Adult attachment style and cortisol responses in women in late pregnancy

Suporte financeiro e não financeiro da Maternidade Alfredo da Costa, Lisboa, Portugal

Alexithymia, craving and attachment in a heavy drinking population

Up to fifty per cent of individuals with Alcohol use disorders (AUD) also have alexithymia a personality construct hypothesized to be related to attachment difficulties. The relationship between alexithymia, craving, anxious attachment and alcohol-dependence severity was examined in 254 patients participating in a Cognitive-Behavioral Therapy (CBT) program for alcohol-dependence. Participants completed the Toronto Alexithymia Scale (TAS-20), the Obsessive Compulsive Drinking Scale (OCDS), the Revised Adult Attachment Anxiety Subscale (RAAS-Anxiety) and the Alcohol Use Disorder Identification Test (AUDIT). MANOVA indicated that individuals with alexithymia reported significantly higher levels of total OCDS, obsessive thoughts about alcohol, and compulsive drinking urges and behavior, compared to the non-alexithymic group. Regression analyses found that anxious attachment partially mediated the relationship between alexithymia and craving. Anxious attachment may be a potential treatment target to reduce alcohol consumption in those with alcohol-dependence and alexithymia. Research Highlights ► There were significant relationships of alexithymia, craving and anxious attachment. ► Alexithymic alcoholics reported higher levels of craving and alcoholism severity. ► Anxious attachment partially mediated the relationship of alexithymia and craving.

Attachment in relation to affect regulation and interpersonal functioning among substance use disorder inpatients

Attachment theory has been conceptualised as an affect regulation theory, proposing that attachment is associated with the expression and recognition of emotions as well as interpersonal functioning. Previous research has reported affect regulation difficulties in substance use disorders and addiction has been considered an attachment disorder. However, scarce empirical research exists on the relationship of attachment in relation to affect regulation and interpersonal functioning in those with substance use problems. Thus, the objective of the present study was to investigate potential associations between attachment, negative mood regulation (NMR) expectancies, fear of intimacy and self-differentiation in substance abusers. The revised adult attachment scale (RAAS), the NMR expectancies scale, the fear of intimacy scale and the differentiation of self inventory were administered to a sample of 100 substance use disorder inpatients. Attachment accounted for significant variance in NMR expectancies and was also a strong predictor of fear of intimacy. The predictive utility of attachment also extended to self-differentiation, suggesting that attachment was strongly related to overall self-differentiation score, Emotional reactivity, Emotional cut-off and I position. These findings support attachment theory suggesting that attachment is associated with and predicts affect regulation abilities and difficulties in interpersonal functioning in a sample of substance use disorder inpatients. The inclusion and assessment of attachment appears to be important in the development of treatment programmes for substance abusing individuals.

Being Grateful : Does it Bring Us Closer? Gratitude, Attachment and Intimacy in Romantic Relationships

To date, little is known about the function of gratitude in romantic relationships. Being grateful has been demonstrated to provide a number of positive benefits for individuals; however, few studies have explored how grateful experiences may be beneficial in enhancing romantic relationships. This study explored the extent to which adult attachment moderates the relationship between dispositional gratitude and the experience of intimacy within romantic relationships. A greater disposition toward gratitude was expected to result in more frequent experiences of gratitude. It was also anticipated that experiences of gratitude would be associated with feelings of closeness. Participants (n = 156) were required to be currently in a relationship of at least six months duration and completed a series of questionnaires assessing dispositional gratitude, attachment and emotional intimacy. Moderation analysis revealed that although a positive, weak correlation existed between dispositional gratitude and intimacy, attachment did not moderate this association. It was concluded that further investigation of the experience of gratitude is necessary to understand the function of gratitude in romantic relationships. Methods focusing on specific experiences of gratitude in romantic relationships, and the associated feelings of closeness experienced by each partner, may yield more conclusive findings and may provide support for therapeutic approaches focused on enhancing closeness between couples by increasing experiences of gratitude.

Attachment Security and Alexithymia in a Heavy Drinking Population

Attachment difficulties have been proposed as a key risk factor for the development of alexithymia, a multifaceted personality trait characterised by difficulties identifying and describing feelings, a lack of imagination and an externally oriented thinking style. The present study investigated the relationship between attachment and alexithymia in an alcohol dependent population. Participants were 210 outpatients in a Cognitive Behavioural Treatment Program assessed on the Toronto Alexithymia Scale (TAS-20) and the Revised Adult Attachment Scale (RAAS). Significant relationships between anxious attachment and alexithymia factors were confirmed. Furthermore, alexithymic alcoholics reported significantly higher levels of anxious attachment and significantly lower levels of closeness (secure attachment) compared to non-alexithymic alcoholics. These findings highlight the importance of assessing and targeting anxious attachment among alexithymic alcoholics in order to improve alcohol treatment outcomes. Keywords: Attachment, alexithymia, alcohol dependence.

Therapist reflective functioning, therapist attachment and therapist effectiveness

This study, for the first time, explored the relationship between reflective functioning of psychotherapists and their effectiveness as therapists. The findings revealed that greater therapist reflective functioning is associated with greater effectiveness and further, that therapist attachment anxiety interacts with reflective functioning to predict therapist effectiveness. This study has significant implications for the recruitment and training of therapists, both in Australia and overseas. Prior to this study, despite knowing that there are significant differences between psychotherapists in terms of effectiveness, we had had little understanding of the therapist attributes contributing to this difference.

Maladaptive trauma appraisals mediate the relation between attachment anxiety and PTSD symptom severity.

OBJECTIVE: In a large sample of community-dwelling older adults with histories of exposure to a broad range of traumatic events, we examined the extent to which appraisals of traumatic events mediate the relations between insecure attachment styles and posttraumatic stress disorder (PTSD) symptom severity. METHOD: Participants completed an assessment of adult attachment, in addition to measures of PTSD symptom severity, event centrality, event severity, and ratings of the A1 PTSD diagnostic criterion for the potentially traumatic life event that bothered them most at the time of the study. RESULTS: Consistent with theoretical proposals and empirical studies indicating that individual differences in adult attachment systematically influence how individuals evaluate distressing events, individuals with higher attachment anxiety perceived their traumatic life events to be more central to their identity and more severe. Greater event centrality and event severity were each in turn related to higher PTSD symptom severity. In contrast, the relation between attachment avoidance and PTSD symptoms was not mediated by appraisals of event centrality or event severity. Furthermore, neither attachment anxiety nor attachment avoidance was related to participants' ratings of the A1 PTSD diagnostic criterion. CONCLUSION: Our findings suggest that attachment anxiety contributes to greater PTSD symptom severity through heightened perceptions of traumatic events as central to identity and severe. (PsycINFO Database Record

Attachment Style in Adults who Failed to Thrive as Children: Outcomes of a 20 Year Follow-up Study of Factors Influencing Maintenance or Change in Attachment Style

A group of children identified as non-organic failure-to-thrive between 1977 and 1980 were investigated, assessed and provided with social work intervention and treatment. Those children and their families have been followed up for the last 20 years. The current paper examines the stability of an internal working model in a sample of individuals who had failed to thrive as children, by comparing each individual's adult attachment style with their childhood attachment to their mother. In this sample, several cases showed changes from insecure to secure attachment styles. Possible reasons are discussed for positive and negative changes, as well as cases when there was no change in attachment style. These include the effectiveness of intervention in addition to changes in life circumstances. The findings suggest that when appropriate support and intervention is provided, or when different circumstances or relationships are experienced, internal working models can change.

Developmental Antecedents of Proactive and Reactive Rebelliousness: The Role of Parenting Style, Childhood Adversity, and Attachment

Adolescence is a time of developmental transition that for one in five young people is characterised by feelings of oppositionality, rebellion, and negativism. Despite the prevalent experience of teen turbulence and despite its significance within the phenomenological framework provided by reversal theory (RT), the childhood antecedents of rebelliousness in adolescence and adulthood have not been given extensive empirical attention within RT, although such work has been carried out using other constructs and theories. We examined recalled parenting style, childhood adversity, and attachment style in adulthood as correlates of proactive and reactive rebelliousness in a sample of 80 participants, aged 18 to 50 years. Each participant responded to a questionnaire package containing the revised Adult Attachment Scale, the Parental Bonding Instrument, the Childhood Experience of Care and Abuse Questionnaire, and the Negativism Dominance Scale. We found that paternal abusive parenting, followed by paternal parenting style, paternal neglect, and paternal antipathy were independently predictive of scores on proactive rebelliousness, the sensation-seeking form. Maternal and paternal indifferent parenting styles each were found to equivalently and independently predict scores on reactive rebelliousness, the interpersonal disaffection form. The results of this study suggest these two forms of rebelliousness may have distinctly different antecedents. A longitudinal study is needed to examine the potentially causal pathways that are suggested by the results of this cross-sectional research. We consider reversal theory explanations of these results and contrast them with complementary theoretical frameworks.

Women's Attachment as a Predictor of Pain During Labour and Post-Delivery: a Prospective Observational Study

INTRODUCTION: Labour is considered to be one of the most painful and significant experiences in a woman's life. The aim of this study was to examine whether women's attachment style is a predictor of the pain experienced throughout labour and post-delivery. MATERIAL AND METHODS:Thirty-two pregnant women were assessed during the third trimester of pregnancy and during labour. Adult attachment was assessed with the Adult Attachment Scale ' Revised. The perceived intensity of labour pain was measured using a visual analogue scale for pain in the early stage of labour, throughout labour and post-delivery. RESULTS:Women with an insecure attachment style reported more pain at 3 cm of cervical dilatation (p < 0.05), before the administration of analgesia (p < 0.01) and post-delivery (p < 0.05) than those securely attached. In multivariate models, attachment style was a significant predictor of labour pain at 3 cm of cervical dilatation and before the first administration of analgesia but not of the perceived pain post-delivery. DISCUSSION: These findings confirm that labour pain is influenced by relevant psychological factors and suggest that a woman's attachment style may be a risk factor for greater pain during labour. CONCLUSION:Future studies in the context of obstetric pain may consider the attachment style as an indicator of individual differences in the pain response during labour. This may have important implications in anaesthesiology and to promote a relevant shift in institutional practices and therapeutic procedures.

Toward a broader approach to the study of infant attachment : links between maternal autonomy-support, attachment state of mind, maternal sensitivity, and infant security of attachment

Dans le but d’examiner les mécanismes qui sous-tendent le développement de la sécurité d’attachement chez l’enfant, Grossmann et al. (1999; 2008) proposent une perspective plus vaste de l’étude de l’attachement chez l’enfant, examinant les comportements parentaux pertinents aux deux côtés de l’équilibre entre le système d’attachement et le système d’exploration. La thèse se base sur cette approche pour explorer la relation entre la sécurité d’attachement chez l’enfant et deux comportements maternels, soit la sensibilité maternelle et le soutien à l’autonomie maternel, de même que la relation entre ces deux comportements et l’état d’esprit maternel face à l’attachement. Le premier article propose que la théorie de l’autodétermination, avec ses études empiriques portant sur les comportements parentaux liés à l’exploration, offre une perspective utile pour l’étude des comportements d’exploration dans le cadre de l’équilibre attachement/exploration. L’article présente une revue théorique et empirique des domaines de l’attachement et de la théorie de l’autodétermination et souligne des analogies conceptuelles et empiriques entre les deux domaines, en plus de décrire la façon dont ils se complètent et se complémentent. Le deuxième article étudie les liens entre la sensibilité maternelle, le soutien à l’autonomie maternel et la sécurité d’attachement chez l’enfant. Soixante et onze dyades ont participé à deux visites à domicile. La sensibilité maternelle a été évaluée lorsque les enfants étaient âgés de 12 mois, alors que le soutien à l’autonomie maternel et la sécurité d’attachement chez l’enfant l’ont été lorsque les enfants avaient atteint l’âge de 15 mois. Les résultats indiquent que le soutien à l’autonomie maternel explique une portion significative de la variance de la sécurité d’attachement, et ce, après avoir contrôlé pour la sensibilité maternelle et le statut socio-économique. Le troisième article examine les relations entre deux dimensions de l’état d’esprit maternel face à l’attachement (esquivant et préoccupé/non-résolu), la sensibilité maternelle et le soutien à l’autonomie maternel. Soixante et onze dyades ont participé à trois visites à domicile. L’Entrevue d’Attachement Adulte (EAA) a été administrée lorsque les enfants étaient âgés de 8 mois, la sensibilité maternelle a été évaluée alors qu’ils avaient atteint l’âge de 12 mois et le soutien à l’autonomie maternel, lorsqu’ils avaient 15 mois. Les résultats révèlent qu’après avoir contrôlé pour le statut socio-économique, la sensibilité maternelle est liée de façon négative à la dimension « esquivant » de l’EAA, alors que le soutien à l’autonomie maternel est lié de façon négative à la dimension « préoccupé/non-résolu ». Les résultats présentés dans le deuxième et le troisième article sont discutés, de même que de leurs répercussions théoriques et cliniques. Des questions susceptibles de guider des recherches futures sont proposées.

Attachment insecurity, depression, and the transition to parenthood

In a longitudinal study of adult attachment and depression during the transition to parenthood, 76 couples completed questionnaires on three occasions: during the second trimester of pregnancy, and six weeks and six months postbirth. On the first and second occasions, the couples were also interviewed about their experiences of pregnancy and parenthood, respectively. Measures were also completed at similar time intervals by a comparison group of 74 childless couples. Attachment security was assessed in terms of the dimensions of discomfort with closeness and relationship anxiety. Relationship anxiety was less stable for transition wives than for other participants. Relationship anxiety also predicted increases in new mothers' depressive symptoms, after controlling for a broad range of other risk factors. However, the association between relationship anxiety and maternal depression was moderated by husbands' caregiving style. Maternal depression was linked to increases in husbands' and wives' attachment insecurity and marital dissatisfaction. Results are discussed in terms of the impact of depression and negative working models of attachment on couple interaction.