-of-consciousness recordings about their separation experience as a behavioral index of attachment-related hyperactivation. Verbal immediacy moderated the association between attachment anxiety and BP at the beginning of a divorce-specific activation task. Participants reporting high attachment anxiety who discussed their separation in a first-person, present-oriented and highly engaged manner evidenced the highest levels of BP at the start of the divorce-specific task. Results provide a deeper understanding of the association between marital dissolution and health and suggest that verbal immediacy may be a useful behavioral index of hyperactivating coping strategies.

More bridges: Investigating the relevance of self-report and interview measures of adult attachment for marital and caregiving relationships

The aim of this report was to investigate the associations between attachment state of mind, romantic attachment style, and indices of maternal functioning in two relational spheres: the mother—child relationship (i.e., maternal sensitivity and child attachment security) and the marital relationship (i.e., mothers’ and their partners’ marital satisfaction). The results, based on 59 families, indicated that attachment state of mind was associated with maternal sensitivity and with child attachment security, although not to mothers’ or their partners’ subjective feelings of marital satisfaction. In contrast, romantic attachment styles were related to both mothers’ and their partners’ marital satisfaction, although not to maternal sensitivity or child attachment. These findings add to the growing literature highlighting the unique value of each tradition of assessment in adult attachment research, by suggesting that variation in attachment security tapped by each measure may bear particular relevance for specific relationships.

Effective Reaction to Danger

People who score high on attachment anxiety or avoidance display poorer adjustment than secure individuals in various social, emotional, and behavioral domains. Yet it may be advantageous for groups to include insecure as well as secure members. The authors tested predictions from social defense theory concerning advantages to groups of including members with different attachment patterns. A total of 46 groups were unobtrusively observed in a threatening laboratory situation: The room gradually filled with smoke, apparently because of a malfunctioning computer. Attachment anxiety was associated with quicker detection of the danger and therefore with greater group effectiveness. Attachment-related avoidance was associated with speedier escape responses to the danger once it was detected and therefore with greater group safety. The results remained significant even when extraversion and neuroticism, two possible confounds, were statistically controlled. Implications of the findings for theory and research concerning group processes, threat detection, and individual differences in attachment are discussed.

The impact of attachment insecurity and sleep disturbance on symptoms and sick days in hospital-based health-care workers

OBJECTIVE

Adult attachment insecurity is associated with many health outcomes and may be associated with sleep disturbance. The purpose of this study was to test the hypothesis that sleep disturbance mediates the relationship between attachment insecurity and three measures of health (perceived general health, physical symptoms and sick days) in a group that is at high risk of sleep disturbance: hospital based health-care workers.

METHODS

One hundred thirty-one nondepressed female hospital workers completed self-report measures of adult attachment, sleep disturbance, depressive symptoms (excluding sleep-related items) and health outcomes. The hypothesis of mediation was tested with sequential regression analyses.

RESULTS

Both attachment anxiety and attachment avoidance were significantly associated with impairment in global sleep quality (ρ=.20 and .19, respectively, P<.05) and physical symptoms (ρ=.21 and .19, P<.05). Attachment anxiety was also associated with depressive symptoms (ρ=.33, P<.001) and sick days (ρ=.21, P<.05). For both physical symptoms and sick days, mediation analyses were consistent with global sleep quality acting as a partial mediator of the relationship between attachment anxiety and physical health. Non-sleep-related depressive symptoms were a stronger mediator.

CONCLUSIONS

This study corroborates evidence that attachment insecurity is associated with sleep disturbance and extends this association to the occurrence of physical symptoms and time off work due to sickness among workers in a high-stress occupation.

Links between attachment and social information processing: examination of intergenerational processes

This chapter describes theory and research on intergenerational connections between parents' attachment and children's social information processing, as well as between parents' social information processing and children's attachment. The chapter begins with a discussion of attachment theorists' early insights into the role that social information processing plays in attachment processes. Next, current theory about the mechanisms through which cross-generational links between attachment and social information processing might emerge is presented. The central proposition is that the quality of attachment and/or the social information processing of the parent contributes to the quality of attachment and/or social information processing in the child, and these links emerge through mediating processes related to social learning, open communication, gate-keeping, emotion regulation, and joint attention. A comprehensive review of the literature is then presented. The chapter ends with the presentation of a current theoretical perspective and suggestions for future empirical and clinical endeavors.

Attachment patterns and emotion regulation strategies in the second year

With the aim of studying the relationship between methods of emotion regulation and quality of attachment we examined 39 infants with different patterns of attachment, of whom 20 were classified as secure (B), 12 as avoidant (A) and 7 as resistant (C), assessing the regulatory strategies adopted by them during the Strange Situation at 13 months. Secure infants used strategies of positive social engagement more than insecure avoidant infants, while resistant infants displayed greater negative social engagement and less object orientation than the other two groups. Avoidant infants adopted positive and negative hetero-regulatory strategies less than the other groups, also differing from resistant infants in their greater use of object regulatory strategies. There were no significant differences as regards self-comforting regulation. Thus, the findings showed how the most significant differences to emerge between the groups concerned hetero-regulatory strategies, developed by the infant in interaction with attachment figures, and regulatory strategies oriented towards objects. Further analysis showed how the use by part of each attachment group of the emotion regulation strategies varies, differentiating the episodes of the SSP according to their level of stress.

Exploring the Role of Experiential Avoidance from the Perspective of Attachment Theory and the Dual Process Model

Avoidance can be adaptive and facilitate the healing process of acute grief or it can be maladaptive and hinder this same process. Maladaptive cognitive or behavioral avoidance comprises the central feature of the condition of complicated grief. This article explores the concept of experiential avoidance as it applies to bereavement, including when it is adaptive when it is problematic. Adaptive avoidance is framed using an attachment theory perspective and incorporates insights from the dual process model (DPM). An approach to clinical management of experiential avoidance in the syndrome of complicated grief is included.

Attachment Insecurity and Perceived Partner Suffering as Predictors of Personal Distress

This study examined the extent to which perceptions of partner suffering mediate the association between attachment insecurity (anxiety and avoidance) and personal distress among spouses of older adults with osteoarthritis. Fifty-three spouses watched two videos of targets (their partner and an opposite sex stranger) perform a pain-eliciting household task, and spouses were asked to rate their own distress and perceptions of the targets' pain. Spouses also completed self-report measures of trait attachment. Results revealed that attachment anxiety was associated with greater personal distress in reaction to the partner's suffering, and heightened perceptions of partner pain mediated this association. Avoidant attachment was associated with less distress in reaction to the partner's suffering, but not with less perceived pain. The results of this study identify an important mechanism linking attachment insecurity and heightened distress responses when observing the suffering of a significant other.

Attachment style and defense mechanisms in parents who abuse their children

Adult attachment style, defense mechanisms, and personal history of abuse was studied in a group of abusive parents. As a group, these parents made unusually high use of the defense of denial; this was especially true of those with a Fearful attachment style. However, the use of Identification was characteristic of those with a Preoccupied attachment style. Further, personal abuse history was related to adult attachment style. Those who reported having been abused as a child were less likely to have a Secure attachment style, and a history of physical or sexual abuse was associated with a Preoccupied style. In general, these findings support the deactivating/hyperactivating defensive theory of Mikulincer et al (Emotion Regulation in Couples and Families: Pathways to Dysfunction and Health. 2006; pp 77-99. Washington (WA): American Psychological Association).