Cognitive Fusion Mediates the Impact of Attachment Imagery on Paranoia and Anxiety

Abstract

Background Paranoia, in both clinical and non-clinical groups, is characterised by unfounded interpersonal threat beliefs. Secure attachment imagery attenuates paranoia, but little is known about the mechanisms of change. Cognitive fusion describes the extent to which we can ‘step back’ from compelling beliefs, to observe these as mental events, and is implicated in psychopathology cross-diagnostically. Aims This study extends previous research demonstrating the impact of attachment imagery on paranoia and anxiety to determine whether cognitive fusion mediates these relationships. Method We utilised a randomized experimental design and recruited an analogue sample with high levels of non-clinical paranoia to test the impact of imagery and the role of cognitive fusion. Results Secure attachment imagery resulted in reduced paranoia and anxiety compared to threat/insecure imagery. Cognitive fusion mediated the relationships between imagery and paranoia, and imagery and anxiety. Conclusions Secure attachment imagery is effective in reducing paranoia and anxiety and operates via cognitive fusion. In clinical practice, these interventions should seek to facilitate the ability to ‘step back’ from compelling threat beliefs, in order to be most beneficial.

How does attachment imagery for paranoia work? Cognitive fusion and beliefs about self and others mediate the impact on paranoia and anxiety

“…These results align with research demonstrating that secure imagery reduces paranoia in individuals with non‐clinical paranoia (Newman‐Taylor et␣al., 2017) and a diagnosis of schizophrenia (Pitfield et␣al., 2020). The results are consistent with research showing that, relative to insecure/threat imagery, secure attachment imagery reduces state paranoia and anxiety via reduced cognitive fusion (Sood & Newman‐Taylor, 2020). The results extend previous research by distinguishing anxious and avoidant imagery and demonstrating that both increase paranoia and anxiety via reduced cognitive fusion and negative self‐ and other‐beliefs.…”

“…Relative to the secure group, the anxious and avoidant imagery groups were more fused with their negative cognitions, held more negative self‐ and other‐beliefs and, therefore, felt more paranoid and anxious. These results align with evidence showing that negative self‐beliefs mediate the attachment–paranoia association (e.g., Wickham et␣al., 2014) and that cognitive fusion mediates the impact of attachment imagery on paranoia and anxiety (Sood & Newman‐Taylor, 2020).…”

“…Attachment imagery (Baldwin, Keelan, Fehr, Enns, & Koh‐Rangarajoo, 1996; Carnelley & Rowe, 2007) has been used to investigate whether it is possible to effect change in state paranoia. When people with high non‐clinical paranoia are primed to feel secure and trusting of others, their paranoia and anxiety decrease, whereas when primed to feel suspicious and untrusting of others, paranoia and anxiety increase (Bullock, Newman‐Taylor, & Stopa, 2016; Newman‐Taylor, Kemp, Potter, & Au‐Yeung, 2017; Sood & Newman‐Taylor, 2020). Similarly, case studies of people with schizophrenia demonstrate that security priming decreases paranoia and negative affect (Pitfield, Maguire, & Newman‐Taylor, 2020).…”

“…This suggests that cognitive fusion may mediate the relationship between attachment and paranoia. One study has examined this; Sood and Newman‐Taylor (2020) found that cognitive fusion mediated the impact of attachment imagery (threat/insecure vs. secure) on paranoia and anxiety in individuals with high non‐clinical paranoia. Relative to the threat/insecure group, the secure group was less fused with their thoughts and, therefore, less paranoid and anxious.…”

The Impact of Repeated Attachment Priming on Paranoia, Mood and Help-Seeking Intentions in an Analogue Sample

“…Initial studies investigating the benefits of attachment security priming for paranoia in analogue groups [30][31][32][33] and preliminary clinical samples [34,35] show that security priming reduces state paranoia and negative affect and increases positive affect and selfesteem. Importantly, security priming reduces state paranoia for people high in trait attachment avoidance and for people high in trait attachment anxiety [32].…”