Romantic attachment and perception of partner support to explain psychological aggression perpetrated in couples seeking couples therapy

Essai doctoral présenté à la Faculté des études supérieures en vue de l’obtention du grade de Docteur en psychologie (D.Psy.), option clinique

Attachment, sexual assertiveness and sexual outcomes in women with provoked vestibulodynia and their partners : a mediation model.

Provoked vestibulodynia (PVD) is a prevalent women’s sexual pain disorder, which is associated with sexual function difficulties. Attachment theory has been used to understand adult sexual outcomes, providing a useful framework for examining sexual adaptation in couples confronted with PVD. Research to date indicates that anxious and avoidant attachment dimensions correlate with worse sexual outcomes in community and clinical samples. The present study examined the association between attachment, pain, sexual function and sexual satisfaction in a sample of 101 couples in which the women presented with PVD. The Actor-Partner Interdependence Model was used in order to investigate both actor and partner effects. This study also examined the role of sexual assertiveness as a mediator of these associations via structural equation modeling. Women completed measures of pain intensity and both members of the couple completed measures of romantic attachment, sexual assertiveness, sexual function and satisfaction. Results indicated that attachment dimensions did not predict pain intensity. Both anxious and avoidant attachment were associated with lower sexual satisfaction. Only attachment avoidance predicted lower sexual function in women. Partner effects indicated that higher sexual assertiveness in men predicted better sexual function in women, while higher sexual assertiveness in women predicted higher sexual satisfaction in men. Finally, women’s sexual assertiveness was found to be a significant mediator of the relationship between their attachment dimensions, sexual function and satisfaction. Findings highlight the importance of examining how anxious and avoidant attachment may lead to difficulties in sexual assertiveness and to less satisfying sexual interactions in couples where women suffer from PVD.

La thérapie conjugale en milieu naturel: Étude du lien entre attachement amoureux, satisfaction conjugale, mandat thérapeutique et résultat de la consultation

L’objectif général de cette thèse est d’examiner le lien entre l’attachement amoureux des conjoints, la satisfaction conjugale, le mandat thérapeutique et le résultat de la thérapie conjugale telle que conduite en milieu naturel. Afin d’atteindre cet objectif, des couples se présentant en thérapie conjugale ont d’abord complété une batterie de questionnaires comprenant l’Échelle d’ajustement dyadique (Spanier, 1976) et le Questionnaire sur les expériences d’attachement amoureux (Brennan, Clark, & Shaver, 1998). Les thérapeutes ont par la suite indiqué le mandat thérapeutique poursuivi avec chaque couple (réconciliation ou résolution de l’ambivalence), suivant la classification de Poitras-Wright et St-Père (2004). À la fin de la consultation, le jugement du thérapeute a été utilisé pour classer chacun des cas comme ayant abandonné ou complété le traitement. Les couples ayant complété la thérapie ont rempli l’Échelle d’ajustement dyadique au post-traitement. Dans le premier des articles composant cette thèse, le lien entre l’attachement amoureux et la satisfaction conjugale a été examiné auprès d’un échantillon de 172 couples en détresse débutant une thérapie conjugale, de même qu’auprès de 56 couples non en détresse débutant également une thérapie conjugale, pour fins de comparaison. Les résultats ont démontré que l’évitement de la proximité semble être une caractéristique distinctive des couples en détresse et que cette dimension de l’attachement est fortement liée à l’insatisfaction conjugale de ce même groupe. Dans le deuxième article, le mandat thérapeutique, l’attachement amoureux et la satisfaction conjugale ont été examinés en tant que prédicteurs de l’abandon de la thérapie conjugale, auprès de 141 couples. Les résultats ont notamment démontré qu’un mandat de résolution de l’ambivalence augmente les probabilités d’abandon de la thérapie conjugale. De plus, les prédicteurs du résultat de la thérapie ont également été examinés dans ce second article. Les résultats obtenus au moyen d’analyses acteur-partenaire ont démontré que la satisfaction conjugale pré-traitement apparaît comme le meilleur prédicteur de la satisfaction conjugale post-traitement, et ce, malgré l’inclusion de l’attachement amoureux parmi les variables investiguées. Considérés dans leur ensemble, les résultats de cette thèse suggèrent que l’insécurité d’attachement serait fortement associée à l’insatisfaction des couples en détresse, mais ne nuirait pas pour autant à l’obtention d’un résultat positif en thérapie conjugale. En somme, cette thèse contribue à l’avancement des connaissances en se penchant sur l’utilité de la théorie de l’attachement en thérapie conjugale et en soulignant la nécessité de tenir compte des mandats thérapeutiques dans les futures études en thérapie conjugale. Les implications cliniques des résultats et des recommandations pour la recherche clinique sont présentées dans la conclusion de l’ouvrage.

The Tuck

Thesis (Master's)--University of Washington, 2016-06

Experiências relacionais na infância e vinculação amorosa no adulto: Um estudo com uma amostra de estudantes universitários

Este estudo debruça-se sobre as experiências relacionais na infância, com as figuras significativas, dimensões e estilos de vinculação amorosa no adulto, de acordo com a Teoria das Relações de Objeto e a Teoria da Vinculação. Participaram 187 estudantes da Universidade de Évora, 109 mulheres e 78 homens. As idades variaram entre os 18 e os 43 anos (M= 22,82; DP= 4,20). Aplicou-se o Protocolo de Avaliação dos Marcadores do Desenvolvimento na Psicopatologia (PAMaDeP, Soares, Rangel-Henriques, Neves e Pinho, 1999) e a versão portuguesa (Ramos, Leal & Maroco, 2006) do Parental Bonding lnstrument (PBI) referente às experiências na infância. Para avaliar a vinculação amorosa foi usada a versão portuguesa (Fonseca, Martins, Soares, Carvalho, Tereno e Carvalho, 2005) do Reciprocai Attachment Questionnaire, (RAQ) e do Loving and Working (L&W, Fonseca, Soares & Martins, 2006). Os resultados são discutidos de um ponto de vista desenvolvimentista, particularmente segundo a perspetiva da Teoria da Vinculação. ABSTRACT: This study focuses on the relational experiences in childhood, with significant figures, dimensions and styles of romantic attachment in adults, according with Object Relations Theory and Attachment Theory Teoria da Vinculação. 187 students from Universidade de Évora had participate, 109 women and 78 men. Ages are ranged from 18 to 43 years (M=22,82; DP=4,20). We used the Protocolo de Avaliação dos Marcadores do Desenvolvimento na Psicopatologia (PAMaDeP, Soares, Rangel-Henriques, Neves e Pinho, 1999) and the Portuguese version (Ramos, Leal & Maroco, 2006) of the Parental Bonding lnstrument (PBI) for the childhood experiments. ln order to avaliate the romantic attachment used the Portuguese version (Fonseca, Martins, Soares, Carvalho, Tereno, e Carvalho, 2005) from the Reciprocal Attachment Questionnaire (RAQ) and from Loving and Working (L&W, Fonseca, Soares & Martins, 2006). The results are discussed from a developmental point of view, particularly from the perspective of Attachment Theory.

Attachment, infidelity, and loneliness in college students involved in a romantic relationship: the role of relationship satisfaction, morbidity and prayer for partner

This study examined the mediating effects of relationship satisfaction, prayer for a partner, and morbidity in the relationship between attachment and loneliness, infidelity and loneliness, and psychological morbidity and loneliness, in college students involved in a romantic relationship. Participants were students in an introductory course on family development. This study examined only students (n = 345) who were involved in a romantic relationship. The average age of participants was 19.46 (SD = 1.92) and 25 % were males. Short-form UCLA Loneliness Scale (ULS-8), (Hays and DiMatteo in J Pers Assess 51:69–81, doi:10.1207/s15327752jpa5101_6, 1987); Relationship Satisfaction Scale (Funk and Rogge in J Fam Psychol 21:572–583, doi:10.1037/0893-3200.21.4.572, 2007); Rotterdam Symptom Checklist (De Haes et al. in Measuring the quality of life of cancer patients with the Rotterdam Symptom Checklist (RSCL): a manual, Northern Centre for Healthcare Research, Groningen, 1996); Prayer for Partner Scale, (Fincham et al. in J Pers Soc Psychol 99:649–659, doi:10.1037/a0019628, 2010); Infidelity Scale, (Drigotas et al. in J Pers Soc Psychol 77:509–524, doi:10.1037/0022-3514.77.3.509, 1999); and the Experiences in Close Relationship Scale-short form (Wei et al. in J Couns Psychol 52(4):602–614, doi:10.1037/0022-0167.52.4.602, 2005). Results showed that relationship satisfaction mediated the relationship between avoidance attachment and loneliness and between infidelity and loneliness. Physical morbidity mediated the relationship between anxious attachment and psychological morbidity. Psychological morbidity mediated the relationship between anxious attachment and physical morbidity. The present results expand the literature on attachment by presenting evidence that anxious and avoidant partners experience loneliness differently. Implications for couple’s therapy are addressed. Future research should replicate these results with older samples and married couples.

Attachment, borderline personality, and romantic relationship dysfunction

Previous studies have implicated attachment and disturbances in romantic relationships as important indicators for Borderline Personality Disorder (BPD). The current research extends our current knowledge by examining the specific associations among attachment, romantic relationship dysfunction, and BPD, above and beyond the contribution of emotional distress and nonromantic interpersonal functioning in two distinct samples. Study 1 comprised a community sample of women (N = 58) aged 25–36. Study 2 consisted of a psychiatric sample (N = 138) aged 21–60. Results from both Study 1 and Study 2 demonstrated that (1) attachment was specifically related to BPD symptoms and romantic dysfunction, (2) BPD symptoms were specifically associated with romantic dysfunction, and (3) the association between attachment and romantic dysfunction was statistically mediated by BPD symptoms. The findings support specific associations among attachment, BPD symptoms, and romantic dysfunction.

Sleep Quality as a Mediator of the Relationship Between Attachment Anxiety and Health Outcomes During Romantic Conflict

Attachment anxiety, or a fear of abandonment by those close to you, is an important predictor of many individual and interpersonal outcomes. Individuals high in attachment anxiety are more likely to experience physical illness due to disrupted immune functioning and deregulated stress responses. I was interested in examining potential mechanisms accounting for why individuals high in attachment anxiety are more likely to become ill. One variable that has been demonstrated to mediate the relationship between stress and health is sleep quality. As attachment anxiety is characterized by the experience of stress and worry over abandonment by romantic partners, I predicted sleep quality would mediate the relationship between attachment anxiety and health. Further, I predicted attachment anxiety would interact with romantic threat, in that individuals high in attachment anxiety who perceive threat to their relationships would have poor sleep quality (compared with individuals low in attachment anxiety and individuals high in anxiety who do not perceive threat) which would mediate the most unhealthy outcomes. I tested these hypotheses using three online diary studies. In the first two studies, participants completed a seven-night diary describing their sleep quality, health, and interaction with their partner. In Study 3, I surveyed participants once a week for eight weeks to examine longer-term health outcomes. Sleep quality did indeed mediate the relationship between attachment anxiety and various health outcomes over one week (Study 2), and showed a trend towards mediating effects over two months (Study 3). Interestingly, however, attachment anxiety did not interact with perceived romantic threat to predict health in the mediation analyses. Implications for sleep as a mediating variable are discussed, as well as the lack of attachment anxiety by romantic threat interaction.

Attachment style, assertive communication, and safer-sex behavior

This research tested the proposition that the effect of attachment security on safer-sex practice may be mediated by communication patterns. One hundred eighty-five undergraduate students completed questionnaire measures of attachment, assertiveness, and attitudes to communication about AIDS. Eight weeks later, they reported on their practice of safer sex in the period since the first testing session. Hierarchical regressions showed that at Step 1, anxiety about relationships (a measure of insecure attachment) was associated with less safer-sex practice, for all outcome measures. Attitudes to communication about AIDS added to the prediction of general reports of safer-sex practice: in line with the mediational model, anxiety about relationships became unimportant as a predictor when communication variables were included. Communication variables failed to add to the prediction of safer sex on the most recent encounter, and both anxiety about relationships and attitudes to communication about AIDS predicted condom use. Some gender differences in patterns of prediction were noted. The results are discussed in terms of attachment style and its links with the negotiation of sexual practice and relationship issues.

Attachment style as a predictor of sexual attitudes and behavior in late adolescence

This research applied attachment theory to the study of sexual attitudes and behaviors in a sample of late adolescents. Four hundred and seventy heterosexual undergraduate students completed questionnaires assessing attachment (discomfort with closeness; anxiety over relationships), relationship history, communication about sex, sexual self-efficacy and locus of control, and attitudes to condoms. Eight weeks later, participants reported on sexual behaviors occurring during the eight-week interval, and perceived risk of these activities. Both discomfort with closeness and anxiety over relationships were associated with external locus of control for sexual outcomes, and with use of drugs before sexual contact. Anxiety over relationships was linked to unsafe sex and to negative attitudes to condoms, but discomfort with closeness was associated with a more cautious approach to sexual risk-taking. Some results were qualified by gender differences, and by differences between the full sample and those who were sexually active. The findings are discussed in terms of attachment style and its links with communication and affect regulation.

Pathological Love: Impulsivity, Personality, and Romantic Relationship

Introduction: Pathological love (PL)-behavior characterized by providing repetitive and uncontrolled care and attention to the partner in a romantic relationship-is a rarely studied condition, despite not being rare and causing suffering. This study aims at investigating impulsivity, personality, and characteristics related to the romantic relationship in this population. Methods: Eighty-nine individuals (50 with PL; 39 individuals with no psychiatric disorder) were compared regarding impulsivity, personality, type of attachment, satisfaction with romantic relationship, and love style. Results: Individuals with PL have higher levels of impulsivity (P<.001; Barratt Impulsiveness Scale), higher self-transcendence, that is, are more unconventional and hold sense of communjon with a widerreality (P<.001; Temperament and Character Inventory) and keep dissatisfactory romantic relationships (P<.001; Adapted Relationship Assessment Scale). Conclusion: Individuals with PL present personality traits and relationship aspects that must be taken into account in devising assessment and therapeutic strategies for this population. CNS Spectr. 2009;14(5):268-274

Attachment and Coping With Two Kinds of Relationship Stressors

This study evaluated the relationship between recalled parental treatment, attachment style, and coping with parental and romantic stressors. A group of 66 undergraduate students completed the Parental Bonding Instrument (PBI) (Parker, Tupling, & Brown, 1979), a measure of attachment style (Simpson, 1990), general questions regarding the intensity and frequency of parental and romantic stressors, and their typical ways of coping with each type (Vitaliano, Russo, Carr, Maiuro, & Becker, 1985). Data analysis showed that attachment scores were significantly correlated with coping with both kinds of stress. The most significant correlations were found between attachment and coping with romantic stressors. Overall, high or low use of a specific approach to coping was consistent in the face of parental and romantic stressors. Further, exploratory analysis revealed that the habitual intensity of the experienced stressors could act as a moderator of coping techniques.

Patterns and Predictors of Stability and Change in Representations of Romantic Relationships in Adolescence and Young Adulthood

Research on the stability of attachment representations across the lifespan has led to two alternative perspectives: the prototype and revisionist perspectives (Fraley, 2002). The prototype perspective posits that there is a stable factor underlying fluctuations in representations and the revisionist perspective argues that there is no inherently stable factor. The current study employed a latent trait-state model to investigate these alternative models of stability and change in representations of romantic relationships in adolescence and young adulthood. The study also sought to identify individual characteristics and relationship experiences that are associated with changes in representations. In a sample of 200 participants, representations were assessed by interview and self-report over seven measurement occasions between ages 15 and 23. Results were consistent with the prototype perspective emphasizing that a stable, latent factor exerts a consistent influence over the lifespan. In addition to a stable component, representations incorporated a component that varies over time. Findings showed that this fluctuating component of representations was associated with internalizing and externalizing symptomatology as well as experiences of support and negative interaction in relationships.

Please Stop Rubbing Your Relationship In My Face(book): An Investigation of Online Romantic Social Comparison

It is well-documented that social networking sites such as Facebook set the stage for social comparison. Such comparison has been linked to a number of negative outcomes including envy, negative moods, and lower self-esteem. The present research aims to extend current understanding of online social comparison by investigating how it pertains to romantic relationships. I hypothesized that for individuals high in attachment anxiety (compared to those low in this construct), online romantic social comparison might be related to negative consequences—which, in the current project, was operationalized as lower mood/affect and state self-esteem. Further, I hypothesized that there would be an interaction between attachment anxiety and relationship insecurities on these negative outcomes, such that the expected difference of attachment anxiety would be more pronounced under conditions priming relationship insecurities, relative to a control condition. Two experiments were conducted, one of which focused on single individuals, and the second focusing on individuals who were themselves in dating relationships. The paradigms of each entailed experimental manipulation of a key relationship-related variable (for single individuals, pessimism for future relationships; for dating individuals, the presence or absence of rejection threat), subsequent exposure to romantic content from Facebook, and finally, measures of affect and state self-esteem. I discovered partial support for the hypothesis that some single individuals—particularly those with higher, rather than lower, attachment anxiety—do indeed report feeling more negative moods and lower state self-esteem following exposure to romantic online content, in contrast to single individuals who had instead viewed neutral online content. The association between attachment anxiety and negative outcome was especially pertinent if individuals had been primed to believe that their own future romantic prospects were grim, or if attention had been drawn to their singleness. Among dating individuals, less support for hypotheses was found; however, exploratory post-hoc analyses revealed a promising (albeit weak) trend indicating that reinvestigation of the current hypotheses would be prudent.