Attachment Patterns in Subjects Diagnosed With a Substance Use Disorder: A Comparison of Patients in Outpatient Treatment and Patients in Therapeutic Communities.

Laura Vismara,Fabio Presaghi,Maria Bocchia,Massimo Ammaniti,Rosolino Vico Ricci

doi:10.3389/fpsyt.2019.00807

Laura Vismara, Fabio Presaghi + Show 3 more

Open Access

https://doi.org/10.3389/fpsyt.2019.00807

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Abstract

The purpose of the present study is to analyze the quality of attachment in substance abuse patients in outpatient treatment vs. patients in therapeutic communities in order to identify the role of attachment insecurity in choosing a care system. The sample consisted of 127 subjects (107 males and 20 females); 97 were outpatients (83 males) and 30 therapeutic community patients (24 males). Attachment with respect to current, significant relationships was assessed using the Relationship Questionnaire. In the outpatient subgroup, the prevailing attachment style was preoccupied; for the therapeutic community patients, the prevailing attachment style was dismissive. The dimensions of care (how the caregiver is perceived as loving and caring) and overprotection (how the caregiver is perceived as intrusive and interfering)—evaluated by means of the Parent Bonding Instrument—were higher in the outpatient subgroup. Scores were higher with respect to maternal subscales regardless of treatment modality. No differences emerged with respect to self-perceived symptoms (SCL-90-R) between the subgroups; however, fearful-avoidant and dismissive-avoidant individuals reported higher self-perceived symptom regardless of treatment modality. Understanding the distribution of different attachment patterns with respect to the treatment modality may improve efficacious interventions, attuning them to the individual and his or her developmental environment.

Highlights

Substance abuse is a relevant phenomenon at a clinical and social level in Western countries: about 50.0% of youths use illicit substances by age 16 [1,2,3]
Data have confirmed the role of attachment in the context of substance use disorders (SUDs), at a behavioral and representational level and at a neuronal level, demonstrating decreased white matter connectivity in poly-drug users [23, 24]
The two sub-populations of subjects diagnosed with a SUD did not diverge with respect to the reported psychopathological distress, we further investigated the hypothesis that there could be a difference in terms of concentration in the two care systems: people “at risk” for developing a psychopathology and those “not at risk,” considering the SCL-90-R cut-off scores indicated by 62, pp. 88–91; T scores > = 70)

Summary

Introduction

Substance abuse is a relevant phenomenon at a clinical and social level in Western countries: about 50.0% of youths use illicit substances by age 16 [1,2,3]. In the context of substance abuse and dependence, family relations are found to lack support and be disorganized, multi-problematic, unpredictable, and inconsistent [5,6,7,8,9,10]. Attachment Patterns in Substance Abusers regulation and self-representation [11,12,13,14]. Existing empirical data have shown a link between first attachment relations and subsequent development of a dependence disorder [12, 18,19,20,21,22]. Data have confirmed the role of attachment in the context of substance use disorders (SUDs), at a behavioral and representational level and at a neuronal level, demonstrating decreased white matter connectivity in poly-drug users [23, 24]. Data do not explain the direction of the influence of attachment and substance abuse

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