An investigation of adult attachment and the nature of relationships with voices (original) (raw)
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Social Psychiatry and Psychiatric Epidemiology, 2007
j Abstract Background If attachment theory is to help inform our understanding of relationship difficulties in people with psychosis, it is first important to understand the composition of attachment networks in this group and how attachment style measured with reference to relationships in general actually relates to attachment in relationships with specific others. Method We examined attachment networks and associations between general attachment style and attachment in relationships with parents and psychiatric staff in a sample of 58 patients with psychosis. We assessed attachment dimensions of anxiety and avoidance using the Psychosis Attachment Measure (PAM) and an adapted version of the instrument asking about relationships with specific others. Results Patients reported a median of two attachment relationships. Both attachment anxiety and avoidance measured with reference to close relationships in general were positively correlated with attachment in key worker and parental relationships, although levels of attachment anxiety and avoidance did vary across relationships. Conclusion Future research should determine factors influencing variations in attachment working models in samples of people with psychosis, as it may be possible to help individuals with insecure attachment styles develop more positive relationships with others.
American Journal of Orthopsychiatry, 2007
The authors tested the hypotheses that the insecure attachment styles of adult patients with schizophrenia are associated with (a) diagnosis, (b) psychopathological syndromes, and (c) course of the disorder. Thirty schizophrenic and 30 age-matching control males answered a self-report questionnaire tapping secure, avoidant, and anxious/ambivalent attachment styles. The patients were diagnosed using the Structured Clinical Interview for DSM-IV (M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1995), and their symptoms were quantified using the Positive and Negative Syndrome Scale (PANSS; S. R. Kay, A. Fizhbein, & L. A. . Patients with schizophrenia did not significantly differ from nonpatient controls in secure style mean scores, but they exceeded the latter in both avoidant and anxious/ambivalent style scores. There were no significant correlations between secure attachment style and any PANSS symptom dimensions, whereas avoidant style correlated positively with both positive and negative syndromes, and anxious/ambivalent style correlated only with positive syndrome. Compared with patients with secure style, those with insecure attachment styles were younger at onset of the illness and had longer psychiatric hospitalizations. The preliminary results suggest that the insecure types of attachment, in particular the avoidant style, are associated with schizophrenic symptomatology and course of the illness in male inpatients. Further studies using a longitudinal design on extended samples are needed to determine the direction of causality in the composite relationships among the distinct attachment styles, psychopathology, and course of schizophrenia.
Attachment styles and symptoms in individuals with psychosis
Nordic journal of psychiatry, 2015
The capacity to manage affects is rooted in early interactions with caregivers, which in adulthood are internalized as different attachment styles. Few studies have explored associations between all four attachment styles and symptoms. Our aim was to investigate the relations between the four attachment styles and psychological distress in a group of people with psychosis. In a cross-sectional study, associations between self-reported attachment style and symptoms in a psychosis group were explored. Attachment styles were measured with the Relationship Questionnaire (RQ) and symptoms were assessed with the revised version of the Symptom Checklist (SCL-90R) RESULTS: The analyses showed a significant positive association between preoccupied attachment and the severity of symptoms. Furthermore, the analyses indicated significant positive associations between preoccupied attachment and the subscales measuring depression, anxiety, interpersonal sensitivity, paranoia and psychoticism. We ...
PLOS ONE, 2015
Background Insecure attachment styles have received theoretical attention and some initial empirical support as mediators between childhood adverse experiences and psychotic phenomena; however, further specificity needs investigating. The present interview study aimed to examine (i) whether two forms of poor childhood care, namely parental antipathy and role reversal, were associated with subclinical positive and negative symptoms and schizophrenia-spectrum personality disorder (PD) traits, and (ii) whether such associations were mediated by specific insecure attachment styles. Method A total of 214 nonclinical young adults were interviewed for subclinical symptoms (Comprehensive Assessment of At-Risk Mental States), schizophrenia-spectrum PDs (Structured Clinical Interview for DSM-IV Axis II Disorders), poor childhood care (Childhood Experience of Care and Abuse Interview), and attachment style (Attachment Style Interview). Participants also completed the Beck Depression Inventory-II and all the analyses were conducted partialling out the effects of depressive symptoms. Results Both parental antipathy and role reversal were associated with subclinical positive symptoms and with paranoid and schizotypal PD traits. Role reversal was also associated with subclinical negative symptoms. Angry-dismissive attachment mediated associations between antipathy and subclinical positive symptoms and both angry-dismissive and enmeshed attachment mediated associations of antipathy with paranoid and schizotypal PLOS ONE |
Adult Attachment in Children Raised by Parents with Schizophrenia
Journal of Adult Development, 2009
Maternal schizophrenia is known to have an adverse effect on the quality of mother-infant interaction; and children of parents with severe mental illness run a higher risk of poor mental health and social outcomes. Hence, children raised by a parent with schizophrenia may be less likely to attain secure attachment, although there is less evidence so far to support this. Moreover, there is a lack of research in this field that focusses on the needs and experiences, the strengths and vulnerabilities, of the children themselves. Qualitative methods are thus needed to generate new insights and hypotheses. The present study uses semi-structured interviews with 23 adults who, as children, were raised with a parent who experienced schizophrenia. This reveals a range of attachment problems, resulting in difficulties in forming secure adult relationships. Problems with trust and intimacy were found to be common.
Clinical Psychology Review, 2007
Attachment styles reflect individual differences in beliefs about self and others, interpersonal functioning and affect regulation. We review and critically appraise studies suggesting higher levels of insecure attachment, and dismissing attachment in particular, in samples with psychosis compared to controls. We also review the role of social cognition, interpersonal factors, and affect regulation in the development and maintenance of psychosis, and specific symptoms associated with the diagnosis. We review studies showing that insecure attachment is associated with poorer interpersonal relationships and less integrative recovery styles and highlight how recent theories and empirical findings in the psychosis literature can be understood within the framework of attachment theory. In doing so, we argue that investigations of the nature of attachment styles in psychosis and how they relate to the cognitive, interpersonal and affective factors that have been implicated in psychosis will help develop theoretical knowledge in relation to the condition. We conclude by outlining the clinical implications of applying attachment theory to the understanding of psychosis and summarising the conceptual and methodological limitations of the theory which should be addressed, including the need for studies with longitudinal designs, larger, more representative samples, and more valid measures of assessing attachment styles in psychosis.
Attachment & Human Development, 2006
This study provides data supporting the reliability and validity of an Italian version of the adult attachment script representation task, designed by Waters & . Specifically, we tested hypotheses concerning positive relations between attachment scriptedness scores and two other representational measures, derived from the Adult Attachment Interview (AAI). In addition, we tested the hypothesis that secure base script scores should predict maternal sensitivity in the context of motherinfant interaction. Thirty-one mothers completed narrative protocols and received scriptedness scores using the Waters & criteria. Prior to the attachment script assessment, mothers had been assessed using the AAI and had been observed in the context of infant -mother interactions to assess maternal sensitivity. Assessment of instrument reliability was satisfactory (Cronbach's a 4.70) and both hypotheses were supported; the attachment scriptedness score (based on 4 attachment narratives) was positively and significantly associated with the AAI coherence score, the continuous security score derived from the AAI State of Mind scales, and with maternal sensitivity. These data extend to another socio-cultural milieu, previous findings supporting reliability, convergent, and predictive validity of the attachment script representation task as a measure of adult attachment. about attachment relevant situations; at a higher level, this experience-near information would be summarized in mental representations concerning the range of responses to be expected from the attachment figure in many attachment relevant contexts. At a more generalized level, internal working models incorporate knowledge about the self and the attachment figure and, ultimately, general expectations in affective relationships and global ideas about the nature of human beings and the world as a more or less reliable place. These representations with respect to attachment reflect the degree of security and confidence within intimate relationships and they accomplish a very important function by providing a personal framework to regulate behavior and expectations both in present relationships and as new ones are constructed .