A systematic review of attachment and psychosis: measurement, construct validity and outcomes
Open accessAbstract
Objective: This review sought to identify, summarise and critically evaluate studies that investigated attachment amongst individuals with psychosis. Method: The following computerised databases searched were CINAHL < 1980 to D ecember 2012; EMBASE < 1980 to D ecember 2012; O vid MEDLINE (R) < 1980 to D ecember 2012; P sych INFO < 1980 to D ecember 2012; and G oogle S cholar < 1980 to D ecember 2012. Results: We identified 22 papers describing 21 studies comprising 1453 participants, with a mean age of 35.0 years (range of 12–71 years), of whom 68.4% (n = 994) were male. Of our sample, 1112 (76.5%) had a diagnosis of schizophrenia. We found small to moderate associations between greater attachment insecurity (as reflected in anxiety and avoidance) and poorer engagement with services, more interpersonal problems, more avoidant coping strategies, more negative appraisals of parenting experiences and more severe trauma. We also found small to modest associations between attachment insecurity and more positive and negative symptoms and greater affective symptom problems. Conclusion: Attachment theory may be useful as a means of understanding the developmental and interpersonal basis of recovery and adaptation in the context of psychosis. However, further research comprising more representative samples in their first episode and using prospective designs is required.
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Paranoia is associated with insecure attachment.
“many studies have reported a strong association between insecure attachment styles and paranoia in both clinical and non‐clinical samples (Carr, Hardy, & Fornells‐Ambrojo, 2018; Gumley, Taylor, Schwannauer, & MacBeth, 2014; Pickering, Simpson, & Bentall, 2008;”
From Mistrust and negative self‐esteem: Two paths from attachment styles to paranoia. (2021) · cites this paper as Gumley, Taylor, Schwannauer, & MacBeth, 2014
The review reports an association between attachment avoidance and paranoia in its Dimensions of outcome section, supporting the core claim for clinical samples. But its Inclusion and exclusion criteria explicitly exclude non-clinical/analogue studies, so it cannot support the sentence’s extension to non-clinical samples. The review also describes the broader symptom associations as small to moderate rather than uniformly strong. (LLM, conf=0.90)
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Cites
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Mistrust and negative self‐esteem: Two paths from attachment styles to paranoia.
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Self-citation
- Authors
- Gumley, A. I., Taylor, H. E. F., Schwannauer, M., & MacBeth, A.
- Affiliations
- NHS Greater Glasgow and Clyde (GB)
- University of Edinburgh (GB)
- University of Aberdeen (GB)
- Corresponding author
- Gumley, A. I.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2013-07-03
- Volume
- 129
- Issue
- 4
- Pages
- 257-274
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2001779377
- Cited by
- 234
- References
- 8
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 11 · 2023: 24 · 2022: 24 · 2021: 18 · 2020: 22 · 2019: 24 · 2018: 12 · 2017: 19 · 2016: 20 · 2015: 16 · 2014: 19
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- attachment, psychosis, insecure attachment, schizophrenia, attachment theory, service engagement, interpersonal problems, avoidance coping, parental experiences, trauma, positive and negative symptoms, affective symptoms, attachment measurement, construct validity
- MeSH terms
- Humans, Object Attachment, Psychotic Disorders, Schizophrenia
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