Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem

Wickham, Sophie; Sitko, Katarzyna; Bentall, Richard P.

doi:10.1017/s0033291714002633

Cited by 65 publications

(79 citation statements)

References 58 publications

(95 reference statements)

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“…This observation has the implication that, in therapeutic work, therapists should focus their interventions on addressing attachment beliefs, and work towards establishing a sense of attachment security. Finally, in concert with previous epidemiological and crosssectional studies that show an association between attachment insecurity and paranoia (Pickering et al, 2008;Wickham et al, 2015) the present findings suggest that policies that promote optimal relationships with caregivers in childhood may help to promote population mental health.…”

Section: Discussionsupporting

confidence: 83%

“…Bentall and Fernyhough (2008) proposed that insecure attachment can facilitate a paranoid attributional style so that, in the presence of other cofactors, paranoia develops as a consequence. This hypothesis has been supported by several recent findings showing specific links between insecure attachment and paranoia in both subclinical (Pickering et al, 2008) and clinical (Wickham et al, 2015) crosssectional studies.…”

Section: Introductionsupporting

confidence: 68%

“…Ponizovsky et al, (2011) found that preoccupied attachment was associated with paranoia. Wickham et al, (2015) found that both attachment avoidance and attachment anxiety were both associated with paranoia. Other researchers have however also shown that insecure attachment is associated with hallucinations (Berry et al, 2012;Korver-Nieberg et al, 2015), a finding which was not supported by our data once comorbid symptoms were controlled for; more recently however, some researchers have proposed that there may be links between how different attachment styles are associated with the appraisal of auditory hallucinations (Berry & Bucci, 2016).…”

Section: Discussionmentioning

confidence: 96%

See 2 more Smart Citations

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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Section: Discussionsupporting

confidence: 83%

Section: Introductionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

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

Sitko

Varese

Sellwood

et al. 2016

Psychiatry Research

View full text Add to dashboard Cite

show abstract

“…Berant et al, 2001;Berry et al, 2007;Calvo and Bianco, 2015;Kohlhoff and Barnett, 2013;Rholes et al, 2006;Wickham et al, 2015). This effect size would mean that a sample of 82 would give us 80% power to detect significant effects using the conventional alpha level of 0.05 (Field, 2014).…”

Section: Discussionmentioning

confidence: 99%

Investigation of associations between attachment, parenting and schizotypy during the postnatal period

Hugill

Fletcher

Berry

2017

Journal of Affective Disorders

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“…Insecure attachment, and particularly disorganized attachment, is associated with childhood victimization, and more severe psychotic experiences (Gumley et al, 2014; Korver-Nieberg et al, 2014; van Dam et al, 2014; Wickham et al, 2015; Bucci et al, 2017). Findings highlighting the role of attachment styles in psychosis are therefore arguably consistent with the view that appraisals in personal semantic memory shape interpretations of intrusions to give rise to psychotic experiences.…”

Section: A Model Of Posttraumatic Stress In Psychosismentioning

confidence: 99%

Pathways from Trauma to Psychotic Experiences: A Theoretically Informed Model of Posttraumatic Stress in Psychosis

2017

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In recent years, empirical data and theoretical accounts relating to the relationship between childhood victimization and psychotic experiences have accumulated. Much of this work has focused on co-occurring Posttraumatic Stress Disorder or putative causal mechanisms in isolation from each other. The complexity of posttraumatic stress reactions experienced in psychosis remains poorly understood. This paper therefore attempts to synthesize the current evidence base into a theoretically informed, multifactorial model of posttraumatic stress in psychosis. Three trauma-related vulnerability factors are proposed to give rise to intrusions and to affect how people appraise and cope with them. First, understandable attempts to survive trauma become habitual ways of regulating emotion, manifesting in cognitive-affective, behavioral and interpersonal responses. Second, event memories, consisting of perceptual and episodic representations, are impacted by emotion experienced during trauma. Third, personal semantic memory, specifically appraisals of the self and others, are shaped by event memories. It is proposed these vulnerability factors have the potential to lead to two types of intrusions. The first type is anomalous experiences arising from emotion regulation and/or the generation of novel images derived from trauma memory. The second type is trauma memory intrusions reflecting, to varying degrees, the retrieval of perceptual, episodic and personal semantic representations. It is speculated trauma memory intrusions may be experienced on a continuum from contextualized to fragmented, depending on memory encoding and retrieval. Personal semantic memory will then impact on how intrusions are appraised, with habitual emotion regulation strategies influencing people’s coping responses to these. Three vignettes are outlined to illustrate how the model accounts for different pathways between victimization and psychosis, and implications for therapy are considered. The model is the first to propose how emotion regulation and autobiographical memory may lead to a range of intrusive experiences in psychosis, and therefore attempts to explain the different phenomenological associations observed between trauma and intrusions. However, it includes a number of novel hypotheses that require empirical testing, which may lead to further refinement. It is anticipated the model will assist research and practice, in the hope of supporting people to manage the impact of victimization on their lives.

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Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem

Cited by 65 publications

References 58 publications

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

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

Investigation of associations between attachment, parenting and schizotypy during the postnatal period

Pathways from Trauma to Psychotic Experiences: A Theoretically Informed Model of Posttraumatic Stress in Psychosis

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