Attachment Styles in Alcoholic Inpatients

Department of Psychoanalysis and Clinical Consulting, University of Ghent, Ghent, Belgium.
European Addiction Research (Impact Factor: 2.1). 02/2007; 13(2):101-8. DOI: 10.1159/000097940
Source: PubMed


Despite the fact that addiction has often been identified as an attachment disorder, empirical studies on this topic are rather scarce. In our study we explore attachment style (secure vs. insecure) in alcoholic inpatients and its relationship with perceived parenting and alcohol-related and psychiatric problems in a sample of 101 alcoholic inpatients (Belgium). Our results reveal that in comparison to the securely-attached group, insecurely-attached alcoholic inpatients perceived their mother as more controlling, reported more severe psychiatric problems in the European Addiction Severity Index, had higher scores on the Beck Depression Inventory, showed more schizotypal and depressive personality traits and had more difficulties with communicating emotions (alexithymia). We argue that it makes sense to differentiate alcoholic inpatients on the basis of attachment style and that both groups (secure/insecure) need different treatment approaches.

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    • "More recently, Ladegaard et al. 2014 replicated these findings and found that depressed patients had significantly more difficulties in forming complex integrated representations of themselves and other than healthy controls. Moreover, patients with somatic and substance abuse disorders have been reported to lack awareness of emotions and the events which evoke negative emotions (Taylor et al., 1997; Honkalampi et al., 2001; De Rick, Vanheule 2007; Lane, 2008). Lastly, a more complex relationship among metacognitive function has been suggested in substance disorders with one report finding that the ability to use metacognitive knowledge moderated the impact of unawareness of emotions on the severity of cluster C traits (Lysaker et al., 2014). "
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    ABSTRACT: While deficits in metacognition have been observed in schizophrenia (SZ), it is less clear whether these are specific to the disorder. Accordingly, this study compared metacognitive abilities of patients with schizophrenia and bipolar disorder (BD) and examined the degree to which neurocognition contributed to metacognitive deficits in both groups. Participants were 30 patients with SZ and 30 with BD. Metacognitive capacity was measured using the Metacognition Assessment Scale Abbreviated (MAS-A). This scale comprises four domains: self-reflectivity, understanding others׳ minds, decentration and mastery. Verbal memory, executive functioning and symptoms were concurrently assessed. Group comparisons revealed that SZ patients had greater deficits in metacognitive self-reflectivity, which correctly classified 85.2% of patients with SZ in a logistic regression. Self-reflectivity and understanding others׳ minds were related to verbal memory and executive functioning in the SZ group, but not in the BD group. Furthermore, greater positive and general psychotic symptoms were associated with poorer metacognition in SZ. Results suggest SZ involves unique deficits in the ability to self-reflect and that these deficits may be uniquely linked with neurocognition.
    Psychiatry Research 06/2014; DOI:10.1016/j.psychres.2014.06.040 · 2.47 Impact Factor
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    • "Because Internet addiction has been described as a behavioural addiction, theories that explain other addictions can be used to elucidate this condition [14]. Several studies have found that alcohol dependence is generally associated with anxious attachment [11] [12] [13] [14]. Studies based on traditional dependency theory have focussed primarily on alcohol dependence. "
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    ABSTRACT: Although the Internet is used effectively in many areas of life, some users experience problems because of over-use due to a lack of control. The diagnostic criteria for Internet addiction include disruptions in family relationships, but adequate data on the attachment styles and family functioning associated with this condition are limited. This study aimed to investigate the attachment styles and family functioning of patients with Internet addiction. The sample included 30 male patients consecutively admitted to the Bakırköy Mental Health and Research Hospital Internet Addiction Outpatient Clinic, who were diagnosed in clinical interviews as having Internet addiction according to Young's (1998) criteria. Thirty healthy males who were matched with the experimental group in terms of sociodemographic characteristics were included as control subjects. Both groups provided sociodemographic data and completed the Beck Depression Inventory (BDI), the Experiences in Close Relationships Questionnaire-r (ECR-r) and the Family Assessment Device (FAD). Patients with Internet addiction had higher BDI scores (P<.001) and higher attachment anxiety subscores on ECR-r (P<.001) compared with those in the control group. Patients with Internet addiction evaluated their family functioning as more negative and reported problems in every aspect addressed by the FAD. Scores on the FAD behaviour control, affective responsiveness, and problem-solving subscales (P<.05) and on the FAD communication, roles, and general functioning subscales (P<.001) were significantly higher in the patient compared with the control group. Patients with Internet addiction have more anxious attachment styles as well as prominent disruptions in family functioning. Thus, it may be important to evaluate the attachment styles and family functioning of patients with Internet addiction. Indeed, comprehensive treatment approaches including other family members may make important contributions to treatment success.
    General hospital psychiatry 10/2013; 36(2). DOI:10.1016/j.genhosppsych.2013.10.012 · 2.61 Impact Factor
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    • "Ainsworth et al. [18], first described different behavioural patterns, so-called “attachment styles” which have subsequently been implemented in various reliable and valid rating scales for the differentiation between individual attachment styles (secure, insecure avoidant, insecure anxious, insecure ambivalent and disorganised). Several reports indicate a higher prevalence of insecure compared to secure attachment styles in alcohol addiction [19-24] and other psychiatric disorders. Subjects with insecure attachment styles have a reduced capability of experiencing reliability, trust, and safety through relationships. "
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    ABSTRACT: Background Insecure early attachment experiences have been reported to play an important role in the manifestation in alcoholism. The purpose of this study was to investigate the relationship of attachment styles with anxiety, anxiety coping and dysfunctional personality styles, as well as with the prevalence of personality disorders, and adverse life-events in adolescence. Methods 59 inpatient alcohol addicted male (n=43) and female (n=16) patients were characterized by an attachment style scale (Relationships-style-questionnaire-RSQ) and completed a questionnaire battery comprising the State-Trait-Anxiety-Inventory (STAI), the Anxiety-Coping-Inventory (ABI), Temperament-and-character-inventory (TCI), Personality-system-interaction-inventory (PSI), and gave information on sociodemography, alcohol history, and adolescent adverse events. A structured interview (SKID-II) was performed to diagnose personality disorders. Results Only 33% of subjects had a secure attachment style. Insecure attachment was associated with significantly higher trait-anxiety, higher cognitive avoidance to control anxiety, and higher values on most personality style dimensions directed to the pathological pole. Conclusions Despite the limitation due to a small sample size, the results of this study show that the consideration of attachment styles is of significance in the diagnosis and therapy of alcohol addiction. Attachment may characterize different styles to control emotional aspects, anxiety cues and interpersonal relationships in individuals suffering from alcohol addiction.
    Substance Abuse Treatment Prevention and Policy 01/2013; 8(1):1. DOI:10.1186/1747-597X-8-1 · 1.16 Impact Factor
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