ATTACHMENT STYLES AND RISKY SEXUAL BEHAVIORS IN ADOLESCENTS

Infection with sexually transmitted diseases and unwanted pregnancies are risks associated with adolescents’ risky sexual behavior. Mental models of attachment relationships influence behavior and may influence adolescents’ involvement in sexual activities that are risky. This study explored whether attachment styles predicted adolescents’ involvement in risky sexual behavior. A correlational study design was adopted with 367 students from public secondary schools in Nairobi County taking part in the study. The Attachment Styles Questionnaire and Risky Sexual Behavior Scale were used to collect data. Multiple regression analysis was used to determine whether secure, preoccupied, dismissing or fearful attachment styles predicted students’ risky sexual behavior. The study found that preoccupied attachment style and secure attachment style had predictive effects on risky sexual behavior. Preoccupied attachment style was predictive of greater involvement in risky sexual behavior whereas secure attachment style was predictive of less risky sexual behavior. It was evident based on the findings that secure attachment style was protective against risky sexual behavior whereas preoccupied attachment style created vulnerability to risky sexual behavior. It was recommended that special attention should be paid to adolescents with insecure attachment styles in guidance and counseling programs aimed at discouraging adolescents’ risky sexual behavior and parents/guardians should be encouraged to be more nurturing towards their children in order to encourage formation of secure attachment which was protective against risky sexual behavior. Keywords: attachment styles, attachment avoidance, attachment anxiety, secure attachment, risky sexual behavior

The Relationship Between Defense Mechanisms and Attachment as Measured by Observer-Rated Methods in a Sample of Depressed Patients: A Pilot Study

Despite many theoretical and clinical writings, the theorized connection between defense mechanisms and adult attachment in depressed patients has received little empirical attention. This is the first study to examine patients’ defense mechanisms in relation to their attachment in a clinical sample of depressed patients and also the first to use observer-rated measures for assessing both defense mechanisms and attachment. In this pilot study, we aimed to investigate the relationship between patients’ attachment and their use of defense mechanisms in psychotherapy sessions, as well as patterns of change over treatment. We conducted a secondary analysis of data from a randomized controlled trial of 30 patients receiving psychotherapy for major depression. Session transcripts were previously coded for defense mechanisms using the Defense Mechanisms Rating Scales, and depression severity data were collected by the clinician-rated HRSD-17 and the self-report BDI-II. Patients’ attachment was assessed in two transcripts, one in an early session and a second in a late session, using the novel observer-rated Patient Attachment Coding System. In contrast with expectations, in the early phase of therapy, preoccupied attachment-related characteristics were significantly positively related to overall defensive functioning and negatively related to Depressive immature defenses. In the late phase of treatment, preoccupied attachment-related characteristics were negatively correlated with Non-depressive immature defenses. Moreover, as expected, early-phase defense use was related to late phase attachment; specifically, early neurotic and immature Depressive and Non-depressive defenses predicted an increase in avoidant, whereas immature Non-depressive defenses predicted a decrease in preoccupied attachment-related characteristics over the course of treatment, after controlling for early attachment effects. The results imply a longitudinal relationship between defenses and change in attachment-related characteristics over the course of treatment in a depressed sample and warrant further research about the relationship between defenses and attachment during psychotherapy.

The Influence of Family Structure and Adult Attachment Style on Theft Behaviors in Men: a Case-Control Study

Background: Theft has leaded to significant costs to commerce and legal system, but its psychological mechanisms and risk factors are barely explored. This study aims to investigate the influence of family structure and adult attachment style on theft behaviors in men. Methods: 257 men with a conviction for theft (theft group) and 405 male college students (control group) were interviewed with Experiences in Close Relationships Scale and a general questionnaire about socio-demographic information, family structure and criminal records. Results: Compared with control group, long-term residency, family economic situation, number of siblings, father’s presence before 5 years old, parents’ state of existence and parents’ marital status of theft group were significantly different (P<0.05). Living in urban area, from relatively poor family, not living with father before 5 years old and parents not divorced increased the likelihood of theft in men (P<0.05). While father not alive and having no siblings decreased the likelihood of theft in men (P<0.05). Then theft group was further divided into first offender group and recidivist group. First offender group had a significantly higher proportion of living with mother/father before 5 years old and father alive than recidivist group (P<0.05). Not living with mother before 5 years old and father not alive increased the possibility of multiple thefts, while preoccupied attachment decreased such possibility (P<0.05). Conclusions: This study suggested that risk factors for theft and multiple thefts were different. A variety of targeted strategies related to family structure and attachment styles are needed to prevent theft from occurring and reoccurring.

The association between attachment pattern and depression severity in Thai depressed patients

Objective We aimed to study attachment patterns and their association with depression severity in Thai depressed patients. Method We conducted a descriptive study of depressed participants at King Chulalongkorn Memorial Hospital from November 2013 to April 2014. The Thai Short Version of Revised Experience of Close Relationships Questionnaire and the Beck Depression Inventory-II (BDI-II) were administered to all participants. We assessed BDI-II scores, classified by attachment patterns, using one-way analyses of variance. The associated factors and predictors of depression severity were analysed by chi-square and logistic regression analyses, respectively. Results A total of 180 participants (75% female; mean age = 45.2 ± 14.3 years) were recruited. Dismissing attachment was the most common pattern in Thai depressed patients (36.1%). Depressed patients with preoccupied attachment demonstrated the highest BDI-II scores. The best predictor of moderate to severe depression severity was preoccupied/fearful attachment (odds ratio = 3.68; 95% confidence interval = 2.05–7.30). Conclusions Anxious attachment was found to be associated with higher depression severity. Preoccupied/fearful attachment was the predictor of moderate to severe depression severity.

Searching in the dark: Shining a light on some predictors of non-response to psychotherapy for borderline personality disorder

Background Borderline Personality Disorder (BPD) is a prevalent and serious mental health condition. People can experience recovery or remission after receiving psychotherapy for BPD; however, it is estimated that about 45% of people in well conducted treatment trials do not respond adequately to current psychological treatments. Aim To further advance psychotherapies for BPD by identifying the factors that contribute to the problem of non-response. Method 184 consecutive participants with BPD in community treatment were naturalistically followed up over 12 months and measures of personality and social functioning were examined. Logistic regressions were used to determine which baseline factors were associated with the likelihood of being a non-responder after 12 months of psychotherapy. After 12 months, 48.4% of participants were classed as non-responders due to a lack of reduction in BPD symptoms according to the Reliable Change Index (RCI) method. Results At baseline intake, patients who endorsed an adult preoccupied attachment relationship style and increased anger were more likely to be a non-responder regarding BPD symptoms at 12 months. In addition, those with preoccupied attachment patterns in their adult relationships were more likely to be non-responders regarding general psychological distress at follow up. Higher baseline levels of paranoia and endorsement of a dismissive adult relationship style was associated with being a non-responder in regard to global functioning. Conclusions Consistent with previous research, almost half of the sample did not achieve reliable change at 12-month follow up. A relationship style characterised by preoccupied insecurity and high anger seemed to be particularly challenging in being able to benefit from psychotherapy. This style may have affected both relationships outside, but also inside therapy, complicating treatment engagement and alliance with the therapist. Early identification and modification of treatment based on challenges from these relationship styles may be one way to improve psychotherapy outcomes for BPD.

Pathological Narcissism and Emotional Responses to Rejection: The Impact of Adult Attachment

Background: Aspects of pathological narcissism, such as grandiosity, vulnerability and entitlement, tend be enacted in therapeutic settings, negatively influencing outcome and alliance between the clients and therapist. This research took an experimental approach to understanding the interplay between the emotional reactions of individuals with a pathological narcissistic presentation, and adult attachment style. We predicted that participants reporting narcissistic vulnerability would report greater insecurity in attachment (fearful and preoccupied styles), greater trait emotional reactivity, and also experience more intense and negative responses to simulated rejectionMethods: 269 participants (75.84% female, median age = 21) completed baseline and rejection trials of a virtual ball-tossing game, following the assessment of grandiose and vulnerable pathological narcissism, entitlement, adult attachment, trait emotional reactivity (measured prior to the rejection) and in-situ affective response (measured both before and after the rejection). Change in affect from baseline was calculated to capture affective responses to the manipulation.Results: Vulnerable narcissism was positively associated with both fearful and preoccupied attachment, and negatively associated with secure and dismissive attachment, whilst grandiose narcissism was significantly related to preoccupied attachment only. Multiple hierarchical regression analyses showed vulnerable narcissism predicted both (1) more negative trait emotional reactivity and (2) a significant increase in negative affect following the rejection trial. Grandiose narcissism was associated with (1) higher positive trait emotional reactivity, and (2) significant reductions in positive affect following rejection.Conclusion: Results indicated that those high in pathological narcissistic vulnerability reported greater insecurity in attachment, negative trait emotional reactivity and experienced a more negative and intense emotional reaction to rejection. Grandiose narcissism was related to a more deactivated pattern of emotional reactivity, and less positive (rather than more negative) emotional reactions. Findings have important implications for therapy, particularly regarding communication of emotions for individuals high in vulnerable and grandiose narcissism.

OD PREOKUPIRAJUĆEG VEZIVANJA DO DEPRESIJE: SERIJSKI MEDIJACIJSKI MODEL NA UZORKU ŽENA

FROM PREOCCUPIED ATTACHMENT TO DEPRESSION: SERIAL MEDIATION MODEL EFFECTS ON A SAMPLE OF WOMEN Existing studies have confirmed the existence of a relation between depressive symptoms and insecure attachment, an undeveloped ability to mentalize, social anxiety and rumination, as well as their increasingly more frequent presence in the population of women. However, none of the studies have analyzed the mutual relations between the aforementioned phenomena. In this study we tested a multiple serial mediation model in which a preoccupied attachment style has an effect on depressive symptoms among women, mediated by the ability to mentalize one’s own state of mind, social anxiety and a tendency towards rumination, successively, in that order. The research was carried out on a geographical cluster sample and included 1258 working-age adults, respondents from 37 urban and rural locations, 20 administrative districts of Serbia, from which a sample of women was extracted (N= 791). The Relationships Questionnaire – RQ (Bartholomew and Horowitz, 1991), the Mentalization Scale – MentS (Dimitrijević et al., 2015), the Scale of Social Anxiety (Tovilović, 2004) and the Ruminative Thought Style Questionnaire – RTSQ; Brinker and Dozois, 2009) were all used in the study. The results have indicated that there is a significant specific indirect effect of the preoccupied attachment style on depression mediated by all three mediators sequentially (estimated indirect effect = .004, boot-strapped 95% CI = .002 - .007), suggesting that the preoccupied attachment style has an effect on depression by leading to a decrease in the ability to mentalize one’s own state of mind, which increases social anxiety, in turn leading to an increase in rumination, which ultimately leads to depression. These findings could be of importance for the treatment of a specific group of female patients with a preoccupied attachment style who suffer from depression.

Role of Attachment and Family Functioning in Problematic Smartphone Use in Young Adults

Overuse of the smartphone causes negative consequences on the health and behavior of younger people. It is necessary to know which factors can determine the problematic use of the smartphone. The aim of the present study was to explore the relationship between problematic smartphone use, attachment styles, and perceived family functioning in young adults. Three hundred and thirteen Spanish young adults took part in the study (255 women, 58 men) and completed the following instruments: the Smartphone Addiction Scale (SAS), the Relationship Questionnaire (RQ), the Parental Bonding Instrument (PBI), and the Family Adaptability and Cohesion Evaluation Scale (FACES IV). The results of the path analyses show that the cohesion and enmeshed functioning variables were the best predictors of problematic smartphone use. The preoccupied attachment scale was the only one whose score also showed indirect effects on problematic smartphone use through the variable of enmeshed family functioning.

Significance of anger suppression and preoccupied attachment in social anxiety disorder: a cross-sectional study

Background There is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD). Method In a cross-sectional study 321 individuals with social anxiety disorder (41% men, age 38.8 ± 13.9) were compared with 94 healthy controls (37% men, age 35.8 ± 15.1) on several questionnaires (Attachment Styles Questionnaire, State Trait Anger Inventory, Social Phobia Inventory, Beck Depression Inventory). Results Individuals with SAD showed moderate-sized reduced levels of secure and large-sized increased levels of fearful and preoccupied attachment style compared to healthy controls (all p < 0.001) as well as small-sized increased levels of trait anger (p = 0.03) and moderate-sized increased levels of anger-in (p < 0.001). Attachment style and anger regulation could predict 21% (R2 = 0.21, p < 0.001) of the extent of social anxiety (SPIN) in SAD; secure (β = − 0.196, p < 0.01) and preoccupied attachment style (β = 0.117, p < 0.05), as well as anger-in (β = 0.199, p < 0.01) were significant cross-sectional predictors. Further analysis revealed that the relationship between preoccupied attachment and social anxiety is partially mediated by anger-in. Conclusion Study findings confirm the relevance of preoccupied attachment style and anger suppression for social anxiety. Disentangling the role of anger regulation in early attachment patterns has significant therapeutic implications in SAD.

Childhood trauma, attachment orientation, and complex PTSD (CPTSD) symptoms in a clinical sample: Implications for treatment

Although there has been significant work on the association between posttraumatic stress disorder (PTSD) and attachment orientation, this is less the case for complex PTSD (CPTSD). The primary aim of this paper was to assess the strength of the association between the four adult attachment styles (i.e., secure, dismissing, preoccupied, and fearful) and severity of CPTSD symptoms (i.e., symptoms of PTSD and disturbances in self-organization [DSO]). We hypothesized that attachment orientation would be more strongly associated with DSO symptoms compared to PTSD symptoms. A trauma exposed clinical sample (N = 331) completed self-report measures of traumatic life events, CPTSD symptoms, and attachment orientation. It was found that secure attachment and fearful attachment were significantly associated with DSO symptoms but not with PTSD symptoms. Dismissing attachment style was significantly associated with PTSD and DSO symptoms. Preoccupied attachment was not significantly associated with CPTSD symptoms. Treatment implications for CPTSD using an attachment framework are discussed.