Emotion Regulation and Mental Representation of Attachment in Patients With Systemic Lupus Erythematosus

Abstract

Mental representations of attachment and emotion regulation influence individual patterns of stress response and vulnerability to illness. The present study investigates the adult attachment states of mind of 40 women with systemic lupus erythematosus (SLE) using the Adult Attachment Interview. We also assessed alexithymia using the Toronto Alexithymia Scale and dissociation using the Dissociative Experiences Scale. The results showed a high prevalence of the unresolved state of mind (13 patients, 32.5%) and the entangled state of mind (10 patients, 25%). The alexithymia score also varied significantly as a function of the mental representation of attachment and was modulated by amnestic dissociation. These findings suggest that adult attachment in patients with SLE influences the presence of alexithymic features. Moreover, these also indicate that dissociative states mediate the perception of painful memories and feelings, thus contributing to the partial avoidance of emotions and the failure to fully experience and recognize them. The clinical implications of these findings are also discussed.

Defense mechanism is predicted by attachment and mediates the maladaptive influence of insecure attachment on adolescent mental health

“…assimilation, with insecure attachment (Cramer and Kelly 2010;Lopez 2001;Mikulincer and Horesh 1999). In a recent study using the Adult Attachment Interview, findings suggest that adult attachment in patients with systemic lupus erythematosus has an influence on the presence of alexithymic features (Barbasio and Granieri 2013). We postulate that emotion regulation difficulties associated with insecure attachment may inhibit the development of adaptive defense mechanisms, while secure attachment may facilitate the use of more mature defense mechanisms (Besharat and Khajavi 2013).…”

Body image, personality profiles and alexithymia in patients with polycystic ovary syndrome (PCOS)

“…We can assume that living with a gynecological disease can be in itself a traumatic condition that gives rise to dysregulated emotions. Moreover, traumatic conditions during development can increase women's somatopsychic vulnerability and their risk for physical health problems [62], leading to more dysfunctional emotion regulation strategies [63,64].…”

The Relationship between Defense Patterns and DSM-5 Maladaptive Personality Domains

“…Somatization allows the individuals to unconsciously avoid painful feelings in their mind and to experience them in form of physical discomfort and symptoms, and it represents an internalizing DM par excellence (Freud, 1896 ). In this DM, the body is the place in which the internal conflict expresses itself, so that it becomes the “theater” of cognitively unprocessed feelings (McDougall, 1989 ; Granieri, 2011 ; Barbasio and Granieri, 2013 ; Granieri and Schimmenti, 2014 ; Barbasio et al, 2015 ; Giovannelli et al, 2016 ). This finding is in line with the previous research that observed somatization as far more common in women (Lipowski, 1988 ; van Wijk and Kolk, 1997 ; Hyphantis et al, 2013a , b ).…”