Attachment Style and Self-Experience

Abstract

The present study aimed to examine the cross-sectional association between attachment style and self-reported disturbed self-awareness (disturbed sense of mineness of experiences) and depersonalization (disturbed sense of first-person perspective) in patients with psychotic disorders, unaffected siblings, and healthy controls. Data pertain to a subsample of the GROUP (Genetic Risk and Outcome of Psychosis) study. We found positive associations between anxious attachment and disturbed self-awareness and depersonalization across participants with different psychosis vulnerability. We also found a positive association between avoidant attachment and depersonalization, although on a trend level. Findings indicate that attachment style is associated with self-reported disturbed self-awareness and depersonalization over and above the influence of psychotic or depressive experiences in people across the vulnerability spectrum of psychosis. This supports the importance of attachment style, self-awareness, and depersonalization as potential targets in prevention and treatment interventions in patients with psychotic disorders or those with increased vulnerability.

Does insecure attachment lead to psychosis via dissociation? A systematic review of the literature

“…Three of four studies found no association with anxious (preoccupied) attachment (McGonagle, 2017; Pearce et al., 2017; Williams, 2017), and one found a small positive association (Sitko, 2015). Using a different measure, one study found large positive associations between anxious attachment and both disturbed self‐awareness and depersonalisation (de With et al., 2023). Four studies found no association between avoidant (dismissive) attachment and dissociation (McGonagle, 2017; Pearce et al., 2017; Sitko, 2015; Williams, 2017), one found a trend (de With et al., 2023) and one a small positive association (Degnan, 2020).…”

“…Using a different measure, one study found large positive associations between anxious attachment and both disturbed self‐awareness and depersonalisation (de With et al., 2023). Four studies found no association between avoidant (dismissive) attachment and dissociation (McGonagle, 2017; Pearce et al., 2017; Sitko, 2015; Williams, 2017), one found a trend (de With et al., 2023) and one a small positive association (Degnan, 2020). Austin (2011) did not report these correlations.…”

“…de With et al. (2023) found avoidant attachment to be strongly associated with positive symptoms of psychosis. Austin (2011) did not report these correlations.…”

“…Of these, Mertens et al (2021) and Puckett et al (2023) ran non-clinical studies and all others recruited clinical participants with diagnosed or self-reported psychosis. One study measured 'unusual perceptual experiences' in a non-clinical group (Strachan et al, 2023), and four measured 'positive symptoms' in clinical samples, but did not distinguish hallucinations, paranoia or other symptoms in the analyses (Austin, 2011;de With et al, 2023;Degnan, 2020;Pollard et al, 2020). Degnan (2020) also measured negative symptoms.…”

“…. Four studies found no association between avoidant (dismissive) attachment and dissociation (McGonagle, 2017;Pearce et al, 2017;Sitko, 2015;Williams, 2017), one found a trend (de With et al, 2023) and one a small positive association (Degnan, 2020). Austin (2011) did not report these correlations.…”