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PubMedDate not supplied

[The differential relevance of attachment classification for psychological disorders].

In recent years, there is a growing acceptance of attachment theory in different fields of psychosocial medicine. This article reviews findings of clinical attachment research - mainly based upon the Adult Attachment Interview - related to three psychological disorders, i.e. Anxiety Disorders, Depression and Borderline Personality Disorder. Whilst there are some indications for a differentiation of de- and hyperactivating attachment strategies connected to depressive disorders, the findings related to anxiety and Borderline Personality Disorders clearly indicate a predominance of preoccupied attachment patterns combined unresolved traumatic experiences. The need for a further differentiation of attachment related features within clinical samples should be considered in the future. Specifically, a differentiation of "organized" vs. "disorganized" attachment representations seems to be promising.

Anxiety Disorders↗
PubMed2000

The contributions of behavioural genetic studies to attachment theory.

This review considers the ways in which the methods and theories of behavioural genetics and attachment theory are mutually informative. Four issues are discussed. First, the benefits of the adoptive and twin research designs for testing attachment theory proposals are examined. Second, the ways in which attachment research may elucidate the behavioural genetic concepts of 'shared' and 'non-shared' environment are assessed. Third, the methods use to clarify the role of child effects on child-parent attachment quality are addressed. Finally, the limitations and data analytic considerations of synthesizing behavioural genetic and attachment research are outlined.

Adoption↗
PubMed2001

Truth, lies, and intimacy: an attachment perspective.

This paper outlines some of the ways in which secure attachment is associated with the capacity to participate in successful intimate relationships. The paper begins with the discussion of four key abilities required for intimacy: the ability to seek care, the ability to give care, the ability to feel comfortable with an autonomous self, and the ability to negotiate. Bowlby's attachment theory (1969/1982, 1973, 1980) and related research are presented as a framework for understanding the development of these abilities. Next, attachment, intimacy, and sexuality are discussed. In the final section, attachment, intimacy, and truth are considered.

Adult↗
PubMed2001

Attachment in mental health institutions: a critical review of assumptions, clinical implications, and research strategies.

Attachment is relevant to institutionalized treatment and the therapeutic process in three identifiable ways: (1) patients bring their mental representations of previous and existing attachment relationships to the treatment; (2) attachment is relevant to the extent to which a therapeutic alliance is established and maintained, both in terms of the mental representations of attachment in the patient and in the therapist and how these influence interactive behaviour and expectations in each partner to the therapeutic work; (3) the outcome of the treatment may be related to attachment; for example, when institutional experiences have an enduring impact on attachment representations and the future attachment behaviour of the patient. However, this brief review of attachment concepts reveals that several theoretical, conceptual and empirical questions remain to be answered before evidence-based clinical attachment guidelines can be formulated concerning patient-staff relationships.

Hospitals, Psychiatric↗
PubMed2004

No association of the dopamine D4 receptor (DRD4) and -521 C/T promoter polymorphisms with infant attachment disorganization.

In a first molecular genetic study Lakatos and colleagues found an association between attachment disorganization and the dopamine D4 receptor (DRD4) gene polymorphism, in particular in the presence of the -521 T allele in the promoter region of the DRD4 gene. Replication of their study in a sample of 132 infants did not confirm the role of the DRD4 7+ -allele and the -521C/T promoter gene in disorganized attachment. Although our sample was larger, and contained more children with CT or TT alleles, which enhanced the probability of finding the DRD4 and C/T interaction, the association was not found. Even when we combined our sample with the Lakatos sample, the interaction effect of the DRD4 and -521 C/T polymorphisms on disorganized attachment was absent.

Alleles↗
PubMed2005

Couple attachment and the quality of marital relationships: method and concept in the validation of the new couple attachment interview and coding system.

This study investigates links between adult attachment and marital quality in 73 married couples, using a new Couple Attachment Interview that was modeled after the Adult Attachment Interview but focuses on the relationship between the partners. A coding system (CAICS) comparing the interview protocol to prototypes for secure, dismissing, and preoccupied attachment styles yielded continuous ratings of all three styles, and categorical classifications of secure/insecure for each partner. The study found direct links between couple attachment and both self-reported and observed marital quality, with all three continuous scores contributing uniquely to the equations. In most cases, the continuous scores explained variation in marital quality after the categorical security scores were entered into the regressions, although categorical scores also contributed uniquely to the explanation of marital quality. Pairing of partners' scores explained significant variance in both self-reported and observed evaluations of the couple relationship. Security of couple attachment served as a mediator in the link between self-reported marital satisfaction and observed marital quality. The results illustrated the interconnection of methodological choices and theoretical advances in the study of attachment and couple relationship quality.

Adult↗
PubMed1995

Attachment and learning disability: a theoretical review informing three clinical interventions.

Attachment theory makes sense of two phenomena observed in some people with learning disabilities: it provides a reason for their limited exploration of the world, and it explains discontinuities in the pattern and intensity of their expressions of anger. Applying this framework to three enmeshed relationships occurring between an adult with learning disabilities and a member of care staff achieved at least partial resolution of their problems. Attachment theory's critics have set a number of challenges for its proponents, including emphasizing an interactional rather than a unidirectional approach to relationships; prioritizing social context; and understanding the attachment dynamic dimensionally rather than as a set of categories. The latter issue is pertinent for residential services: facilitating secure attachment relationships for distressed clients may be difficult for professionals, but partial assuagement of their attachment needs is a realistic clinical goal.

Adult↗
PubMed1991

Maternal representations of attachment during pregnancy predict the organization of infant-mother attachment at one year of age.

While strong retrospective and concurrent associations between maternal and infant patterns of attachment have been noted, this is one of the first reports of a prospective investigation of such associations. The Adult Attachment Interview was administered to 100 mothers expecting their first child, and, at 1-year follow-up, 96 of these were seen with their infants at 12 months in the Strange Situation. Maternal representations of attachment (autonomous vs. dismissing or preoccupied) predicted subsequent infant-mother attachment patterns (secure vs. insecure) 75% of the time. These observed concordances, as well as the discordances, are discussed in terms of the uniquely powerful contribution the Adult Attachment Interview makes to the study of representational and intergenerational influences on the development of the infant-mother attachment.

Adult↗
PubMedDate not supplied

Assessing attachment security with the Attachment Q Sort: meta-analytic evidence for the validity of the observer AQS.

The reliability and validity of the Attachment Q Sort (AQS; Waters & Deane, 1985) was tested in a series of meta-analyses on 139 studies with 13,835 children. The observer AQS security score showed convergent validity with Strange Situation procedure (SSP) security (r = .31) and excellent predictive validity with sensitivity measures (r = .39). Its association with temperament was weaker (r = .16), which supports the discriminant validity of the observer AQS. Studies on the stability of the observer AQS are still relatively scarce but they have yielded promising results (mean r = .28; k = 4, n = 162). It is concluded that the observer AQS, but not the self-reported AQS, is a valid measure of attachment.

Child↗
PubMed1998

Inter-judge agreement in evaluation of adult attachment style: the impact of acquaintanceship.

Inter-judge agreement in the evaluation of attachment style was examined across different levels of acquaintanceship. A self-rating scale on attachment style was administered to 242 students. Then, 72 participants--25 avoidant, 25 secure, and 22 ambivalent--were invited to the laboratory in unacquainted same-sex pairs, videotaped during a five-minute conversation, and asked to rate the attachment style of their conversion partner. In addition, each participant asked four friends to rate his/her attachment style and the videotaped interactions were shown to a separate sample of strangers who rated participants' attachment styles. The results showed high correlations between participants' self-reported attachment styles and the manner in which they were perceived by their friends and conversation partners. In contrast, correlations with ratings by strangers based on videotaped interactions were low. This pattern of findings was observed in both discrete and continuous measures of attachment. The findings suggest that attachment style can be considered an observable interpresonal trait.

Adolescent↗
PubMed2006

Measuring adult attachment representation in an fMRI environment: concepts and assessment.

Human attachment is defined as a biologically based behavioral system that influences motivational, cognitive, emotional, and memory processes with respect to intimate relationships (parents, life partner, own children). Recent neurobiological studies in this field have in common that they investigated social relationships by examining fMRI neuroimaging patterns while individuals viewed pictures of their beloved relationship partner versus friends, acquaintances, strangers, or mothers' responses to their young children. The researchers showed that the neural underpinnings of these unique intimate emotional states are linked to functionally specialized areas in the brain. Conceptualizing this work from a behavioral systems-attachment theory perspective, these studies did not directly address the subject's attachment representational system. Traditional attachment theory and research has been built on the analysis of attachment narratives, called 'attachment representation'. The Adult Attachment Projective developed by George and West in 2001 is a set of attachment-based schematic pictures. It is constructed to increasingly activate the participant's attachment system in the course of the task, that is, by the introduction of increasingly stressful attachment scenes concluding with pictures of individuals facing death and potential abuse alone. The attachment patterns are evaluated based on individuals' overall verbal response to the picture set. This paper proposes that the AAP is a fruitful measure to use in an fMRI environment to examine brain activation patterns in adults while they are speaking overtly about attachment stories in a standardized setting.

Adult↗
PubMed2004

An integrated approach to the formulation and psychotherapy of medically unexplained symptoms: meaning- and attachment-based intervention.

Persistent medically unexplained symptoms (MUS) are a serious problem because they are common, difficult to treat effectively, and have a significant impact on both functional outcomes and health-care utilization costs. An attachment-existential formulation of psychological factors that are associated with persistent MUS is presented, based on the interaction of death anxiety and preoccupied (anxious) attachment. Psychotherapeutic treatment recommendations that follow from this formulation are described in the form of a brief psychotherapy, involving semi-structured weekly sessions and narrative-writing homework that explores attachment and existential themes. This is the first description of a brief psychotherapy that integrates attachment theory and existential psychology.

Delivery of Health Care, Integrated↗
PubMed2003

Predicting change in self-reported and interviewer-assessed adult attachment: tests of the individual difference and life stress models of attachment change.

The study tested the key assumption of the individual difference model of adult attachment change: that people who have experienced certain vulnerability factors will be prone to change attachment styles because they have developed unclear models of self and others that render their attachment models unstable. This model was compared to a life stress model, which states that change occurs as an adaptation to new, interpersonally relevant life circumstances. Changes in self-reported and interviewer-assessed attachment were examined among 94 young adults who were followed over 1 year. Analyses yielded support for the individual difference model for change in both self-reported and interviewer-assessed attachment. The life stress model was supported for change in interviewer-assessed attachment only. Implications for differential change processes for self-reported versus interviewer-assessed aspects of adult attachment are discussed.

Adolescent↗
PubMed2004

Attachment style and the regulation of negative affect: exploring individual differences in mood congruency effects on memory and judgment.

Three studies examined the role that attachment style plays in moderating the effects of induced negative affect on memory and judgment. Israeli undergraduates completed an attachment style scale and were exposed to a negative or neutral affect induction. In Study 1, incidental recall of negative and positive information was assessed; in Study 2, the attribution of negative and positive relational events was studied; and in Study 3, findings of Study 1 were replicated using a different affect induction procedure. Whereas securely attached persons reacted to induced negative affect with an affect-incongruent pattern of cognitions (better recall of positive information, more unstable/specific attribution of negative event), anxiously attached persons reacted with an affect-congruent pattern (worse recall of positive information, more stable/global attribution of negative event). Persons scoring high on attachment avoidance showed no significant cognitive effect of negative affect. The discussion emphasizes the role that attachment strategies play in the affect-cognition link.

Adult↗
PubMed2004

Personality characteristics associated with romantic attachment: a comparison of interview and self-report methodologies.

This study compared the personality attributes associated with self-report versus interview assessment of romantic attachment. Twenty-three-year-olds (N = 83) completed the Romantic Attachment Interview, the Experiences in Close Relationship Inventory, and measures of response bias, self-enhancement, and self-insight. Five psychologists evaluated the participants' personality. Although both self-report and interview assessment were related to attachment-relevant personality attributes, interview assessment was slightly more likely to explain unique variance in personality, especially regarding intrapsychic attributes. Self-enhancement was negatively related to secure attachment and positively related to dismissing attachment. The opposite pattern emerged for self-insight. A subgroup of 12 vulnerable individuals who described themselves as securely attached on self-report was judged as dismissing according to interview assessment. These individuals scored low on self-insight and high on self-enhancement and psychological vulnerability. The results are discussed with reference to the relative strengths of different measures of romantic attachment and relations among dismissing attachment, self-enhancement, and narcissism.

Adult↗
PubMed1987

Maternal self-esteem and prenatal attachment in high-risk pregnancy.

Results of a study concerned with maternal self-esteem and prenatal attachment in women experiencing a high-risk pregnancy and women experiencing a normal pregnancy are presented. A statistically significant difference between the two groups was found in self-esteem as measured by scores on the Rosenberg Self-Esteem Scale. No significant differences were found on prenatal attachment as measured by a subscale of the Prenatal Tool developed by Rees.

Adolescent↗
PubMed1998

An attachment theory approach to treatment of the difficult patient.

This article reviews the role of attachment in difficult-to-treat patients. It is suggested that difficulty often arises in the treatment of these patients because of their inadequate understanding of mental functioning in themselves and in others. The capacity to mentalize is seen as a function of early attachment relationships. Vulnerability introduced by insecure attachment is frequently compounded by a history of intense trauma, leading these patients to defensively inhibit their capacity to think about mental states in their abusers, which then generalizes to other attachment relationships. The clinical implications of this model are discussed.

Child↗