The role of attachment anxiety in the relationship between childhood trauma and schizophrenia-spectrum psychosis
Abstract
Childhood trauma (CT) is a comprehensive concept encompassing experiences of sexual, physical, and emotional abuse, and neglect during childhood and adolescence. Patients with schizophrenia-spectrum psychosis (SSP) display higher rates of CT than healthy controls. Among the potential mediators of this association, insecure attachment has gained attention and empirical validation. The present study aimed to extend existing knowledge on this field by exploring the role of the two attachment dimensions, attachment anxiety and attachment avoidance, in the CT-SSP association. A clinical sample of 63 SSP inpatients was compared to a healthy control group on CT and attachment style measures. Correlations between CT, attachment dimensions and psychopathology were sought. Mediation analyses were also performed to examine whether attachment anxiety and/or attachment avoidance mediated the CT-SSP association. Patients displayed higher rates of CT and insecure attachment than controls. Attachment anxiety and severity of Mother Antipathy were linked to severity of hallucinations. Attachment anxiety was recognized as the sole mediator of the CT-SSP association. Our findings suggest that individuals with severe CT and increased attachment anxiety represent a risk population warranting early clinical attention, regular monitoring and tailored therapeutic interventions aimed at reducing the psychological impact of trauma.
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Insecure attachment represents a key mechanism linking early adversity to later psychopathology.
“Insecure attachment, which often emerges as a developmental consequence of adverse caregiving environments, represents a key mechanism linking early adversity to later psychopathology [19, 20].”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [19]
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- Authors
- Chatziioannidis, S., Andreou, C., Agorastos, A., Kaprinis, S., Malliaris, Y., Garyfallos, G., & Bozikas, V. P.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- Universitäre Psychiatrische Kliniken Basel (CH)
- Corresponding author
- Chatziioannidis, Stylianos
- ORCID
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 276
- Pages
- 223-231
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2943943387
- Semantic Scholar
- 931ffa699be49f80ba15e5727588016654e7dbf6
- Cited by
- 41
- References
- 94
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 9 · 2020: 3
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- childhood trauma, attachment anxiety, attachment avoidance, insecure attachment, hallucinations, mediation, trauma exposure
- MeSH terms
- Adult Survivors of Child Adverse Events, Adult, Anxiety, Female, Hallucinations, Humans, Male, Middle Aged, Object Attachment, Psychopathology, Psychotic Disorders, Risk Factors, Schizophrenia, Schizophrenic Psychology, Case-Control Studies
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