Insecure Attachment Patterns Research Articles

Disturbances in eating behavior and body image: The role of attachment, media internalization, and self-objectification

ObjectiveResearch has increasingly demonstrated the need to conceptualize the etiology of eating disorders beyond a sole focus on body image disturbance. Attachment patterns, media internalization, and self-objectification have been previously found to play a potential role in the development and maintenance of eating psychopathology. MethodThis study 1) examined the associations between eating behavior, body dissatisfaction, attachment, media internalization, and self-objectification, 2) evaluated media internalization and self-objectification as mediators of the relationship between insecure attachment patterns and both eating disorder symptomatology and body dissatisfaction, and 3) explored predictors of eating behavior in a sample of 252 Lebanese individuals between the ages of 18 and 25. ResultsEating disorder symptomatology was positively correlated with body dissatisfaction, insecure attachment patterns, media internalization, and self-objectification. Positive associations between attachment anxiety and avoidance and eating disorder symptomatology were mediated by media internalization and self-objectification. Positive associations between attachment anxiety and avoidance and body dissatisfaction were also mediated by media internalization and self-objectification. Body dissatisfaction, media internalization, attachment anxiety and avoidance, and self-objectification were identified as predictors of eating behavior, with media internalization accounting for the highest variance in eating behavior. ConclusionsInsecure attachment, heightened susceptibility to internalizing unrealistic media portrayals, and an objectifying self-concept were found to be associated with eating disorder symptomatology and body image dissatisfaction. Findings were interpreted in light of suggested directions and considerations for the design of prevention and intervention programs.

The Mediating Role of Psychological Capital in the Relationship between Insecure Attachment and Subjective Well-being of Chinese Left-behind Children

The rising number of left-behind children in China, particularly in rural areas, underscores the urgent need to understand the complex interplay between insecure attachment and subjective well-being among this vulnerable population. The absence of one or both parents during their developmental years exposes these children to unique familial dynamics, contributing to unmet emotional needs and compromised parent-child relationships. Insecure attachment patterns often emerge as a consequence, further exacerbating the risk of mental health challenges. This study employs regression analysis and difference analysis to investigate the relationship between insecure attachment and subjective well-being among left-behind children, with psychological capital as a mediating variable. By elucidating the mechanisms underlying these associations, this research aims to inform targeted intervention strategies tailored to the needs of left-behind children.The findings underscore the multifaceted nature of subjective well-being in this population, emphasizing the importance of comprehensive interventions that address social, emotional, and psychological needs within familial and peer contexts. By fostering supportive relationships, enhancing emotional resilience, and promoting positive coping strategies, interventions can mitigate the adverse effects of parental migration on the well-being of left-behind children. While this study contributes valuable insights, future research should consider incorporating mixed-method approaches to capture the nuanced experiences and perceptions of left-behind children, thereby enhancing the validity and comprehensiveness of findings.

Perinatal Predictors and Mediators of Attachment Patterns in Preschool Children: Exploration of Children's Contributions in Interactions with Mothers.

Insecure and disorganized attachment patterns in children are linked to poor health outcomes over the lifespan. Attachment patterns may be predicted by variables that influence the quality of children's interactions with their primary caregivers/parents (usually mothers) such as prenatal and postnatal exposures and the children's own behaviours in interactions. The purposes of this exploratory study were to examine: (1) prenatal predictors of children's attachment patterns, and (2) postnatal mediators and moderators of associations between prenatal predictors and children's attachment patterns, with adjustment for relevant covariates. Mother-child dyads (n = 214) from the longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) cohort were studied using valid and reliable measures. Hayes' mediation analysis was employed to determine direct and indirect effects. Mothers' prenatal cortisol levels directly predicted disorganized (versus organized) child attachment in unadjusted models. Children's passivity (in adjusted models) and compulsivity (in unadjusted and adjusted models) in parent-child interactions mediated the pathway between mothers' prenatal cortisol levels and children's disorganized attachment patterns. Serial mediation analyses revealed that mothers' cortisol levels predicted their children's cortisol levels, which predicted children's compulsivity, and, ultimately, disorganized attachment in both unadjusted and adjusted models. No predictors were correlated with children's insecure (versus secure) attachment. This exploratory research suggests that prenatal exposure to mothers' cortisol levels and children's behavioural contributions to parent-child interaction quality should be considered in the genesis of children's attachment patterns, especially disorganization. Interventions focused on parent-child interactions could also focus on addressing children's behavioral contributions.

The Links Between Insecure Attachment to God, Divine Struggles, and Happiness and Depressive Symptoms Among Muslims and Jews in Israel

This investigation aimed to explore a theoretical model that examines the relationship between patterns of insecure attachment to God (i.e., anxious, avoidant), God-focused religious coping (i.e., divine struggles, positive religious coping), and mental health and well-being (i.e., happiness, depressive symptoms). The study's participants were 340 Israeli Jewish and Muslim individuals who completed electronic self-report questionnaires to assess the main variables of the study. The theoretical model was tested using Structural Equation Modeling. The analysis' findings indicated that there were no direct links between both patterns of insecure attachment to God and both happiness and depressive symptoms. Additionally, both anxious and avoidant attachment to God were found to be positively associated with divine struggles, and the latter mediated the relationship between both anxious and avoidant attachment to God and depressive symptoms. Furthermore, there were no significant associations between positive religious coping and any of the other variables in the study. Moreover, a comparative analysis revealed that the pattern of associations between the variables in the study was not dependent on gender or religious affiliation. Theoretical and practical implications of the findings are discussed.

Pattern of video game usage and video game disorder in Portugueses adolescents: A study about parental and peer attachment, parenting styles, and communication in parenting

Introduction Video game disorder has been a subject of increasing interest, being associated with patterns of insecure attachment and authoritarian and permissive parenting styles. However, there is still a gap concerning the relationship between video game disorder and parent-child communication, one of the fundamental components of attachment to parents. Particularly in the Portuguese context, research on these topics and their interrelations is still scarce, thus remaining relatively unexplored.ObjectivesTo explore the pattern of video game usage and video game disorder, as well as their relationships with parental and peer attachment, parenting styles, and communication in parenting within a sample of Portuguese adolescents.Methods 150 Portuguese teenagers, recruited at public Portuguese schools, aged between 10 and 19 years old (mean age = 14.37, DP = 3.12; 52.7% girls (n = 79), and mostly living with both parents (79.7%, n = 106) fulfilled a sociodemographic and an academic questionnaire, a questionnaire on video game use patterns, the Video Game Disorder Scale - Short Version 9, the People in My Life Questionnaire, the Portuguese hetero-report version of the Parenting Styles and Dimensions Questionnaire: Short Versionand the Perception Scale of Parenting Communication.ResultsThe majority of the sample indicated 3rd childhood (n = 81, 54.0%), specifically at 8 years old, as the age of video game initiation and a playtime of less than or equal to 2 hours (n = 111, 74.0%), with only 2 participants found to have a video game disturbance index (1.3%). A positive association was found between video game disturbance and the average hours of gameplay, as well as a negative association with the age of game initiation. Additionally, relationships were explored, revealing that video game disturbance is negatively related to lower quality of attachment to parents and peers, positively related to an authoritative parenting style, and negatively related to less available, open, and affectionate parent-child communication.ConclusionsThis study provides an in-depth understanding of adolescents’ behavior regarding video games, contributing to the knowledge of the topic in the Portuguese context. Furthermore, the identification of factors associated with video game disturbance allows for the development of remediation and prevention programs for this addictive disturbance, which are essential tools in psychological practice.Disclosure of InterestNone Declared

The revised Psychosis Attachment Measure: further psychometric evidence

PurposeDisorganised attachment is a key concept in understanding the development of psychosis. However, existing questionnaires of adult attachment do not adequately measure this construct hindering future research into the psychosocial causes of psychosis. The most widely measure of adult attachment in people experiencing psychosis is the Psychosis Attachment Measure (PAM). The measure has recently been revised to include disorganised attachment items. This study develops previous research by providing a rigorous examination the psychometric properties of the revised questionnaire (PAM-R).MethodsA total of 407 participants with self-reported experiences of psychosis completed a battery of questionnaires which included the PAM-R and other measures which were conceptually related to the concept of disorganised attachment.ResultsConfirmatory factor analysis (CFA) indicated a three-factor solution with factors corresponding to anxious, avoidant, and disorganised attachment. The majority of the fit statistics were acceptable with the exception of the RMSEA statistic. Internal consistency and test–retest reliability were good for all subscales. The disorganised subscale correlated in expected directions with other measures of attachment, dissociation, trauma, and psychotic experiences.ConclusionThe PAM-R is a valid and reliable measure of adult attachment. It is a practical assessment tool for clinicians and researchers to measure insecure and disorganised attachment patterns that is acceptable to people experiencing psychosis.

The Importance of Attachment for Human Beings and Dogs - Implications for Dog-Assisted Psychotherapy

Attachment theory is known as an important therapeutic foundation. Establishing a secure attachment to a caregiver is equally relevant for the mental health of both humans and dogs. A bond can be formed between humans and dogs that is comparable to the attachment between mother and child. Patients with adverse attachment experiences often struggle to maintain stable relationships due to internal working models. Building a therapeutic alliance can also be challenging. On the other hand, establishing a relationship with a dog seems to be successful for patients with adverse attachment experiences. Inclusion of a therapy dog provides them with the opportunity for experiences of trustful relationships.These experiences can then be transferred to the therapist. Later on, internal working models of the patients can indeed come into play in the relationship with the dog. The resulting patterns of relationship can become visible in the interaction with the dog. Within the therapeutic triade of patient, therapy dog and therapist, these patterns can be reflected and integrated into the therapy process. However, achieving this requires a targeted and professionally grounded use of the dog. If dogs are employed with a therapeutic purpose but without professional guidance, there is a risk of reestablishing insecure attachment patterns, which could potentially lead to more disadvantages than benefits for both humans and dogs.

Multiple Factors Leading to Anxiety and Depression in Adolescents

Depression is a prevalent mental health issue that has a significant impact on teenagers across the globe. This paper reviews the current literature on adolescent depression and its relationship with family factors. In addition, this paper tries to analyze the associations between depression and family intimacy, parenting style, attachment patterns, and adaptability. The findings from the studies suggest that family factors play a critical role in adolescent depression. Adolescents who lack emotional closeness with their families, are subjected to harmful parenting practices, exhibit insecure attachment patterns, and struggle to adapt to changes are more likely to experience depression. While the existing literature provides valuable insights into the relationship between family factors and adolescent depression, much remains to be explored. Future research could further investigate how family factors impact adolescent mental health and the potential for interventions to improve family relationships to prevent or alleviate depression in this population. Additionally, future studies could examine the impact of cultural and socioeconomic factors on the relationship between family factors and adolescent depression. Exploring this subject in more depth could pave the way for evidence-based approaches that have the potential to impact the lives of adolescents and their families positively.

High rate of insecure attachment patterns in preterm infants at early school age.

In preterm infants, insecure attachment is associated with behavioural and emotional problems but data on attachment beyond toddler age are scarce. This study assessed attachment security at 6-8 years in very and moderate or late preterm infants. The results were compared to a non-clinical full-term sample. Attachment security of 38 very and 20 moderate or late preterm infants was assessed during a home visit with the German version of the Attachment Story Completion Task. Attachment patterns of 28 full-term controls were taken from a previous study. Primary outcomes were attachment security and attachment security score. Secondary outcomes for the preterm groups were infant behavioural problems, parental stress, perceived social support, maternal depressive symptoms, and infant development. Very preterm infants had the highest rate of insecure attachment (81%) compared to moderate or late preterm infants (60%) and full-term infants (47%); (p= 0.013). Attachment security scores differed significantly between very preterm and full-term infants (p= 0.001). Secondary outcomes were similar in very and moderate or late preterm cohorts. Prematurity was associated with an increased risk of insecure attachment at early school age. Interventions targeting attachment security are reasonable considering the high rate of behavioural problems following premature birth.

Relationship between attachment style of 4-7-year-old children and their behavior during dental visit.

The general health and quality of life are directly correlated with oral health. Oral health is one of the unique health concerns that apply to all children. Pediatric dentistry is built on effective communication with children, which is also a requirement for providing pediatric dental care. Many pediatric dentists find it difficult to anticipate children's behavior and how they will respond to therapeutic procedures. The purpose of this study was to evaluate children's attachment types in order to forecast their behavior during a dentist appointment. The participants were 120 children between the ages of 4 and 7 who were reported to the Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Bareilly. The youngsters were evaluated by a dental graduate student. While they waited in the waiting area, the parents were asked to complete the Kinship Center Attachment Questionnaire regarding their kids. In the second visit, dental work was scheduled for the kids who had met the requirements for inclusion in the first visit. Another pediatric dentistry postgraduate student evaluated the children's conduct during the dental procedure using a predefined questionnaire and the Frankl scale. The Chi-squared test, t-test, Pearson's correlation coefficient, and linear regression were used to examine the data. According to the findings, 55.8% of the total children were cooperative, among which 59.1% were female and 52.0% were males. The average age of the kids was 6.2 ± 0.95. Moreover, 21.3% of kids had insecure attachment styles and 78.7% of kids had secure attachment types. The child-dentist communication and the insecure ambivalent attachment pattern were significantly correlated. As a result, our study demonstrated that children's safe attachment styles varied with age. Our results showed that there is an inverse relationship between children's collaboration and age, with cooperation rising as age increases. According to the findings of this study and considering its limitations, in young ages, the attachment style of the mother plays an important role in behavior of children. The significant correlations existed between the insecure ambivalent attachment style and child-dentist communication, as well as the secure attachment type and mother-child separation.

القدرة التنبؤية لعالقات معلمات الروضة باألطفال ذوي التعلق غير اآلمن بحب االستطالع والتفاعل مع األقران وفقاً لمستويات القدرة اللفظية لديهم بمدينة ع مان

The present study aimed to identify the predictive ability of kindergarten teachers' relationships with children of insecure attachment to curiosity and interaction with peers according to their levels of verbal ability in the city of Amman in Al-Jami’ah district. The sample of the study consisted of (110) children (71 male children and 39 female children). To achieve the objectives of the study, the scale of Attachment pattern was used in addition to the measures of the teacher-child relationships, interaction with peers, curiosity and verbal ability. The findings showed that the level of the positive relationships between the kindergarten teacher and the children of the insecure attachment style, the level of children’s curiosity, and the level of their verbal ability were all moderate, with an average of (2.60), (0.63) and (% 51.8), respectively. Besides, children had a high level of interaction with their peers with an average of (3.03). The findings also showed that the kindergarten teacher's relationship with the children of the insecure attachment pattern explained (19.6%) of their curiosity, and (17.8%) of their interactions with peers. Results also revealed that there were no statistically significant differences in the relationship between the teacher's relationship with children, and their curiosity from one hand, and their interaction with peers on the other hand according to the variables of verbal ability and gender.

Childhood behavioral inhibition and attachment: Links to generalized anxiety disorder in young adulthood.

Generalized anxiety disorder (GAD) is under-treated yet prevalent among young adults. Identifying early risk factors for GAD would contribute to its etiological model and identify potential targets for intervention. Insecure attachment patterns, specifically ambivalent and disorganized, have long been proposed as childhood risk factors for GAD. Similarly, childhood behavioral inhibition has been consistently associated with anxiety disorders in adulthood, including GAD. Intolerance of uncertainty (IU), the tendency to react negatively to uncertain situations, has also been shown to be a crucial component of GAD. Furthermore, maternal anxiety is an important feature of developmental models of anxiety including GAD. Yet, to date, no study has examined, within a comprehensive model, how attachment and behavioral inhibition in childhood, maternal anxiety in adolescence, and IU in emerging adulthood contribute to GAD in adulthood. The present study thus examines these links using a longitudinal design with 62 Canadian participants and their mothers. At age 6, participants' attachment and behavioral inhibition were assessed observationally. Maternal anxiety was measured when participants were 14 years of age. IU and GAD were assessed when participants were 21 and 23 years of age, respectively. Structural equation modeling showed that IU mediates the relationships between behavioral inhibition and GAD, while controlling for maternal anxiety. Ambivalent and disorganized-controlling attachment patterns are also indirectly associated with increased GAD symptoms via greater IU scores. Furthermore, a direct and positive effect of behaviorally disorganized attachment was found on GAD symptoms. This longitudinal study supports integrating attachment, behavioral inhibition, and IU in a model of GAD.

Avoidant and borderline personality disorder patients during the first Covid-19 wave in Norway – a survey-based comparison of therapy changes and patients’ accommodations

Background Patients with personality disorders (PDs) often have insecure attachment patterns and may be especially vulnerable to abrupt treatment changes. Patients with borderline PD (BPD) are often considered vulnerable to treatment interruption due to chronic fear of abandonment. Nonetheless, other PDs are poorly investigated. In the first Covid-19 wave in Norway, in-person treatment facilities and group treatments were strongly restricted from March 12th until May/June 2020. Objectives To examine and compare changes in outpatient treatment for patients with avoidant (AvPD) and BPD during the first Covid-19 wave in Norway, and patients’ reactions to these changes. Methods The study is based on a cross-sectional survey distributed to 1120 patients referred to 12 different PD treatment units on a specialist mental health service level within the Norwegian Network for Personality Disorders. The survey included questions on treatment situation, immediate reactions, and changes during the crisis. From 133 responders (response rate 12%), 40 patients reported BPD and 30 AvPD as diagnosis. Results All patients were followed up from their therapist after March 12th. Almost all patients in both groups expressed satisfaction under the new circumstances. Both groups experienced the same regularity as before, but more AvPD patients reported less than weekly consultations. AvPD patients reported more negative feelings about changes in therapy, and missed the therapy and group members more than the BPD group. Conclusion After the lockdown, BPD patients received a closer follow-up than AvPD patients, and the latter reported more negative feelings related to change in their treatment situation.

The impact of low birthweight in infant patterns of regulatory behavior, mother-infant quality of interaction, and attachment

It remains unclear whether infants born preterm are more likely to develop an insecure attachment with their mothers. In this study, instead of using gestational age criteria, we observe attachment in infants born with very low birthweight. Although the collinearity between gestational age and birthweight is high, infants born with very low birthweight for their gestational age tend to stay more days in NICU and to have more comorbidities than other infants with the same gestational age. Thus, we wonder about the impact of low gestational birth (per se) in infants' regulatory behavior, the quality of mother-infant interactions, and attachment security. The participants are 71 infants' weight lower than 1599 g of gestational weight (varying between 23 and 34 weeks of gestational) and their mothers. Dyads were observed in free play and during Face to Face Still-Face paradigm with infants at 3 months of corrected age. At 12 months of corrected age, mother-infant attachment was observed during Strange Situation. Results indicate that infants with low/very low gestational birthweight have high levels of insecure attachment (70 %) and non-positive patterns of regulatory behavior (64 %). Maternal and infant interactive behavior is highly associated with infant attachment. In turn, maternal interactive behavior is associated with gestational age, birthweight, and number of days in NICU.

Eating disorder psychopathology: The role of attachment anxiety, attachment avoidance, and personality functioning

ObjectiveAlthough the relationship between insecure attachment patterns and eating disorder (ED) psychopathology has repeatedly been demonstrated, the underlying mechanisms of this association are not fully understood. Therefore, the current study aimed to examine personality functioning, defined as an impairment in self and interpersonal functioning, as a mediator between attachment insecurity and ED psychopathology. MethodsIn a representative population-based sample (N = 2508; age range 14–92 years) ED symptomatology, personality functioning, and attachment insecurity (anxiety and avoidance) were assessed. Besides descriptive uni−/bivariate analysis, path analysis was used to test a mediation model while controlling for the effects of age, gender, mental distress, and BMI. ResultsED symptomatology was associated with lower levels of personality functioning (r = 0.22) and higher levels of attachment anxiety (r = 0.14) but did not correlate with attachment avoidance (r = 0.02). Path analysis revealed that personality functioning fully mediated the effect of attachment anxiety on ED symptomatology: The indirect effect via personality functioning (β = 0.04, p < .001) accounted for 77% of the total effect. Fit indices were excellent. Sensitivity analyses revealed that the main results were mainly applicable to women and the middle age group. ConclusionThe present findings contribute to the growing body of research using dimensional conceptualizations of personality functioning, suggesting that it provides an informative, overarching framework for understanding and treating ED psychopathology. Findings indicate that underlying individual differences, e.g., with respect to insecure attachment configurations, have relevant implications for symptom manifestations. Potential clinical implications and avenues for future research are discussed.

Adult Attachment Styles and Psychosocial Health

IntroductionEarly relationship experiences with parents or other important caregivers provide the matrix on which people form subsequent bonds in their lives. An attachment style relates to how people perceive themselves and significant others in terms of the possibility of obtaining support and care in stressful situations. There can be distinguished a secure attachment style and three insecure patterns of bond: preoccupied, dismissing and fearful (or disorganized). Psychosocial functioning of individuals with particular attachment styles is related to mental health in adulthood.PurposeThe aim of this paper is to discuss the relationship between different attachment styles and mental health (in the context of emotional regulation, coping with stress, the quality of interpersonal relationships and the prevalence of mental disorders).The state of knowledgeA secure attachment style is positively related to the mentalization ability and fosters forming more satisfying interpersonal relationships. People with a secure attachment style cope better in stressful situations and are less likely to develop depression and anxiety disorders. People with insecure attachment patterns use less social support as an effective coping strategy. Insecure attachment styles are also a risk factor for depression and anxiety disorders.ConclusionsProfessional support aimed at people characterized by insecure attachment styles is very important in the context of developing the ability to form close and satisfying interpersonal relationships, and in the context of mitigating the symptoms of mental health disorders.

The role of attachment styles in attention-deficit hyperactivity disorder: A meta-analytic review from the perspective of a transactional development model

ABSTRACT Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by pervasive alterations in self-regulation. Attachment patterns could be involved in maintaining the clinical features of ADHD during development. This meta-analytic review summarizes the findings of 26 cross-sectional and longitudinal studies that assessed correlations between attachment styles and ADHD features among children and adolescents. Results show that insecure attachment highlighted significant correlations with ADHD inattention and hyperactivity symptoms. Dismissive/avoidant attachment was associated with inattention features. Ambivalent/preoccupied attachment correlated with hyperactivity symptoms. Disorganized attachment was associated with inattentive symptoms. Insecure attachment was prospectively associated with later ADHD symptoms. Cross-sectional correlations between insecure attachment and ADHD symptoms were comparable to longitudinal ones. This might suggest a transactional developmental model of ADHD considering mutual reinforcement effects of insecure attachment patterns and core clinical features of the disorder. Clinical samples with ADHD should be assessed in order to support this theoretical framework.

Adult Attachment as a Mediator of the Link Between Interpersonal Trauma and International Classification of Diseases (ICD)-11 Complex Posttraumatic Stress Disorder Symptoms Among College Men and Women.

Previous research indicates that insecure attachment patterns are associated with interpersonal trauma and posttraumatic symptomatology, and that they mediate various trauma-related symptoms. However, no study to date has examined whether these patterns mediate the link between interpersonal trauma and the newly recognized diagnostic features of complex posttraumatic stress disorder (CPTSD), as published by the World Health Organization (2019) in the 11th version of the International Classification of Diseases (ICD-11). Mediators of CPTSD are important to identify because they can provide a deeper understanding of the condition's etiology. Moreover, if amenable to clinical intervention, they can be targeted to improve treatment effectiveness. The purpose of the present study was to formally test our hypothesis that two underlying dimensions of adult attachment insecurity (i.e., attachment anxiety and avoidance) would mediate the link between interpersonal trauma and ICD-11 CPTSD symptoms. Participants were a culturally diverse sample of 169 college men and women. They completed a modified version of the Life Events Checklist (LEC-5), the revised Experiences in Close Relationships (ECR-R) scale, and the International Trauma Questionnaire (ITQ). Results of path analysis partially supported our hypothesis, indicating that attachment anxiety, but not avoidance, partially mediated the link between interpersonal trauma and PTSD and DSO ("Disturbances in Self-Organization") features of CPTSD. Although longitudinal research is needed, findings suggest that attachment anxiety may contribute to the development and maintenance of CPTSD symptoms following interpersonal trauma. Clinical interventions that help individuals rework and integrate representations of attachment that involve a fear of not being able to access adequate care and protection, and a negative view of self may be particularly useful in ameliorating the symptoms of CPTSD.

Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community.

Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology.Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER).Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology.Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.

Link between History of Childhood Maltreatment and Emotion Dysregulation in Adults Suffering from Attention Deficit/Hyperactivity Disorder or Borderline Personality Disorder.

Childhood maltreatment (CM) may have a long-term effect on emotion regulation. This study aimed to explore the relationship between CM and emotion dysregulation (ED) in a heterogeneous population. Four hundred seventy French-speaking outpatients (N = 279 ADHD, N = 70 BPD, N = 60 ADHD + BPD, N = 61 clinical controls) completed the Emotion Reactivity Scale (ERS), the Cognitive Emotional Regulation Questionnaire (CERQ), the Childhood Trauma Questionnaire (CTQ), and the Relationship Scales Questionnaire (RSQ). Reports of childhood maltreatment experiences were significantly associated with increased levels of emotion reactivity in all our groups and in the whole population, with a greater use of non-adaptive cognitive emotion regulation strategies and insecure attachment patterns. Emotional abuse showed the strongest effect. Further analysis indicated that an anxious attachment style significantly mediated the relationship between CM and the use of non-adaptive cognitive emotion regulation strategies and emotion reactivity. The results of our study suggest an impact of CM on ED and a potentially marked effect of emotional abuse. They also indicate a potentially mediating role of insecure attachment in the relationship between a history of childhood abuse and emotion reactivity and a higher use of non-adaptive cognitive emotion regulation strategies in adulthood.