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Cited by 45Obsessive-Compulsive Spectrum DisordersPsychoanalysis and Psychopathology ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Attachment in OCD: A meta-analysis

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van Leeuwen, W.A., van Wingen, G.A., Luyten, P., Denys, D., van Marle, H.J.F.·2020·Journal of Anxiety Disorders
DOI 10.1016/j.janxdis.2020.102187
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Abstract

Introduction It has been proposed to extend the cognitive-behavioural model of obsessive-compulsive disorder (OCD) with attachment theory to shed light on the affective and developmental factors underlying the disease. With a growing number of empirical studies on the subject, this meta-analysis aims to quantify a possible relationship between attachment insecurity and OCD. Methods A systematic search was conducted for studies in adult populations of patients with OCD as well as general populations displaying symptoms of OCD. Effect sizes of attachment anxiety and attachment avoidance were calculated separately. Covariates of demographic variables were used in meta-regressions. Results Sixteen studies were included. Meta-analyses showed an association of medium to large effect size (Hedges' g = 0.69; 95 % CI 0.58 - 0.80; p < 0.001) between OCD and attachment anxiety, and an association of medium effect size (Hedges' g = 0.47; 95 % CI 0.39 - 0.54; p < 0.001) between OCD and attachment avoidance. Effect sizes in OCD population and general population studies did not differ significantly. Discussion Robust effect sizes of both attachment anxiety and avoidance in relation to OCD symptomatology corroborate an attachment-centred view of OCD. These findings furthermore suggest that integrating cognitive and attachment-based therapeutic approaches to OCD may benefit patients in which developmental or emotional factors hinder successful treatment.

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Cited by

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Authors
van Leeuwen, W. A., van Wingen, G. A., Luyten, P., Denys, D., & van Marle, H. J. F.
Affiliations
  • University College London (GB)
  • Amsterdam Neuroscience (NL)
ORCID
Venue
Journal of Anxiety Disorders
Publisher
Elsevier BV
Published
2020-03
Volume
70
Pages
102187
ISSN
0887-6185 (ISSN-L)
DOI
10.1016/j.janxdis.2020.102187
OpenAlex
W2999985237
Cited by
39
References
0
Citations by year
2026: 4 · 2025: 8 · 2024: 8 · 2023: 5 · 2022: 3 · 2021: 10 · 2020: 1
FWCI
0.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Anxiety Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Lirias (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Funders
ZonMw
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
obsessive-compulsive disorder, attachment theory, insecure attachment, attachment anxiety, attachment avoidance, attachment-based therapy
MeSH terms
Adolescent, Adult, Female, Humans, Male, Object Attachment, Obsessive-Compulsive Disorder, Young Adult

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