Abstract
Objectives: The Adult Attachment Interview (AAI) has been the gold standard of attachment assessment, but requires special training. The Relationship Scales Questionnaire (RSQ) is a widely used self-report measure. We investigate how each correlates with brain activity during appraisal of subjects’ mothers.Methods: Twenty-eight women were scored on the AAI, RSQ, and mood measures. During functional magnetic resonance imaging, subjects viewed their mothers in neutral-, valence-, and salience-rating conditions. We identified regions where contrasts in brain activity between appraisal and neutral viewing conditions correlated with each measure of attachment after covarying for mood. AAI and RSQ measures were then compared in terms of the extent to which regions of correlating brain activity overlapped with “default mode network” (DMN) vs. executive frontal network (EFN) masks and cortical vs. subcortical masks. Additionally, interactions with mood were examined.Results: Salience and valence processing associated with increased thalamo-striatal, posterior cingulate, and visual cortex activity. Salience processing decreased PFC activity, whereas valence processing increased left insula activity. Activity correlating with AAI vs. RSQ measures demonstrated significantly more DMN and subcortical involvement. Interactions with mood were observed in the middle temporal gyrus and precuneus for both measures.Conclusion: The AAI appears to disproportionately correlate with conscious appraisal associated activity in DMN and subcortical structures, while the RSQ appears to tap EFN structures more extensively. Thus, the AAI may assess more interoceptive, ‘core-self’-related processes, while the RSQ captures higher-order cognitions involved in attachment. Shared interaction effects between mood and AAI and RSQ-measures may suggest that processes tapped by each belong to a common system.
Highlights
Attachment and its Role in Psychotherapy ResearchMeasuring patient changes has been a longstanding challenge for psychotherapy outcome research, and patient personality in addition to symptomatology and functioning is an important consideration in the assessment of patient change (Strupp et al, 1997)
Attachment characteristics are important personality traits that bear on the assessment and understanding of treatment efficacy as direct measures thereof, and in numerous other ways
As the Relationship Scales Questionnaire (RSQ) overtly captures conscious/explicit attributions, and is liable to assess primarily the explicit processes involved in the function of the internal attachment model, our second hypothesis is that RSQ measures will correlate with brain activity primarily in regions associated with conscious/expressive brain function and will preferentially identify executive frontal network (EFN) and generally cortical rather than subcortical structures (Northoff et al, 2006; Northoff and Panksepp, 2008; Sajonz et al, 2010; Oosterwijk et al, 2015). To this end we examine the distributions of brain activity specific to conscious appraisal of a primary attachment figure correlating with the Attachment interview (AAI) and RSQ measures in relation to their basis in default mode network (DMN) vs. EFN networks as well as cortical vs. subcortical regional masks
Summary
Measuring patient changes has been a longstanding challenge for psychotherapy outcome research, and patient personality in addition to symptomatology and functioning is an important consideration in the assessment of patient change (Strupp et al, 1997). Dimaggio et al (2013) organized a special issue for Psychotherapy Research in which this subject matter received considerable attention. In this issue, they once again drew attention to attachment theory as a valuable approach to understanding personality. Attachment characteristics are important personality traits that bear on the assessment and understanding of treatment efficacy as direct measures thereof, and in numerous other ways. Studies examining attachment characteristics’ bearing on psychotherapy include investigations of: (1) patient factors in treatment efficacy (Wei et al, 2004), (2) patient factors in treatment process (Mallinckrodt, 2000; Mallinckrodt et al, 2005), (3) therapist factors in treatment efficacy (Bruck et al, 2006), (4) therapist factors in treatment process and alliance formation (Sauer et al, 2003), and (5) patient-therapist matching (Wiseman and Tishby, 2014)
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