Attachment and coping in psychosis in relation to spiritual figures

Positive Religious Coping and Associated Factors Among Participants with Severe Mental Illness Attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, 2021

Background

Religion has been reported to be the most widely used coping resource in stressful conditions including physical and mental illnesses. Different studies consistently find that positive religious coping is associated with a reduced level of severe mental illness such as depression. Despite its high prevalence and being a significant coping mechanism for persons with severe mental illness, there are no published studies on positive religious coping in Ethiopia.

Objective

To assess the prevalence of positive religious coping and associated factors among people with severe mental illness attending outpatient service at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, northwest Ethiopia, 2021.

Methods

A cross-sectional institution-based study was conducted and systematic random sampling was applied to select participants. Data were collected through a face-to-face interview. The collected data were entered into EpiData version 3.1 and exported to SPSS version 20 for processing and analysis. Multivariable logistic regression was used to identify independent factors associated with religious coping. P-value <0.05 was declared a statistically significant association with a 95% confidence interval.

Results

The prevalence of positive religious coping among severe mental illness was 72.4% (95% CI= 68.2, 76.4). Having no comorbid medical illness, good quality of life, good medication adherence, and mild subjective severity scale were associated with positive religious coping.

Conclusion

The magnitude of positive religious coping among severe mental illness was relatively high. Not having a comorbid medical illness, good medication adherence, good quality of life, and mild subjective severity scale were factors associated with it. Patients report different factors that affect practicing positive religious coping factors. In the other direction, positive religious coping was reported to contribute to symptom alleviating and increasing a sense of well-being.

States of Mind with Respect to Attachment: a comparative study between women who killed their children and mothers diagnosed with post-partum depression

INTRODUCTION

Attachment theory has been linked with the caregiving system, acting as a drive for a mother's behavior towards her offspring. The most dramatic consequence of distress following maternity is filicide. Despite this, only few studies addressed the attachment models of women who committed filicide, and very little provided comparisons with mothers diagnosed with post-partum depression.

OBJECTIVE

We described the socio-demographic and psychopathological characteristics of mothers who committed filicide. Our aim was to detect differences in the attachment models between mothers who committed filicide, mothers with post-partum depression and control mothers. Participants and setting: We recruited 19 women who committed filicide (group F) along with 52 women with post-partum depression (group D), and 23 control mothers (group C).

METHODS

We administered a semi-structured interview on socio-demographic aspects and psychiatric history along with the Adult Attachment Interview. We performed an ANOVA, a post-hoc analysis and a logistic regression.

RESULTS

The logistic regression showed a higher prevalence of Dismissing and Disorganized attachments in women of group F compared with group C (p = 0.002, p = 0.007). Dismissing attachment was also overrepresented in group D vs group C (p = 0.012). Interestingly, women of group F showed a Preoccupied/entangled attachment to a lesser extent than those of group D, reaching a borderline significance (p = 0.056).

CONCLUSIONS

Disorganized and Dismissing models of attachment are prevalent in women who committed filicide compared with mothers with post-partum depression and controls, while other models of attachment are less frequent. Therefore, attachment could be taken into consideration to define the risk for committing filicide.

Adult Attachment and Personal, Social, and Symptomatic Recovery From Psychosis: Systematic Review and Meta-Analysis

Despite growing evidence for the role of attachment in psychosis, no quantitative review has yet been published on the relationship in this population between insecure attachment and recovery in a broad sense. We therefore used meta-analytic techniques to systematically appraise studies on the relationship between attachment and symptomatic, social and personal recovery in clients with a psychotic disorder. Using the keywords attachment, psychosis, recovery and related terms, we searched six databases: Embase, Medline Epub (OVID), Psycinfo (OVID), Cochrane Central (trials), Web of Science, and Google Scholar. This yielded 28 studies assessing the associations between adult attachment and recovery outcome in populations with a psychotic disorder. The findings indicated that insecure anxious and avoidant attachment are both associated with less symptomatic recovery (positive and general symptoms), and worse social and personal recovery outcomes in individuals diagnosed with a psychotic disorder. The associations were stronger for social and personal recovery than for symptomatic recovery. Attachment style is a clinically relevant construct in relation to the development and course of psychosis and recovery from it. Greater attention to the relationship between attachment and the broad scope of recovery (symptomatic, social, and personal) will improve our understanding of the illness and efficacy of treatment for this population.

The relationship between existential well-being and mood-related psychiatric burden in Indian young adults with attachment deficits: a cross-cultural validation study

BACKGROUND

Attachment and spirituality are thought to have deep evolutionary roots but are always interpreted within the framework of culture, religion and personal beliefs. While insecure attachment has been observed to be positively related with psychopathology, a positive mental health effect has often been described for spirituality. To examine the cross-cultural validation of previous research focused on Austrian young adults with Western socialization, we attempt to replicate our study examining the influence spirituality has on the connection between insecure attachment and mood-related psychiatric burden with Indian young adults.

METHODS

We investigated Avoidant (AV) and Anxious (AX) Attachment (ECR-RD), Religious (RWB) and Existential (EWB) Well-Being (MI-RSWB), and mood-related psychiatric burden (Anxiety, Depression, Somatization; BSI-18) in 443 (31% female) Indian young adults (age range: 18-30 years) with a Hindu upbringing.

RESULTS

Compared to young adults with a Roman Catholic upbringing in a Western socialization, Indian participants did not differ in AX and EWB but scored higher in mood-related psychiatric burden (eta2 = .04), AV (eta2 = .14), as well as RWB (eta2 = .28; all p < .01). As in previous research only AX (β = .40) positively predicted mood-related psychiatric burden (ΔR2 = .15, all p < .01), while EWB was an additional negative predictor (β = -.11, p < .05).

CONCLUSIONS

Our findings emphasize the universal importance of attachment and spirituality for mental health as well as the potential influence of socialization on their development. Furthermore, they underline that Existential Well-Being - including hope for a better future, forgiveness, and the experience of sense and meaning - appears to have a compensating effect on the relation between insecure attachment and impaired mental health.

Relationship between attachment style and symptom severity across the psychosis spectrum: A meta-analysis

There is growing evidence for the role of attachment in psychosis, however, to date there has been no quantitative review of the prevalence of insecure attachment in psychosis. The current study sought to systematically appraise studies investigating the prevalence of insecure attachment and the association with psychosis-spectrum experiences using meta-analytic techniques. A systematic search of studies carried out between January 1980 and 30th November 2015 found 25 papers eligible for inclusion. The meta-analysis showed that the prevalence of insecure attachment style was significantly higher in individuals with psychosis (76%) than in non-clinical samples (38%), with fearful attachment being the most prevalent. Across the continuum, there was a small but significant relationship between positive symptom severity and insecure attachment and a significant relationship between negative symptom severity and insecure attachment in the non-clinical analysis. This relationship was not found in the clinical group. The prevalence of insecure attachment appears to be high in psychosis, however, the relationship between symptom severity and attachment is small. Attachment theory may provide greater understanding of the development of positive symptoms than previously thought, however, research needs to include more at-risk samples and longitudinal research to fully understand the dynamics of this relationship.

[Spirituality - Value of the relationship]

Nowadays, issues of religiosity and spirituality are viewed differently than 50 years ago. Social upheaval, migration and secularization have changed the interpretation of religious meaning but have not made religion obsolete. This article describes the differences between a religious and a secular global view and defines spirituality as attachment to a larger entirety. The resources of spirituality are described and the dangers of fanaticism and fundamentalism should not be neglected. Criteria for healthy belief are compared to religious delusion. In the context of attachment theory and the concept of self-transcendence, the value of spirituality is explained by connectedness and relationship.