Adult attachment, working models, and relationship quality in dating couples

Factor Structure and Convergent Validity of the Short Version of the Bielefeld Partnership Expectations Questionnaire in Patients With Anxiety Disorder and Healthy Controls

The short version of the Bielefeld Partnership Expectations Questionnaire (BPEQ-12) assesses the partner-related attachment dimensions fear of rejection, readiness for self-disclosure, and conscious need for care. The presented study investigated the factor structure in two samples and evaluated the convergent validity of scales. The sample included N = 175 patients with panic disorder and/or agoraphobia and N = 143 healthy controls. Besides, the BPEQ, the Experiences in Close Relationships Questionnaire (ECR), and the Brief Symptom Inventory (BSI) were assessed as well, and the Adult Attachment Prototype Rating (AAPR) was conducted. A confirmatory factor analysis of the three factor model (using a WLSMV estimator) revealed an acceptable model fit for the entire sample, patients and controls in terms of low RMSEA and SRMR (< 0.08) and high CFI and TLI (> 0.95). We found metric, scalar, and strict measurement invariance for the presence of anxiety disorder (ΔCFI ≤ –0.01 and ΔRMSEA ≥ 0.01). However, only for fear of rejection and readiness for self-disclosure the reliability was acceptable (Cronbach’s α > 0.7), and convergent validity in terms of large correlations (r > 0.7) with the ECR scales was found in both samples. The scale conscious need for care had a questionable reliability (Cronbach’s α > 0.6) and correlated only slightly with ECR-R scales. We conclude that fear of rejection and readiness for self-disclosure of the BPEQ-12 are reliable and valid scales for measuring partner-related attachment in healthy and clinical samples.

Couple Communication in Cancer: Protocol for a Multi-Method Examination

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples' ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.

Avoidant Attachment, Withdrawal-Aggression Conflict Pattern, and Relationship Satisfaction: A Mediational Dyadic Model

This study was conducted with the purpose of analyzing the combined and mediating effect of actor's withdrawal-partner's demand conflict resolution strategies between avoidance attachment dimension and relationship satisfaction. We conducted a dyadic study with 175 heterosexual couples (aged between 18 and 72 years) who filled in the questionnaires. Six hypotheses were tested using the actor-partner interdependence model with mediation analysis (APIMeM). Results showed that the avoidance dimension of attachment was more strongly associated with actor's withdrawal strategy than with demand/aggression strategy. Furthermore, avoidance attachment was negatively associated with both actor's and partner's relationship satisfaction, the actor effect being higher. Withdrawal strategy was a mediator between actor's avoidance and actor's relationship satisfaction, but it was not a mediator for partner's relationship satisfaction. The interactive pattern of actor's withdrawal-partner's demand/aggression was associated with low levels of both actor's and partner's relationship satisfaction. These results point out to the need of discerning the interactive pattern of conflict-solving strategies as well as their intertwined effect on relationship satisfaction.

Relation of parenting child abuse based on attachment styles, parenting styles, and parental addictions

The purpose of this study was to complete the cycle of recognizing these relationships. In this regard, the effect of parenting styles, attachment styles, and the mediating variable of addiction was investigated on child abuse (CA). Multi-stage random sampling and sample size were selected based on the sample size estimation software (510 people) and according to the 20% probability of a drop in the number of subjects, 530 people (265 boys and 265 girls) and 1060 parents were selected. The available method was selected from a sample of 530 people who were selected based on the Addiction Severity Index (ASI) and answered Baumrind's Parenting Styles Questionnaire (PSQ), Childhood Trauma Questionnaire (CTQ), and Adult Attachment Scale (AAS). Data were assessed by analysis of variance, mediator analysis, and path analysis. The results showed that differences in parenting styles cause differences in their attachment styles. The results supported only the relationship between the two components of parental affection and control with the attachment avoidance index, and no relationship was observed between these components and the anxiety index. Perceived emotional abuse, mediates the relationship between parental parenting components and the child attachment avoidance index. Finally, it was achieved to a model that shows how the two factors of affection and control simultaneously affect the avoidance index, mediated by parental addiction.

Patient's and the Therapist's Attachment Representations, Attachment to Therapists, and Self-Esteem-Change Through Psychotherapy

Objectives: The present naturalistic study aims to investigate the differential effects of the patient’s and the therapist’s attachment representations on the attachment to the therapist as perceived by the patient, and their impact on self-esteem-change through psychotherapy.

Methods: Attachment variables of N = 573 patients as well as N = 16 therapists were assessed. Attachment representations were measured for therapists and patients via the Bielefelder Questionnaire for Client Attachment Exploration, the Relationship Specific Attachment to Therapist Scales and the Adult Attachment Interview. The patient’s attachment to therapists was evaluated and patients’ self-esteem was measured via the Frankfurter Selbstkonzeptskalen at the beginning and end of psychotherapy.

Results: Although there were significant effects of the patient’s attachment representations on the perceived attachment to the therapist as well as between the perceived attachment to the therapist and the amount of self-esteem-change, the therapist’s attachment style had no significant influence on the perceived attachment to the therapist.

Conclusion: Self-esteem-change through psychotherapy is influenced by the actually formed attachment relationship as perceived by the patient. The patient’s attachment representations but not the therapist’s attachment style contributes to the actual patient’s attachment to the therapist.

Attachment Style and Mental Health Profiles of Parents Caring for a Child with Autism: Suicidal Ideation, Depression and Anxiety

The study investigated association between attachment style of parents with a child diagnosed with Autism and mental health. A cross-sectional web-based survey collected data from 184 parents of individuals with autism. Findings from the study indicated association between an avoidant and anxious attachment style and mental health. Mainly, a link between avoidant attachment style and parents' levels of suicidal ideation and depression, an association between anxious attachment style and the parent's level of suicidal ideation, depression and anxiety. Several sociodemographic variables were associated with suicidal ideation and mental health. Specifically, we identified impacts of child's race on suicidal ideation, marital status on depression as well as impact of education on anxiety. Implication for future research, assessment and treatment are presented.

Individuals with Major Depressive Disorder Report High Scores of Insecure-Avoidant and Insecure-Anxious Attachment Styles, Dissociative Identity Symptoms, and Adult Traumatic Events

Objective: Individuals with major depressive disorder (MDD) report more issues in social interaction compared to the general population. Moreover, dimensions of dissociation are considered dysfunctional strategies to cope with adverse life events. In this regard, current symptoms of MDD could be associated with traumatic events that occurred in childhood and in adult life. Given this background, the aim of the present study was to explore the associations between attachment styles as a proxy of quality of social interaction, dimensions of dissociation, and childhood and adult traumatic life events among individuals with MDD. Method: A total of 300 individuals with MDD (mean age: 31.31 years; 58.7% female) took part in this study. They completed a series of questionnaires on sociodemographic information, attachment styles, dimensions of dissociation, and childhood and adult traumatic life events. Results: Prevalence rates for attachment styles were as follows: anxious/ambivalent attachment style—71.7%; avoidant/dependent attachment style—13%; secure/close attachment style—15.3%. Compared to the general population, the participants reported higher prevalence rates of insecure attachment styles. Current symptoms of dissociation were associated with adult but not childhood traumatic life events. An anxious attachment style was associated with higher scores of dissociation. Conclusion: Psychotherapeutic treatment of individuals with MDD should consider the individuals’ challenging attachment styles and their risk of dissociation. While it is important to consider both adult and childhood traumatic events, in this research, more recent trauma occurring in adulthood was associated with current symptoms of dissociation.

Thriving Through Relationships in Sport: The Role of the Parent-Athlete and Coach-Athlete Attachment Relationship

The aim of this research was to examine whether attachment relationships to significant others, such as to parents and/or sports coaches, enable thriving and competition performance within sport. Two studies employing cross-sectional and prospective designs were carried out across different samples of athletes of varied skill levels and sports. In Study 1, we found athletes' attachment to their sports coach was significantly associated with athlete thriving and mediated by psychological needs satisfaction. Results of Study 2 found that athletes' secure attachment to their mother and/or father positively predicted the experience of thriving at the competition while athletes' insecure attachment did not predict thriving. Furthermore, athletes' attachment to both mother and father did not predict competition performance. Together, these two studies acknowledge the significant role that athletes' secure attachment relationships with parents and coaches play in facilitating thriving in athletes. These findings have significant implications for research and practice.

Attachment Style and Jealousy in the Digital Age: Do Attitudes About Online Communication Matter?

Romantic jealousy, a complex response to a real or perceived threat to a romantic relationship, can have serious negative consequences for individuals, partners and perceived rivals. The likelihood of a jealous response is heightened among individuals who experience attachment anxiety, and online communication and social media provide unique fodder for romantic jealousy. The purpose of the current study is to test whether the association between attachment anxiety and online jealousy (jealous response to ambiguous hypothetical online scenarios) is moderated by negative attitudes about online communication. Individuals in dating relationships were asked about attachment anxiety and attitudes about online communication (i.e., apprehension and concern about misunderstandings) as well as emotional, cognitive, and behavioral online jealousy. Hierarchical linear regression revealed an attachment anxiety-attitude interaction, such that the link between attachment anxiety and jealousy was stronger for participants with relatively low levels of negative attitudes about online communication compared to participants with relatively high levels of negative attitudes. The current study expands knowledge about attachment anxiety and jealousy in the context of online communication and social media, and highlights the importance of considering attitudes about online communication when studying relationship processes in the digital arena.

The effects of intimate relationship characteristics on unprotected anal intercourse among same-sex male couples in China: a dyadic analysis using the actor-partner interdependence model

BACKGROUND

Unprotected anal intercourse (UAI) within the context of concurrent sexual relationship are prevalent among men who have sex with men (MSM) who have regular male sex partners and it aggravates the risk of HIV infection among this community. The aim of this study was to assess the effect of intimate relationship characteristics on UAI among MSM couples at the dyadic level.

METHODS

Two hundred four MSM couples were recruited from a HIV testing clinic from April 2017 to April 2018 in Guangzhou, China. The actor-partner interdependence model (APIM) was applied for dyadic analysis. Each MSM couple was divided into the insertive role and the receptive role according to their regular anal sex role. In this context, actor effect is the impact of an MSM's intimate relationship characteristics on his own UAI, and partner effect is the impact of his partner's intimate relationship characteristics on his UAI.

RESULTS

Of the 408 participants, 58.82% had UAI with regular male sex partner (UAI-RP) and 8.09% had concurrent UAI. Intimate relationship characteristics were associated with concurrent UAI, but not associated with UAI-RP. For the receptive role, his relationship investment exerted significant actor and partner effects on concurrent UAI (AOR actor = 1.31, P < 0.001; AOR partner = 1.17, P < 0.001). Meanwhile, receptive role's violence experience within relationship exerted significant actor effects on his own concurrent UAI (AOR actor = 6.43, P = 0.044).

CONCLUSIONS

Relationship investment and violence experience influenced concurrent UAI among MSM couples and it varied in different sex roles. Additional assistance on empowerment, relationship therapy and sexual agreement is urgently needed to reduce their high possibility on engagement of HIV-related risk behaviors.

Relationship between coping/attachment styles and infertility-specific distress in Iranian infertile individuals: A cross-sectional study

Background

Infertility has been recognized as a stressful clinical condition, significantly affecting couples' emotional functioning.

Objective

To investigate the relationship between coping/attachment styles and infertility-specific distress (ISD) in infertile participants.

Materials and Methods

Atotal number of 240 infertile participants (120 women and 120 men) who attend the Outpatient Infertility Clinic in Sari, Iran between February and October 2017 were selected using the convenience sampling method. Data were collected using a questionnaire addressing sociodemographic variables. In addition, coping and attachment styles were evaluated via the Coping Strategies Questionnaire and the Revised Adult Attachment Scale by Collins and Read (1990); respectively. Ultimately, the Infertility Distress Scale was used to assess ISD.

Results

The mean ISD score was 42.53 ± 9.63. Secure and insecure attachment styles were observed in 37.9% and 62.1% of the cases, respectively. There was a significant difference among ISD and different groups of attachment styles (p = 0.001) and emotion-focused coping style (p = 0.021). However, no significant relationship was found between problem-focused coping style and ISD (p = 0.985).

Conclusion

Considering the relationship between coping/attachment styles and ISD, it was recommended to implement stress prevention and coping education within the framework of coping/attachment theories for infertile individuals.

Social Support, Attachment Closeness, and Self-Esteem Affect Depression in International Students in China

With an increase in the number of international students in China, there has been a simultaneous increase in their emotional problems, such as depression, as well as the importance of their emotional well-being. This study aimed to investigate the influence of social support on depression and the mediation and moderation mechanisms of this relationship in international students. In total, 349 international students in China responded to a questionnaire survey comprising the Social Support Rating Scale, Self-rating Depression Scale, Adult Attachment Scale, and Self-Esteem Scale. The results showed that: (1) attachment closeness had a significant direct predictive effect on depression; (2) attachment closeness played a mediating role in the relationship between social support and depression; and (3) the direct effect of social support on depression and the mediating effect of attachment and closeness are regulated by self-esteem. Therefore, interventions aimed at improving the social support, attachment closeness, and self-esteem of international students in China can be effective in reducing their depressive symptoms.

Development and Psychometric Properties of a New Self-Report Questionnaire Measuring Attachment in School-Age Children: The Attachment in Middle Childhood Questionnaire (AMCQ)

Although conscious aspects of attachment representations can be effectively assessed in middle childhood, the few available self-reports are based on different operationalizations of attachment and do not always show adequate psychometric properties. The current study aimed to develop and evaluate the psychometric properties of the Attachment in Middle Childhood Questionnaire (AMCQ). Using three independent samples of Italian children (Mage = 10 years, 52% = girls), in three interrelated studies we (1) selected a pool of items from existing questionnaires, adapted them to the same response format, and subjected them to exploratory factor analysis; (2) performed confirmatory factor analyses on the retained items; and (3) used structural equation modeling to assess the factor structure, external validity, and invariance across gender and age groups. The final 15-item questionnaire comprised two dimensions (anxiety and avoidance) and a supplementary scale (security). Overall, results supported the reliability and validity of the AMCQ for Italian children.

Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults

BACKGROUND

Attachment and support from family and friends are core to the experiences of ageing for older adults. The purpose of this study is to examine the relationships between attachment styles and hope, religiosity, and life satisfaction and provide new knowledge that may assist future planning for a rapidly ageing global population.

METHODS

In this cross-sectional study, 504 Iranian older adult participants from Qazvin province were recruited between December 2015 and April 2016. They completed a questionnaire that included the Revised Adult Attachment Scale, the Life Satisfaction Index-Z, and the Herth Hope Index.

RESULTS

Participants in the study had a mean age of 66.20 years (SD: 5.76) and most of them were women (57.5%). A mediation model testing the direct relationships between attachment, hope, religiosity, and life satisfaction showed a positive relationship between close attachment and religiosity (β = .226, p < .001) and a negative relationship between anxiety attachment and religiosity (β =  - .229, p < .001). Religiosity was positively related to hope (β = .384, p < .01) and hope was related to life satisfaction (β = .448, p < .001). Religiosity and hope mediated the relationship between close attachment (β = .119, p < .001) and anxiety attachment (β =  - .056, p < .01) with life satisfaction. More specifically, while religiosity and hope fully mediated the relationship between close attachment and life satisfaction, they partially mediated the attachment anxiety-life satisfaction link.

CONCLUSIONS

Findings of the study provide insight into only a narrow perspective of life satisfaction and attachment given the many and varied variables that influence these constructs. Future research is needed whereby other related variables are introduced into the model to be examined further.

Exploration of the Spanish Version of the Attachment Style Questionnaire: A Comparative Study between Spanish, Italian, and Japanese Culture

Nowadays, there are several human attachment measures, most in the form of questionnaires that assess adult attachment styles. This study investigates the use of Feeney, Noller, Hanrahan, Sperling and Berman’s five-factors Attachment Style Questionnaire (ASQ, 1994), based on Bartholomew’s four-factors model (1991), and Hazan and Shaver’s three-factors model (1987). Nevertheless, no robust study has explored the ASQ questionnaire in Spanish compared to other cultures, such as Italian and Japanese. Therefore, the linguistic translation of the Spanish version of the ASQ was performed, based on the back-translation methodology. The results indicate that 5-factors ASQ Spanish version explains 43.67% of the variance, similar to the original English-Australian ASQ version. The Italian and Japanese versions explain 49.37% and 52.27% of the variance, respectively. No age correlation for any ASQ factors in the Japanese sample was found; meanwhile, the Spanish and Italian cultures showed a positive correlation with age and “Confidence” and negative correlation with age and “Relationships as Secondary” ASQ factors. Some transcultural differences and possible research approaches are addressed.

Adult Attachment and Personal, Social, and Symptomatic Recovery From Psychosis: Systematic Review and Meta-Analysis

Despite growing evidence for the role of attachment in psychosis, no quantitative review has yet been published on the relationship in this population between insecure attachment and recovery in a broad sense. We therefore used meta-analytic techniques to systematically appraise studies on the relationship between attachment and symptomatic, social and personal recovery in clients with a psychotic disorder. Using the keywords attachment, psychosis, recovery and related terms, we searched six databases: Embase, Medline Epub (OVID), Psycinfo (OVID), Cochrane Central (trials), Web of Science, and Google Scholar. This yielded 28 studies assessing the associations between adult attachment and recovery outcome in populations with a psychotic disorder. The findings indicated that insecure anxious and avoidant attachment are both associated with less symptomatic recovery (positive and general symptoms), and worse social and personal recovery outcomes in individuals diagnosed with a psychotic disorder. The associations were stronger for social and personal recovery than for symptomatic recovery. Attachment style is a clinically relevant construct in relation to the development and course of psychosis and recovery from it. Greater attention to the relationship between attachment and the broad scope of recovery (symptomatic, social, and personal) will improve our understanding of the illness and efficacy of treatment for this population.

Psychodynamic and sociopolitical predictors of COVID Distress and Gravity

This study examined the relationship between attachment style and fear of contamination during the COVID-19 pandemic, hypothesizing that anxiously attached participants would be more distressed when their safe space was threatened by someone leaving and returning. During May 2020, n = 355 participants provided demographics, personality, health anxiety scores, attachment styles, political ideology, and attitudes towards the pandemic. In both social media and MTurk subsamples (but not in a subsample from a ListServ of professional psychologists), anxious attachment was a significant predictor of distress above and beyond personality and health anxiety. In addition, political ideology emerged as a consistent predictor of perceptions of the seriousness of COVID-19, even holding the other predictors constant. Understanding an individual's attachment style may be helpful in working with them in their trauma. This research also contributes to early empirical evidence for the impact of political ideology on self-reported attitudes and behaviors during the COVID-19 pandemic.

Using the attachment network Q-sort for profiling one's attachment style with different attachment-figures

Attachment instruments vary substantially in practicability of administration, employment of categorical versus dimensional scoring, quality of scales, and applicability to different attachment figures. The Attachment Network Q-sort (ANQ) is a self-report, quasi-qualitative instrument that discriminates relationship-specific attachment styles for multiple attachment figures. The current study assesses the properties of the ANQ in psychotherapy patients and in non-patient respondents, using mother, father and romantic partner as possible attachment figures. Analyzing the ANQ-data with latent class analysis, we found four types or classes of participants: a group with an overall secure profile, a group only insecure for father, a group only insecure for mother, and a group insecure for mother as well as father but not for partner (if available). These profiles proved to have good concurrent, discriminant and construct validity. We conclude that the ANQ is potentially a useful alternative clinical self-report instrument to assess combinations of attachment styles for a range of attachment figures such as parents and a romantic partner.

Reconnecting Homeless Adolescents and Their Families: Correlates of Participation in a Family Intervention

Behavioral family interventions are an effective way to intervene to prevent negative developmental outcomes for adolescents. Participation in family interventions encompasses behavioral and cognitive/attitudinal dimensions, among others, indicated by retention and engagement, respectively. Two dimensions of participation, retention and engagement, in a family intervention were examined in a sample of newly homeless adolescents and their parents or guardians. Correlates of participation included parents with more income and less perceived family conflict and adolescents with higher endorsement of depression, anxiety, somatization, obsessive-compulsive, phobic, and psychotic symptoms on the Brief Symptom Inventory (BSI). Stronger therapeutic alliance was correlated with being more distressed (i.e., lower income, more hostility), being a female adolescent participant, and having greater comfort discussing sex with parents. Furthermore, parents and adolescents with greater distress and thus greater need were more apt to finish the intervention. The finding that families who were experiencing more distress had higher alliance scores suggests that there is an additional need for development of interventions for families in crisis. Both participant and provider perceptions are also important in development of a strong therapeutic alliance. This study's findings have implications for further exploration of the development of cultural humility and improving mental health literacy among facilitators of behavioral interventions.

Intergenerational attachment orientations: Gender differences and environmental contribution

After more than four decades of research and almost 100 attachment studies, the mechanisms of intergenerational transmission of attachment still remain unclear. To better understand the mechanisms moderating the associations of attachment orientations from one generation to the next, this empirical study examined the roles of 1) shared and non-shared environmental factors that characterize critical events in adulthood such as career choice, income and child care; 2) gender differences in attachment between parents (Generation 1, G1) and their adult offspring (Generation 2, G2) and their possible interactions. A sample of 321 families with G2 adults aged 18 and over and two G1 parents up to the age of 81 took part in this study. Both generations completed the Experiences in Close Relationships attachment measure as well as a comprehensive detailed measure of current core characteristics in adulthood (e.g. employment status, income, whether they had children) and demographic variables (gender, age). The findings suggest that the associations between the attachment orientations of G1 and the attachment orientations of G2 were moderated by G2’s income, their G1 paternal income and employment status, whether G2 had children (G3) of their own, and their family status after controlling for the age of G2, and the age of both paternal and maternal G1. When the associations for both paternal and maternal G1attachment orientation with both their male and female G2 was analyzed separately, this accounted for 35% of the variance of males’ G2 attachment orientation. The discussion focuses on the contribution of these findings to attachment theory and draws clinical conclusions.

Pinpointing Neural Correlates of Attachment in Poly-Drug Use: A Diffusion Tensor Imaging Study

An increasing amount of evidence indicates the significance of attachment in the etiology of poly-drug use disorder (PUD). The aim of this study was to investigate associations between PUD and adult attachment in particular, with a focus on white matter (WM) fiber tract integrity. For this purpose, we selected several regions-of-interest based on previous findings which were examined for their role in PUD and estimated whole-brain associations between adult attachment and WM integrity. A total sample of 144 right-handed males were investigated (Age: M = 27; SD = 4.66). This included a group of patients diagnosed with PUD (n = 70) and a group of healthy controls (HC; n = 74). The Adult Attachment Scales (AAS) was applied to assess attachment attitudes in participants. Diffusion Tensor Imaging was used to investigate differences in WM integrity. The findings suggest substantially less attachment security in PUD patients compared to HC. Furthermore, PUD patients exhibited reduced integrity in WM fiber tracts, most pronounced in the bilateral corticospinal tract, the fronto-occipital fasciculus, and the right inferior longitudinal fasciculus. However, these results were not controlled for comorbid depressiveness. With regard to associations between adult attachment and WM integrity, the results for PUD patients indicate a negative relationship between "Comfort with Closeness" and the structural integrity of a cluster comprising parts of the right anterior thalamic radiation, the inferior fronto-occipital fasciculus and the uncinate fasciculus. Despite being limited by the cross-sectional design of this study, the results emphasize the significance of attachment in PUD etiology, both at a behavioral and a neurological level. Largely in line with previous research, the findings revealed tentative links between adult attachment and WM fiber tracts related to cognitive and affective functions in PUD patients.

Measuring adult romantic attachment: psychometric properties of the brief Spanish version of the experiences in close relationships

The Experiences in Close Relationships (Brennan et al, Attachment theory and close relationships, 1998) questionnaire is one of the most widely used measures of adult romantic attachment. Despite the advantages of the ECR, the length of this measure may discourage its use in clinical and research contexts. Consequently, the goal of this study was to develop a brief Spanish version of the ECR questionnaire and to examine its psychometric properties when administered to six different Spanish-speaking samples from Chile. Confirmatory factor analyses replicated the two-dimensional structure of the ECR and its invariance across gender. Results also supported the reliability and concurrent validity of our brief Spanish version of the ECR (i.e., Spanish ECR-12), by its association with measures of emotion regulation, dyadic empathy, psychological distress and well-being, and relationship satisfaction. The Spanish ECR-12 can be used by researchers and clinical professionals as an abridged measure of adult attachment.

Attachment Style and Insight in Schizophrenia: a Cross-Sectional Study

Attachment theory provides a model for understanding impairments in social and interpersonal functioning. Schizophrenia is a neuropsychiatry disorder frequently associated with compromised social functioning and limited social support networks. However, the relationship between attachment style and psychopathology dimensions, including insight, isn't fully understood To determine whether there is a relationship between the attachment style and markers for severity of schizophrenia and insight. We conducted a cross-sectional study of 41 patients with schizophrenia and 34 patients with non-psychotic disorders used as a control group. Patients were assessed using semi-structured diagnostic interviews and self-reporting questionnaires, including Adult Attachment Scale-Revised. The schizophrenia group was also given the Positive and Negative Syndrome Scale and the Markova and Berrios Insight Scale. Insecure attachment was overrepresented in the schizophrenic group, and this difference was mainly accounted for lower levels of dependence, representing a moderate effect size (Cohen's d = 0.32). In the schizophrenia group, the closeness and the dependence subscale were negatively correlated with psychopathology severity. Using a multiple regression analysis, the insight was predicted by attachment anxiety, accounting for 20% of the total variance (R² = 0.199, p <0.05). Our data confirm previous evidence that insecure attachment is associated with schizophrenia and suggest that the less comfortable the patient is with closeness and intimacy the greater the severity of symptoms. Furthermore, our findings indicate that higher separation anxiety might predict a better insight.

The Effectiveness of Attachment Security Priming in Improving Positive Affect and Reducing Negative Affect: A Systematic Review

: Attachment security priming has been extensively used in relationship research to explore the contents of mental models of attachment and examine the benefits derived from enhancing security. This systematic review explores the effectiveness of attachment security priming in improving positive affect and reducing negative affect in adults and children. The review searched four electronic databases for peer-reviewed journal articles. Thirty empirical studies met our inclusion criteria, including 28 adult and 2 child and adolescent samples. The findings show that attachment security priming improved positive affect and reduced negative affect relative to control primes. Supraliminal and subliminal primes were equally effective in enhancing security in one-shot prime studies (we only reviewed repeated priming studies using supraliminal primes so could not compare prime types in these). Global attachment style moderated the primed style in approximately half of the studies. Importantly, repeated priming studies showed a cumulative positive effect of security priming over time. We conclude that repeated priming study designs may be the most effective. More research is needed that explores the use of attachment security priming as a possible intervention to improve emotional wellbeing, in particular for adolescents and children.

The Influence of an Attachment-Related Stimulus on Oxytocin Reactivity in Poly-Drug Users Undergoing Maintenance Therapy Compared to Healthy Controls

BACKGROUND

Substance use disorders (SUDs) have been described as a dysfunctional way to compensate for deficiencies in that person's underlying attachment system. Furthermore, the neuropeptide oxytocin (OT), which is a critical component of the neurobiology of the attachment system, has been shown to effectively reduce addictive behavior and therefore has been discussed as a potential medication in SUD treatment. This study investigates variation in peripheral OT plasma levels as a function of exposure to an attachment-related stimulus in SUD patients compared to healthy controls (HCs).

METHODS

A total sample of 48 men, 24 inpatients in maintenance treatment who were diagnosed with poly-drug use disorder (PUD) and 24 HC, was investigated. A 15-min exposure to the Adult Attachment Projective Picture System (AAP) was used as an attachment-related stimulus and coded for attachment status. Blood samples before and after the AAP-assessment were taken and assayed for OT levels. Variation in baselines level of OT was examined in relation to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Adult Attachment-Scale (AAS), and the Brief Symptom Inventory (BSI).

RESULTS

Following the AAP stimulus controls showed no significant difference in OT levels elevation from baseline compared to the PUD group's OT levels. Furthermore, in the PUD group only OT-baseline-levels may be negatively associated with the AAS subscale "Comfort with Closeness" and "Anxiety" and lifetime substance use.

DISCUSSION

Our results suggest that peripheral OT levels in poly-drug users undergoing maintenance treatment are not significantly different in responsiveness to an attachment related stimulus compared to HC. With regard to non-significant tendencies observed in this study which hint toward decreased OT-reactivity in the PUD group, further research is needed to explore this hypothesis with increased statistical power.

Attachment and Adulthood in a Sample of Southeastern Mexico

The main purpose of this research is to analyze the attachment styles of men and women from 20 to 40 years old (early adulthood) and from 40 to 65 years old (middle adulthood) who are in a romantic relationship and live in the City of San Francisco Campeche. A sample of 50 men and 50 women in early adulthood and 50 men and 50 women in middle adulthood was selected, and the questionnaire “Styles of Attachment” was applied. For the data analysis, we used the SPSS version 23 program along with student’s “t” and X² (Chi²) tests. The results show no significant differences in attachment styles between male and female relationships. However, with respect to the stages analyzed, significant differences are found in attachment styles. In addition, there are significant differences with respect to the type of relationship: single people have secure attachment while married people display anxious attachment. We conclude that in early adulthood, secure attachment predominates, while in middle adulthood anxious attachment predominates.

Internet Interpersonal Connection Mediates the Association between Personality and Internet Addiction

Backgrounds: The development of the Internet has changed interpersonal interactions, so that people no longer need to physically meet each other. However, some people are more vulnerable to becoming addicted to Internet activities, something to which the ease of Internet access and usage has contributed. In this study, we examined the association between personality traits and feelings about online interpersonal interactions to predict Internet addiction. This was accomplished using an online advertisement that asked participants to complete the questionnaires in the laboratory. Methods: Two hundred and twenty-three participants with a mean age of 22.50 years were recruited for this study and asked to complete the following questionnaires: the Beck Depressive Inventory (BDI), the Beck Anxiety Inventory (BAI), the Chen Internet Addiction Scale (CIAS), the Eysenck Personality Questionnaire (EPQ), the Internet Usage Questionnaire (IUQ) and the Feelings of Internet Interpersonal Interaction Questionnaire (FIIIQ). Results: The results showed that people with a neurotic personality and anxious feelings about Internet interpersonal interactions are more likely to become addicted to the Internet. In addition, people with neuroticism and who are more anxious about Internet interpersonal relationships are more likely to develop Internet addiction. Conclusions: People who tend to develop new interpersonal relationships via the Internet and be anxious about online interpersonal relationships are more vulnerable to becoming addicted to the Internet. The individuals who are more anxious about Internet interpersonal interaction and tend to develop new interpersonal relationships via the Internet are more likely to develop Internet addiction.

The Role of Attachment in Poly-Drug Use Disorder: An Overview of the Literature, Recent Findings and Clinical Implications

Background: Substance use disorders (SUDs) represent a worldwide epidemic with extensive costs to the individual and to society. Occasionally described as an attachment disorder, they have been linked to various impairments in self-regulation and social functioning. However, while there have been significant advances in the development and validation of treatment strategies for SUD in recent years, the components of these treatment approaches have yet to be fully explored. The characteristics of polydrug use disorder (PUD) especially need to be addressed in more detail, as this diagnosis is highly common in individuals seeking treatment, while simultaneously being associated with poor treatment success. Aim and Scope: This review aims at further exploring the relevance of attachment in PUD and its treatment. To this end, this review provides a concise summary of relevant theories on the development and treatment of SUD in general, including related parameters of attachment, emotion regulation, and neuroscience. Furthermore, several studies focused specifically on PUD are described in more detail. These studies explored the connections between attachment, personality structure, primary and higher emotions (including spirituality), as well as structural and functional neural parameters in inpatients with PUD as well as in healthy controls. Most notably, the described studies highlight that insecure attachment and impairments in personality structure are present in inpatients with PUD. In addition, these characteristics are paralleled by extensive impairments in white matter integrity, especially in tracts connected to facets of emotion regulation. Conclusions: Based on our findings, we emphasize conceptualization of PUD as an Attachment Disorder, on a behavioral as well as on a neural level. Furthermore, we point out the importance of an integrated bio-psycho-social approach in this research area. Consequently, future studies might more closely focus on the influence of attachment-based interventions on emotion regulation abilities as well as a potentially related neuroplasticity. Neuroplastic changes, which are still rather unexplored, might represent important parameters for the assessment of treatment outcomes especially in long-term SUD treatment.

[Addiction as an attachment disorder]

BACKGROUND

There is no commonly accepted model for describing the development and treatment of substance use disorders (SUD); however, over several decades the attachment theory has represented an important basis for the clinical handling of SUD. This study gives a systematic review of empirical studies regarding the relationship between SUD and disorders of attachment behavior.

OBJECTIVE

Is there a positive relationship between disorders of attachment behavior and the presence of SUD?

METHOD

Various databases (PsychInfo, Web of Science, PubMed) were systematically searched in order to pinpoint relevant studies in books and articles published in English or German. Based on the results 22 publications were selected. After a stricter limitation to original research, 12 articles could finally be accepted as eligible.

RESULTS

A significant relationship was found between SUD and insecure attachment in 10 out of the 12 studies.

CONCLUSION

Based on the results of the research studies reviewed the hypothesis to characterize SUD as a possible expression of an attachment disorder was confirmed. This corroborates the importance of considering attachment parameters in dealing with prevention and treatment of SUD. Further research might focus on non-substance-related addictive disorders and therapy outcome studies.

Disentangle the neural correlates of attachment style in healthy individuals

Since its development and theorisation in the 60s, attachment theory has greatly influenced both clinical and developmental psychology suggesting the existence of complex dynamics based on the relationship between an infant and its caregiver, that affects personality traits and interpersonal relationships in adulthood. Many studies have been conducted to explore the association between attachment styles and psychosocial functioning and mental health. By contrast, only a few studies have investigated the neurobiological underpinnings of attachment style, showing mixed results. Therefore, in this review, we described current evidence from structural and functional imaging studies with the final aim to disentangle the neural correlates of attachment style in healthy individuals. Overall, different attachment styles have been correlated with volumetric alterations mainly in the cingulate cortex, amygdala, hippocampus and anterior temporal pole. Consistently, functional imaging studies suggested patterns of activations in fronto-striatal-limbic circuits during the processing of social and attachment-related stimuli. Further studies are needed to clarify the neurobiological signature of attachment style, possibly taking into consideration a wide range of demographic, psychosocial and clinical factors that may mediate the associations between the style of attachment and brain systems (e.g., gender, personality traits, psychosocial functioning, early-life experience).

Early Secure Attachment as a Protective Factor Against Later Cognitive Decline and Dementia

The etiology of neurodegenerative disorders such as dementia is complex and incompletely understood. Interest in a developmental perspective to these pathologies is gaining momentum. An early supportive social environment seems to have important implications for social, affective and cognitive abilities across the lifespan. Attachment theory may help to explain the link between these early experiences and later outcomes. This theory considers early interactions between an infant and its caregiver to be crucial to shaping social behavior and emotion regulation strategies throughout adult life. Furthermore, research has demonstrated that such early attachment experiences can, potentially through epigenetic mechanisms, have profound neurobiological and cognitive consequences. Here we discuss how early attachment might influence the development of affective, cognitive, and neurobiological resources that could protect against cognitive decline and dementia. We argue that social relations, both early and late in life, are vital to ensuring cognitive and neurobiological health. The concepts of brain and cognitive reserve are crucial to understanding how environmental factors may impact cognitive decline. We examine the role that attachment might play in fostering brain and cognitive reserve in old age. Finally, we put forward the concept of affective reserve, to more directly frame the socio-affective consequences of early attachment as protectors against cognitive decline. We thereby aim to highlight that, in the study of aging, cognitive decline and dementia, it is crucial to consider the role of affective and social factors such as attachment.

Patterns of Romantic Pathways among 23 Year Olds and their Adolescent Antecedents

Observation of the romantic lives of the majority of young people shows that they might move between transitory and inconsistent states, being in and out of a relationship. The present study aims to better understand the meaning of these fluctuations. For this purpose, and employing a multi-method design, 144 Israeli adolescents (59.7% females) were followed from age 16 to 23. At age 23 in-depth interviews were conducted with the participants, focusing on their romantic histories. Analyses of interviews at age 23 yielded four distinctive romantic pathways differing in stability and the ability to progress toward intimacy: Sporadic and Casual Encounters, Sporadic Encounters in Response to a Stressful Romantic Experience, Steady Non-Intimate Involvements, and Progression toward Steady Intimate Involvements. The findings showed that more than half of participants belonged to the Progression toward Steady Intimate Involvements pathway, suggesting that romantic fluctuations served as means to progress toward intimate involvements. Progression toward steady intimate involvement was explained by greater secure attachment, greater capacity to face tension and to express one's views, and greater parental support measured seven years earlier. In contrast, lower earlier intra- and interpersonal assets during adolescence were more likely to associate with a variety of romantic experiences during emerging adulthood that are characterized by romantic instabilities and difficulty to progress toward intimacy. The findings are discussed within the framework of the Developmental Systems Theory.

The Young Adult Love Lives of Happy Teenagers: The Role of Adolescent Affect in Adult Romantic Relationship Functioning

This study assessed early adolescent positive and negative affect as long-term predictors of romantic conflict, anxious and avoidant attachment, romantic and social competence, and relationship satisfaction in adulthood utilizing a longitudinal, multi-informant study of 166 participants assessed annually at ages 14-17, and again at ages 23-25. Positive affect in adolescence predicted greater self-rated social competence during late adolescence and greater self-rated romantic competence and less partner-reported hostile conflict almost a decade later. Negative affect predicted lower social and romantic competence. Results generally remained significant after controlling for personality traits, providing greater support for the hypothesis that affect has a robust, direct relation to romantic development over time.

Effects of Non-verbal Priming on Attachment-Style Activation

Using an affective priming procedure, two experiments examined the effects of non-verbal cues on activating attachment styles. In Study 1, the secure attachment group, which was primed non-verbally, showed higher levels of self-esteem, interpersonal competence, and positive affect than the insecure attachment group, which was also primed non-verbally. In contrast, no significant difference was found between the two attachment groups that were primed verbally. In Study 2, using a different priming method and adding a neutral group, similar interactions between priming modality (non-verbal or verbal cues) and attachment styles were found: the differences in self-esteem, interpersonal competence, and positive affect between the secure attachment group, neutral group, and insecure attachment group were greater when primed non-verbally than when primed verbally. Finally, the limitations of the research and recommendations for follow-up study are discussed.

Attachment Dimensions and Spatial Navigation in Female College Students: The Role of Comfort With Closeness and Confidence in Others

There is preliminary evidence suggesting that hippocampal functioning is associated with attachment style. However, it is unknown if attachment is also associated with hippocampal-related cognitive function such as spatial learning and recall. This study aims to verify if attachment dimensions are associated with spatial learning and recall. Sixty-five female participants were recruited and were evaluated using the Adult Attachment Scale-R and tested on a virtual maze navigation task (VMT) at one moment (exploratory trial + 3 trials) and 24 h later (3 trials). There was a significant Moment × Trial × Close-Depend interaction for the outcome time, F(2,126) = 3.807, p = 0.025, with post hoc analysis indicating that the High Close-Depend group displayed significant improvements between Trial 1 and Trial 3 in the post-test assessment. Conversely, the Low Close-Depend group displayed significant improvements between Trial 1and Trial 3 but on the pre-test assessment. Furthermore, the Low Close-Depend group presented significant better performance in pre-test Trial 3 in comparison to the High Close-Depend group. Thereby, it seems that low comfort with proximity and trust in others is associated with reduced spatial recall, although spatial learning performance was actually superior in these participants. It is possible that reduced exposure to social interaction and meaningful relationships may be reduced in the Low Close-Depend group, leading to modifications in hippocampal function and, ultimately, reduced spatial recall. Oppositely, participants in the High Close-Depend group may not display typical spatial learning in the proposed task as they are more willing to freely explore the presented environment.

Intergenerational transmission of war-related trauma assessed 40 years after exposure

BACKGROUND

The intergenerational transmission of posttraumatic stress disorder (PTSD) from parent to offspring has been suggested in the literature, but this is highly controversial. We aimed to study the association between veterans' war exposure and lifetime PTSD and the psychological characteristics of their respective offspring, 40 years after war-related trauma.

METHODS

Forty-four adult offspring of veterans with PTSD and 29 offspring of veterans without PTSD were included in the study, from a total of 46 veterans. War exposure intensity, lifetime PTSD, and the general psychopathology (with Brief Symptom Inventory-BSI) of the veterans were studied, as were childhood trauma, attachment, and the general psychopathology (with BSI) of their offspring.

RESULTS

Veterans' war exposure was associated with BSI in the offspring with regard to somatisation (β = 0.025; CI 0.001, 0.050), phobic anxiety (β = 0.014; CI: 0.000, 0.027), Global Severity Index (GSI) (β = 0.022; CI 0.005, 0.038), and Positive Symptom Distress Index (β = 0.020; CI 0.006, 0.033). The fathers' GSI mediated only 18% of the effect of the veterans' total war exposure on offspring's GSI. Fathers' war exposure was associated with offspring's physical neglect as a childhood adversity, although non-significantly (p = 0.063). None of the other variables was associated with veterans' war exposure, and veterans' lifetime PTSD was not associated with any of the variables studied.

CONCLUSIONS

The offspring of war veterans showed increased psychological suffering as a function of their fathers' war exposure intensity, but not of their fathers' lifetime PTSD. These results could be used to suggest that mental health support for veterans' offspring should consider the war exposure intensity of their fathers, and not just psychopathology. This could spare offspring's suffering if this mental health support could be delivered early on, after veterans return from war.

Testing a Neuro-Evolutionary Theory of Social Bonds and Addiction: Methadone Associated With Lower Attachment Anxiety, Comfort With Closeness, and Proximity Maintenance

Evidence from non-human mammals for the involvement of the endogenous opioid system in prosocial behavior is reasonably extensive and robust; however, studies in humans are lacking. This study tests the neuro-evolutionary hypothesis that exogenous opiates, including morphine, heroine, and methadone, decrease separation anxiety and proximity by hijacking the neuro-peptide endogenous opioid system modulating social bonds. Participants were 486 subjects, 43% male, with ages between 18 and 62 years (M = 26.4; SD = 9.4), divided in three naturalistic groups: 1: addicts in drug-free treatment; 2: addicts in methadone programs; 3: normative non-clinical controls. Instruments: 1) Adult Attachment Scale (AAS) composed of three subscales: Anxiety about being rejected (α = 0.83), Comfort with Intimacy (α = 0.68), and Comfort Depending on Others (α = 0.70). 2) Caregiving Questionnaire composed of four subscales: Proximity Maintenance: (α = 0.83), Sensitivity: (α = 0.76), Controlling Caregiving (α = 0.77) and Compulsive Caregiving (α = 0.68). Results: Multivariate Analysis of Co-variance (MANCOVA) models were computed; gender, age, and education were included in the models. Methadone patients and drug-free treatment addicts were equivalent and reported significantly lower Comfort Depending on Others, Comfort with Intimacy, and Caregiving Proximity. However, methadone users reported significantly lower Anxiety about being rejected than drug-free addicts and were equivalent to non-clinical controls. In addition, correlations between the methadone intake dose and the questionnaires' scales showed that dose was significantly and negatively correlated with Comfort with Closeness (rs = -0.36; p < 0.01) and with Caregiving Proximity (rs = -0.28; p < 0.05).

Differences in Parenting Stress, Parenting Attitudes, and Parents' Mental Health According to Parental Adult Attachment Style

Objectives:

We aimed to compare the differences in parenting stress, parenting attitudes, and parents’ mental health between different adult attachment styles.

Methods:

Forty-four parents who completed a parental education program were enrolled in our study. They completed the Korean version of the Experience of Close Relationship Revised, Korean-Parenting Stress Index-Short Form, Maternal Behavior Research Instrument, and Symptom Checklist-90-Revised.

Results:

The avoidant attachment score positively correlated with parenting stress. The anxious attachment score showed a positive relationship with parenting stress, hostile parenting attitude, and psychopathology, but a negative association with an affectionate parenting attitude. The secure attachment group exhibited a more autonomous, affectionate parenting style and a less hostile parenting attitude and less parenting stress than the insecure attachment group. Dismissing-avoidant attachment parents reported significantly higher parenting stress scores than secure attachment parents. Preoccupied and fearful-avoidant attachment parents displayed a more hostile parenting style than secure attachment parents. Dismissing-avoidant and preoccupied parents reported a less affectionate parenting attitude than secure attachment parents.

Conclusion:

There were differences in parenting stress, parenting attitudes, and parents’ mental health depending on the adult attachment style. More specific education and interventions based on parental attachment type are necessary for parents.

[Cultural differences concerning depressive disorders and attachment dimensions]

BACKGROUND

Attachment is a psychological parameter across cultures and is influenced by childhood experiences. Though the construct of attachment tends to certain stability, different influences, like culture, can change the quality of attachment during lifetime. As can be seen from the example of depression in adulthood the clinical symptoms of this disorder may be different due to the cultural background.

METHODS

The present study focuses on inter- and intracultural differences concerning the attachment qualities of Turkish people in the homeland, Turkish migrants in Austria and Austrians (N = 297) by using the self-assessment questionnaire RSQ. Each ethnic group consisted of a healthy control group (N = 153) as well as a patient group currently suffering from a depressive episode (N = 144) and were getting an in or outpatient treatment.

OBJECTIVE

The hypothesis tested was whether culture moderates a correlation between depressive disorders and attachment abilities.

RESULTS

There were significant differences in attachment ability between cultures whereby controls presented significantly more secure attachment ability in all parameters compared to patients. While the Austrian control group showed the most secure attachment orientation, the Austrian patients had the highest level of insecurity, followed by the migrant group. However, the comparison of healthy and depressive Turks revealed no significant differences.

CONCLUSION

Thus, culture shows significant effects concerning depressive disorders and attachment dimensions.

Intimate relationship characteristics as determinants of HIV risk among men who have sex with regular male sex partners: a cross-sectional study in Guangzhou, China

Background

China faces a serious HIV epidemic among men who have sex with men (MSM), and a large proportion of new infections are attributed to their regular male sex partners (RP). The objective of this study was to investigate the association between intimate relationship characteristics and HIV-related behaviors among MSM with RP in Guangzhou, China.

Methods

A convenience-sampling method was used in data collection. A total of 608 MSM were screened, of whom 406 HIV negative MSM with at least one RP in the past six months were used for data analysis. Three-step logistic regressions were used to analyze the data.

Results

The prevalence of unprotected anal intercourse (UAI) with regular male sex partners, non-regular male sex partners, and concurrent UAI in the past six months was 53.9%, 23.6%, 20.7%, respectively. Variables associated with UAI with regular male sex partners included expectations for this relationship (adjusted odds ratio in multiple forward stepwise logistic regression, OR_m = 1.66) and open communication about the sexual relationship (OR_m = 1.79), while expectations for the relationship (OR_m = 0.46 to 0.54) and conflicts of interest (OR_m = 5.46 to 5.97) were associated with concurrent UAI and UAI with non-regular male sex partners.

Conclusion

Intimate relationship characteristics were related to HIV-related risk behaviors. Future HIV prevention interventions should take MSM couples into consideration, include a focus on the quality of their intimate relationships, and encourage open communication about their sexual relationships.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3044-6) contains supplementary material, which is available to authorized users.

A meta-analysis of longitudinal associations between substance use and interpersonal attachment security

Substance use has long been associated with close relationship distress. Although the direction of influence for this association has not been established, it has often been assumed that substance use is the causal agent and that close relationship distress is the effect. But research seeking to establish temporal precedence in this link has produced mixed findings. Further, theoretical models of substance use and close relationship processes present the plausibility of the inverse pathway-that insecure close relationships may serve as a vulnerability factor for the development of later substance problems. The current review applies an attachment-theoretical framework to the association between close social bonds and substance use and substance-related problems. Targeting longitudinal studies of attachment and substance use, we examined 665 effect sizes drawn from 34 samples (total N = 56,721) spanning time frames ranging from 1 month to 20 years (M = 3.8 years). Results revealed a significant prospective correlation between earlier attachment and later substance use (r = -.11, 95% CI [-.14, -0.08]). Further, cross-lagged coefficients were calculated which parsed auto-regressive effects, indicating that lower attachment security temporally preceded increases in substance use (r = -.05, 95% CI [-.06, -.04]). Analyses further indicated that the pathway from earlier attachment to later substance use was significantly stronger than that from earlier substance use to later attachment. Results also revealed several moderators of the attachment-substance use link. These findings suggest that insecure attachment may be a vulnerability factor for substance use, and indicate close relationship quality as a promising line of inquiry in research on substance use disorder risk. (PsycINFO Database Record

Thriving in midlife: The roles of childhood nurturance and adult defense mechanisms

The current study examined whether reliance on more adaptive defense mechanisms throughout early adulthood may help explain previously documented relationships between childhood nurturance and better midlife functioning. Utilizing a unique longitudinal study, data were from age 18 through midlife (age 63) on 135 males. Childhood nurturance was assessed upon study entry and defense mechanism usage was assessed throughout earlier adulthood. Percentage of 'engaging' (more adaptive) vs. 'avoidant' (less adaptive) defenses mediated the relationship between childhood nurturance and 3 midlife outcomes: participants' relationship quality with their children, marriage stability, and maximum earned income. Results suggest that greater childhood nurturance relates to more adaptive defensive styles in early adulthood, which is then associated with healthier midlife functioning at work and in relationships.

The Past Is Present: Representations of Parents, Friends, and Romantic Partners Predict Subsequent Romantic Representations

This study examined how representations of parent-child relationships, friendships, and past romantic relationships are related to subsequent romantic representations. Two-hundred 10th graders (100 female; Mage  = 15.87 years) from diverse neighborhoods in a Western U.S. city were administered questionnaires and were interviewed to assess avoidant and anxious representations of their relationships with parents, friends, and romantic partners. Participants then completed similar questionnaires and interviews about their romantic representations six more times over the next 7.5 years. Growth curve analyses revealed that representations of relationships with parents, friends, and romantic partners each uniquely predicted subsequent romantic representations across development. Consistent with attachment and behavioral systems theory, representations of romantic relationships are revised by representations and experiences in other relationships.

Brain activity to transitional objects in patients with borderline personality disorder

Adult patients with borderline personality disorders (BPD) frequently have attachments to inanimate transitional objects (TOs) such as stuffed animals. Using event-related potential (ERP) recordings, we determined in patients with BPD the neural correlates of the processing of these attachment-relevant objects and their functional significance. Sixteen female patients with BPD viewed pictures of their TOs, other familiar stuffed toys (familiar objects, FOs), and unfamiliar objects (UOs). ERPs in the patients were compared to those in 16 matched healthy controls who possessed a stuffed animal of comparably high familiarity. Here, we found a specific increase of frontal P3/LPP amplitude in patients with BPD, which was related to attachment anxiety and depression scores. Attachment-related TO stimuli in patients with BPD specifically modulated stages of emotional stimulus evaluation reflecting processing of self-relevance. The relation of the frontal ERP effect to patients' attachment anxiety and depression highlights the function of TOs for coping with anxiety about being abandoned by significant others and for dealing with depressive symptoms.

Data quality and factor analysis of the Danish version of the Relationship Scale Questionnaire

Background

The Relationship Scale Questionnaire (RSQ) is a widely-used measure of adult attachment, but whether the results obtained by the RSQ fit the attachment construct has only been examined to a limited extent.

Objective

The objectives of this study were to investigate the psychometric properties of the Danish translation of the RSQ and to test whether the results are consistent with the hypothesized model of attachment.

Methods

The study included two samples: 602 general practitioners and 611 cancer patients. The two samples were analyzed separately. Data quality was assessed by mean, median and missing values for each item, floor and ceiling effects, average inter-item correlations and Cronbach’s α for each subscale. Test-retest was assessed by intra-class correlations among 76 general practitioners. A confirmatory factor analysis was conducted to establish evidence of the four proposed subscales. Due to an inadequate fit of the model, data was randomly split into two equally sized subsamples and an exploratory factor analysis was conducted for all 30 items in the first subsample comprised of 286 cancer patients and 285 general practitioners. The EFA yielded a three-factor structure which was validated through a confirmatory factor analyses in a second subsample comprised of 278 cancer patients and 289 general practitioners.

Results

The data quality of the RSQ was generally good, except low internal consistency and low to moderate test-retest reliability. The four subscales of the RSQ were not confirmed by the confirmatory factor analysis. An exploratory factor analysis suggested a three-factor solution for both general practitioners and patients, which accounted for 61.1% of the variance among general practitioners and 62.5% among patients. The new three-factor solution was verified in a confirmatory factor analyses.

Conclusion

The proposed four-factor model of the RSQ could not be confirmed in this study. Similar challenges have been found by other studies validating the RSQ. An alternative three-factor structure was found for the RSQ.

The Multimodal Assessment of Adult Attachment Security: Developing the Biometric Attachment Test

BACKGROUND

Attachment theory has been proven essential for mental health, including psychopathology, development, and interpersonal relationships. Validated psychometric instruments to measure attachment abound but suffer from shortcomings common to traditional psychometrics. Recent developments in multimodal fusion and machine learning pave the way for new automated and objective psychometric instruments for adult attachment that combine psychophysiological, linguistic, and behavioral analyses in the assessment of the construct.

OBJECTIVE

The aim of this study was to present a new exposure-based, automatic, and objective adult-attachment assessment, the Biometric Attachment Test (BAT), which exposes participants to a short standardized set of visual and music stimuli, whereas their immediate reactions and verbal responses, captured by several computer sense modalities, are automatically analyzed for scoring and classification. We also aimed to empirically validate two of its assumptions: its capacity to measure attachment security and the viability of using themes as placeholders for rotating stimuli.

METHODS

A total of 59 French participants from the general population were assessed using the Adult Attachment Questionnaire (AAQ), the Adult Attachment Projective Picture System (AAP), and the Attachment Multiple Model Interview (AMMI) as ground truth for attachment security. They were then exposed to three different BAT stimuli sets, whereas their faces, voices, heart rate (HR), and electrodermal activity (EDA) were recorded. Psychophysiological features, such as skin-conductance response (SCR) and Bayevsky stress index; behavioral features, such as gaze and facial expressions; as well as linguistic and paralinguistic features, were automatically extracted. An exploratory analysis was conducted using correlation matrices to uncover the features that are most associated with attachment security. A confirmatory analysis was conducted by creating a single composite effects index and by testing it for correlations with attachment security. The stability of the theory-consistent features across three different stimuli sets was explored using repeated measures analysis of variances (ANOVAs).

RESULTS

In total, 46 theory-consistent correlations were found during the exploration (out of 65 total significant correlations). For example, attachment security as measured by the AAP was correlated with positive facial expressions (r=.36, P=.01). AMMI's security with the father was inversely correlated with the low frequency (LF) of HRV (r=-.87, P=.03). Attachment security to partners as measured by the AAQ was inversely correlated with anger facial expression (r=-.43, P=.001). The confirmatory analysis showed that the composite effects index was significantly correlated to security in the AAP (r=.26, P=.05) and the AAQ (r=.30, P=.04) but not in the AMMI. Repeated measures ANOVAs conducted individually on each of the theory-consistent features revealed that only 7 of the 46 (15%) features had significantly different values among responses to three different stimuli sets.

CONCLUSIONS

We were able to validate two of the instrument's core assumptions: its capacity to measure attachment security and the viability of using themes as placeholders for rotating stimuli. Future validation of other of its dimensions, as well as the ongoing development of its scoring and classification algorithms is discussed.

Relationship between attachment styles and happiness in medical students

Background:

Attachment theory is one of the most important achievements of contemporary psychology. Role of medical students in the community health is important, so we need to know about the situation of happiness and attachment style in these students.

Objectives:

This study was aimed to assess the relationship between medical students’ attachment styles and demographic characteristics.

Materials and Methods:

This cross-sectional study was conducted on randomly selected students of Medical Sciences in Kurdistan University, in 2012. To collect data, Hazan and Shaver's attachment style measure and the Oxford Happiness Questionnaire were used. The results were analyzed using the SPSS software version 16 (IBM, Chicago IL, USA) and statistical analysis was performed via t-test, Chi-square test, and multiple regression tests.

Results:

Secure attachment style was the most common attachment style and the least common was ambivalent attachment style. Avoidant attachment style was more common among single persons than married people (P = 0.03). No significant relationship was observed between attachment style and gender and grade point average of the studied people. The mean happiness score of students was 62.71. In multivariate analysis, the variables of secure attachment style (P = 0.001), male gender (P = 0.005), and scholar achievement (P = 0.047) were associated with higher happiness score.

Conclusion:

The most common attachment style was secure attachment style, which can be a positive prognostic factor in medical students, helping them to manage stress. Higher frequency of avoidant attachment style among single persons, compared with married people, is mainly due to their negative attitude toward others and failure to establish and maintain relationships with others.

The psychometric properties of the Persian version of Interpersonal Sensitivity Measure

BACKGROUND

Investigating the psychometric properties of existing psychometric scales in societies with differing dynamics can help with their external validity. This research specifically aimed at standardization and validation of Interpersonal Sensitivity Measure (IPSM) scale in Iran.

MATERIALS AND METHODS

Persian version of the IPSM was produced through forward translation, reconciliation, and back translation. A total of 357, nonclinical students were selected through multistage sampling method and completed a set of questionnaires including IPSM. Internal consistency, convergent validity, divergent validity, and test-retest reliability of the Persian version of the IPSM were analyzed. To assess the construct validity, confirmatory factor analysis (CFA) was performed.

RESULTS

Total IPSM, as well as all subscales showed satisfactory internal consistency (Cronbach's α =0.86 and 0.51-0.71, respectively). Test-retest reliability at a 2-week interval was significant, with intraclass correlation coefficient ranging between 0.73 and 0.92. In terms of convergent validity, IPSM showed the significant positive correlation with self-report measures of depression, social anxiety, and anxious attachment style. IPSM showed negative correlation with Social Desirability Scale and secure (C subscale of avoidant attachment style [AAS]) and dependent (D subscale of AAS), thus demonstrated divergent validity with these constructs. According to the CFA, the responses of the sample in this study were fitted to the original five-factor structure.

CONCLUSION

The IPSM showed good validity and reliability and could be useful in assessing interpersonal sensitivity in Iranian population.

The effects of computer-based mindfulness training on Self-control and Mindfulness within Ambulatorily assessed network Systems across Health-related domains in a healthy student population (SMASH): study protocol for a randomized controlled trial

BACKGROUND

Self-control is an important ability in everyday life, showing associations with health-related outcomes. The aim of the Self-control and Mindfulness within Ambulatorily assessed network Systems across Health-related domains (SMASH) study is twofold: first, the effectiveness of a computer-based mindfulness training will be evaluated in a randomized controlled trial. Second, the SMASH study implements a novel network approach in order to investigate complex temporal interdependencies of self-control networks across several domains.

METHODS

The SMASH study is a two-armed, 6-week, non-blinded randomized controlled trial that combines seven weekly laboratory meetings and 40 days of electronic diary assessments with six prompts per day in a healthy undergraduate student population at the Johannes Gutenberg University Mainz, Germany. Participants will be randomly assigned to (1) receive a computer-based mindfulness intervention or (2) to a wait-list control condition. Primary outcomes are self-reported momentary mindfulness and self-control assessed via electronic diaries. Secondary outcomes are habitual mindfulness and habitual self-control. Further measures include self-reported behaviors in specific self-control domains: emotion regulation, alcohol consumption and eating behaviors. The effects of mindfulness training on primary and secondary outcomes are explored using three-level mixed models. Furthermore, networks will be computed with vector autoregressive mixed models to investigate the dynamics at participant and group level. This study was approved by the local ethics committee (reference code 2015_JGU_psychEK_011) and follows the standards laid down in the Declaration of Helsinki (2013).

DISCUSSION

This randomized controlled trial combines an intensive Ambulatory Assessment of 40 consecutive days and seven laboratory meetings. By implementing a novel network approach, underlying processes of self-control within different health domains will be identified. These results will deepen the understanding of self-control performance and will guide to just-in-time individual interventions for several health-related behaviors.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02647801 . Registered on 15 December 2015 (registered retrospectively). .