Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients.

Ponizovsky, Alexander M.; Nechamkin, Yakov; Rosca, Paola

doi:10.1037/0002-9432.77.2.324

Cited by 59 publications

(93 citation statements)

References 72 publications

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“…Groh et al 2012), depression (Brumariu and Kerns 2010), and externalizing behaviour problems (Fearon et al 2010). Many separate studies support this effect for a list of other problems such as dissociation (Liotti 2006), eating pathology (Goossens et al 2012), non-suicidal self-injury (Bureau et al 2010), or even the symptomatology and course of schizophrenia (Ponizovsky et al 2007). As a consequence, insecure attachment is considered an important transdiagnostic risk factor in the development of psychopathology and could therefore be an important factor to take into account during the treatment of any child and adolescent emotional or behavioural disorder.…”

Section: Attachment Theorymentioning

confidence: 96%

Cognitive Behaviour Therapy for Children and Adolescents: Can Attachment Theory Contribute to Its Efficacy?

Bosmans

2016

Clin Child Fam Psychol Rev

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Meta-analyses consistently demonstrate that cognitive behaviour therapy (CBT) provides effective evidence-based treatment for children and adolescents with emotional and behaviour problems. Also consistent across meta-analyses is the observation that CBT treatment effects are often medium in size. This observation has instigated a search for factors that could help explain the limited treatment effects and that could be focused upon to enhance CBT treatment outcomes. The current qualitative review focuses on the parent-child attachment relationship as one factor that could be relevant to enhance CBT treatment effects. This review first acknowledges reasons why CBT has historically not been attracted to attachment theory and its postulates. Second, recent evidence is examined to evaluate whether attachment can be approached from a cognitive schema perspective. Subsequently, research is described showing how restoring attachment relationships could result in large treatment effects. Finally, this evidence is integrated in a model of attachment assessment and intervention that might be compatible with CBT. In sum, this review suggests that restoring trust in insecure parent-child attachment relationships can be integrated within CBT and could contribute to its treatment outcomes.Cognitive behaviour therapy (CBT) is one of the most clearly conceptualized and best-studied therapeutic approaches for treating children and adolescents (e.g. Seligman and Ollendick 2011). Years of research confirm the positive effects of CBT and demonstrate significant reductions in a variety of child and adolescent emotional and behavioural problems (Hofmann et al. 2012). Part of the strength of CBT is its dynamic nature and flexibility to addressing these problems. Consequently, during the past decades, CBT with adults has broadened its treatment emphasis from focusing solely on changing behaviour, to focusing on challenging maladaptive cognitions, and, more recently, to accepting existential emotional distress (e.g. De Houwer et al. 2016). CBT for children and adolescents has roughly followed these developments and benefited from them. This is illustrated by the increasing number of meta-analyses that confirm that CBT provides an effective treatment for a plethora of child and adolescent internalizing and externalizing behaviour problems (e.g. Reynolds et al. 2012).However, meta-analyses also suggest that effect sizes often remain small to medium in size (e.g. Cuijpers et al. 2006;Kazdin 1995;Klein et al. 2007;Reynolds et al. 2012;Silverman et al. 2008;Weisz et al. 2006;Weisz et al. 2013) and that relapse rates following treatment are quite high (e.g. 30-50 % for mood disorders, Lewinsohn et al. 1990;Brent et al. 1999). This suggests that CBT for children and adolescents might benefit from a new conceptualization and expansion of treatment goals. The current literature review aims at providing arguments that one such expansion could be restoring attachment relationships. This paper will discuss the main components of tradition...

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Section: Attachment Theorymentioning

confidence: 96%

Cognitive Behaviour Therapy for Children and Adolescents: Can Attachment Theory Contribute to Its Efficacy?

Bosmans

2016

Clin Child Fam Psychol Rev

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“…High rates of insecure attachment styles have also been reported in people with psychosis (e.g. Couture et al, 2007;Ponizovsky, Nechamkin, & Rosca, 2007; MacBeth, Gumley, Schwannauer, & Fisher, 2011). Investigation of the mechanisms, such as attachment and affect regulation, by which early adversity can lead to psychiatric symptoms, will bring us closer to a complete psychological understanding of psychosis.…”

Section: Directions For Future Researchmentioning

confidence: 98%

“…Groups of people with psychosis (including chronic and first episode samples) show a high rate of insecure attachment styles (Dozier, Cue, & Barnett, 1994;Couture, Lecomte, & Leclerc, 2007;Dozier & Lee, 1995;Dozier, Stevenson, Lee, & Velligan, 1991), particularly of the avoidant type (MacBeth, Gumley, Schwannauer, & Fisher, 2011;Ponizovsky, Nechamkin, & Rosca, 2007;Berry, Barrowclough, & Wearden, 2008) (reviewed in Berry et al, 2007;Read & Gumley, 2008). Data are scarce regarding specific relationships of attachment styles with individual symptoms, but there is some evidence of a significant association between insecure attachment and paranoia (Berry, Wearden, Barrowclough, & Liversidge, 2006;Berry et al, 2008;MacBeth, Schwannauer, & Gumley, 2008).…”

Section: Attachment Theory and Psychosismentioning

confidence: 99%

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

Vorontsova¹,

Garety²,

Freeman³

2013

Journal of Abnormal Psychology

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Depression is common in people with schizophrenia, but how it might directly contribute to the persistence of psychotic symptoms has rarely been tested. The key aim of the present study was to test whether depression and associated cognitive processes predict the maintenance of persecutory delusions. Three groups of participants were tested at baseline: 60 patients with persecutory delusions in the context of a schizophrenia spectrum diagnosis, 30 patients with depression, and 30 nonclinical controls. They completed interviewer and self-report assessments of depression and paranoia, and measures of six cognitive factors (schematic beliefs, experiential avoidance, autobiographical memory, problem solving, rumination, worry style). The patients with persecutory delusions were then assessed again, six months later. It was found that 50% of the patients with persecutory delusions met diagnostic criteria for major depression. Cognitive processes found to be associated with depression across the groups were negative schematic beliefs about the self, experiential avoidance and rumination, but not autobiographical memory or problem solving. The severity of initial depression in patients with persecutory delusions predicted the persistence of paranoia over six months. A number of cognitive factors also predicted the persistence of persecutory delusions, including negative schematic beliefs about the self, worry, and problem-solving difficulties. In conclusion, depression is common in patients with current persecutory delusions, and it shows similar cognitive features to major depressive disorder. The results of this study indicate that depression and related processes may contribute to the maintenance of paranoia. Trials are warranted of depression-related therapeutic techniques for people with persecutory delusions.

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“…A large and influential epidemiological study found evidence for an association between insecure adult attachment and schizophrenia (Mickelson et al, 1997), and although this association has been replicated in non-clinical (Berry et al, 2007b;Berry et al, 2006;Korver-Nieberg et al, 2014;Meins et al, 2008) and clinical samples (Berry et al, 2007a;Gumley et al, 2014;Korver-Nieberg et al, 2014;Korver-Nieberg et al, 2015;Ponizovsky et al, 2007;Ponizovsky et al, 2013) it has been suggested that it could be more informative to explore such associations in relation to specific symptoms of psychosis (Bentall, 2004). Such specificities can provide a clearer understanding of how certain psychological mechanism are meaningfully related to the experiences of individuals with psychosis (Bentall and Fernyhough, 2008) and, in turn this information may help clinicians focus psychological interventions appropriately.…”

Section: Introductionmentioning

confidence: 99%

The dynamics of attachment insecurity and paranoid thoughts: An experience sampling study

Sitko

Varese

Sellwood

et al. 2016

Psychiatry Research

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It has been proposed that insecure attachment can have adverse effects on the course of psychosis once symptoms have emerged. There is longitudinal evidence that increased insecure attachment is associated with increased severity of psychotic symptoms. The present study examined whether in the flow of daily life attachment insecurity fluctuates, whether elevated stress precedes the occurrence of attachment insecurity, and whether elevated attachment insecurity precedes the occurrence of paranoia. Twenty clinical participants with a psychosis-spectrum diagnosis and twenty controls were studied over six consecutive days using the experience sampling method (ESM). The findings revealed that fluctuations in attachment insecurity were significantly higher in the clinical group, that elevated stress predicted a subsequent increase in attachment insecurity, and that elevated attachment insecurity predicted a subsequent increase in paranoia; this effect was not observed in auditory hallucinations once co-occurring symptoms were controlled for. Finally, although previous ESM studies have shown that low self-esteem precedes the occurrence of paranoia, attachment insecurity continued to predict paranoia even when self-esteem was controlled for. The findings suggest that attachment security may be associated with a lower risk of paranoia, and that psychological interventions should address attachment beliefs and work towards establishing a sense of attachment security.

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Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients.

Cited by 59 publications

References 72 publications

Cognitive Behaviour Therapy for Children and Adolescents: Can Attachment Theory Contribute to Its Efficacy?

Cognitive Behaviour Therapy for Children and Adolescents: Can Attachment Theory Contribute to Its Efficacy?

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

The dynamics of attachment insecurity and paranoid thoughts: An experience sampling study

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