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

Background: Aspects of pathological narcissism, such as grandiosity, vulnerability and entitlement, tend be enacted in therapeutic settings, negatively influencing outcome and alliance between the clients and therapist. This research took an experimental approach to understanding the interplay between the emotional reactions of individuals with a pathological narcissistic presentation, and adult attachment style. We predicted that participants reporting narcissistic vulnerability would report greater insecurity in attachment (fearful and preoccupied styles), greater trait emotional reactivity, and also experience more intense and negative responses to simulated rejection

Methods: 269 participants (75.84% female, median age = 21) completed baseline and rejection trials of a virtual ball-tossing game, following the assessment of grandiose and vulnerable pathological narcissism, entitlement, adult attachment, trait emotional reactivity (measured prior to the rejection) and in-situ affective response (measured both before and after the rejection). Change in affect from baseline was calculated to capture affective responses to the manipulation.

Results: Vulnerable narcissism was positively associated with both fearful and preoccupied attachment, and negatively associated with secure and dismissive attachment, whilst grandiose narcissism was significantly related to preoccupied attachment only. Multiple hierarchical regression analyses showed vulnerable narcissism predicted both (1) more negative trait emotional reactivity and (2) a significant increase in negative affect following the rejection trial. Grandiose narcissism was associated with (1) higher positive trait emotional reactivity, and (2) significant reductions in positive affect following rejection.

Conclusion: Results indicated that those high in pathological narcissistic vulnerability reported greater insecurity in attachment, negative trait emotional reactivity and experienced a more negative and intense emotional reaction to rejection. Grandiose narcissism was related to a more deactivated pattern of emotional reactivity, and less positive (rather than more negative) emotional reactions. Findings have important implications for therapy, particularly regarding communication of emotions for individuals high in vulnerable and grandiose narcissism.

Mechanism Influencing Older People's Willingness to Use Intelligent Aged-Care Products

Background: With the continuous integration of information technology in the aged-care industry, intelligent aged-care products have gradually appeared, positively promoting the development of the industry. To support the use of these products and to help older people to improve their own health literacy, we built a theoretical model of the mechanism influencing older people’s willingness to use intelligent aged-care products. Methods: A total of 241 valid questionnaires were collected through surveys in aged-care institutions in Anhui Province, China, for empirical analysis. Results: Older people’s perception of quality can significantly affect their emotional attachment and willingness to use these products. Emotional attachment has a significant positive impact on the willingness to use. Self-perceived ageing can also significantly affect the emotional attachment and willingness of older people to use these products. Conclusion: Through empirical analysis, the comprehensive mechanism influencing older people on the willingness to use intelligent aged-care products is clarified, which can help older people to better deal with the problems caused by ageing and help aged-care institutions better relieve the pressure on nursing staff.

An Attachment Theory Approach to the Short-Term Treatment of a Woman With Borderline Personality Disorder and Comorbid Diagnoses

The current case study highlights the treatment of “Thelma,” a 48-year-old woman of African American and Hispanic descent who was diagnosed with borderline personality disorder (BPD), major depressive disorder, post-traumatic stress disorder, and bulimia. An attachment theory approach was used to elicit core structure change in Thelma's BPD symptoms after traditional modern cognitive approaches proved ineffective. It was hypothesized that treating her Axis II disorder would actually serve to reduce her Axis I symptoms. The attachment approach entailed a shift toward second-order change processes, a shift away from problem-solving approaches, a focus on the quality and intensity of the relationship, and a more relaxed approach to boundary setting in the context of treatment. The approach did appear to reduce many Axis I symptoms including self-mutilation, suicidal ideation, and binging and purging behaviors and appeared to improve her interpersonal functioning.

An investigation of the mediating role of personality and family functioning in the association between attachment styles and eating disorder status

Background

This study examined relationships between attachment style, eating disorders (EDs), personality variables and family functioning.

Methods

In our study, 253 women (M = 25.72 years, SD = 8.73) were grouped into one of four categories either according to self-reported ED diagnosis or by exceeding cut-offs for a clinical diagnosis on the Eating Disorder Examination Questionnaire (EDE-Q) or Short Evaluation of Eating Disorders (SEED): anorexia nervosa (AN), bulimia nervosa (BN), other eating disorder (O-ED), no eating disorder (Non-ED). The ED group (AN, BN, O-ED) included 106 women (M = 24.74 years, SD = 7.71), and the Non-ED group 147 women (M = 26.42 years, SD = 9.37). Approximately half of the ED group had a comorbid disorder (59.4 %), while the majority of the Non-ED group had no psychological disorder (89.1 %).

Results

Participants with an ED were significantly more often insecurely attached (Adult Attachment Scale; AAS), emotionally unstable, less extraverted (Big-Five-Test of Personality; B5T) and showed less positive family functioning (Experiences in Personal Social Systems Questionnaire; EXIS.pers). Results showed partial mediation for attachment and EDs through neuroticism, extraversion and family functioning.

Discussion

The study found further evidence for elevated problems with attachment, personality, and family experiences in individuals with EDs, while suggesting mechanisms that may link these constructs. Implications for research and practice were discussed.

Conclusion

This study supports findings that acknowledge the mediating role played by personality factors and family functioning in the relationship between attachment and EDs.

Attachment Theory, Counseling Process, and Supervision

This article is designed to stimulate interest in the clinical utility of attachment theory and examine how its constructs are relevant to counseling and counseling supervision. The initial section illustrates attachment constructs in action and demonstrates how the theory and its related research can be used to conceptualize clients' experience in their emotionally important relationships. The authors then discuss counseling process focusing on the ways attachment theory can contribute to understanding the client-counselor relationship and change strategies. The implications of the central constructs are also explored in relation to counseling supervision. In concluding, the authors discuss research and clinical extensions of attachment theory, alluding briefly to areas that are also extensions of traditional counseling psychology. Throughout, the article's intent is to help the reader appreciate the complexity of attachment theory as well as its science-practice links and its potential contribution to clinical research and service delivery.

Attachment Theory and Career Development

This article reviews the growing literature on attachment theory and career development. The empirical and theoretical literature that has examined the contribution of attachment theory to ego identity formation, preimplementation career behavior, and postimplementation career adjustment is reviewed. Drawing from this literature, four propositions are advanced to guide subsequent empirical and theoretical efforts in this area. Implications for counseling practice that are derived from this review are also presented.

Attachment to Parents and Adjustment in Late Adolescent College Students

The attachment model holds considerable promise for understanding the challenges and adjustment vicissitudes of late adolescent college students. The model is potentially valuable for counseling psychologists, further more, in linking knowledge of developmental theory with counseling intervention and prevention. Existing research supports an association between secure parental attachment and adjustment for first-year college students. A variety of methodological challenges, however, need to be addressed in order to fully assess the validity of attachment-based developmental and intervention models, especially for women and culturally and racially diverse college students.

Attachment Theory

The contributors to this special issue not only have taken on the immense task of reviewing and integrating the burgeoning research literature on attachment, but have also challenged readers to consider the relevance of this literature for the domain of counseling psychology. More specifically, Lopez suggests that attachment theory may be a potential "metaperspective capable of integrating important personality and developmental constructs in ways that both inform and stimulate our research and practice". With this consideration in mind, my comments will focus on the viability of attachment theory as an overarching framework for counseling psychology with particular emphasis on the integrative potential and heuristic value of the theory.

A Conceptual Framework for Counseling Psychologists in Schools

This article explores how contemporary developmental psychology, specifically developmental-contextualism, provides a conceptual framework for practice and research by counseling psychologists who work with schools. Developmental-contextualism articulates how human development (a) is affected by context, (b) involves bio-psycho-social levels, (c) occurs during the life span, and (d) includes strengths and deficits. The authors delineate how these four developmental principles, in conjunction with the traditional strengths of counseling psychology, can guide the application of effective interventions with school-aged children and their families.

An exploration of nursing preceptorship and functions and nurses' intention to stay from the perspective of cultural differences

BACKGROUND

Culture has a great impact on human behavior; this is the key for organizational cultures in the Chinese society where relationships and hierarchy are emphasized and is especially exerted to the utmost by relationalism in Taiwan's collective society.

PURPOSE

The purpose of this study was to explore the differences in the nature of preceptorship and functions between Eastern and Western cultures.

METHODS

An exploratory research design was used. Qualitative field interviews were carried out with 20 new nurses who had worked in hospital settings for one year or less.

RESULTS

In addition to the existing phases of a mentoring relationship, we drew out another preceptorship function dimension which represented the unique family ethics and superior-subordinate relationships in the Chinese nursing field and also added an important function, the quasi-family functions to the mentoring.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

With the in-depth understanding of preceptorship in the Chinese culture, the development of localized teaching strategies for preceptors could effectively improve new nurses' job satisfaction and intention to stay and reduce their reality shock and role ambiguity.

Pre-treatment attachment anxiety predicts change in depressive symptoms in women who complete day hospital treatment for anorexia and bulimia nervosa

OBJECTIVES

Individuals with eating disorders are prone to depressive symptoms. This study examines whether depressive symptoms can change in women who complete intensive day treatment for anorexia and bulimia nervosa (BN), and whether these changes are associated with pre-treatment attachment insecurity.

DESIGN

Participants were 141 women with anorexia nervosa restricting type (n = 24), anorexia nervosa binge purge type (n = 30), and BN (n = 87) who completed a day hospital treatment programme for eating disorders. They completed a pre-treatment self-report measure of attachment, and a pre-treatment and post-treatment self-report measure of depressive symptoms.

RESULTS

Participants experienced significant reductions in depressive symptoms at post-treatment. Eating disorder diagnosis was not related to these improvements. However, participants lower in attachment anxiety experienced significantly greater improvement in depressive symptoms than those who were higher in attachment anxiety.

CONCLUSIONS

These results suggest that clinicians may tailor eating disorders treatments to patients' attachment patterns and focus on their pre-occupation with relationships and affect regulation to improve depressive symptoms.

PRACTITIONER POINTS

That depressive symptoms can decrease in women who complete day hospital treatment for anorexia and BN. That improvements in depressive symptoms do not vary according to eating disorder diagnosis in these women. That patients who complete treatment and who have higher attachment anxiety experience less improvements in depressive symptoms compared to those lower in attachment anxiety. That clinicians may attend to aspects of attachment anxiety, such as need for approval and up-regulation of emotions, to improve depressive symptoms in female patients with eating disorders.

Structural relationships among attachment insecurity, alexithymia, and body esteem in women with eating disorders

Patients with eating disorders tend to experience low levels of body esteem. To assess the psychosocial processes that may predict low body esteem in these individuals, we assessed the structural interrelations among attachment anxiety, attachment avoidance, alexithymia, and body esteem in a cross-sectional sample of patients with eating disorders. We tested a model in which alexithymia mediates the relationship between attachment insecurity and body esteem. Participants were 300 women with anorexia nervosa (n = 109), bulimia nervosa (n = 130), and eating disorders not otherwise specified (n = 61) who completed pretreatment self-report questionnaires at intake for a day hospital treatment program. We found a direct and negative relationship between attachment anxiety and body esteem. Additionally, attachment avoidance had an indirect negative relationship to body esteem through alexithymia. These results indicate that therapists may attend to attachment insecurity and affective regulation strategies when addressing body image issues in patients with eating disorders.

Spouse Similarity in Recollections of Parenting Received: A Study in a Nonclinical Sample

Despite a large body of research on both children’s relationships to their parents and adult dyadic relationships, associations between these types of relationships have rarely been studied. In this paper, spouse similarity in recollections of parenting received in childhood was assessed in a nonclinical sample. Parenting by the same- and opposite-sex parent was measured using the Parental Bonding Instrument (PBI). Spouse similarity was found with respect to the recalled level of care received from the same-sex parent. This correlation was independent of similarity in sociodemographic variables or current psychiatric symptomatology. The fact that spouse similarity did not increase with increasing age suggests that similarity is a result of assortative mating rather than convergence during marriage. These results suggest a significant association between parent-child relationships and the mating process.

Parental psychological control and attachment in late adolescents and young adults

The aim of this study was to examine the association between parental psychological control and parental attachment. Another goal was to investigate the differential and combined effects of these two constructs on indices of psychological well-being, namely, self-esteem, positive or negative affect, and personal and interpersonal efficacy. Subjects were 319 males (n = 142) and females (n = 177) with an age range of 15 yr., 9 mo. to 22 yr., 5 mo. (M = 20.0, SD = 1.6). Analysis showed that psychological control was negatively related to attachment. Both psychological control and attachment predicted self-esteem, and there was some indication that psychological control exercised by mothers had a stronger influence on self-esteem. Attachment was also a significant predictor of positive and negative affect and perceived personal efficacy. No sex or age differences were found.