1
|
Crompton C, Wan MW, Dewan S, Wittkowski A. Navigating their child's attachment-related difficulties: Parents' journey from shame into awareness. Clin Child Psychol Psychiatry 2023; 28:1463-1479. [PMID: 36349510 PMCID: PMC10540477 DOI: 10.1177/13591045221135993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Attachment-related difficulties frequently present in child and adolescent clinical services. Yet how parents engage with being informed of their child's attachment-related difficulties is little understood. In this qualitative study, ten parents with a birth child with attachment-related difficulties, as informed by a relevant service, and six healthcare professionals, were interviewed. The aim was to explore both perspectives on how parents experienced and engaged with this process, of their understanding of the child's difficulties and the supports they engaged with. Using grounded theory, the parental journey from shame to awareness is described, based around four main themes: failing as a parent, the process of making sense, a call to action, and awareness of attachment and interrelated difficulties. The intensity of shame and defensive processes felt by parents came through strongly in narratives, forming a key barrier to sense-making and action, while specific clinical, personal and support/resource characteristics facilitated progress. The findings highlight how parents can be better supported into a space of attachment-related awareness and understanding, which may in turn facilitate more positive outcomes for the child. The study also raises wide ranging implications relevant to all involved in the investment, planning and delivery of care for this client group.
Collapse
Affiliation(s)
- Chloe Crompton
- School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Ming W Wan
- School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | | | - Anja Wittkowski
- School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
2
|
Lei Y, Wang YY, Wan JM, Patel C, Li H. Association between negative parent-related family interactions and child social anxiety: A cross-cultural systematic review and meta-analysis. J Anxiety Disord 2023; 99:102771. [PMID: 37729824 DOI: 10.1016/j.janxdis.2023.102771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 07/28/2023] [Accepted: 09/03/2023] [Indexed: 09/22/2023]
Abstract
This meta-analysis systematically evaluates the strength and direction of the association between negative parent-related family interactions and child social anxiety, and identifies several influencing moderators. Two investigators independently searched international (PsycINFO, PubMed, and Web of Science) and Chinese (CNKI, WanFang, and VIP) databases from their inception dates until March 5, 2023, for suitable articles. Of the 5771 identified records, 85 studies were selected based on inclusion of at least one of the following three dimensions of negative family interactions: insecure attachment (n = 27), parent-related family conflicts (n = 19), or negative parenting styles (n = 46). Meta-analyses showed that all three dimensions were significantly associated with child social anxiety (insecure attachment: r = 0.271, p < 0.0001; parent-related family conflicts: r = 0.226, p < 0.0001; negative parenting styles: r = 0.186, p < 0.0001). For all three dimensions, this association was stronger in children from East Asian culture than in those from European or American culture. In addition, age group, information source, and publication year also significantly moderated this association. Our findings will help guide further research and provide recommendations for the development of effective interventions for reducing social anxiety.
Collapse
Affiliation(s)
- Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China.
| | - Yuan-Yuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
| | - Jia-Ming Wan
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Chetna Patel
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
| | - Hong Li
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China.
| |
Collapse
|
3
|
Lev Arey D, Sagi A, Blatt A. The relationship between exercise addiction, eating disorders, and insecure attachment styles among recreational exercisers. J Eat Disord 2023; 11:131. [PMID: 37550767 PMCID: PMC10408237 DOI: 10.1186/s40337-023-00855-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Exercise addiction (EA) and eating disorders (ED) frequently co-occur in both professional and amateur athletes, with up to 48% of individuals with EA also exhibiting symptoms of ED. Furthermore, pathological attachment styles have been linked to both EA and ED. The current study aimed to explore the unique association between types of insecure attachment styles (i.e., anxiety or avoidance) and EA and ED. METHOD Four hundred and five Israelis (199 women, 206 men) who were recreational exercisers (i.e., exercised at least four hours a week for at least one year) with ages ranging from 18 to 78 (M = 38, SD = 12.31) completed a set of questionnaires, including the Eating Attitudes Test (EAT-26), Exercise Addiction Inventory, and the Experiences in Close Relationship Scale. Path analysis was used to simultaneously examine the associations of attachment anxiety and avoidance with EA and ED symptoms. Attachment anxiety and avoidance were specified as independent variables predicting ED and EA symptoms and were entered into the analysis as two parallel dependent variables. RESULTS The results of the study indicate that attachment anxiety is positively associated with symptoms of EDs, while the association between attachment anxiety and symptoms of EA is not significant. On the other hand, attachment avoidance shows a positive association with symptoms of exercise addiction, but no significant association with symptoms of EDs is found. CONCLUSIONS These results imply that the anxious attachment regulation strategy is highly associated with body image concerns. Furthermore, individuals characterized by avoidance attachment manifest regulation strategies through excessive exercise. Scholars and practitioners could use these results to examine dispositional risk factors for insecure attachment styles and to assess specific pathologies among the population of recreational exercisers. The study also discusses limitations, future directions, and implications in detail.
Collapse
Affiliation(s)
- Dalit Lev Arey
- School of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel.
| | - Adi Sagi
- School of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Asaf Blatt
- School of Behavioral Sciences, College of Management Academic Studies, Rishon LeZion, Israel
| |
Collapse
|
4
|
Yousefi S, Ashouri A. The Role of Emotion Regulation Difficulties and Intrusive and Deliberate Rumination in the Association Between Insecure Attachment and Prolonged Grief. Omega (Westport) 2023:302228231189539. [PMID: 37439023 DOI: 10.1177/00302228231189539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
This study investigated the role of emotion regulation difficulties and intrusive/deliberate rumination in the relationship between insecure attachment and prolonged grief symptoms. A total sample of 342 bereaved participants was included in the study. Both anxious and avoidant attachment styles were found to be associated with prolonged grief symptoms, with an avoidant attachment showing a stronger effect. Emotion regulation difficulties and rumination mediated the relationships between attachment styles and prolonged grief symptoms, supporting the proposed mediation model. The study identified specific mediating pathways for anxious and avoidant attachment styles. Additionally, female gender, higher age, unexpected death, and closeness of the relationship with the deceased were significant predictors of prolonged grief symptoms.
Collapse
Affiliation(s)
- Shahab Yousefi
- Student Research Committee, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ashouri
- Student Research Committee, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Zhang Y, Ding Y, Huang H, Peng Q, Wan X, Lu G, Chen C. Relationship between insecure attachment and mobile phone addiction: A meta-analysis. Addict Behav 2022; 131:107317. [PMID: 35413487 DOI: 10.1016/j.addbeh.2022.107317] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/19/2022] [Accepted: 03/25/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Many studies have explored the relationship between insecure attachment and mobile phone addiction from different theoretical perspectives; however, the results have been different. This meta-analysis aimed to explore the relationship between insecure attachment and mobile phone addiction. METHODS Studies published before November 2021 were identified through a systematic online search. A total of 22 studies, including 38 independent effect sizes were included from a systematic search of multiple databases, with a total sample size of 11,810 cases. Stata Version 16.0 was used for meta-analysis. RESULTS The meta-analysis based on random-effects model showed that mobile phone addiction was highly positively associated with attachment anxiety (r = 0.395, 95%CI [0.345, 0.442]) and weakly positively correlated with attachment avoidance (r = 0.194, 95%CI [0.137, 0.250]). The relationship between attachment anxiety and mobile phone addiction and that between attachment avoidance and mobile phone addiction were both moderated by mobile phone addiction measures but not moderated by gender and attachment measures. CONCLUSION There is a positive correlation between mobile phone addiction and insecure attachment. In the future, measures to prevent mobile phone addiction should focus on insecure attachment individuals and help them construct a healthy attachment relationship and secure attachment model.
Collapse
Affiliation(s)
- Yiming Zhang
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Yueming Ding
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Haitao Huang
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Qianwen Peng
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Xiao Wan
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Guangli Lu
- School of Business, Henan University, Kaifeng, China.
| | - Chaoran Chen
- School of Nursing and Health, Henan University, Kaifeng, China.
| |
Collapse
|
6
|
Trucharte A, Valiente C, Espinosa R, Chaves C. The role of insecure attachment and psychological mechanisms in paranoid and depressive symptoms: An exploratory model. Schizophr Res 2022; 243:9-16. [PMID: 35220038 DOI: 10.1016/j.schres.2022.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
Attachment theory is considered an important theoretical framework for understanding the ontogenesis of psychopathology. In this regard, insecure attachment styles have been associated with the development and maintenance of paranoid and depressive symptoms. Furthermore, different psychological processes (i.e., self-esteem and experiential avoidance) have been identified as mediating mechanisms between the relationship of insecure attachment and these symptoms. Nowadays, there is a more positive view in psychology focusing on factors that contribute to well-being, although little is known about the role of these psychological well-being variables as mediators between insecure attachment and psychopathology. For thus, the aim of this study was to test one explorative structural equation model of insecure attachment on paranoid and depressive symptoms through psychological mediating mechanisms to elucidate the processes involved in each of them. To evaluate the model, 141 individuals with severe psychiatric conditions participated in the study. The results revealed good model fit, highlighting that avoidant attachment has a direct and indirect effect on the symptoms, while anxious attachment has only an indirect effect through mediating mechanisms. On the other hand, lower levels of self-acceptance and environmental mastery have been identified as important processes associated with paranoid and depressive symptoms. However, less positive relationships were a significant mediating mechanism only for paranoid ideation symptoms. These results have important clinical implications by shedding light on the relationship between insecure attachment, paranoid and depressive symptoms, and the psychological mediating mechanisms involved in this relationship, which may be considered key variables in clinical treatments.
Collapse
Affiliation(s)
- Almudena Trucharte
- Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
| | - Carmen Valiente
- Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, Faculty of Health, Camilo Jose Cela University, Madrid, Spain
| | - Covadonga Chaves
- Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
7
|
Yang R, Zhang L, Wu X, Fu Q, Bao Q. Caregivers' mind-mindedness and rural left-behind young children's insecure attachment: The moderated mediation model of theory of mind and family status. Child Abuse Negl 2022; 124:105472. [PMID: 34991010 DOI: 10.1016/j.chiabu.2021.105472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND China's rapid development and urbanization since the early 1980s have compelled many rural residents to move from rural to urban areas for work, leaving thousands of children at home. OBJECTIVE This study tested the mediating effect of children's theory of mind on the relationship between caregivers' mind-mindedness and their children's insecure attachment differently depending on the different family status (the moderator) of left-behind and non-left-behind. PARTICIPANTS The participants were 3 to 6 years old 74 left-behind children (LBHC) and 89 non-left-behind children (NLBHC). SETTINGS Participants were from rural counties of central China in Henan province that has experienced a large labor migration. METHODS A cross-sectional moderated mediation model linked mind-mindedness (independent variable) and insecure attachment (dependent variable) through the theory of mind (mediator) and family status (moderator: left-behind/non-left-behind), controlling for age, gender, and siblings. RESULTS First, LBHC scored higher on insecure-disorganized attachment than NLBHC. Second, the early childhood theory of mind mediated the relationship between the caregiver's mind-mindedness and young children's insecure attachment. Third, family status moderated the effects of the theory of mind on insecure attachment. The mediating role was established only for the left-behind family, and the lower theory of mind ability was associated with the greater insecure attachment of LBHC. CONCLUSIONS Our findings highlight the critical role of mind-mindedness, theory of mind, and family status in the attachment theory and clarify the association between different levels of young children's theory of mind and insecure attachment based on family status.
Collapse
Affiliation(s)
- Rui Yang
- School of Psychology, Shaanxi Normal University, China.
| | - Lijin Zhang
- School of Psychology, Shaanxi Normal University, China; Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China; Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Xi'an, China.
| | - Xiujuan Wu
- School of Psychology, Shaanxi Normal University, China
| | - Qianqian Fu
- School of Psychology, Shaanxi Normal University, China
| | - Qing Bao
- School of Psychology, Shaanxi Normal University, China
| |
Collapse
|
8
|
Chia K, Pasalich DS, Fassnacht DB, Ali K, Kyrios M, Maclean B, Grisham JR. Interpersonal attachment, early family environment, and trauma in hoarding: A systematic review. Clin Psychol Rev 2021; 90:102096. [PMID: 34717158 DOI: 10.1016/j.cpr.2021.102096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/07/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
The formation of intense emotional attachments to objects, difficulty parting with possessions, and the extreme accumulation of clutter are key features of Hoarding Disorder (HD). Although substantial literature implicates processes such as dysfunctional beliefs and maladaptive emotional cycles in HD, little is known about the vulnerability factors that lead to their development and hoarding symptomatology. The current review sought to systematically collate and integrate findings from studies investigating the relationship between hoarding symptoms and three proposed vulnerability factors: i) interpersonal attachment, ii) early family environment, and iii) traumatic or adverse life events. A comprehensive search of the databases PsycInfo, PubMed, and Scopus identified a total of 39 studies for inclusion. The results presented a complex pattern that supported the presence of relationships between insecure attachment, cold and controlling family experiences, and exposure to adverse life events with increased hoarding severity. However, the specificity of these factors to HD over other clinical groups remains unclear and findings are limited by the heterogenous and small number of studies. We conclude by discussing the clinical implications and limitations of these findings and propose new directions for future research.
Collapse
Affiliation(s)
- Kerryne Chia
- Research School of Psychology, The Australian National University, Canberra, Australia.
| | - Dave S Pasalich
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Daniel B Fassnacht
- Research School of Psychology, The Australian National University, Canberra, Australia; Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
| | - Kathina Ali
- Research School of Psychology, The Australian National University, Canberra, Australia; Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
| | - Michael Kyrios
- Research School of Psychology, The Australian National University, Canberra, Australia; Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
| | - Bronte Maclean
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Jessica R Grisham
- School of Psychology, University of New South Wales, Sydney, Australia
| |
Collapse
|
9
|
Saint-Eloi Cadely H, Finnegan V, Spears EC, Kerpelman JL. Adolescents and sexual risk-taking: The interplay of constraining relationship beliefs, healthy sex attitudes, and romantic attachment insecurity. J Adolesc 2020; 84:136-148. [PMID: 32916596 DOI: 10.1016/j.adolescence.2020.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/04/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Although sexual exploration during adolescence may be perceived as normative, many adolescents who are sexually active are likely to engage in risky sexual behaviors detrimental to their well-being. The present study examined the influence of insecure attachment (anxious and avoidant dimensions), healthy sex attitudes, and constraining relationship beliefs on the following sexual risk indicators: age at first sex, number of sexual partners, condom use, length of time knowing sexual partners, seriousness of relationship, and frequency of sex. METHODS Cross-sectional data from two cohorts recruited one year apart for a five-year project were analyzed. Adolescents were public high school students from a Southern state in the USA (cohort 1: N = 878, 51.1% females, M = 16.50 years old; cohort 2: N = 759, 46.9% females, M = 15.78 years old). RESULTS Across both cohorts, healthy sex attitudes were related to having sex for the first time at an older age, having less sexual partners in a lifetime, and knowing one's sexual partner longer. High scores on the avoidant attachment dimension were related to less commitment to the relationship. This dimension also was related to holding lower scores on healthy sex attitudes, which in turn was related to having more sexual partners and knowing one's sexual partner for a shorter time. Although not replicated, higher endorsement of constraining relationship beliefs was associated with inconsistent condom use and greater sex frequency. CONCLUSION Findings suggests that attachment insecurity, healthy sex attitudes, and constraining relationship beliefs work together to influence adolescent sexual risks.
Collapse
Affiliation(s)
- Hans Saint-Eloi Cadely
- University of Rhode Island, Auburn University, University of North Texas Health Science Center, United States.
| | - Vanessa Finnegan
- University of Rhode Island, Auburn University, University of North Texas Health Science Center, United States
| | - Erica C Spears
- University of Rhode Island, Auburn University, University of North Texas Health Science Center, United States
| | - Jennifer L Kerpelman
- University of Rhode Island, Auburn University, University of North Texas Health Science Center, United States
| |
Collapse
|
10
|
Liese BS, Kim HS, Hodgins DC. Insecure attachment and addiction: Testing the mediating role of emotion dysregulation in four potentially addictive behaviors. Addict Behav 2020; 107:106432. [PMID: 32330652 DOI: 10.1016/j.addbeh.2020.106432] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/19/2022]
Abstract
Insecure attachment has been associated with an array of addictive behaviors. However, the mechanism by which insecure attachment leads to addictive behaviors remains largely unknown. In the present research we tested whether emotion dysregulation mediated the relationship between insecure attachment (anxious, avoidant) in substance use (alcohol, marijuana) and DSM-5 (Internet gaming) and non-DSM-5 (texting) behavioral dependencies. A sample (N = 712) of participants recruited from a university in the United States completed an online battery of instruments, assessing adult attachment style, emotion dysregulation, and self-reported DSM-5 symptoms adapted from substance use disorder criteria. In separate mediation analyses, anxious attachment was associated with self-reported DSM-5 symptoms for alcohol, marijuana, texting, but not Internet gaming; whereas emotion dysregulation was associated with self-reported DSM-5 symptoms of all four potentially addictive behaviors. Avoidant attachment was not associated with self-reported DSM-5 symptoms for any of the addictive behaviors. Emotion dysregulation mediated the relationship between both anxious and avoidant attachment and self-reported DSM-5 symptoms for alcohol, marijuana, and texting. In contrast, emotion dysregulation mediated the relationship between anxious but not avoidant attachment and Internet gaming. Insecure attachment, specifically anxious attachment and emotion dysregulation may be important psychological characteristics that increase the risk for alcohol, marijuana and texting, while Internet gaming corresponds with unique characteristics. Whereas attachment styles may be resistant to change, emotion dysregulation has been found to be modifiable and may provide a potential target in the treatment of substance use disorders and some behavioral dependencies for those who manifest attachment insecurities.
Collapse
|
11
|
Scott M, Rossell SL, Meyer D, Toh WL, Thomas N. Childhood trauma, attachment and negative schemas in relation to negative auditory verbal hallucination (AVH) content. Psychiatry Res 2020; 290:112997. [PMID: 32470717 DOI: 10.1016/j.psychres.2020.112997] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 11/30/2022]
Abstract
Auditory verbal hallucinations (AVHs, or hearing voices) are particularly characterized by negative content such as criticism and threats. The extent of negative content is a major predictor of distress, yet there is limited research on what contributes to the content of AVHs. The current study aimed to assess the relationships between childhood trauma, attachment styles (anxious and avoidant) and negative self schemas as plausible mechanisms underlying negative AVH content. Structural equation modelling was used to test a theoretical model, including these constructs, in a transdiagnostic sample of 140 people with AVHs. Findings indicated that collectively, emotional trauma during childhood, insecure anxious attachment and negative self schemas predicted the proportion of negative AVH content experienced by voice hearers. Whereby, trauma predicted attachment, which predicted schemas and in turn negative AVH content. This study marks an important step towards understanding the underlying mechanisms involved in negative AVHs. The results highlight the importance of recognising early experiences of trauma, adult attachment styles and self schemas in developing formulations and effective treatments for negative and distressing AVHs. Psychological interventions that target these underlying mechanisms of negative AVHs may lead to a reduction in negative content, thereby reducing voice related distress.
Collapse
Affiliation(s)
- Monique Scott
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Psychiatry, St Vincent's Hospital Melbourne, Australia
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Alfred Health, Melbourne, Australia.
| |
Collapse
|
12
|
Salehi Shahrabi M, Shahrabi M, Heidari A, Ghaderi H. Role of attachment style in prediction of behavior of 3 to 6-year-old children. Eur Arch Paediatr Dent 2020; 21:647-656. [PMID: 32157636 DOI: 10.1007/s40368-019-00495-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 11/14/2019] [Indexed: 10/24/2022]
Abstract
PURPOSE Efficient communication with children is the basis of pediatric dentistry and is a prerequisite for provision of pediatric dental care. Prediction of the behavior of children and their reaction to therapeutic procedures is a challenge for many pediatric dentists. This study aimed to assess the attachment styles of children to predict their behavior during a dental visit. METHODS The participants included 117 healthy children aged 3 to 6 years presented to the Department of Pediatric Dentistry, Tehran University of Medical Sciences, in 2017-2018. A postgraduate dental student examined the children. The parents were requested to fill out the Kinship Center attachment questionnaire (KCAQ) regarding their children, while waiting in the waiting room. The children who met the inclusion criteria in the first visit were scheduled for a dental procedure in the second visit. Another postgraduate student of pediatric dentistry assessed the behavior of children during the dental procedure according to the designed questionnaire and based on the Frankl scale. A third examiner along with the second examiner evaluated the behavior of children on a random basis to determine the inter-examiner agreement. Data were analyzed using the Chi-squared test, t test, Pearson's correlation coefficient, and linear regression. RESULTS The results showed that 67.5% of the children were cooperative, including 54.7% of boys. The mean age of children was 5.1 ± 0.95 years. Also, 80.3% of children had secure and 19.7% had insecure attachment styles (11.97% insecure avoidant and 7.69% insecure ambivalent). A significant association existed between the insecure ambivalent attachment style and child-dentist communication. A significant inverse correlation was also noted between the total score of the questionnaire and parent-child separation in dental office. CONCLUSIONS The current findings revealed no significant difference in the attachment styles of cooperative and uncooperative children. Significant associations only existed between the insecure ambivalent attachment style and child-dentist communication, and also between mother-child separation and secure attachment style. Thus, the children's behavior in dental office cannot be predicted based on their attachment style.
Collapse
Affiliation(s)
- M Salehi Shahrabi
- Department of Pediatric Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M Shahrabi
- Department of Pediatric Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - A Heidari
- Department of Pediatric Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - H Ghaderi
- Master of Family Counseling from University of Social Welfare and Rehabilitation Science, Tehran, Iran
| |
Collapse
|
13
|
Smith M, South S. Romantic attachment style and borderline personality pathology: A meta-analysis. Clin Psychol Rev 2019; 75:101781. [PMID: 31918217 DOI: 10.1016/j.cpr.2019.101781] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/13/2019] [Accepted: 10/15/2019] [Indexed: 12/24/2022]
Abstract
Borderline Personality Disorder (BPD) implies profound impairment in interpersonal relationships, particularly romantic relationships (Daley, Burge, & Hammen, 2000). Insecure attachment bears striking resemblance to BPD traits in both empirical and theoretical work (Levy, Johnson, Clouthier, Scala, & Temes, 2015) and may be particularly suited for understanding the BPD-related deficits in romantic functioning. Despite several qualitative reviews concluding that secure attachment is disrupted in those with BPD traits, no consensus has emerged regarding the form of this disruption (Levy et al., 2015), with most reviews focusing on whether BPD is best captured as high levels of attachment anxiety or attachment avoidance. The purpose of the current review is to provide a quantitative synthesis of the strength and direction of the associations between attachment insecurity and BPD traits. Searches on PsycINFO and Pubmed resulted in 27 effect sizes that measured BPD and adult romantic attachment on the two primary dimensions of anxiety and avoidance (Fraley, Waller, & Brennan, 2000). Results demonstrated that attachment anxiety correlates most strongly with BPD traits (r = 0.48); however, attachment avoidance also evinced a significant effect (r = 0.30). Findings from regression analyses indicate that attachment anxiety and avoidance interact, suggesting a particularly strong relationship between attachment disorganization and BPD traits.
Collapse
Affiliation(s)
- Madison Smith
- Psychological Sciences, Purdue University, 703 3rd Street, West Lafayette, IN, United States of America.
| | - Susan South
- Psychological Sciences, Purdue University, 703 3rd Street, West Lafayette, IN, United States of America.
| |
Collapse
|
14
|
Ma Y, Ma H, Chen X. Security priming improves attentional processing to infant emotions among insecurely attached women: The different roles of supraliminal and subliminal priming. Neuropsychologia 2019; 134:107216. [PMID: 31580880 DOI: 10.1016/j.neuropsychologia.2019.107216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/22/2019] [Accepted: 09/27/2019] [Indexed: 11/28/2022]
Abstract
In two ERP experiments, we examined the attention-related mechanism involved in perceiving infant emotions following exposure to security priming. Specifically, we examined how security priming affected securely and insecurely attached women. We found that both supraliminal and subliminal security priming resulted in increased attention allocation in anxiously and avoidantly attached women but had no effect on securely attached women. Moreover, we also found that supraliminal and subliminal security priming differed in their effectiveness in increasing attention allocation among anxiously and avoidantly attached women. Supraliminal security priming were more effective for anxiously attached women, whereas subliminal security priming were more effective for avoidantly attached women. The implications of these findings and directions for future research are discussed.
Collapse
Affiliation(s)
- Yuanxiao Ma
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Haijing Ma
- Department of Communication, The University of OKlahoma, Oklahoma City, 73019, United States
| | - Xu Chen
- Faculty of Psychology, Southwest University, Chongqing, 400715, China.
| |
Collapse
|
15
|
Chatziioannidis S, Andreou C, Agorastos A, Kaprinis S, Malliaris Y, Garyfallos G, Bozikas VP. The role of attachment anxiety in the relationship between childhood trauma and schizophrenia-spectrum psychosis. Psychiatry Res 2019; 276:223-231. [PMID: 31112856 DOI: 10.1016/j.psychres.2019.05.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/10/2019] [Accepted: 05/10/2019] [Indexed: 01/21/2023]
Abstract
Childhood trauma (CT) is a comprehensive concept encompassing experiences of sexual, physical, and emotional abuse, and neglect during childhood and adolescence. Patients with schizophrenia-spectrum psychosis (SSP) display higher rates of CT than healthy controls. Among the potential mediators of this association, insecure attachment has gained attention and empirical validation. The present study aimed to extend existing knowledge on this field by exploring the role of the two attachment dimensions, attachment anxiety and attachment avoidance, in the CT-SSP association. A clinical sample of 63 SSP inpatients was compared to a healthy control group on CT and attachment style measures. Correlations between CT, attachment dimensions and psychopathology were sought. Mediation analyses were also performed to examine whether attachment anxiety and/or attachment avoidance mediated the CT-SSP association. Patients displayed higher rates of CT and insecure attachment than controls. Attachment anxiety and severity of Mother Antipathy were linked to severity of hallucinations. Attachment anxiety was recognized as the sole mediator of the CT-SSP association. Our findings suggest that individuals with severe CT and increased attachment anxiety represent a risk population warranting early clinical attention, regular monitoring and tailored therapeutic interventions aimed at reducing the psychological impact of trauma.
Collapse
Affiliation(s)
- Stylianos Chatziioannidis
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Lagada Street 196, 56430 Stavroupoli, Greece.
| | - Christina Andreou
- University Psychiatric Clinics Basel, Wilhelm Klein-Strasse 27, CH-4002 Basel, Switzerland
| | - Agorastos Agorastos
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Lagada Street 196, 56430 Stavroupoli, Greece
| | - Stergios Kaprinis
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Lagada Street 196, 56430 Stavroupoli, Greece
| | - Yanni Malliaris
- EDO the Hellenic Bipolar Organization and BipolarLab.com, Asimaki Fotila Street 3, 11473, Pedion Areos, Athens, Greece
| | - George Garyfallos
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Lagada Street 196, 56430 Stavroupoli, Greece
| | - Vasilios P Bozikas
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Lagada Street 196, 56430 Stavroupoli, Greece
| |
Collapse
|
16
|
Rückert-Eheberg IM, Lukaschek K, Brenk-Franz K, Strauß B, Gensichen J. Association of adult attachment and suicidal ideation in primary care patients with multiple chronic conditions. J Affect Disord 2019; 246:121-125. [PMID: 30580197 DOI: 10.1016/j.jad.2018.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 11/07/2018] [Accepted: 12/16/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicidal ideation is a common health concern in primary care. Attachment theory indicates that subjects with higher anxiety and/or avoidance may be more susceptible to suicidal ideation. Therefore, the aim of our study was to examine the association of attachment anxiety, avoidance, and suicidal ideation in middle-aged to elderly, chronically ill primary care patients. METHODS The APRICARE Study comprised 207 patients aged 50-85 years with a minimum of three chronic diseases. Adult attachment, depressive symptoms and suicidal ideation were measured via the self-report questionnaires Experiences in Close Relationships-Revised (ECR-RD12) and Patient Health Questionnaire - 9 (PHQ-9). Univariable and adjusted associations of suicidal ideation with ECR-RD12-attachment anxiety, ECR-RD12-attachment avoidance, and ECR-RD12-insecure adult attachment were examined via logistic regression analyses. RESULTS Suicidal ideation was present in 13% of all patients. ECR-RD12-anxiety was significantly associated with suicidal ideation (OR = 1.88, CI 1.44-2.44), while ECR-RD12-avoidance was not associated. In patients with suicidal ideation, 85% were insecurely attached compared to 63% in those without suicidal ideation - thus the OR for suicidal ideation in insecurely attached patients was 3.33 (CI = 1.10-10.04) with securely attached patients as reference. Further variables associated with suicidal ideation were depressive symptomatology, living alone (especially in men) and obesity (especially in women). LIMITATIONS The study was cross-sectional in design, and suicidal ideation was assessed using a single item self-report measure. CONCLUSION General practitioners should be aware of attachment styles in order to have a better chance to identify patients at risk for suicide.
Collapse
Affiliation(s)
- Ina-Maria Rückert-Eheberg
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 8a/10, D-80336 Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.
| | - Karoline Lukaschek
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 8a/10, D-80336 Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany
| | - Katja Brenk-Franz
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Stoystr. 3, D-07740 Jena, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Stoystr. 3, D-07740 Jena, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 8a/10, D-80336 Munich, Germany; Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University, Bachstr. 18, D-07743 Jena, Germany
| |
Collapse
|
17
|
Wambua GN, Obondo A, Bifulco A, Kumar M. The role of attachment relationship in adolescents' problem behavior development: a cross-sectional study of Kenyan adolescents in Nairobi city. Child Adolesc Psychiatry Ment Health 2018; 12:27. [PMID: 29881453 PMCID: PMC5984764 DOI: 10.1186/s13034-018-0237-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a significant link between insecure attachment and the development of psychopathology in adolescence. We investigated the relationship between adolescent attachment styles and the development of emotional and behavioral problems among adolescents in Kenya. We also examined the modifying influence of socio-economic-status (SES). METHOD One hundred and thirty-seven adolescents who were attending two schools participated in the study. One school (low SES school) catered for children from predominantly low-income households, while the second school (middle SES school) catered for children from predominantly middle-income households. The data were collected using three instruments: researcher designed questionnaire to obtain socio-demographic information, the Strength and Difficulties Questionnaire (SDQ) that is designed to assess symptoms of disorder, and the Vulnerable Attachment Scale Questionnaire (VASQ) that is designed to measure attachment style. RESULTS Adolescents from the low SES school had higher vulnerable attachment scores than those from the middle SES school (t(135) = - 2.5, P = 0.02). Male students had higher vulnerable attachment scores than females (P = 0.03). Adolescents who had experienced adversity in childhood had higher vulnerable attachment scores than those who had not (P < 0.00). Results from Pearson's correlation showed moderate to strong positive correlations between attachment insecurity and emotional and behavioral problems with participants who had higher emotional symptoms (r = 0.47, P < 0.01), conduct problem score (r = 0.33, P < 0.01), hyperactivity (r = 0.26, P < 0.01) and total difficulty scores (r = 0.47, P < 0.01), experiencing significantly higher levels of attachment insecurity than those with lower scores. CONCLUSIONS AND RECOMMENDATIONS This study supports the notion that attachment insecurity increases the adolescents' susceptibility to develop psychological problems.
Collapse
Affiliation(s)
- Grace Nduku Wambua
- 0000 0001 2019 0495grid.10604.33Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 19676, 00202 Nairobi, Kenya
| | - Anne Obondo
- 0000 0001 2019 0495grid.10604.33Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 19676, 00202 Nairobi, Kenya
| | - Antonia Bifulco
- 0000 0001 0710 330Xgrid.15822.3cDepartment of Psychology, Middlesex University, London, UK
| | - Manasi Kumar
- 0000 0001 2019 0495grid.10604.33Department of Psychiatry, College of Health Sciences, University of Nairobi, 47074, 00100 Nairobi, Kenya ,0000000121901201grid.83440.3bResearch Department of Clinical Health and Educational Psychology, University College London, London, WC1E7BT UK
| |
Collapse
|
18
|
Palagini L, Petri E, Novi M, Caruso D, Moretto U, Riemann D. Adult insecure attachment plays a role in hyperarousal and emotion dysregulation in Insomnia Disorder. Psychiatry Res 2018; 262:162-167. [PMID: 29453034 DOI: 10.1016/j.psychres.2018.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/27/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
Studies show that unhelpful cognitive processes play a role in insomnia, whereas interpersonal factors have been less studied in insomnia. Attachment theory can be used as a cognitive-interpersonal framework for understanding insomnia. Because attachment insecurity (vs security) is related to psychiatric disorders the objective was to study the attachment style in insomnia. To this aim sixty-four subjects with Insomnia Disorder (DSM-5) and 38 good sleepers were evaluate in a cross-sectional study with: Attachment Style Questionnaire (ASQ), Arousal Predisposition Scale (APS), Pre-Sleep Arousal Scale (PSAS) and Difficulties in Emotion Regulation Scale (DERS). Differences in means between groups were assessed using t-test or Mann-Whitney U/Wilcoxon test. Linear/multiple regression analyses were performed. Subjects with insomnia (mean age 47.1 + 13 yrs) presented an insecure attachment style and higher scores in all the scales (ASQ, APS, PSAS, DERS p < 0.0001) than good sleepers (mean age 48.2 + 14 yrs). After taking into account anxiety/depressive symptoms, insecure attachment was related to hyperarousal trait (p = 0.02), pre-sleep hyperarousal (p = 0.04) and emotion dysregulation (p = 0.002). In conclusion subjects with insomnia showed an insecure attachment which was related to hyperarousal trait, pre-sleep hyperarousal and emotion dysregulation. It may intervene in the trajectory of insomnia starting from predisposition to perpetuation. Clinical implications are discussed.
Collapse
Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Pisa, School of Medicine, Via Roma 67, 56100 Pisa, Italy.
| | - Eleonora Petri
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Pisa, School of Medicine, Via Roma 67, 56100 Pisa, Italy
| | - Martina Novi
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Pisa, School of Medicine, Via Roma 67, 56100 Pisa, Italy
| | - Danila Caruso
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Pisa, School of Medicine, Via Roma 67, 56100 Pisa, Italy
| | - Umberto Moretto
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Pisa, School of Medicine, Via Roma 67, 56100 Pisa, Italy
| | - Dieter Riemann
- Freiburg University Medical Center, Department of Psychiatry and Psychotherapy, Germany
| |
Collapse
|
19
|
Keough MT, Penniston TL, Vilhena-Churchill N, Michael Bagby R, Quilty LC. Depression symptoms and reasons for gambling sequentially mediate the associations between insecure attachment styles and problem gambling. Addict Behav 2018; 78:166-172. [PMID: 29175293 DOI: 10.1016/j.addbeh.2017.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 11/28/2022]
Abstract
One of the central pathways to problem gambling (PG) is gambling to cope with negative moods, which is a cardinal feature of depression. Insecure attachment styles are also etiologically related to depression; and, therefore, by extension, those who are insecurely attached may engage in excessive gambling behaviors to cope with depression. In this study, we aimed to evaluate this and to this end predicted that depression severity and coping motives for gambling would conjointly mediate the relations between insecure attachment styles and PG. Data came from a larger investigation of PG within mood disorders. Participants exhibited a lifetime depressive or bipolar disorder and endorsed a mood episode within the past ten years. Participants (N=275) completed self-report measures during a two-day assessment. Path analysis supported two main indirect effects. First, anxious attachment predicted elevated depression, which in turn predicted increased coping motives for gambling, which subsequently predicted greater PG severity. Second, this double mediational pathway was also observed for avoidant attachment. Results suggest that insecure attachment relates to PG via depressive symptoms and coping-related gambling motives. Mood symptoms and associated gambling motives are malleable and are promising targets of gambling interventions for insecurely attached individuals.
Collapse
Affiliation(s)
- Matthew T Keough
- University of Manitoba, Department of Psychology, 190 Dysart Road, P314 Duff Roblin Building, Winnipeg, MB R3T 2N2, Canada.
| | - Trinda L Penniston
- University of Manitoba, Department of Psychology, 190 Dysart Road, P314 Duff Roblin Building, Winnipeg, MB R3T 2N2, Canada
| | - Natalie Vilhena-Churchill
- Altum Health, University Health Network, Krembil Discovery Tower, 399, Bathurst St., Toronto, Ontario M5T 2S8, Canada
| | - R Michael Bagby
- University of Toronto, Departments of Psychology and Psychiatry, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - Lena C Quilty
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 100 Stokes Street, Bell Gateway Building, Toronto, Ontario M6J 1H4, Canada; University of Toronto, Department of Psychiatry, 250 College St., Toronto, Ontario M5T 1R8, Canada
| |
Collapse
|
20
|
Carr SC, Hardy A, Fornells-Ambrojo M. Relationship between attachment style and symptom severity across the psychosis spectrum: A meta-analysis. Clin Psychol Rev 2017; 59:145-158. [PMID: 29229220 DOI: 10.1016/j.cpr.2017.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/02/2017] [Accepted: 12/03/2017] [Indexed: 01/10/2023]
Abstract
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.
Collapse
Affiliation(s)
- Sarah Christina Carr
- Department of Clinical, Education and Health Psychology, University College London, 4th Floor, 1-19 Torrington Place, London WC1E 7HB, UK.
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, King's College London, Henry Wellcome Building, De Crespigny Park, London SE5 8AF, UK
| | - Miriam Fornells-Ambrojo
- Department of Clinical, Education and Health Psychology, University College London, 4th Floor, 1-19 Torrington Place, London WC1E 7HB, UK
| |
Collapse
|
21
|
Sippel LM, Han S, Watkins LE, Harpaz-Rotem I, Southwick SM, Krystal JH, Olff M, Sherva R, Farrer LA, Kranzler HR, Gelernter J, Pietrzak RH. Oxytocin receptor gene polymorphisms, attachment, and PTSD: Results from the National Health and Resilience in Veterans Study. J Psychiatr Res 2017; 94:139-47. [PMID: 28715704 DOI: 10.1016/j.jpsychires.2017.07.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/23/2017] [Accepted: 07/07/2017] [Indexed: 01/08/2023]
Abstract
The human oxytocin system is implicated in social behavior and stress recovery. Polymorphisms in the oxytocin receptor gene (OXTR) may interact with attachment style to predict stress-related psychopathology like posttraumatic stress disorder (PTSD). The objective of this study was to examine independent and interactive effects of the OXTR single nucleotide polymorphism (SNP) rs53576, which has been associated with stress reactivity, support-seeking, and PTSD in prior studies, and attachment style on risk for PTSD in a nationally representative sample of 2163 European-American (EA) U.S. military veterans who participated in two independent waves of the National Health and Resilience in Veterans Study (NHRVS). Results revealed that insecure attachment style [adjusted odds ratio (OR) = 4.29; p < 0.001] and the interaction of rs53576 and attachment style (OR = 2.58, p = 0.02) were associated with probable lifetime PTSD. Among individuals with the minor A allele, the prevalence of probable PTSD was significantly higher among those with an insecure attachment style (23.9%) than those with a secure attachment style (2.0%), equivalent to an adjusted OR of 10.7. We attempted to replicate these findings by utilizing dense marker data from a genome-wide association study of 2215 high-risk civilians; one OXTR variant, though not rs53576, was associated with PTSD. Exploratory analyses in the veteran sample revealed that the interaction between this variant and attachment style predicting probable PTSD approached statistical significance. Results indicate that polymorphisms in the OXTR gene and attachment style may contribute to vulnerability to PTSD in U.S. military veterans.
Collapse
|
22
|
Sternheim LC, Fisher M, Harrison A, Watling R. Predicting intolerance of uncertainty in individuals with eating disorder symptoms. J Eat Disord 2017; 5:26. [PMID: 28883918 PMCID: PMC5580198 DOI: 10.1186/s40337-017-0152-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 05/10/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Intolerance of Uncertainty (IU) is recognized for its contribution to various psychopathologies, in particular anxiety and depression. Studies highlight the relevance of IU for Eating Disorders (EDs) however, potential factors contributing to IU in EDs remain unstudied. METHODS Three hundred and forty-nine women with ED symptoms and 214 individuals without ED symptoms were recruited and compared on levels of IU, insecure (anxious and avoidant) attachment styles, extraversion and openness. Secondly, the contribution of these factors to IU were tested. RESULTS Compared to the non-ED group, the ED group scored higher on IU, insecure attachment, and lower on extraversion and openness. Regression analyses confirmed that higher insecure attachment, and lower extraversion predicted higher IU scores in the ED group, and that insecure attachment predicted higher IU scores in the non-ED group. CONCLUSIONS Results confirm the relevance of IU to ED, and demonstrate that personality traits and insecure attachment styles contribute to IU in ED. Findings add to the growing literature on IU in ED and suggest that people with EDs may benefit from clinical interventions targeting IU.
Collapse
Affiliation(s)
- Lot C. Sternheim
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
- Social, Health and Organisation Psychology, Faculty of Social Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Martin Fisher
- School of Psychotherapy & Psychology, Regent’s University London, London, UK
| | - Amy Harrison
- School of Psychotherapy & Psychology, Regent’s University London, London, UK
- Ellern Mede Service for Eating Disorders, London, UK
| | - Rosamond Watling
- School of Psychotherapy & Psychology, Regent’s University London, London, UK
| |
Collapse
|
23
|
Zietlow AL, Nonnenmacher N, Reck C, Mueller M, Herpertz SC, Neukel C, Fuchs A, Bermpohl F, Fuehrer D, Kluczniok D, Attar CH, Jaite C, Dittrich K, Boedeker K. Early life maltreatment but not lifetime depression predicts insecure attachment in women. Arch Womens Ment Health 2017; 20:477-486. [PMID: 28612177 DOI: 10.1007/s00737-017-0731-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/10/2017] [Indexed: 12/31/2022]
Abstract
Early life maltreatment (ELM) poses a risk for the development of insecure attachment and depression over the life span, depending on the type of maltreatment (physical, sexual, emotional, neglect) and its severity. The aim of this study was to investigate the influence of ELM and lifetime depression on adult insecure attachment in a female sample (N = 188), consisting of n = 81 women with ELM and n = 107 without ELM. Women with ELM reported significantly higher scores on insecure attachment than women without ELM. A significant interaction effect for ELM × lifetime depression was found: Contradictory to the hypotheses, women with ELM but without lifetime depression scored highest on avoidant attachment, differing significantly from women with ELM and lifetime depression, even though the severity of ELM was higher among women with ELM and lifetime depression and they experienced significantly more severe neglect and sexual abuse, but not physical or emotional abuse. Regression analyses revealed that ELM was the only predictor of avoidant attachment, explaining 15.5% of the variance. Results underline the strong influence of ELM on adult attachment and are of special importance for prevention and intervention programs.
Collapse
Affiliation(s)
- Anna-Lena Zietlow
- Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg University Hospital, Bergheimer Str. 20, 69115, Heidelberg, Germany.
| | - Nora Nonnenmacher
- Center for Psychosocial Medicine, General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Corinna Reck
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Mitho Mueller
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sabine C Herpertz
- Center for Psychosocial Medicine, General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Corinne Neukel
- Center for Psychosocial Medicine, General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Anna Fuchs
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Fuehrer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dorothea Kluczniok
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Catherine Hindi Attar
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Dittrich
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Boedeker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
24
|
Goh EK, Kim OY, Jeon HJ. Depression Is a Mediator for the Relationship between Physical Symptom and Psychological Well-being in Obese People. Clin Nutr Res 2017; 6:89-98. [PMID: 28503505 PMCID: PMC5426210 DOI: 10.7762/cnr.2017.6.2.89] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 04/16/2017] [Accepted: 04/18/2017] [Indexed: 11/19/2022] Open
Abstract
This present study aimed to investigate the association effect of obesity status, physical symptom, insecure attachment, and depression on psychological well-being in non-diabetic healthy Koreans. Height, weight, waist circumference, blood pressure, and socio-psychological questionnaires (insecure attachment, depression, and physical symptom psychological well-being, etc.) were examined in 123 healthy Koreans. Student t-test, correlation analysis, and mediation analysis were performed. Study subjects were divided into 2 groups based on body mass index (BMI, kg/m2): obesity (BMI ≥ 25, n = 36) and non-obesity (BMI < 25, n = 87). Obese people were older and showed higher proportion of males than non-obese ones. Regarding the values of socio-psychological test, obesity group showed lower insecure attachment, and higher physical symptom than non-obesity group. In correlation and mediation analyses, depression was positively related to insecure attachment and physical symptom in both BMI groups. Positive relationship between physical symptom and insecure attachment was observed only in non-obesity group, but not in obesity group. The effect of insecure attachment on psychological well-being was completely mediated by depression in both BMI groups. On the other hand, the effect of physical symptom on psychological well-being was completely mediated by depression in obesity group, but not in non-obesity group. In conclusion, this study presented that the effects of physical symptom and insecure attachment on psychological well-being were completely mediated by depression in obese healthy Koreans, but not in non-obese ones. It will provide useful data for extending the knowledge on the relationship between the physical health and mental health.
Collapse
Affiliation(s)
- Eun Kyoung Goh
- Human Life Research Center, Dong-A University, Busan 49315, Korea
| | - Oh Yoen Kim
- Human Life Research Center, Dong-A University, Busan 49315, Korea
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
| | - Hyo Jeong Jeon
- Human Life Research Center, Dong-A University, Busan 49315, Korea
- Department of Child Studies, Dong-A University, Busan 49315, Korea
| |
Collapse
|
25
|
Macinnes M, Macpherson G, Austin J, Schwannauer M. Examining the effect of childhood trauma on psychological distress, risk of violence and engagement, in forensic mental health. Psychiatry Res 2016; 246:314-20. [PMID: 27744234 DOI: 10.1016/j.psychres.2016.09.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022]
Abstract
Previous research has found an association between childhood trauma and insecure attachment and psychological distress, risk of violence and engagement in therapy. The aim of this study was to investigate the relationships between these factors in a forensic population. Sixty-four participants from three secure psychiatric hospitals completed the Childhood Trauma Questionnaire (CTQ), the Relationship Scales Questionnaire (RSQ) and the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Overall scores from participants' Historical Clinical Risk Management Violence Risk Assessment Scheme, (HCR-20) were calculated. Staff evaluated participants' engagement in therapy via completion of the Service Engagement Scale (SES). This retrospective study found childhood trauma and insecure attachment significantly predicted psychological distress and risk of violence. No associations with engagement were found, but methodological reasons for this outcome were acknowledged. The importance of routinely assessing for a history of childhood trauma and insecure attachment was highlighted.
Collapse
|
26
|
Koelen JA, Eurelings-Bontekoe EHM, Stuke F, Luyten P. Insecure attachment strategies are associated with cognitive alexithymia in patients with severe somatoform disorder. Int J Psychiatry Med 2015; 49:264-78. [PMID: 26060261 DOI: 10.1177/0091217415589303] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In light of interpersonal difficulties and their relation to alexithymia in patients with somatoform disorder, the primary aim of this study was to explore the association between two insecure attachment strategies (deactivation and hyperactivation strategies), and affective and cognitive alexithymia in a sample of 128 patients with severe somatoform disorder, over and above the levels of negative affectivity and personality pathology. METHOD In a cross-sectional study among patients with somatoform disorder, self-report data were obtained using measures for alexithymia (Bermond-Vorst Alexithymia Questionnaire), attachment (Experiences in Close Relationships Questionnaire), personality pathology (Inventory of Personality Organization), and negative affectivity (Dutch Short Form of the MMPI). We used hierarchical regression analyses to test main effects of attachment deactivation and hyperactivation strategies in the prediction of both cognitive and affective alexithymia, while controlling for the levels of negative affectivity and personality pathology. RESULTS Only cognitive alexithymia, i.e., the inability to analyze, identify, and verbalize emotions, was associated with personality dysfunction, in particular insecure attachment strategies. Affective alexithymia, i.e., the inability to fantasize and to experience emotions, was associated (negatively) with negative affectivity but not with the personality variables. CONCLUSIONS This study, therefore, indicates that both types of alexithymia are relevant for the assessment and treatment of severe somatoform disorder, yet each type may tap into different features of somatoform disorder.
Collapse
Affiliation(s)
| | | | | | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, University of Leuven, Belgium Research Department of Clinical, Educational and Health Psychology, University College London, UK
| |
Collapse
|
27
|
Quijada Y, Kwapil TR, Tizón J, Sheinbaum T, Barrantes-Vidal N. Impact of attachment style on the 1-year outcome of persons with an at-risk mental state for psychosis. Psychiatry Res 2015; 228:849-56. [PMID: 26032461 DOI: 10.1016/j.psychres.2015.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 04/29/2015] [Accepted: 05/11/2015] [Indexed: 11/16/2022]
Abstract
Attachment theory provides key elements for understanding the psychosocial vulnerability for and response to the emergence of psychosis. This study examined (1) whether pre-treatment attachment styles are differentially associated with clinical and functional outcome in at-risk mental state (ARMS) for psychosis patients across one year of psychosocial treatment, and (2) whether clinical change is associated with changes in attachment ratings beyond the effect of baseline symptom severity. Thirty-eight ARMS patients (mean age=16.7, S.D.=5.9) identified from a psychosocial needs-adapted treatment were evaluated with the Positive and Negative Syndrome Scale, the Global Assessment of Functioning, and the Relationships Questionnaire. Lower levels of insecure-avoidant attachment predicted better clinical outcomes, whereas higher levels of secure attachment predicted improvement in functioning. A decrease in preoccupied-anxious attachment was associated with symptom amelioration. The findings suggest that the intensity of insecure attachment plays a significant role in the clinical outcome of ARMS patients involved in psychosocial treatment. Reducing the levels of insecure attachment in the therapeutic setting probably favors a better course in the early phases of psychosis. Furthermore, the finding that negative models of the self and others were associated with symptom outcome is consistent with current psychosocial models of psychosis.
Collapse
Affiliation(s)
- Yanet Quijada
- Facultad de Psicología, Universidad San Sebastián, Concepción, Chile; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jorge Tizón
- Institut Universitari de Salut Mental Fundació Vidal i Barraquer, Universitat Ramon Llull, Barcelona, Spain
| | - Tamara Sheinbaum
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain; Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.
| |
Collapse
|
28
|
Shakory S, Van Exan J, Mills JS, Sockalingam S, Keating L, Taube-Schiff M. Binge eating in bariatric surgery candidates: The role of insecure attachment and emotion regulation. Appetite 2015; 91:69-75. [PMID: 25828596 DOI: 10.1016/j.appet.2015.03.026] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/21/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
Abstract
Binge eating has a high prevalence among bariatric patients and is associated with post-surgical weight gain. This study examined the potential mediating role of emotion regulation difficulties in the relation between attachment insecurity and binge eating among this population. Participants were 1388 adult pre-bariatric surgery candidates from an accredited bariatric surgery assessment centre in Toronto, Ontario. Participants completed measures of psychological functioning, including attachment style and emotion regulation. Mediation analyses revealed that difficulties with emotion regulation mediated a positive association between insecure-anxious attachment and binge eating. An insecure-avoidant attachment was found to have a non-significant association with binge eating when examining the total effect. However, when difficulties with emotion regulation were controlled for in the model to examine its role as a mediator, this association became significant, and emotion regulation difficulties also mediated the relationship between attachment avoidance and binge eating. These findings suggest that difficulties in emotion regulation may be an important clinical issue to address in order to reduce binge eating in adult bariatric surgery candidates.
Collapse
Affiliation(s)
- Sharry Shakory
- Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada
| | - Jessica Van Exan
- Psychosocial Bariatric Surgery Program, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada.
| | - Jennifer S Mills
- Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada
| | - Sanjeev Sockalingam
- Psychosocial Bariatric Surgery Program, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada
| | - Leah Keating
- Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada
| | - Marlene Taube-Schiff
- Psychosocial Bariatric Surgery Program, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada
| |
Collapse
|