Pathways from insecure attachment dimensions to paranoia: The mediating role of hyperactivating emotion regulation versus blaming others
Pathways from insecure attachment dimensions to paranoia: The mediating role of hyperactivating emotion regulation versus blaming others
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DOI：
10.1111/papt.12208
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发表时间：
2020-03-01
影响因子：
3.4
通讯作者：
Lincoln, Tania M.
中科院分区：
文献类型：
--
作者：
Ascone, Leonie;Schlier, Bjoern;Lincoln, Tania M.
目的有证据表明不安全依恋与偏执之间存在联系，但我们还没有完全了解中介机制。依恋理论强调不安全依恋维度的差异相关性（即，焦虑与回避）与特定的情绪调节方式（ER）。我们测试了依恋焦虑与回避和偏执之间的联系是否是由过度激活（即，情绪放大策略的使用：自责，沉思，灾难化）与责备他人ER。此外，我们探讨了是否自责与指责他人ER差异介导的依恋焦虑与回避和paranoias.Method之间的关联，我们包括60例精神病患者和40名健康对照（HC），我们进行了标准化的诊断访谈。我们通过问卷调查评估了偏执、依恋和ER。结果与HCs相比，HCs患者表现出更多的依恋焦虑和回避，更多地使用过度激活的ER和责备他人的策略。我们发现，精神病患者的依恋焦虑和偏执之间通过过度激活ER产生了显着的间接影响。然而，没有显着的间接影响，包括指责他人或自责中的任何groups.Conclusions我们的研究提供了一个起点，进一步调查如何偏执妄想精神病可能会出现不安全的附件通过ER。这可能会启发进一步研究的依恋理论的ER偏执狂。从长远来看，这可以为这一目标群体提供一个发展人际导向干预的基础。从业者指出，在精神病患者中，似乎存在一个依恋特异性情绪调节（ER）途径，从依恋焦虑通过过度激活ER到偏执。责怪他人并不能解释依恋回避和偏执之间的显著联系。针对偏执的依恋特异性治疗方法，专注于过度激活ER，可能是改善偏执妄想症的有效方法。
Objectives There is evidence of associations between insecure attachment and paranoia, but we do not yet fully understand the mediating mechanisms. Attachment theory emphasizes differential relatedness of insecure attachment dimensions (i.e., anxiety vs. avoidance) with specific emotion regulation styles (ER). We tested whether the associations between attachment anxiety versus avoidance and paranoia were mediated specifically by hyperactivating (i.e., the use of emotion-amplifying strategies: self-blame, rumination, catastrophization) versus blaming others ER, respectively. In addition, we explored whether self-blame versus blaming others ER differentially mediated the associations between attachment anxiety versus avoidance and paranoia.Method We included 60 patients with psychosis and 40 healthy controls (HCs) with whom we conducted standardized diagnostic interviews. We assessed paranoia, attachment, and ER via questionnaires. A structural equation mediation model including attachment anxiety and avoidance (predictor), the ER styles (mediators), and paranoia (outcome) was calculated.Results Compared with HCs, patients exhibited significantly more attachment anxiety and avoidance, and used more hyperactivating ER as well as strategies of blaming others. We found a significant indirect effect between attachment anxiety and paranoia via hyperactivating ER in patients with psychosis. However, no significant indirect effects involving blaming others or self-blame in any of the groups were found.Conclusions Our study provides a starting point for further investigation of how paranoid delusions in psychosis could emerge from insecure attachment via ER. This might inspire further research into attachment theories of ER in paranoia. In the long term, this could provide a basis to develop interpersonally oriented interventions for this target group.Practitioner pointsIn individuals with psychosis, there appears to be an attachment-specific emotion regulation (ER) pathway from attachment anxiety via hyperactivating ER to paranoia.Blaming others did not explain the significant association between attachment avoidance and paranoia.Attachment-specific therapeutic approaches to paranoia, that focus on hyperactivating ER, could be a valid way to ameliorate paranoid delusions.