Insecure attachment and frequent attendance in primary care: a longitudinal cohort study of medically unexplained symptom presentations in ten UK general practices

2011 ◽  
Vol 42 (4) ◽  
pp. 855-864 ◽  
Author(s):  
R. E. Taylor ◽  
T. Marshall ◽  
A. Mann ◽  
D. P. Goldberg
Keyword(s):  
Primary Care ◽  
Physical Function ◽  
Attachment Style ◽  
Adult Attachment ◽  
Attachment Styles ◽  
Insecure Attachment ◽  
Consultation Rate ◽  
Frequent Attendance ◽  
Medically Unexplained

BackgroundIn primary care frequent attenders with medically unexplained symptoms (MUS) pose a clinical and health resource challenge. We sought to understand these presentations in terms of the doctor–patient relationship, specifically to test the hypothesis that such patients have insecure emotional attachment.MethodWe undertook a cohort follow-up study of 410 patients with MUS. Baseline questionnaires assessed adult attachment style, psychological distress, beliefs about the symptom, non-specific somatic symptoms, and physical function. A telephone interview following consultation assessed health worry, general practitioner (GP) management and satisfaction with consultation. The main outcome was annual GP consultation rate.ResultsOf consecutive attenders, 18% had an MUS. This group had a high mean consultation frequency of 5.24 [95% confidence interval (CI) 4.79–5.69] over the follow-up year. The prevalence of insecure attachment was 28 (95% CI 23–33) %. A significant association was found between insecure attachment style and frequent attendance, even after adjustment for sociodemographic characteristics, presence of chronic physical illness and baseline physical function [odds ratio (OR) 1.96 (95% CI 1.05–3.67)]. The association was particularly strong in those patients who believed that there was a physical cause for their initial MUS [OR 9.52 (95% CI 2.67–33.93)]. A possible model for the relationship between attachment style and frequent attendance is presented.ConclusionsPatients with MUS who attend frequently have insecure adult attachment styles, and their high consultation rate may therefore be conceptualized as pathological care-seeking behaviour linked to their insecure attachment. Understanding frequent attendance as pathological help seeking driven by difficulties in relating to caregiving figures may help doctors to manage their frequently attending patients in a different way.

scholarly journals Adult attachment styles and alcohol consumption in young adults

2021 ◽  
Vol 25 (111) ◽  
pp. 183-190
Author(s):  
Francis Segundo Cevallos Robayo ◽  
Diana Carolina Garcia Ramos ◽  
Carmen Varina Barba Guzman ◽  
Gabriela Lorena Abril Lucero
Keyword(s):  
Young Adults ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Attachment Style ◽  
Adult Attachment ◽  
Attachment Styles ◽  
Protective Factor ◽  
Buenos Aires ◽  
Insecure Attachment ◽  
Secure Attachment

The objective of this study was to describe the styles of adult attachment and alcohol consumption in young adults, measured through the CaMir-R test and the AUDIT questionnaire, analyzed under the InfoStat statistical program, respectively. Based on a sample of 167 young adults, men and women, between the ages of 18 and 32. The results show that 82.6% of the population is a consumer of alcohol with the highest prevalence in the secure attachment style, followed by the preoccupied insecure, insecure avoidant attachment style and the disorganized attachment indicator. The higher the level of alcohol consumption, the secure attachment scores decrease and rise in preoccupied insecure attachment style. The result does not statistically infer the linear causality of the study variables. The secure attachment style can function as a protective factor and the preoccupied insecure attachment as a risk factor for increasing the level of alcohol consumption. Keywords: adult attachment, alcohol use, alcoholism, risk of addiction. References [1]Organización Panamericana de la Salud; Organización Mundial de la Salud, «Agenda de Salud Sostenible para las Américas 2018-2030: Un llamado a la acción para la salud y el bienestar en la región,» de 29.a Conferencia Sanitaria Panamericana, Washington, 2017. [2]Comisión Interamericana para el Control del Abuso de Drogas; Organización de los Estados Americanos , «Informe sobre el Consumo de Drogas en las Américas 2019,» Organización de los Estados Americanos, Washington, D.C., 2019. [3]Instituto Nacional de Estadísticas y Censos, «Compendio de Resultados de la Encuesta de Condiciones de Vida ECV 2014,» INEC, Quito, 2014. [4]E. Becoña Iglesias, E. Fernández del Río, A. Calafat and J. Fernández-Hermida, «Apego y consumo de sustancias en la adolescencia: Una revisión de aspectos conceptuales y metodológicos,» Adicciones, vol. 26, nº 1, pp. 1-11, 2014. [5]K. MacDonald, The Interfaces Between Sociobiology and Devolopmental Psychology, New York: Springer, 1988. [6]J. Feeney and P. Noller, Apego Adulto, Bilbao: Desclée de Brouwer, 2001. [7]J. Bowlby, Vínculos afectivos: Formación, Desarrollo y Pérdida, Madrid: Ediciones Morata, 2014. [8]O. Barroso, «El Apego Adulto: La relación de los Estilos de Apego Desarrollados en la Infancia en la Elección y las Dínamicas de Pareja,» Revista Digital de Medicina Psicosomática y PSicoterapia, vol. 4, nº 1, pp. 1-25, 2014. [9]S. Freud, El malestar de la cultura, Obras Completas, Buenos Aires: Amorrortu, 1930. [10]F. Naparstek, Introducción a la clínica con toxicomanías y alcoholismo, Buenos Aires: Grama Ediciones, 2005. [11]J. A. Miller, La experiencia de lo real en la cura psicoanalítica, Buenos Aires: Paidós, 2003. [12]M. Barradas, N. Fernández and L. Gutierrez, «Prevalencia de consumo de alcohol en estudiantes universitarios, » Revista Iberoamericana para la Investigación y el Desarrollo Educativo, vol. 6, nº 12, 2016. [13]M. Cornellà-Font, F. Viñas-Poch, J. Juárez-López, M. d. l. M. Martín-Perpiñá and S. Malo-Cerrato, «Temperament and attachment as predictive factors for the risk of addiction to substances in adolescents,» Revista De Psicopatología Y Psicología Clínica, vol. 23, nº 3, pp.179-187, 2019. [14]L. Anderson, J. Connor, J. Voisey, R. Young and M. Gullo, «The unique role of attachment dimensions and peer drinking in adolescent alcohol use,» Personality and Individual Differences, vol. 149, pp. 118-122, 2019. [15]C. Pinto-Cortez, M. Beyzaga, M. F. Cantero, X. Oviedo and V. Vergara, «Apego y psicopatología en adolescentes del Norte de Chile,» Revista de PsicologíaClínica con Niños y Adolescentes, vol. 5, nº 3, pp. 23-29, 2018. [16]K. Ward and G. Limb, «Emerging Adult Attachment and Alcohol Abuse Among American Indians Raised in Stepfamilies,» The British Journal of Social Work, vol. 49, nº 6, pp. 1452-1471, 2019. [17]C. Fairbairn, D. Briley, D. Kang, C. Fraley, B. Hankin and T. Ariss, «A meta-analysis of longitudinal associations between substance use and interpersonal attachment security,» Psychological Bulletin, vol. 144, nº 5, pp. 532-555, 2018.

scholarly journals Exploring How UK Adults' Attachment Style in Romantic Relationships Affects Engagement in Controlling Behaviours

2021 ◽  
Vol 12 ◽  
Author(s):  
Molly C. Gilbert ◽  
Robert Blakey
Keyword(s):  
Romantic Relationships ◽  
Attachment Style ◽  
Adult Attachment ◽  
Attachment Styles ◽  
Clinical Sample ◽  
Interpersonal Relationship ◽  
Insecure Attachment ◽  
Self Report ◽  
Online Questionnaire ◽  
Anxious Attachment

Copious studies have identified a link between disorganised attachment and engagement in controlling caregiving or controlling punitive behaviours. Studies have suggested that consistently engaging in these behaviours can cause difficulties within relationships and contribute to the development of a personality disorder. Most of the literature thus far has focused on engagement in controlling behaviours by children with a disorganised attachment style, despite there being theoretical grounds to suggest they may also be used by adults and across all types of insecure attachment. This study aimed to address these gaps by looking at adult attachment style and engagement in controlling behaviours in romantic relationships, across all insecure attachment styles; avoidant, anxious and disorganised. The current study recruited a non-clinical sample; specifically, 149 English-speaking adults, living in the UK, between the ages of 18 and 77 years old (M = 34.28, SD = 14.90). The participants answered an anonymous online questionnaire containing four self-report measures which assessed the participants' attachment security and organisation, caregiving style and engagement in punitive behaviours. The results indicated that participants who scored higher in disorganised attachment were more likely to use controlling punitive behaviours in their romantic relationships. Moreover, participants who reported a more insecure-anxious attachment style were more likely to use compulsive caregiving behaviours in their romantic relationships. In contrast, participants who reported a higher insecure avoidant attachment style were less likely to use compulsive caregiving behaviours in their romantic relationships. These results have implications for adult attachment theory and aid the understanding of some of the behaviours that can be harmful within romantic relationships. The findings could be used to help at-risk individuals develop healthy interpersonal relationship going forward.

scholarly journals Measuring attachment and parental bonding in psychosis and its clinical implications

2014 ◽  
Vol 25 (2) ◽  
pp. 142-149 ◽  
Author(s):  
S. Mathews ◽  
J. Onwumere ◽  
S. Bissoli ◽  
M. Ruggeri ◽  
E. Kuipers ◽  
...  
Keyword(s):  
Attachment Theory ◽  
Attachment Style ◽  
Attachment Styles ◽  
Parental Bonding ◽  
Insecure Attachment ◽  
Self Report ◽  
Future Research ◽  
Clinical Implications ◽  
Term Outcome ◽  
Long Term Outcome

Background.Attachment theory proposes that psychological functioning and affect regulations are influenced by the attachment we form with others. Early relationships with parents or caregivers lay the foundations for attachment styles. These styles are proposed to influence how we relate to others during our life can be modified by the relationships and events we experience in our lifespan. A secure attachment style is associated with a capacity to manage distress, comfort with autonomy and the ability to form relationships with others, whereas insecure attachment can lead to dysfunctional relationships, emotional and behaviour avoidance. Attachment theory provides a useful framework to inform our understanding of relationship difficulties in people with psychosis. This paper aims to complement recent systematic reviews by providing an overview of attachment theory, its application to psychosis, including an understanding of measurement issues and the clinical implications offered.Method.A narrative review was completed of the measures of attachment and parental bonding in psychosis. Its clinical implications are also discussed. The paper also explores the link between insecure attachment styles and illness course, social functioning and symptomatology. The following questions are addressed: What are the key attachment measures that have been used within the attachment and psychosis literature? What are the results of studies that have measured attachment or parental bonding in psychosis and what clinical implications can we derive from it? What are some of the key questions for future research from these findings in relation to the onset of psychosis research field?Results.The most commonly used measures of attachment in psychosis research are reviewed. Self-report questionnaires and semi-structured interviews have mainly been used to examine attachment styles in adult samples and in recent years comprise a measure specifically developed for a psychosis group. The review suggests that insecure attachment styles are common in psychosis samples. Key relationships were observed between insecure, avoidant and anxious attachment styles and psychosis development, expression and long-term outcome.Conclusions.Attachment theory can provide a useful framework to facilitate our understanding of interpersonal difficulties in psychosis that may predate its onset and impact on observed variability in outcomes, including treatment engagement. Greater attention should be given to the assessment of attachment needs and to the development of interventions that seek to compensate for these difficulties. However, further investigations are required on specifying the exact mechanisms by which specific attachment styles impact on the development of psychosis and its course.

scholarly journals Individual Differences in Work-Related Well-Being: The Role of Attachment Style

2014 ◽  
Vol 10 (4) ◽  
pp. 694-711
Author(s):  
Tiziana Lanciano ◽  
Vanda Lucia Zammuner
Keyword(s):  
Job Satisfaction ◽  
Attachment Style ◽  
Adult Attachment ◽  
Attachment Styles ◽  
Job Involvement ◽  
Well Being ◽  
Anxious Attachment ◽  
Work Related ◽  
Dispositional Trait

Integrating theories of adult attachment and well-being at the workplace, the present study tested the role of attachment style in predicting work-related well-being in terms of job satisfaction and job involvement, over and above dispositional trait measures (emotional traits and work-related traits). A sample of workers took part in a correlational study that explored the relationships among a) adult attachment, b) emotional traits, c) work-related traits, and d) work-related well-being indices. The results showed that both secure and anxious attachment style explained workers’ job involvement, whereas the secure and avoidant attachment styles explained workers’ job satisfaction. The current findings thus confirm and expand the literature's emphasis on studying the variables and processes that underlie people's mental health in the work setting, and have implications for assessing and promoting well-being in the workplace.

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

2014 ◽  
Vol 45 (7) ◽  
pp. 1495-1507 ◽  
Author(s):  
S. Wickham ◽  
K. Sitko ◽  
R. P. Bentall
Keyword(s):  
Attachment Style ◽  
Attachment Styles ◽  
Self Esteem ◽  
Insecure Attachment ◽  
Future Research ◽  
Schizophrenia Spectrum Disorders ◽  
Attachment Representations ◽  
Co Morbidity ◽  
The Relationship

BackgroundA growing body of research has investigated associations between insecure attachment styles and psychosis. However, despite good theoretical and epidemiological reasons for hypothesising that insecure attachment may be specifically implicated in paranoid delusions, few studies have considered the role it plays in specific symptoms.MethodWe examined the relationship between attachment style, paranoid beliefs and hallucinatory experiences in a sample of 176 people with a diagnosis of schizophrenia spectrum disorders and 113 healthy controls. We also investigated the possible role of negative self-esteem in mediating this association.ResultsInsecure attachment predicted paranoia but not hallucinations after co-morbidity between the symptoms was controlled for. Negative self-esteem partially mediated the association between attachment anxiety and clinical paranoia, and fully mediated the relationship between attachment avoidance and clinical paranoia.ConclusionsIt may be fruitful to explore attachment representations in psychological treatments for paranoid patients. If future research confirms the importance of disrupted attachment as a risk factor for persecutory delusions, consideration might be given to how to protect vulnerable young people, for example those raised in children's homes.

scholarly journals Problems with Recall-Based Attachment Style Priming Paradigms: Exclusion Criteria, Sample Bias and Reduced Power

2017 ◽  
Author(s):  
John Kitchener Sakaluk
Keyword(s):  
Attachment Style ◽  
External Validity ◽  
Attachment Styles ◽  
Sexual Experience ◽  
Insecure Attachment ◽  
Exclusion Criteria ◽  
Sample Bias ◽  
Internal And External Validity

Attachment styles are often primed by having participants recall and describe a relationship that is prototypical of a given attachment style. Researchers may exclude participants who cannot recall such a relationship, or who describe relationships that do not conform to the assigned prime. I suggest that excluding participants is untenable, and may threaten a study’s validity. In the present research, I examine predictors of exclusion from an attachment priming study. Priming insecure attachment resulted in greater odds of exclusion relative to a control condition. Female participants with greater sexual experience also had lesser odds of exclusion. These results suggest that attachment-priming procedures contribute to participant exclusion that compromise internal and external validity. Discussion focuses on directions for future attachment-priming research.

scholarly journals Is attachment style in early childhood associated with mental health difficulties in late adolescence?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S15-S15
Author(s):  
Philippa Clery ◽  
Angela Rowe ◽  
Marcus Munafò ◽  
Liam Mahedy
Keyword(s):  
Mental Health ◽  
Early Childhood ◽  
Attachment Style ◽  
Attachment Styles ◽  
Late Adolescence ◽  
Insecure Attachment ◽  
Secure Attachment ◽  
Childhood Attachment ◽  
Mental Health Difficulties ◽  
Self Harm

AimsIdentifying factors that contribute to mental health difficulties in young people as early in life as possible are needed to inform prevention strategies. One area of interest is attachment. Although existing research has suggested an association between insecure attachment styles and mental health difficulties, these studies often have small sample sizes, use cross-sectional designs, and measure attachment as a discrete variable at a single point or use romantic relationship attachment as a proxy for childhood attachment. It is also unclear whether these associations persist into late adolescence. In this large prospective study we aimed to determine whether an insecure attachment style measured at repeated points in early childhood, is associated with depression and self-harm at 18 years.MethodWe used data from the Avon Longitudinal Study of Parents and Children cohort. Mothers completed attachment related questionnaires when their child was 18, 30, and 42 months old. Offspring depression and lifetime self-harm was assessed at 18 years in clinic using the Clinical Interview Schedule-Revised. Attachment was derived as a continuous latent variable in a structural equation modelling framework. Logistic regression was performed on participants with complete attachment data (n = 7032) to examine the association between attachment style and depression and self-harm, with adjustment for potential confounders. Differential dropout was accounted for using multiple imputation.ResultWe found some evidence for an association between a more insecure attachment style in childhood, and a diagnosis of depression and life-time self-harm at age 18. In the fully adjusted imputed model, a one standard deviation increase in insecure attachment was associated with a 13% increase in the odds of depression (OR = 1.13; 95%CI = 1.00 to 1.27) and a 14% increase in the odds of self-harm at age 18 (OR = 1.14; 95%CI = 1.02 to 1.25), for children who had more insecure attachment in early childhood, compared with children who had more secure attachment.ConclusionThis is the largest longitudinal study to examine the prospective association between childhood attachment and depression and self-harm in late adolescence. Our findings strengthen the evidence suggesting that a childhood insecure attachment style is associated with mental health difficulties in late adolescence. Policies and interventions to support parenting behaviours that foster the development of secure attachment styles, or attachment-based therapies to improve attachment quality, could help reduce depression and self-harm in adolescence/young adulthood.Philippa Clery is supported by the Elizabeth Blackwell Institute for Health Research at the University of Bristol and the Wellcome Trust Institutional Strategic Support Fund.

Dismissive Attachment and Posttraumatic Stress Disorder among Securely and Insecurely Attached Belgian Security Workers

2009 ◽  
Vol 105 (3) ◽  
pp. 889-899 ◽  
Author(s):  
Stefan Bogaerts ◽  
Maarten J. J. Kunst ◽  
Frans W. Winkel
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Attachment Style ◽  
Attachment Styles ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
Insecure Attachment ◽  
Grandiose Narcissism ◽  
Preoccupied Attachment

This study examined Posttraumatic Stress Disorder in relation to secure and insecure attachment styles based on data collected in a sample of 81 Belgian security workers. All had experienced one traumatic event in the previous year. The sample was divided into a securely attached and an insecurely attached group. The three PTSD symptom scales, Re-experiencing, Avoidance, and Hyperarousal, differentiated significantly between the two attachment groups; the dismissive attachment style was negatively related to PTSD. Individuals with a positive view of themselves and a negative view of others have less risk of developing PTSD than those with a fearful or preoccupied attachment style. A relationship between the dismissive attachment style with grandiose narcissism seems possible. Interest has been expressed in medical approaches; therefore, the importance of medical research on PTSD is emphasized.

Measure of Attachment Style

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Naseem Ahmad ◽  
Azmat Jahan ◽  
Nasheed Imtiaz
Keyword(s):  
Construct Validity ◽  
Attachment Style ◽  
Attachment Styles ◽  
Insecure Attachment ◽  
Validity And Reliability ◽  
Mary Ainsworth

This paper describes the development and standardization of a measure of perceived attachment styles. The four attachment styles namely secure, avoidant insecure, ambivalent insecure, and disorganized insecure attachment proposed by Mary Ainsworth (1970), Main and Soloman 1986 (Disorganized- insecure attachment). The items are constructed on socio-cultural and educational circumstances of the individuals using mix strategy for construction of the scale by selecting the items from various attachment scales and by writing some original items. Hence the tool will be largely suitable for measuring the attachment styles among the adults and adolescents in India. The tool has good construct validity and reliability.

scholarly journals Insecure Attachment and Other Help-Seeking Barriers among Women Depressed Postpartum

2020 ◽  
Vol 17 (11) ◽  
pp. 3887
Author(s):  
Emily Cacciola ◽  
Elia Psouni
Keyword(s):  
Attachment Style ◽  
Help Seeking ◽  
Attachment Styles ◽  
Qualitative Methodology ◽  
Insecure Attachment ◽  
Treatment Programs ◽  
Entire Family ◽  
Relational Experiences ◽  
Avoidant Attachment ◽  
Seeking Behavior

When untreated, postpartum depression (PPD) can severely, negatively affect maternal health, child development, and the wellbeing and functioning of the entire family. Yet, despite screening and treatment programs for PPD, many women who experience depression with onset in the postpartum year do not communicate their symptoms. Negative relational experiences early in life, such as not receiving sensitive help and support when needed, often result in so-called insecure attachment styles, and there is evidence that these may contribute to the development and maintenance of PPD. However, the role of insecure attachment styles in non-help-seeking is unknown for this group. Using mixed quantitative and qualitative methodology, we identified help-seeking barriers of women who experienced depression with onset in the postpartum year but who had not sought help for their depression (N = 37), and explored links to their attachment orientations as assessed through both self-reported attachment style and narrative based attachment script assessment. The sample was non-normative regarding attachment, with an over-representation of avoidant attachment styles. Help-seeking barriers varied systematically with the mother’s adult attachment style. Specifically, convictions of a strong self and lack of trust in healthcare professionals constituted a common barrier among women with avoidant attachment styles, while unrealistic expectations about motherhood constituted a barrier for women with secure attachment styles. This new knowledge on how barriers to communicating symptoms and seeking help when suffering from PPD vary systematically with attachment orientation can help formulate individualized, and therefore more efficient, approaches to addressing non-help-seeking behavior in women who suffer in silence.

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