Relationship between attachment style and symptom severity across the psychosis spectrum: A meta-analysis. (February 2018)

• Record Type: Journal Article
• Authors: Carr, Sarah Christina; Hardy, Amy; Fornells-Ambrojo, Miriam
• Is Part Of: Clinical psychology review. Volume 59(2018)
• Page Start: 145
• Page End: 158
• Publication Date: 2018-02
• Subjects: Insecure attachment -- Psychosis -- Schizophrenia -- Meta-analysis; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2017.12.001
• Languages: English
• ISSNs: 0272-7358

Abstract

Abstract: There is growing evidence for the role of attachment in psychosis, however, to date there has been no quantitative review of the prevalence of insecure attachment in psychosis. The current study sought to systematically appraise studies investigating the prevalence of insecure attachment and the association with psychosis-spectrum experiences using meta-analytic techniques. A systematic search of studies carried out between January 1980 and 30th November 2015 found 25 papers eligible for inclusion. The meta-analysis showed that the prevalence of insecure attachment style was significantly higher in individuals with psychosis (76%) than in non-clinical samples (38%), with fearful attachment being the most prevalent. Across the continuum, there was a small but significant relationship between positive symptom severity and insecure attachment and a significant relationship between negative symptom severity and insecure attachment in the non-clinical analysis. This relationship was not found in the clinical group. The prevalence of insecure attachment appears to be high in psychosis, however, the relationship between symptom severity and attachment is small. Attachment theory may provide greater understanding of the development of positive symptoms than previously thought, however, research needs to include more at-risk samples and longitudinal research to fully understand the dynamics of this relationship. Highlights: Prevalence of insecure attachment is significantly higher in psychosis sample. Within psychosis samples, a fearful attachment style was most prevalent. There is a small relationship between insecure attachment and positive symptoms. Insecure attachment only linked to negative symptoms within non-clinical samples. Longitudinal studies may increase our understanding of attachment in psychosis.