Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T22:44:01.912Z Has data issue: false hasContentIssue false

Attachment organization and treatment use for adults with serious psychopathological disorders

Published online by Cambridge University Press:  31 October 2008

Mary Dozier
Affiliation:
Trinity University

Abstract

Individual differences in attachment organization among adults with serious psychopathological disorders were related to strategies of treatment use. Forty young adults with serious psychopathological disorders were administered the Adult Attachment Interview (George, Kaplan, & Main, 1984), and their clinicians completed ratings of treatment use. Attachment organization was assessed using the Attachment Q-set (Kobak, 1989), yielding ratings of security/anxiety and avoidance/preoccupation. In preliminary analyses, diagnosis was found to be related to security, with greater security associated with affective rather than thought disorders. Gender was related to avoidance/preoccupation, with males having stronger avoidant tendencies than females. The effects of diagnosis and gender were partialled out of subsequent analyses. As predicted, greater security was associated with more compliance with treatment, as rated by clinicians. Stronger avoidant tendencies were associated with greater rejection of treatment providers, less self-disclosure, and poorer use of treatment. These findings suggest that attachment organization may be an important determinant of how individuals with serious psychopathological disorders approach attachment figures.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.Google Scholar
American Psychiatric Association [APA]. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.Google Scholar
Arend, R., Gove, F. L., & Sroufe, L. A. (1979). Continuity of individuel adaptation from infancy to kindergarten: A predictive study of ego resiliency and curiosity in preschoolers. Child Development, 50, 950959.CrossRefGoogle Scholar
Benedek, T. (1938). Adaptation to reality in early infancy. Psychoanalytic Quarterly, 7, 200214.CrossRefGoogle Scholar
Block, J. H., & Block, J. (1980). The role of egocontrol and egoresiliency in the organization of behavior. In Collins, W. A. (Ed.), Minnesota symposium on childpsychology. (Vol. 13, pp. 39101). Hillsdale, NJ: Erlbaum.Google Scholar
Bowlby, J. (1969). Attachment and loss. Vol. 1: Attachment. New York: Basic.Google Scholar
Bowlby, J. (1973). Attachment and loss. Vol. 2: Separation. New York: Basic.Google Scholar
Bowlby, J. (1980). Attachment and loss. Vol. 3: Loss, sadness, and depression. New York: Basic.Google Scholar
Bowlby, J. (1988). Developmental psychiatry comes of age. American Journal of Psychiatry, 145, 110.Google ScholarPubMed
Brown, G. W., Birley, J. L. T., & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241258.CrossRefGoogle ScholarPubMed
Cairns, R. B. (1979). Social development: The origins and plasticity of interchanges (pp. 100124). San Francisco: Freeman.Google Scholar
Cicchetti, D., Cummings, E. M., Greenberg, M. T., & Marvin, R. S. (1990). An organizational perspective on attachment beyond infancy: Implications for theory, measurement, and research. In Greenberg, M. T., Cicchetti, D., & Cummings, E. M. (Eds.). Attachment in the preschool years: Theory, research, and intervention (pp. 349). Chicago: University of Chicago Press.Google Scholar
Cicchetti, D., & Schneider-Rosen, K. (1984). Theoretical and empirical considerations in the investigation of the relationship between affect and cognition in atypical populations of infants: Contributions to the formulation of an integrative theory of development. In Izard, C., Kagan, J., & Zajonc, R. (Eds.), Emotions, cognitions, and behavior (pp. 366406). New York: Cambridge University Press.Google Scholar
Coie, J. D., & Kupersmidt, J. B. (1983). A behavioral analysis of emerging social status in boys' groups. Child Development, 54, 14001416.CrossRefGoogle Scholar
Crowell, J. A., & Feldman, S. S. (1988). Mothers' internal models of relationships and children's behavioral and developmental status: A study of mother–child interaction. Child Development, 59, 12731285.CrossRefGoogle ScholarPubMed
Cummings, E. M., & Cicchetti, D. (1990). Toward a transactional model of relations between attachment and depression. In Greenberg, M. T., Cicchetti, D., & Cummings, E. M. (Eds.), Attachment in the preschool years: Theory, research, and intervention. Chicago: University of Chicago Press.Google Scholar
Dodge, K. A. (1980). Social cognition and children's aggressive behavior. Child Development, 54, 13861399.CrossRefGoogle Scholar
Dozier, M., Harris, M., & Bergman, H. (1987). Social network density and rehospitalization among young adult patients. Hospital and Community Psychiatry, 38, 6165.Google ScholarPubMed
Dozier, M., & Kobak, R. (1989). Individual differences in physiological responsiveness to the Adult Attachment Interview. Unpublished manuscript.Google Scholar
Edwards, A. L. (1967). Statistical methods (2nd ed.). New York: Holt, Rinehart & Winston.Google Scholar
Egeland, B., Jacobvitz, D., & Sroufe, L. A. (1988). Breaking the cycle of abuse. Child Development, 59, 10801088.CrossRefGoogle ScholarPubMed
Egeland, B., & Sroufe, L. A. (1981). Attachment and early maltreatment. Child Development, 52, 4452.CrossRefGoogle ScholarPubMed
Elicker, J. (1989, 04). The role of attachment in children's understanding of peer relationships in middle childhood. Paper presented at the meeting of the Society for Research in Child Development, Kansas City, MO.Google Scholar
Erickson, M., Sroufe, L. A., & Egeland, B. (1985). The relationship between quality of attachment and behavior problems in preschool in a high risk sample. In Bretherton, I. & Waters, E. (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, 147186.CrossRefGoogle Scholar
George, C., Kaplan, N., & Main, M. (1984). Attachment interview for adults. Unpublished manuscript, University of California, Berkeley.Google Scholar
Gottesman, I. I., & Shields, J. (1976). A critical review of recent adoption, twin, and family studies of schizophrenia: Behavioral genetics perspectives. Schizophrenia Bulletin, 2, 360401.CrossRefGoogle ScholarPubMed
Greenberg, M. R., & Speltz, M. L. (1988). Attachment and the ontogeny of conduct problems. In BeIsky, J. & Nezworski, T. (Eds.), Clinical implications of attachment (pp. 177218). Hillsdale, NJ: Erlbaum.Google Scholar
Henderson, R. W. (1978). Forgetting of conditioned fear inhibition. Learning and Motivation, 8, 1630.CrossRefGoogle Scholar
Kobak, R. (1989). The Attachment Interview Q-Set. Unpublished document, University of Delaware.Google Scholar
Kobak, R. R., Cole, H., Ferenz-Gillies, R., & Fleming, W. (1989). A component process analysis of adolescent attachment patterns. Unpublished manuscript.Google Scholar
Kobak, R. R., & Hazan, C. (1989). Parents and spouses: Working models of attachment and marital satisfaction. Unpublished manuscript.Google Scholar
Kobak, R. R., & Sceery, A. (1988). Attachment in late adolescence: Working models, affect regulation and representations of self and others. Child Development, 59, 135146.CrossRefGoogle ScholarPubMed
Main, M., & Goldwyn, R. (in press-a). Adult attachment classification system. In Main, M. (Ed.), Behavior and the development of representational models of attachment: Five methods of assessment. Cambridge: Cambridge University Press.Google Scholar
Main, M., & Goldwyn, R. (in press-b). Interviewbased adult attachment classifications: Related to infant–mother and infant–father attachment. Developmental Psychology.Google Scholar
Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. In Bretherton, I. & Waters, E. (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, 66104.CrossRefGoogle Scholar
Matas, L., Arend, R. A., & Sroufe, L. A. (1978). Continuity of adaptation in the second year. The relationship between quality of attachment and later competence. Child Development, 49, 547556.CrossRefGoogle Scholar
Pennebaker, J. W., Hughes, C., & O'Heeron, R. C. (1987). The psychophysiology of confession: Linking inhibitory and psychosomatic processes. Journal of Personality and Social Psychology, 52, 781793.CrossRefGoogle ScholarPubMed
Pennebaker, J. W., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239245.CrossRefGoogle ScholarPubMed
Pepper, B., Kirshner, M., & Ryglewicz, H. (1981). The young adult chronic patient: A new breed of psychiatric patient. In Pepper, B. & Ryglewicz, H. (Eds.), New directions in mental health services: The young adult chronic patient. No. 14. (pp. 314). San Francisco: Jossey-Bass.Google Scholar
Pianta, R. C., Sroufe, L. A., & Egeland, B. (1989). Continuity and discontinuity in maternal sensitivity at 6, 24, and 42 months in a high-risk sample. Child Development, 60, 481487.CrossRefGoogle Scholar
Radke-Yarrow, M., Cummings, E. M., Kuczynski, L., & Chapman, M. (1985). Patterns of attachment in two- and three-year-olds in normal families and families with parental depression. Child Development, 56, 884893.CrossRefGoogle ScholarPubMed
Rieder, C., & Cicchetti, D. (1989). Organizational perspective on cognitive control functioning and cognitive-affective balance in maltreated children. Developmental Psychology, 25, 382393.CrossRefGoogle Scholar
Ritter, J. M., & Langlois, J. H. (1988). The role of physical attractiveness in the observation of adultchild interactions: Eye of the beholder or behavioral reality? Developmental Psychology, 24, 254263.CrossRefGoogle Scholar
Schneider-Rosen, K., Braunwald, K. G., Carlson, V., & Cicchetti, D. (1985). Current perspectives in attachment theory: Illustration from the study of maltreated infants. In Bretherton, I. & Waters, E. (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, 194210.CrossRefGoogle Scholar
Sheets, J. L., Prevost, J. A., & Reihman, J. (1981). Young adult chronic patients: Three hypothesized subgroups. Hospital and Community Psychiatry, 33, 197203.Google Scholar
Snyder, M. (1981). On the self-perpetuating nature of social stereotypes. In Hamilton, D. L. (Ed.). Cognitive processes in stereotyping and intergroup behavior. Hillsdale, NJ: Erlbaum.Google Scholar
Snyder, M., Tanke, E. D., & Berscheid, E. (1977). Social perception and interpersonal behavior: On the self-fulfilling nature of social stereotypes. Journal of Personality and Social Psychology, 35, 656666.CrossRefGoogle Scholar
Snyder, M., & Uranowitz, S. W. (1978). Reconstructing the past: Some cognitive consequences of person perception. Journal of Personality and Social Psychology, 36, 941950.CrossRefGoogle Scholar
Sroufe, L. A. (1983). Infant–caregiver attachment and patterns of adaptation in pre-school: The roots of maladaption and competence. In Perlmutter, M. (Ed.), Minnesota symposium on child psychology (Vol. 16, pp. 4181). Hillsdale, NJ: Erlbaum.Google Scholar
Sroufe, L. A. (1988). The role of infant-caregiver attachment in development. In Belsky, J. & Nezworski, T. (Eds.), Clinical implications of attachment (pp. 1840). Hillsdale, NJ: Erlbaum.Google Scholar
Sroufe, L. A., & Waters, E. (1977). Attachment as an Organizational construct. Child Development, 48, 11841199.CrossRefGoogle Scholar
Surtees, P. G. (1980). Social support, residual adversity and depressive outcome. Social Psychiatry, 15, 7180.CrossRefGoogle Scholar
Turner, R. J. (1981). Social support as a contingency in psychological well-being. Journal of Health and Social Behavior, 22, 357367.CrossRefGoogle Scholar
Vaughn, B., Egeland, B., Sroufe, L. A., & Waters, E. (1979). Individual differences in infant–mother attachment at twelve and eighteen months: Stability and change in families under stress. Child Development, 50, 971975.CrossRefGoogle ScholarPubMed
Waters, E. (1978). The reliability and stability of individual differences in infant–mother attachment. Child Development, 48, 11841199.Google Scholar
Weiss, R. S. (1982). Attachment in adult life. In Parkes, C. M. & Stevenson-Hinde, J. (Eds.), The place of attachment in human behavior (pp. 171184). New York: Basic.Google Scholar
Wilcox, B. L. (1981). Social support, life stress, and psychological adjustment: A test of the buffering hypothesis. American Journal of Community Psychology, 8, 371386.CrossRefGoogle Scholar
Winer, B. J. (1971). Statistical principles in experimental design. New York: McGraw-Hill.Google Scholar
Zigler, E., and Glick, M. (1986). A developmental approach to adult psychopathology. New York: Wiley.Google Scholar
Zigler, E., Glick, M., and Marsh, A. (1979). Premorbid social competence and outcome among schizophrenie and nonschizophrenic patients. Journal of Nervous and Mental Disease, 167, 478483.CrossRefGoogle Scholar
Zigler, E., & Levine, J. (1981). Premorbid competence in schizophrenia: What is being measured? Journal of Consulting and Clinical Psychology, 49, 96105.CrossRefGoogle ScholarPubMed
Zigler, E., & Phillips, L. (1960). Social effectiveness and symptomatic behaviors. Journal of Abnormal and Social Psychology, 61, 231238.CrossRefGoogle ScholarPubMed
Zigler, E., & Phillips, L. (1961). Case history data and psychiatric diagnosis. Journal of Consulting Psychology, 25, 258.CrossRefGoogle Scholar