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PubMed1993

Anxious attachment as a determinant of adult psychopathology.

Traditionally, an excess of interpersonal dependency has been used to characterize disturbed interpersonal relationships in adults. This approach stands in sharp contrast to that of attachment theorists who conceptualize attachment as functionally distinct from dependency. Attachment theory focuses on anxious attachment in the definition and dynamics of disturbed adult interpersonal relationships. The purpose of this study was to examine the relevance of anxious attachment to the differentiation of psychiatric outpatients from nonpatients. Empirically, three scales (feared loss of the attachment figure, proximity seeking, and separation protest) measure the components of anxious attachment as defined by Bowlby. The scales were administered to two research samples. Sample 1 was composed of 136 respondents to a survey within the Calgary community. Sample 2 consisted of 110 psychiatric outpatients drawn from the psychotherapy clinic of the Calgary General Hospital. The results indicate that the three components of anxious attachment offer a clinically relevant system for differentiating between psychiatric outpatients and nonpatients. Of these three components, feared loss has the predominant effect. The implications of this finding for the delineation of disturbed interpersonal relationships in adults is discussed.

Adult↗

PubMed2005

Indirect pathways between depressive symptoms and marital distress: the role of conflict communication, attributions, and attachment style.

Previous studies have focused on concomitants of depression and marital distress in order to help explain the relationship between the two, suggesting that several variables, such as conflict communication, attributions, and attachment style, are associated with depression, marital distress, or both. Our contention is that the selected variables may be important mediators (hypothesis 1) or moderators (hypothesis 2) of the concomitance between depression and marital adjustment, exploring the direct and indirect ways in which depressive symptoms and marital adjustment are related. In total, 415 heterosexual couples were recruited, and a series of regression analyses was conducted to test our hypotheses separately for men and women. Results indicated that demand-withdrawal, avoidance, causal attributions, and secure, ambivalent, and avoidant attachment mediated the relation between depressive symptoms and marital adjustment in the female sample, whereas constructive communication and causal and responsible attributions were significant mediators of men's levels of depressive symptoms and marital adjustment. In addition, avoidance and secure attachment moderated the association between depressive symptoms and marital adjustment in the female sample, and causal attributions were significant moderators of the association between depressive symptoms and marital adjustment for men. Several conclusions and implications for theory and future research are discussed.

Adaptation, Psychological↗

PubMed1984

Aspects of identification and growth during late adolescence and young adulthood.

Psychological growth proceeds through emotional attachment and separation processes. Inhibition of emotional separation in late adolescence can result in delayed psychological differentiation and sometimes identity diffusion. Three cases of analytic psychotherapy are described, in which nonfunctional identifications and idealizations are treated, and delayed maturation resumes through the formation of new, recombinant identifications.

Adolescent↗

PubMed1986

Controlled evaluation of rural regional perinatal care: developmental and neurologic outcomes at 1 year.

The effectiveness of a rural regionalized perinatal care (RPC) program was evaluated by a controlled, population-based design. The RPC program, begun in a carefully selected study region in July 1975, evolved into a system of care which included the following major components: identification of high-risk pregnancies and high-risk newborn infants; obstetric and newborn consultation and referral services between Level I, II, and III centers; professional education for physicians, nurses, and other health professionals; and nutrition and social work consultation. Substantial resources were made available from 1975 to 1980 to implement this "total package" of RPC. A matched, control region was identified which, except for the RPC program, was as comparable as possible to the study region. It was hypothesized that the RPC intervention would have the following effects when the study region was compared with the control region: reduction in fetal and neonatal mortality, no increase in postneonatal mortality, and reduction in obstetric and newborn morbidity. These findings were reported previously. This paper presents results of hypothesized reductions in adverse developmental, neurologic, maternal-infant attachment, and selected physical health outcomes. A sample of 447 infants was assessed by an extensive battery of instruments at 1 year, adjusted for gestational age. The most notable findings were mothers' reports of receptive language development and observations of maternal attachment behaviors that significantly favored the study region. No significant differences between study and control regions were observed for Bayley Mental and Motor Scores, abnormal neurologic signs, and the physical health measures.(ABSTRACT TRUNCATED AT 250 WORDS)

Child Behavior↗

PubMed1995

Adrenocortical responses to the strange situation in infants with disorganized/disoriented attachment relationships.

Salivary cortisol levels were assessed in 19-month-old infants following the Ainsworth Strange Situation procedure. 38 infants participating in Project STEEP at the University of Minnesota served as subjects. Project STEEP is a longitudinal intervention program designed to promote healthy parent-child relationships and to prevent emotional problems among children born to mothers who are at high risk for parenting problems. Following the Strange Situation, saliva samples were collected and assayed for cortisol, a steroid hormone frequently examined in studies of stress. Behavior during the Strange Situation was coded by trained coders, and attachment classifications were determined for each infant. Cortisol concentrations did not differ between the 6 Avoidant/Resistant (A/C) and 17 Securely Attached (B) toddlers. Toddlers (n = 11) who were classified as having Disorganized/Disoriented (Type D) attachments exhibited higher cortisol concentrations than toddlers in the traditional (ABC) classifications. Results of this study were consistent with a model of stress reactivity that conceptualizes the organization of coping behaviors as a factor that mediates physiological stress responses.

Anxiety, Separation↗

PubMed1997

The relationship between attachment cognitions and psychological adjustment in late adolescent women.

This longitudinal study of 137 female high school seniors investigated the relationship of attachment cognitions, current psychological functioning, and psychological functioning 12 months later. Attachment cognitions, assessed with the Revised Adult Attachment Scale and the Inventory of Parent and Peer Attachment, were significantly associated with current symptomatology. The Revised Adult Attachment Scale, in interaction with initial symptomatology, predicted depression, substance abuse, eating disorders, and personality disorders 12 months later. The Inventory of Parent and Peer Attachment parent subscales predicted eating disorder and personality disorder symptomatology, whereas the peer subscales predicted substance abuse, eating disorder, and personality disorder symptomatology.

Adaptation, Psychological↗

PubMed2002

Risk factors for deliberate self-harm among college students.

This self-report study examined the risk factors for deliberate self-harm among college students. Results indicated that insecure attachment, childhood separation, emotional neglect, sexual abuse, and dissociation were significant predictors of self-harm. Substantial gender differences in the risk factors for self-harm behavior were also revealed. Suggestions for future research are provided.

Adolescent↗

PubMed1999

The nature of attachment in a neonatal intensive care unit.

Attachment is defined as the formation of a relationship between a mother and her newborn infant. The concept of attachment has been inadequately defined and often confused with feelings associated with love, instinct, engrossment, and being connected to others. Prematurity and associated maternal-infant separation at birth can affect the attachment process. In this article, a research project, using Leninger's ethnonursing approach is described. Leninger's method was chosen to study the phenomenon of attachment in a neonatal intensive care unit (NICU). Ethnonursing has been found to be a suitable approach for the study of complex situations. Ethnonursing is based on an observation, participation in care, and reflection model. Qualitative data for this study were collected by observation, participation in care, and interviews of mothers (N = 25) in a tertiary NICU. Data were analyzed by comparison of narratives from field notes and transcripts. Findings from the analysis indicate the process of attachment was not automatic. Attachment should be considered as an individualized process. Two dichotomies associated with attachment were identified through the research. These were overt and covert attachment processes and may be dependent on the health status of the infant and the mother, environmental circumstances, and on the quality of care the infant receives.

Adolescent↗

PubMedDate not supplied

Marital quality, marital disruption, and immune function.

Marital disruption is associated with significant increases in a variety of psychologic and physical disorders. In order to examine psychologic and physiologic mediators, self-report data and blood samples were obtained from 38 married women and 38 separated/divorced women. Among married subjects, poorer marital quality was associated with greater depression and a poorer response on three qualitative measures of immune function. Women who had been separated 1 year or less had significantly poorer qualitative and quantitative immune function than their sociodemographically matched married counterparts. Among the separated/divorced cohort, shorter separation periods and greater attachment to the (ex)husband were associated with poorer immune function and greater depression. These data are consistent with epidemiologic evidence linking marital disruption with increased morbidity and mortality.

Adult↗

PubMedDate not supplied

Lack of social support and incidence of coronary heart disease in middle-aged Swedish men.

Lack of social support has been found to predict all causes of mortality in population studies. It has often been assumed that the lack of social ties is associated with the general social conditions related to mortality and has little to do with specific disease etiology. So far, the association between lack of support and cardiovascular disease incidence has not been demonstrated. We have measured both emotional support from very close persons ("attachment") and the support provided by the extended network ("social integration"). This measure was applied along with standard measures of traditional risk factors to a random sample of 50-year-old men born in Gothenborg in 1933. All men (n = 736) were followed for 6 years and the incidence of myocardial infarction and death from coronary heart disease (CHD) was determined. Both "attachment" and "social integration" were lower in men who contracted CHD, with a significant effect for social integration (p = 0.04) and an almost significant effect for attachment (p = 0.07). When controlling for other risk factors in multiple logistic regression analyses, both factors remained as significant predictors of new CHD events. Smoking and lack of social support were the two leading risk factors for CHD in these middle-aged men.

Coronary Disease↗

PubMed2005

Attachment insecurity moderates the relationship between disease activity and depressive symptoms in ulcerative colitis.

BACKGROUND: Among people with ulcerative colitis, depression occurs more frequently when inflammation is active. We hypothesized that individual differences in interpersonal style affect the risk that active disease will be accompanied by depressive symptoms. METHODS: In this study, disease activity, depressive symptoms, and 2 dimensions of interpersonal style, attachment anxiety and attachment avoidance, were measured in 146 ulcerative colitis outpatients at time 1 and in 99 of these patients at a second time-point, 7 to 37 months later. Test-retest correlations of attachment anxiety (r = 0.83, P < 0.001) and attachment avoidance (r = 0.76, P < 0.001) confirmed that these dimensions are stable. RESULTS: There was a stepwise increase in the correlation between time 2 disease activity and depression from the lowest tercile of attachment anxiety (r = 0.00, P = 0.99), through the middle tercile (r = 0.36, P = 0.05), to the highest tercile (r = 0.52, P = 0.002). For attachment avoidance, disease activity and depression were only significantly correlated in the highest tercile (r = 0.49, P = 0.005). CONCLUSIONS: Attachment anxiety meets all tested criteria as a moderator of the relationship between disease activity and depressive symptoms. Further attention to interpersonal style as a moderator of depressive risk in ulcerative colitis is warranted.

Adult↗

PubMed2004

Attachment styles and violence within couples.

This study examined whether an individual's attachment style and/or a couple's combination of attachment styles predicted violence within the marriage and explored whether other variables moderated the risk of violence. Measures of attachment style were administered to 41 discordant couples who presented to four different clinics. The couples' presenting complaints were not violence, and those who did report violence on questioning did not manifest severe violence, i.e., requiring shelters or legal intervention. Self-report measures of violence and marital satisfaction, including problem-solving communication, were also given. Using analysis of covariance and logistic regression, the relative contributions to strength of predicting being a victim of conjugal violence were calculated. An anxious attachment style was a significant predictor of females being victims of violence and of men not being victims. A dismissive style in men was predictive of men being victims when entered into the model with problem solving communication. The combination of anxiously attached females and dismissive males was a potent predictor of violence, and longer duration of marriage and poor problem-solving communication added power to the prediction. Marital interaction, which is influenced by couples' attachment styles and problem-solving communication, is a significant factor in marital partners experiencing physical violence. For couples with milder levels of violence, a more nuanced approach (compared with the legally based approach used for severe violence) seems indicated.

Adult↗

PubMedDate not supplied

The stability of attachment security from infancy to adolescence and early adulthood: general discussion.

For over three decades, critics of the developmental and psychometric paradigms have argued that individual differences are neither stable, coherent, nor clinically significant. The present studies extend a long line of research demonstrating the coherence of individual development in attachment security. They make it clear that attachment security can be stable from infancy through early adulthood and that change in attachment security is meaningfully related to changes in the family environment. The task now is to better understand the roles of cross-age consistency in caregiver behavior and the structure of mental representations of early experience in stability and change.

Adolescent↗

PubMedDate not supplied

Psychosomatic factors in first-onset alopecia areata.

Although the onset of alopecia areata has often been anecdotally linked with emotional stress, findings from the few controlled studies have not been univocal. The authors compared outpatients experiencing a recent onset of alopecia areata (N=21) with outpatients affected by skin conditions commonly believed as having a low psychosomatic component (N=102). Participants were administered Paykel's Interview for Recent Life Events, the Experiences in Close Relationships scale, the 20-item Toronto Alexithymia Scale, and the Multidimensional Scale of Perceived Social Support. Multiple logistic regression was used to control for age and gender. The total number of recent life events (last 12 months) was not different between the alopecia patients and the comparison subjects. Also, the alopecia patients and the comparison subjects did not differ in terms of the number of undesirable or major events. The comparison subjects even experienced a greater number of uncontrollable events. Alopecia areata tended to be associated with high avoidance in attachment relationships, high alexithymic characteristics, and poor social support. The results suggest that personality characteristics might modulate individual susceptibility to alopecia areata.

Adolescent↗

PubMed2004

Close relationships and the working self-concept: implicit and explicit effects of priming attachment on agency and communion.

Two studies investigated how contextually activating attachment relationships influences the working self-concept in terms of agency and communion. In Study 1, 245 participants were primed with a secure, avoidant, or anxious-ambivalent relationship and the implicit accessibility of agency and communion was assessed using word fragments. Activating a secure relationship increased the accessibility of communion, whereas activating an anxious-ambivalent relationship increased the accessibility of agency. In Study 2, 123 participants were primed with a secure, preoccupied, avoidant-dismissive, or avoidant-fearful relationship and explicit self-perceptions of agency and communion traits were assessed using the Extended Personality Attributes Questionnaire (EPAQ). Gender interacted with the attachment prime, such that men primed with a secure relationship reported higher communion than did men primed with an avoidant (dismissive or fearful) relationship, whereas women primed with an anxious (preoccupied or fearful) relationship reported higher agency than did women primed with a secure relationship.

Adolescent↗

PubMed2006

Head start is too late: integrating and applying infant observation studies, and attachment, trauma, and neurobiological research to groups with pregnant and new mothers.

In this paper new knowledge generated from theoretical and empirical work in infant observation studies and attachment, trauma, and neurobiology research is integrated and applied to the development of a group for pregnant and new mothers. The purposes of this group were to (1) promote the establishment of a secure base for each baby through optimum self and dyadic affect regulation, the repair of ruptures, and the emergence of positive heightened affective moments; (2) to facilitate secure attachment between mother and infant by helping mothers mentalize the experiences of their babies; (3) to build affiliative bonds between group members and; at the very least, (4) to prevent insecure disorganized attachments. The group interactions also were thought to prevent new psychopathology from developing, as well as to minimize the intergenerational transmission of trauma. A discussion of how this group came out of gestation and birthed itself in a community setting is included.

Child, Preschool↗

PubMed2001

Addiction as an attachment disorder: implications for group therapy.

This article presents a perspective on addiction that not only substantiates why group therapy is the treatment of choice for addiction, but also integrates diverse perspectives from 12-step abstinence-based models, self psychology, and attachment theory into a complementary integrative formula. Attachment theory, self psychology, and affect regulation theory characterize addiction as an attachment disorder induced by a person's misguided attempt at self-repair because of deficits in psychic structure. Vulnerability of the self is the consequence of developmental failures and early environmental deprivation leading to ineffective attachment styles. Substance abuse, as a reparative attempt, only exacerbates that condition because of physical dependence and further deterioration of existing physiological and psychological structures. Prolonged stress on existing structures leads to exaggerated difficulty in the regulation of affect, which leads to inadequate modulation of appropriate behavior and self-care and increased character pathology.

Adult↗

PubMed1994

From 'Our Town' to 'Ghost Town'?: the changing context of home for rural elders.

This research, grounded in a contextual view of environmental stress, employed an experiential field approach to explore outcomes of the continuing rural crisis of the past decade for elderly residents of four small Kansas towns. These rural changes threaten the survival of many towns, and affect their elderly residents, who often have enduring economic, social, and psychological investments in their homes and communities. At the same time, changes associated with aging may lead to transitions in the experience of home and community for these elderly individuals, regardless of the town's health. The two sources of change may have multi-faceted impacts on the well-being of the elderly individuals who experience them. Aspects of the research described here focus on environmental stressors related to housing and the meaning of attachment to home within economically-threatened communities. Some findings presented support previous research, while others reflect the region's unique socio-historical environment as a part of the Western Frontier. Implications for policy alternatives and the well-being of rural elderly are discussed.

Aged↗