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Accessible Summary: What is known on the subject: Secondary traumatic stress (STS) is the indirect traumatisation of a person through the stress of helping or knowing about other's trauma. Burnout is gradual exhaustion in response to long‐term work‐related stress. Both have negative psychological, physiological and/or organisational consequences; however, the existing research in forensic health care professionals (FHCPs) is limited.One study explored STS in FCHPs and found that lower psychological flexibility (ability to adapt) was a predictor of greater STS. Existing research on burnout in FHCPs suggests that individual differences, such as the ways in which we cope (talking to people vs. using substances), may predict burnout levels. What the paper adds to existing knowledge: Prevalence findings add to the recent evidence base, which also found moderate levels of burnout. However, this study is the first to find high levels of secondary traumatic stress in FHCPs.Similar to existing literature, the study's findings suggest that FHCP's with lower levels of psychological flexibility and more maladaptive coping strategies may experience greater STS and burnout symptoms, while staff who use more adaptive coping strategies may experience less burn‐out.Unexpectedly, staff who reported a more anxious attachment style were burnt‐out; however, there are limitations to this finding. What are the implications for practice: Policies and practices in forensic settings should reflect the risk of STS and burnout.Practices or interventions should enhance adaptive coping strategies and psychological flexibility, such as Resilience Enhancement Programmes or Acceptance and Commitment Therapy (ACT). Introduction: Secondary traumatic stress (STS) and burnout literature in inpatient forensic health care professionals (FHCPs) is limited, despite the psychological, physiological and organisational consequences. Aims: This study aimed to further this limited evidence base, investigating predictors of STS and burnout in FHCPs. Method: 98 healthcare professionals working in two UK forensic inpatient settings completed measures assessing: burnout, STS, psychological flexibility, coping style, attachment style and a demographic questionnaire recording length of service and the sex of staff. Results: Results indicated high STS and moderate burnout levels. The main predictors of STS and burnout were poorer psychological flexibility and greater maladaptive coping styles, whereas lower burnout was predicted by greater adaptive coping styles and an anxious attachment style. Discussion: This study has contributed towards a limited evidence base and indicates poorer psychological flexibility and greater maladaptive coping may be risk factors for STS and burnout in FHCPs, whereas greater maladaptive coping may be a protective factor. Implication for Practice: The findings suggest that interventions such as Acceptance and Commitment Therapy (ACT) and coping skills interventions, may offer protective benefits to inpatient forensic healthcare professionals. [ABSTRACT FROM AUTHOR]

Aim: In this study, it was aimed to evaluate the attachment styles and life satisfaction of adolescents (12–18 years old) with and without smoking, alcohol, and substance use. Method: With the questionnaire applied on the digital platform and 225 adolescents between the ages of 12–18 were reached. The data were collected using a questionnaire, attachment style scale, and life satisfaction scale. The analyzes of the research were performed using the SPSS 25 program. Findings: The rate of young people who stated that they have smoked, or used alcohol and drugs was 40%. Of the adolescents, 35.6% used cigarettes, 0.4% used substances, and 6% used alcohol. Attachment styles and life satisfaction scale mean scores were lower in smoking, alcohol, and substance-using youth than in those who did not use these. It was observed that the average avoidant and anxious context styles scores of adolescents with smoking, alcohol and substance use were higher. Conclusions: It is important to take initiatives to support adolescents with problematic attachment styles and to protect their health [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The insecure attachment styles are associated with mental health problems and can influence reality perception, particularly in individuals with schizophrenia. What the paper adds to existing knowledge?: The paper provides empirical evidence for the correlation between insecure attachment styles and reality‐testing impairment in clients with schizophrenia.Higher reality testing impairment scores were observed in specific demographics: males who were unmarried and aged between 40 and 50 years old, as well as those with a duration of illness of less than 5 years. What are the implications for practice?: The findings underscore the importance for nurses to understand insecure attachment styles, particularly anxious and avoidant styles, in clients with schizophrenia.Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships.A secure, structured and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation.Secure Attachment Style Psycho‐Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality‐testing impairment.Imply early intervention through educating mothers on fostering secure bonds can potentially prevent future occurrences of schizophrenia. What are the implications for future research?: Conducting empirical studies to explore the associations between insecure attachment style, social functioning, and poor service engagement is essential.Research is needed to investigate specific techniques for managing insecure attachment styles, particularly the avoidant ones, and reality testing impairments within the therapeutic setting. Introduction: Insecure attachment styles are associated with mental health problems and may influence reality perception. Aim: This study investigated the link between attachment styles and reality‐testing impairment in individuals with schizophrenia. Methods: A cross‐sectional survey with 200 participants diagnosed with schizophrenia assessed their attachment styles (Psychosis Attachment Measure) and reality‐testing abilities (Bell Reality Testing Inventory). Results: A significant positive correlation emerged between insecure attachment and poorer reality testing (r =.394, p <.001). Avoidant attachment was most prevalent (mean scores: 17.01, SD = 3.71), followed by anxious attachment (16.53, SD = 4.20). Reality‐testing impairment manifested across all three domains: uncertainty of perception (7.16, SD = 2.45), reality distortion (3.52, SD = 1.21), and hallucinations/delusions (26.63, SD = 5.83). Interestingly, specific demographics (male, unmarried, 40–50 years old) and those with a duration of illness of less than 5 years had higher mean scores (27.35, SD = 5.61). Discussion: Insecure attachment styles, notably anxious and avoidant, are dominant among clients with schizophrenia, who also struggle with reality distortion, perceptual uncertainty, and hallucinations/delusions in all three domains. Implication for Practice: Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships. A secure, structured, and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation. Secure Attachment Style Oriented Psycho‐Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality‐testing impairment. Fostering Maternal and Child Health (MCH) centers on empathizing secure bonds between mothers (and mothers‐to‐be) and their children to promote healthy attachment styles as a preventive measure. [ABSTRACT FROM AUTHOR]

The current study sought to examine attachment styles as mediators between intimate partner violence (IPV) and stress coping styles among Iranian women. Data were collected from September to December 2020. The study population was composed of 102 women who were referred to Social Emergency Centers in Isfahan and affected by domestic violence. They were given self-report questionnaires to measure IPV (the Haj-Yahia Violence Questionnaire), Stress Coping Styles (CISS), and Attachment Styles (AAQ). Structural Equation Modeling was used to test the hypothesized relationships. Sexual IPV victimization was related to both avoidant attachment (β =.229, p =.015) and anxious attachment (β =.245, p =.008). Anxious attachment style was related to emotion-oriented coping (β =.437, p =.000). There was a negative relationship between avoidant attachment and anxious attachment (β = −.237, p =.032) with avoidance-oriented coping. Sexual IPV victimization and economic IPV victimization were associated with avoidance-oriented coping (β = −.225, t = 0.816, p =.015; β =.188, t = 0.816, p =.044). Women who had experienced IPV and had an insecure attachment style were more likely to utilize avoidance and emotional coping strategies. For women who had a secure attachment style, there was no association was found between IPV victimization and coping styles. Attachment styles may influence the relationship between IPV and coping strategies in Iranian women who have experienced violence. [ABSTRACT FROM AUTHOR]

Despite a growing literature, experiments directly related to attachment are still needed. We explored brain processes involved in two aspects of attachment, distress and comfort. Seventy-eight healthy adult males with different attachment styles (secure, avoidant, and anxious) viewed distress, comfort, complicity-joy and neutral images (picture database BAPS-Adult) in an fMRI block design. ROIs from the modules described in the functional Neuro-Anatomical Model of Attachment (Long et al. 2020) were studied. Secure participants used more co- and self-regulation strategies and exhibited a higher activation of the reward network in distress and comfort viewing, than insecure participants. Avoidant participants showed the lower brain activations. Their approach and reward modules were the least activated in distress and comfort. Anxious participants presented both higher activations of the approach and aversion modules during complicity-joy. In addition, comfort and complicity-joy were processed differently according to attachment styles and should be differentiated among positive stimuli to disentangle attachment processes. [ABSTRACT FROM AUTHOR]

A fundamental principle of attachment theory is that threatening situations give rise to individual differences in the extent to which people seek proximity to close others. The current research examines the way in which attachment styles predict individual differences in attachment-relevant behavior during threatening events. We tested alternative theoretical perspectives concerning the association between adult attachment (specifically, attachment avoidance) and attachment behavior in the presence of natural clues to danger by observing couples (N = 204) when they were watching horror vs. control film excerpts. Results suggest that highly avoidant people engaged in less attachment behavior across both threatening and non-threatening situations. These findings have implications for the understanding of attachment-related processes and how working models of the self and others facilitate (or inhibit) the expression of attachment behavior. [ABSTRACT FROM AUTHOR]

Support-seeking, a critical and strategic function of close relationships, is increasingly practiced via texting. Guided by attachment theory and an affordance-centric approach, this study investigated to what extent individuals in a romantic relationship would use texting and face-to-face for support-seeking, and what stimulates their interest in mediated support-seeking. A survey of college students in exclusive romantic relationships (N = 211) found that several affordances (i.e., accessibility, the availability of social cues, and conversation control) were associated with varying levels of interest in texting or face-to-face for support-seeking. Both accessibility and the availability of social cues were perceived as less important by avoidant individuals, which was related to a lack of interest in texting and face-to-face interactions for support-seeking. Anxious individuals valued the availability of social cues more, which led to a greater interest in face-to-face interactions when seeking assistance. These findings contribute to a better understanding of support-seeking behavior in today's mediated world. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the relationship between attachment styles and Separation Anxiety Disorder (SAD) through the internalized symptoms and stress coping strategies in badly-cared and orphan adolescent girls living in Tehran in 2022. Method: This was a correlational study of a Structural Equation Modeling (SEM) type. The statistical population included all adolescent girls aged between 12 and 18 under the direct or indirect supervision of Tehran's welfare center, of whom 200 were selected by the convenience sampling method. The participants answered the questionnaires of Collins and Reed's attachment styles, Billings and Moss's coping strategies, Achenbach and Rascorella's adolescent self-report, and Morris et al.'s SAD. Results: The findings of SEM demonstrated that the hypothesized model of this study has a good fit in the studied sample. The findings reveal that the secure attachment style is related to separation anxiety both directly (T=-4.18 and b=-.22) and indirectly through problem-oriented coping style (P<.01 and Z=-10.83) and emotion-oriented coping style (P<.01 and Z=-7.23). Avoidant attachment style is directly (T=4.98 and b=.25) and indirectly related to separation anxiety through problem-oriented coping style (P<.01 and Z=4.33) and emotion-oriented coping style (P<.01 and Z=8.79) and internalized symptoms (P<.01 and Z=2.61). Finally, ambivalent attachment style had no significant correlation (P>.05) with separation anxiety. Conclusion: These results emphasize the importance of attachment patterns formed under the influence of adverse conditions of the vulnerable group, and the lifelong effects of these patterns in the mental health of them. [ABSTRACT FROM AUTHOR]

Background: Insecure attachment styles are associated with retrospectively reported suicide attempts (SAs). It is not known if attachment styles are prospectively associated with medically documented SAs. Methods: A representative sample of US Army soldiers entering service (n = 21 772) was surveyed and followed via administrative records for their first 48 months of service. Attachment style (secure, preoccupied, fearful, dismissing) was assessed at baseline. Administrative medical records identified SAs. Discrete-time survival analysis examined associations of attachment style with future SA during service, adjusting for time in service, socio-demographics, service-related variables, and mental health diagnosis (MH-Dx). We examined whether associations of attachment style with SA differed based on sex and MH-Dx. Results: In total, 253 respondents attempted suicide. Endorsed attachment styles included secure (46.8%), preoccupied (9.1%), fearful (15.7%), and dismissing (19.2%). Examined separately, insecure attachment styles were associated with increased odds of SA: preoccupied [OR 2.5 (95% CI 1.7–3.4)], fearful [OR 1.6 (95% CI 1.1–2.3)], dismissing [OR 1.8 (95% CI 1.3–2.6)]. Examining attachment styles simultaneously along with other covariates, preoccupied [OR 1.9 (95% CI 1.4–2.7)] and dismissing [OR 1.7 (95% CI 1.2–2.4)] remained significant. The dismissing attachment and MH-Dx interaction was significant. In stratified analyses, dismissing attachment was associated with SA only among soldiers without MH-Dx. Other interactions were non-significant. Soldiers endorsing any insecure attachment style had elevated SA risk across the first 48 months in service, particularly during the first 12 months. Conclusions: Insecure attachment styles, particularly preoccupied and dismissing, are associated with increased future SA risk among soldiers. Elevated risk is most substantial during first year of service but persists through the first 48 months. Dismissing attachment may indicate risk specifically among soldiers not identified by the mental healthcare system. [ABSTRACT FROM AUTHOR]

As behavioral addictions (BAs) significantly affect well-being, paying attention to the characteristics associated with their onset is relevant. Current studies suggest that BAs should be addressed from an adaptive–maladaptive continuum perspective to define what and how some behaviors became problematic. The multi-faceted nature of behaviors attributed to possible BA involves psychological and individual backgrounds (e.g., attachment style). Given its role in affecting personality processes, social development, and motivational drives, the attachment style would be involved in addiction-like behaviors from adolescence, defined as a critical period for BA onset. This study analyzed the association between the attachment dimensions and two possible BAs that can be included in an adaptive–maladaptive continuum (i.e., social network use and TV series watching). A sample consisting of 493 late adolescents/emerging adults (age range: 18–24) completed questionnaires assessing social network use, TV series watching, and attachment style. The results showed a positive association between problematic attachment styles and BAs. High worry and need for relationships (anxious attachment) would be risk factors for problematic social network use and relationships as secondary (avoidant attachment) would be a risk factor for problematic TV series watching. These findings suggest the importance of further analyzing the role of attachment styles and their dimensions in influencing behavioral expression early to prevent the occurrence of BA. [ABSTRACT FROM AUTHOR]

Introduction: Marital satisfaction serves as a fundamental predictor of stability and well-being within individuals' lives and families. Aim: This study aims to develop a structural model that predicts marital satisfaction among young couples by examining the interplay between behavioral activation/inhibition systems and attachment styles. Method: The current study was a description of structural equations. A sample of 370 young couples in Tehran during the year 2021 was selected using convenience sampling. Data were collected through demographic questionnaires, Enrich's Marital Satisfaction Questionnaire (1998), the Behavioral Activation/ Inhibition Scale (1994), and the Adult Attachment Scale (2015). Path analysis was conducted using SPSS version 25 and LISREL version 8.8 for data analysis. Results: The results of the path analysis revealed several significant findings. Firstly, the inhibition system demonstrated a direct negative impact on marital satisfaction (ß=-0.16, P<0.05), along with ambivalent insecure attachment (ß=-0.42, P<0.01) and avoidant insecure attachment (ß=-0.19, P<0.05). Conversely, secure attachment displayed a direct and positive effect on marital satisfaction (ß=0.26, P<0.01). Furthermore, the inhibition system exhibited a direct and positive influence on avoidant insecure attachment (ß=0.18, P<0.01) and ambivalent insecure attachment (ß=0.19, P<0.01). Additionally, the activation system had a direct positive effect on secure attachment (ß=0.28, P<0.05) but a direct negative effect on avoidant attachment (ß=-0.30, P<0.01). Conclusion: The results of the study underscore the direct predictive role of the activation/inhibition system in marital satisfaction, with attachment styles playing an indirect role. Therefore, therapists should consider these variables to enhance satisfaction levels in couples. [ABSTRACT FROM AUTHOR]

Introduction: Attachment style has been associated with socio-emotional outcomes, however little evidence suggests a possible association with executive functioning. Few studies have demonstrated that attachment style mediates working memory and learning relationships. We hypothesized that attachment style affects performance and cortical activity patterns of working memory. Methods: We compared working memory performance and cortical activity in securely and insecurely attached first-year college students (N=49) using three n-back task conditions. Cortical activity was recorded by functional near-infrared spectroscopy during these three conditions of the n-back task. Attachment style was assessed using the Relationship Scale Questionnaire, categorized into four groups. Results: Both study groups showed similar working memory performance. The cortical representation of working memory was different between the two groups. The securely attached group demonstrated higher activity in the right superior frontal and superior-medial frontal areas across all n-back conditions as well as in the right superior frontal cortex during the two-back and three-back conditions. The insecurely attached group displayed higher activity in the bilateral supplementary motor area and the left premotor area only during the three-back condition. Conclusion: These findings emphasize the potential influence of attachment style on the cortical representation of working memory. Different activity maps between the two groups may reflect varying cognitive strategies employed to achieve a comparable working memory performance. Moreover, these results suggest that each style may have a distinct strategy to achieve attachment-relevant and irrelevant neurocognitive tasks. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents are one of the most vulnerable groups against risky behaviors. Therefore, this research was conducted with the aim of determining the relationship between attachment styles and rumination of anger in high-risk behaviors of adolescents by analyzing the mediating role of difficulty in emotion regulation. Methods: The method of the current research is descriptive-analytical of the correlation-path analysis type. The statistical population of this research was all the students of the first secondary level in the marginal areas of Kermanshah city in the academic year of 2011-2014 and the sample included 530 people who They were selected by multi-stage cluster sampling method. To collect data, Iranian youth risk-taking questionnaire, Hazen and Shiver attachment scale, Sakodolski, Glob and Cromwell anger rumination scale, and Gertz and Roemer scale of difficulty in regulating emotions were used. The data obtained from the questionnaires were analyzed using the path analysis model and the statistical software Smart PLS version 3.3 and SPSS version 25. This study with ID IR.IAU.KSH.REC.1402. 014 has been approved by the Research Ethics Committee of Kermanshah Islamic Azad University. Results: The path of attachment style to risky behaviors (β = 0.81 and t = 2.32), the path of anger rumination to risky behaviors (β = 0.45 and t = 2.32), the path of attachment style to risky behaviors with mediation Emotion regulation difficulty (β = 0.61 and t = 3.28), rumination to risky behaviors with the mediation of emotion regulation difficulty (β = 0.21 and t = 3.55), it was found that all values at the error level are less than 0.05 are significant. Conclusions: Through the mediation of difficulty in emotion regulation, there is a positive and significant relationship between attachment styles and rumination of anger in high-risk behaviors of adolescent girls. These results emphasize the difficult role of brahmin in regulating emotions in high-risk behaviors of adolescent girls. [ABSTRACT FROM AUTHOR]

Introduction: Couple satisfaction is a major and complicated aspect of marital life inside a family. Various factors are involved in it and affect it. The goal of the present study was to investigate the mediating role of boredom and mentalization in the relationship between attachment and marital satisfaction of women and men in the city of Bandar Abbas. Method: The study method falls under descriptive and correlative research. The statistical population of the study consisted of all married people in the city of Bandar Abbas in 2021-2022, out of whom 350 people were selected via the convenience sampling method. To gather data, Pines' Marital Boredom Scale (1996), Fonagy's Reflective Functioning Questionnaire (2016), Attachment Questionnaire, and Olson's Marital Satisfaction Scale (1994). To evaluate the hypothetical model and indirect effects, the maximum likelihood estimation and Bootstrap test were used. To analyze data, SPSS (version 23) and LISREL (Version 8.8) Software were used. Results: Secure and avoidant attachment styles with the standard coefficients of -0.37 and -0.24 were found to affect mentalization and marital boredom; mentalization and marital boredom with the standard coefficients of -0.17 and -0.14 affected marital satisfaction. In addition, secure and insecure attachment styles with the standard coefficients of 0.20 and -0.47 affected marital satisfaction (all effects were significant at p=0.001). Conclusion: According to the findings of the present study, it can be stated that couples' attachment (secure or avoidant) styles and other variables affecting attachment, i.e., mentalization and boredom can affect couples' marital satisfaction. [ABSTRACT FROM AUTHOR]

During the perinatal period, up to 25% of women experience difficulties in relating to their child. The mother-child bond promotes the transition to motherhood, protects the woman from depression, and protects the child from the intergenerational transmission of the disease. This study prospectively investigated if the relationship with the co-parent, the attachment style, and the bond that women had with their parents influenced the mother-fetus and then mother-child bond. We also explored the role of depression and anxiety. One hundred nineteen pregnant women were enrolled. We administered clinical interviews and psychometric tools. A telephone interview was conducted at 1, 3, and 6 months of follow-up. Maternal insecure attachment style (r = −0.253, p = 0.006) and women's dyadic adjustment in the couple's relationships (r = 0.182, p = 0.049) were correlated with lower maternal–fetal attachment. Insecure attachment styles and depression correlate with bottle-feeding rather than breastfeeding. The bond women had with their mothers, not their fathers, was associated with breastfeeding. Depression (OR = 0.243, p = 0.008) and anxiety (OR = 0.185, p = 0.004; OR = 0.304, p < 0.0001) were related to mother-infant bonding. Close relationships, past and present, affect the bond with the fetus and the child differently. Psychotherapy can provide reassuring and restorative intersubjective experiences. [ABSTRACT FROM AUTHOR]

Herein, we examined the impact of attachment style, acculturation orientation, and social support on psychological distress and sociocultural adaptation difficulties among international students in China. This study was based on an online survey that involved 229 international students [117 (51.05 %) Asians, 105 (45.46 %) Africans, 3 (1.74 %) Europeans, 1 (0.44 %) Oceanian, and 3 (1.74 %) from the Americas]. Our sample's average [Standard Deviation (SD)] GHQ-12 and Sociocultural Adaptation Scale (SCAS) scores were 0.906 (0.477) and 2.240 (0.746), respectively. Furthermore, hierarchical regression analysis revealed that our predictors could account for 25.4 % and 14.3 % of the explained variance in international students' psychological distress and sociocultural difficulties, respectively. In such instances, Chinese language proficiency correlated negatively with both psychological distress and sociocultural adaptation difficulties. Additionally, there was a positive correlation between attachment avoidance/anxiety and psychological distress, as well as between attachment anxiety and sociocultural adaptation difficulties. Moreover, heritage culture orientation and co-national support correlated negatively with psychological distress. Besides providing valuable insights for policymakers in education, our findings could also aid international students in quickly and effectively adapting to new environments. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is associated with paradoxical trust behaviours, specifically a faster rate of trust growth in the face of trust violations. The current study set out to understand whether attachment style, self-protective beliefs, and feelings of rejection underpin this pattern. Young adults (N=234) played a 15-round trust game in which partner cooperation was varied to create three phases of trust: formation, dissolution, and restoration. Discontinuous growth modelling was employed to observe whether the effect of BPD trait count on trust levels and growth is moderated by fearful or preoccupied attachment style, self-protective beliefs, and feelings of rejection. Results suggest that the slower rate of trust formation associated with BPD trait count was accounted for by feelings of rejection or self-protective beliefs, both of which predicted a slower rate of trust growth. The faster rate of trust growth in response to trust violations associated with BPD trait count was no longer significant after self-protective beliefs were accounted for. Interventions targeting self-protective beliefs and feelings of rejection may address the trust-based interpersonal difficulties associated with BPD. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the role of attachment insecurity in predicting a worse longitudinal trend of eating disorder (ED) psychopathology and body uneasiness in patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) treated with Enhanced Cognitive Behavior Therapy, considering the longitudinal interplay between these dimensions. Method: In total, 185 patients with AN or BN performed the baseline assessment, and 123 were re‐evaluated after 1 year of treatment. Participants completed questionnaires evaluating ED psychopathology (Eating Disorders Examination Questionnaire) and body uneasiness (body uneasiness test). For the assessment of adult attachment, the Experiences in Close Relationships‐Revised was administered at baseline. Bivariate latent change score analysis within the structural equation modeling framework was performed to investigate the evolution of ED psychopathology and body uneasiness, their longitudinal interplay, and the role of attachment style as an outcome predictor. Results: After treatment, all psychopathological features showed an overall improvement. Higher baseline levels of body uneasiness predicted a worse course of ED psychopathology. The change in body uneasiness over time depended on changes over time in ED psychopathology, but not vice versa. Insecure attachment predicted a worse longitudinal trend of ED psychopathology, and, through this impairment, it indirectly maintained higher levels of body uneasiness, as confirmed by mediation analyses. Discussion: The role of attachment insecurity as a predictor of treatment outcome suggests the need for an integration of the cognitive‐behavioral conceptualization of EDs with a developmental perspective that considers attachment‐related issues. Public significance statement: Considering the burden of EDs in terms of public health and the unsatisfactory response to standard treatments, the identification of outcome predictors is of considerable clinical interest. This study demonstrated that attachment insecurity was associated with worse longitudinal trends of ED psychopathology and body uneasiness in patients with AN and BN treated with CBT‐E, highlighting the importance of personalizing treatment programs taking into account a developmental perspective on these disorders. [ABSTRACT FROM AUTHOR]

Background: Subgenual cingulate cortex (SCC) responses to self-blaming emotion-evoking stimuli were previously found in individuals prone to self-blame with and without a history of major depressive disorder (MDD). This suggested SCC activation reflects self-blaming emotions such as guilt, which are central to models of MDD vulnerability. Method: Here, we re-examined these hypotheses in an independent larger sample. A total of 109 medication-free participants (70 with remitted MDD and 39 healthy controls) underwent fMRI whilst judging self- and other-blaming emotion-evoking statements. They also completed validated questionnaires of proneness to self-blaming emotions including those related to internal (autonomy) and external (sociotropy) evaluation, which were subjected to factor analysis. Results: An interaction between group (remitted MDD v. Control) and condition (self- v. other-blame) was observed in the right SCC (BA24). This was due to higher SCC signal for self-blame in remitted MDD and higher other-blame-selective activation in Control participants. Across the whole sample, extracted SCC activation cluster averages for self- v. other-blame were predicted by a regression model which included the reliable components derived from our factor analysis of measures of proneness to self-blaming emotions. Interestingly, this prediction was solely driven by autonomy/self-criticism, and adaptive guilt factors, with no effect of sociotropy/dependency. Conclusions: Despite confirming the prediction of SCC activation in self-blame-prone individuals and those vulnerable to MDD, our results suggest that SCC activation reflects blame irrespective of where it is directed rather than selective for self. We speculate that self-critical individuals have more extended SCC representations for blame in the context of self-agency. [ABSTRACT FROM AUTHOR]

This research identified participant profiles in level and changes in depression among working age (18–64 years old) clients (N = 137) diagnosed with depression, who participated in a 20-session dance movement therapy (DMT) intervention. Using Latent Profile Analysis Mild, sharply reducing depression (9%), Mild, reducing depression (58%) and Severe, reducing depression (33%) profiles were established, using Beck Depression Inventory scores gathered at pre-intervention, post-intervention, and follow-up points. At the pre-intervention point, being in full-time work was related to the Mild, sharply reducing depression profile. Being on a disability pension, having a history of one's own or a close person's substance abuse, a more fearful attachment style, and deficiencies in mindfulness skills were related to the Severe, reducing depression profile. All participants benefited from the short-term DMT intervention, which may offer a good outcome for patients with less complex depression, whereas those with more complicated symptomology may require longer treatment. [ABSTRACT FROM AUTHOR]

Introduction: Given that basic psychological needs, cognitive emotion regulation, attachment styles and mental vitality are among the factors that play a protective role in the occurrence of high-risk behaviors; therefore, predicting the underlying or eliminating factors of high-risk behaviors seems necessary. Aim: This study was conducted to predicting high-risk behaviors based on satisfying basic psychological needs, cognitive regulation of emotion and attachment styles mediated by mental vitality in female adolescents. Method: The statistical population of this descriptive-correlational study included all female students of the second year of high school in Tabriz in the academic year 2018-2019, from which 282 people were selected using multi-stage cluster sampling. Data were collected through Iranian Adolescents Risk-Taking Scale (IARTS), Basic Psychological Needs Scale (BPNS), Adult Attachment Inventory (AAI), Cognitive Emotion Regulation Questionnaire (CERQ) and Mental Vitality Questionnaire (MVQ). Data were analyzed using path analysis method in SPSS-23 and Lisrel-8 software. Results: There is a negative and significant relationship between high-risk behaviors with the satisfaction of basic psychological needs (P=0.001, r=-0.230), and mental vitality (P=0.001, r=-0.313) and attachment styles (P=0.001, r=0.247) there is a positive and significant relationship; while only the satisfaction of basic psychological needs (P=0.004) can predict high-risk behaviors due to the mediating role of mental vitality. Conclusion: Satisfaction of basic psychological needs due to the mediating role of mental vitality has the ability to predict high-risk behaviors; these findings can be helpful in effectively preventing high-risk behaviors among female adolescents. [ABSTRACT FROM AUTHOR]

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Objectives: Obsessive‐compulsive disorder (OCD) is a debilitating psychiatric disorder, often complicated with comorbidities. Social phobia (SP) is the most frequent co‐occurring anxiety disorder in OCD, associated with increased clinical severity. However, no study had examined the relevance of interpersonal processes in this comorbidity, which are at the core of SP. This study characterized the clinical (i.e., symptom profile, age of onset, chronicity, and comorbidity), vulnerability (i.e., childhood trauma, negative life events), and interpersonal (attachment style, expressed emotion, and social support) correlates of comorbid SP in a large sample of OCD patients. Methods: We analysed the data of 382 OCD patients participating in the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. We examined the correlates of SP in OCD using self‐report questionnaires and structured clinical interviews. In addition, data of 312 non‐OCD SP patients were drawn from the Netherlands Study of Depression and Anxiety (NESDA), to compare the age of onset of SP between groups. Descriptive univariate analyses were followed by backward stepwise logistic regression analyses. Results: Social phobia was present among approximately 20% of OCD patients. Social phobia in OCD was associated with increased depression severity and decreased ratings of secure attachment style. Among OCD patients, SP had a significantly earlier age onset as compared to SP in non‐OCD patients. Conclusion: Social phobia in OCD might render a vulnerable clinical picture, characterized with early onset of SP symptoms, insecure attachment style, and increased depressive symptoms. Future studies should use prospective designs to better understand the nature of comorbid SP in OCD. Practitioner points: Approximately one fifth of OCD patients were diagnosed with comorbid social phobia in a large representative clinical sample.OCD patients with comorbid social phobia presented with a vulnerable clinical picture, characterized with increased depression severity and decreased ratings of secure attachment style.Social phobia in OCD was associated with an earlier AOO as compared to the AOO of social phobia without OCD.The findings are limited by a cross‐sectional design; thus, causality could not be assessed.Research is needed to further examine the mechanisms of comorbid social phobia in OCD. [ABSTRACT FROM AUTHOR]

Different measures of attachment are usually weakly correlated. In a subsample of an RCT comparing short‐term cognitive‐behavioural therapy (CBT) and psychodynamic therapy (PDT), we examined the association between attachment and outcome using two attachment measures. The sample comprises 148 patients with social anxiety disorder who were treated in the SOPHO‐NET trial. Pretreatment attachment was assessed using the Adult Attachment Prototype Rating (AAPR) and the Bielefeld Questionnaire of Client Expectations (BQCE). Regression models were used to predict the therapeutic alliance (HAQ) at session 8, the Liebowitz Social Anxiety Scale (LSAS) at the end of therapy and a 6‐month follow‐up. Attachment groups (secure, avoidant, and ambivalent) classified with the AAPR and the BQCE were not significantly correlated (Cohen's κ = 0.08). Only the BQCE was associated with the HAQ indicating avoidantly attached patients showing lower HAQ scores than securely attached (Cohen's d = 0.722). Regarding the AAPR, we found an interaction effect of treatment and attachment related to the post‐treatment LSAS scores. Post hoc tests revealed that securely attached patients in CBT had lower scores than securely attached in PDT (d = 0.922) and, on a trend level, avoidantly attached in CBT (d = 0.782). We conclude that attachment–outcome associations are affected by the applied measure. The identified differential effects suggest that psychotherapists should adapt the interventions on the attachment of their patients. [ABSTRACT FROM AUTHOR]

Background and Objectives: Adolescence is one of the most important stages of life in this period, due to physical, psychological and behavioral changes, the need to adapt to family and society is felt more. The purpose of this study was to investigate the role of attachment styles and religious attitudes in predicting adjustment of students. Methods: The present study was a descriptive correlational study. The research samples included 162 students who were selected by a Multi-stage cluster sampling method of first high school students in the city of Najaf Abad. To collect the data of the Sinha & Singh adjustment Questionnaire (1993), Hazen and Shaver Attachment Styles Questionnaire (1987), Barahani and Golriz Religious Attitude Questionnaire (1975) were used. To analyze the relationships among the variables and to predict variances in adjustment, the Pearson correlation coefficient and the stepwise regression analysis were used. Results: The results showed that there is a significant relationship between attachment styles and religious attitude with students' adjustment (P<0.001). The regression analysis results showed that the strongest compatibility predictor variables in students are ambivalent attachment style, religious attitude and avoidant attachment style (P<0.001). Conclusion: These results indicate that ambivalent attachment style, religious attitude and avoidant attachment style can be important factors in adjustment of students. [ABSTRACT FROM AUTHOR]

Objective: the aim of this longitudinal study was to evaluate the impact of COVID‐19 epidemic on Eating Disorders (EDs) patients, considering the role of pre‐existing vulnerabilities. Method: 74 patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) and 97 healthy controls (HCs) were evaluated before lockdown (T1) and during lockdown (T2). Patients were also evaluated at the beginning of treatment (T0). Questionnaires were collected to assess psychopathology, childhood trauma, attachment style, and COVID‐19‐related post‐traumatic symptoms. Results: A different trend between patients and HCs was observed only for pathological eating behaviors. Patients experienced increased compensatory exercise during lockdown; BN patients also exacerbated binge eating. Lockdown interfered with treatment outcomes: the descending trend of ED‐specific psychopathology was interrupted during the epidemic in BN patients. Previously remitted patients showed re‐exacerbation of binge eating after lockdown. Household arguments and fear for the safety of loved ones predicted increased symptoms during the lockdown. BN patients reported more severe COVID‐19‐related post‐traumatic symptomatology than AN and HCs, and these symptoms were predicted by childhood trauma and insecure attachment. Discussion COVID‐19 epidemic significantly impacted on EDs, both in terms of post‐traumatic symptomatology and interference with the recovery process. Individuals with early trauma or insecure attachment were particularly vulnerable. [ABSTRACT FROM AUTHOR]

Purpose: To assess fear of intimacy (FOI) in the Lebanese population, and its correlates such as depression, social phobia, self‐esteem, attachment, and maladaptive schemas. Design/Methods: This cross‐sectional study, conducted between November 2017 and May 2018, enrolled 707 community‐dwelling participants. Results: Higher FOI scores were associated with an increase in the defectiveness schema (β = 0.483), social phobia score (β = 0.16), mistrust schema (β = 0.519), vulnerability schema (β = 0.482), emotional deprivation schema (β = 0.548), attachment style D (dismissing) (β = 0.913) and failure schema, whereas lower FOI was significantly associated with an increase in the entitlement schema (β = −0.362), insufficient schema (β = −0.377), and the self‐esteem score (β = −0.288). Practice Implications: Implementing educational programs are needed to enable persons to develop healthy intimate relationships, taking into account attachment styles and inappropriate early schemas. [ABSTRACT FROM AUTHOR]

Latinx college students face challenges regarding depression. The relationships between early maladaptive schemas (EMS) and attachment style on depression and relationship satisfaction were investigated among 236 Latinx college student participants. The Young Schema Questionnaire–Short Form (YSQ-S3) total score was utilized to identify overall schema. Significant correlations were found. Overall schema, attachment anxiety, attachment avoidance, and depression were all positively correlated, while attachment anxiety, attachment avoidance, and depression were negatively correlated with relationship satisfaction. In multiple regression analyses, Model 1, overall schema and attachment anxiety significantly predicted depression. In Model 2, overall schema, attachment anxiety, and attachment avoidance significantly predicted relationship satisfaction, with EMS acting as a positive predictor. Results suggest that Latinx college students with EMS and anxious attachment style endorse more depression, while the influence of EMS and attachment style on relationship satisfaction needs to be further investigated. Considerations for the use of schema therapy and future research are discussed. [ABSTRACT FROM AUTHOR]

The aim of this study was to observe the relationship between hypnotizability scores, as defined by the Hypnotic Induction Profile (HIP), and the following psychological tests: Ten-Item Personality Inventory (TIPI), Relationships Questionnaire (RQ), Experiences in Close Relationships-Revised (ECR-R), Spontaneity Assessment Inventory-Revised (SAI-R), Testoni Death Representation Scale (TDRS), 20-Item Cognitive Flexibility Inventory (CFI) and The Flexible Regulation of Emotional Expression Scale (FREE Scale), as well as a questionnaire provisionally named the Hypnotic Ability Trace (HAT), including a set of items significantly related to hypnotizability). A structural model based on path analysis showed a positive association between hypnotizability and both spontaneity and extraversion, and a negative association between hypnotizability and both avoidance and cognitive flexibility, which in turn were positively related to HAT. in addition, spontaneity, extraversion and emotional stability were positively associated with the sub-scale of control of the cognitive flexibility, which in turn was negatively related to the HAT. There were no associations among attachment, spontaneity, personality traits and emotional flexibility, while the HAT was positively related to emotional flexibility, openness to experiences and the HIP score. Our results suggest the relevance and role of both cognitive and emotional flexibility as well as their positive interaction with HAT in hypnotic ability. [ABSTRACT FROM AUTHOR]

Following recent literature, which stresses the importance of broadening the conceptualization of mental functioning in youth, this paper investigated the relations between indicators of attachment styles, internalizing symptoms, and separation anxiety in 379 non-referred Italian university students, as captured by the relationship questionnaire, the experiences in close relationships-revised, the Personality Assessment Inventory (PAI), and the adult separation anxiety-27. Psychometric properties of all measures were scrutinized and a confirmatory factor analysis was conducted to support the soundness of a one-factor model representing indicators of all PAI internalizing symptoms: Anxiety, Anxiety-related disorders, Depression, Somatization, and Suicidal ideation. Then, a multivariate analysis was performed in order to test a model of relation linking attachment styles, internalizing symptoms, and separation anxiety scores. Results supported the mediation role of Internalizing symptoms in the association between preoccupied attachment and separation anxiety scores. Preoccupied attachment towards the romantic partner, as compared to attachment towards family and friends, played a more relevant role in predicting internalizing symptoms and separation anxiety scores. Findings corroborate the combined use of the over-mentioned indicators as a screening battery for the dimensional assessment of the interplay among these variables in young adults. Implications and limitations of the study are presented and discussed. [ABSTRACT FROM AUTHOR]

Introduction: This research aims to present, explore and analyze the dynamics and interactions between the attachment style developed by the individual in the couple, death anxiety and separation anxiety. The focus on these three concepts can be justified by the fact that these are important processes that occur during the experiential journey of each individual, processes which significantly influence the quality of the relationship between the partners. Objectives: Objectives and assumptions underlying the present study support the exploratory and investigative approaches, to identify the attachment styles developed, levels of death anxiety, but also the level of separation anxiety manifested in the erotic partnership in which the participant was a part of at the time of the data collection phase. Besides the exploratory aspects of the research, I inter-linked these concepts to capture the dynamic interaction and specific principles. Methods: Three instruments were used in the present study: a questionnaire for investigating the attachment style (AAS), a questionnaire for investigating the level of separation anxiety (AS-FI), and a third one for investigating the level of death anxiety (TDAS). Results: Regarding the specific assumptions, three research hypotheses were confirmed: H1, that there is a statistically significant positive correlation between separation anxiety in couples and ambivalent attachment style (r = .45, p < .01), showing that people who have a high level of attachment anxiety have reported a higher tendency to worry about separation than those who have a lower level of this dimension; H2, that there is no statistically significant correlation between separation anxiety in couples and secure attachment style (r = -.07, p > .01), as the dynamics of the relationship of those with a secure attachment style makes the separation anxiety appear unlikely; H5, that ambivalent attachment style predicts separation anxiety (r2 = .21). The H3 hypothesis was partially confirmed, with ambivalent attachment style and avoidant attachment style correlating statistically significant with death anxiety (r = .31, p = .001, respectively r = .29, p = .001), while there is no statistically significant correlation between secure attachment style and death anxiety (r = -10, p > .001), people with a secure attachment style defending themselves against the awareness of death in a different way than those with an ambivalent or avoidant attachment style. The H4 hypothesis has not been confirmed, as death anxiety does not modulate the relationship between secure attachment style and separation anxiety. Conclusions: Individuals with an ambivalent or avoidant attachment style score higher on the scales that measure death and separation anxiety, while individuals with a secure attachment style register lower values on these scales. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the association of adults' attachment styles with mental disorders in Lebanon. Design/Methods: A cross‐sectional observational study enrolled 789 participants between November 2017 and March 2018. Findings: People with distress (with dismissing‐ and fearful‐dominant relationship styles) and people with instability (preoccupied‐dominant relationship style with equal presence of the secured, fearful, and dismissing styles) had higher alcohol use disorder, alexithymia, depression, anxiety, stress, decreased emotional intelligence (emotional awareness, emotional management, and social‐emotional awareness), burnout scores and suicidal ideation compared people with wellbeing, with a secure‐dominant relationship style. Practice implications: It is very important to assess bonding traits in disease prevention centers, caregiver institutions, employment assessments, and then coaching might help those individuals under risk to prevent mental health problems. [ABSTRACT FROM AUTHOR]

We tested the association between the palliative patient's attachment style and the patient–doctor relationship, by means of Revised Adult Attachment Scale and a self-designed, patient–doctor relationship questionnaire. The study included 110 (52 M, 58 F) cancer, hospice patients, aged 36–80 years. We observed 54 percent of secure, 18 percent of dismissive, 9 percent of preoccupied, and 19 percent of fearful styles. Securely attached patients developed significantly (p < .05) better relationships with doctors than insecure patients. There was no difference in the quality of the patient–doctor relationship among dismissive versus preoccupied versus fearful patients. We argue that attachment theory should be applied in palliative care to improve patients' quality of life and dying. [ABSTRACT FROM AUTHOR]

Attachment style is a relatively stable trait linked to emotion regulation and coping as measured by questionnaire responses. An increasing number of functional brain imaging studies have explored the neural underpinnings of attachment style during emotional processing. However, until now, an overall picture of brain regions involved in this trait remained unexplored. Here, we conducted a meta-analysis of 12 peer-reviewed studies on attachment style using activation likelihood estimation (ALE) in functional magnetic resonance imaging (fMRI). We observed a significant negative correlation between avoidance attachment scores and activation of left inferior frontal gyrus to emotional stimuli, implying an inhibition processing for emotional stimuli in people with high avoidance attachment. In addition, there was a significant positive correlation between anxiety attachment scores and activation of left amygdala during emotional processing, which suggested an increased vigilance to emotional stimuli. [ABSTRACT FROM AUTHOR]

We aim to investigate nurses’ feelings of comfort or discomfort with three different types of touch: task-oriented contact, touch promoting physical comfort, and touch providing emotional containment. A questionnaire was administered to a sample of 198 nurses. We present results of multiple regression analysis identifying some antecedents of nurses’ feelings of comfort with touch, namely, attachment style, worry, gender, and length of service. Worry is negatively associated with task-oriented contact and touch promoting physical comfort. Attachment security and length of service are associated with comfort with touch aimed at emotional containment; female nurses feel more comfortable than male nurses in performing this type of touch. Practical implications of findings are discussed in relation to the promotion of focused training courses for practitioners who are willing to improve the quality of care services. [ABSTRACT FROM AUTHOR]

Attachment theory has increasingly been utilized to understand the etiology of sexual violence, and anxious attachment appears to be especially informative in this domain. We investigate the influence of general anxious attachment and specific anxious attachment on hostile masculine attitudes to predict male-perpetrated sexual assault. We hypothesize that hostile masculinity will mediate the relationship between general anxious attachment style and sexual assault perpetration (Hypothesis 1) and the relationship between specific anxious attachment to the assaulted woman and sexual assault perpetration (Hypothesis 2). Men (N = 193) completed the Sexual Experiences Survey (SES) to determine sexual assault history and completed measures of general attachment style, specific attachment to the woman involved in the sexual activity, and measures of hostile masculine attitudes. Results support the hypothesized mediation models, such that general anxious attachment and specific anxious attachment are significantly associated with hostile masculinity, which in turn, predicts the likelihood of male-perpetrated sexual assault. The findings suggest that the unique characteristics of anxious attachment may escalate into hostile masculinity, which then increases the likelihood of sexual assault perpetration. This research is the first to investigate attachment bonds to the woman involved in the sexual activity and likelihood of sexual assault perpetration against the same woman. [ABSTRACT FROM AUTHOR]

This study aims to explore the relations between attachment styles and pain intensity and certain emotional variables (anxiety, depression and alexithymia) in a sample of fibromyalgia patients, in comparison with healthy women. Data were collected from 146 women with fibromyalgia and 122 healthy women. The variables studied were attachment style, pain intensity, anxiety, depression and alexithymia dimensions. Patients with fibromyalgia showed lower percentages of secure attachment style (69.9% vs. 86%) whilst showing higher avoidant attachment (19.8% vs. 7.4%), as well as increased numbers of anxious–ambivalent attachment (10.3% vs. 6.6%) than healthy women (X2 = 9.915, p = .007). Also, fibromyalgia patients showed significantly higher scores in two of the insecure attachment factors (p < .000; p = .020) and lower scores on the secure attachment factor (p = .008) in comparison with healthy women. Higher scores of alexithymia were found in women showing anxious–ambivalent and avoidant attachment styles in comparison with those showing a secure attachment style, regardless of the group they belonged to. In fibromyalgia patients, higher anxiety (p = .005) was found among the women with anxious–ambivalent attachment styles (Mean = 15.15; SD = 1.15) in comparison with those with secure attachment style (Mean = 11.18; SD = .45). No relation was found between attachment style and pain intensity. Avoidant attachment seems to carry out a contradictory role and warrants further research. The results found seem to highlight the need for the Attachment–Diathesis Model of Chronic Pain to include attachment styles as a predictor of the emotional experience of pain in fibromyalgia patients. [ABSTRACT FROM AUTHOR]

Objective: This paper investigates the connections in pregnant women between their mother attachment style and their self-image as a mother, the image of their mother as a mother, and their bond with the unborn child. Background: The relationship with one's mother plays a crucial role in the process of becoming a mother. It influences what a pregnant woman thinks about herself as a mother. This relationship is a predictor of the bond with the child during the pregnancy. Methods: This research was participated in by 165 pregnant women. They completed the following: a modified version of the Experiences in Close Relationships (ECR) questionnaire, investigating a mother's attachment to her own mother; the Adjective Check List (ACL), developed by Gough and Heilbrun; the Maternal-Fetal Attachment Scale (MFAS); and a sociodemographic survey. Results: A mother's attachment style is connected with the need for autonomy, as measured by the ACL, and with 'assuming a parental role' in the MFAS questionnaire. The strongest connection was found between a mother's attachment style and the image of one's own mother as a mother. Statistically-significant correlations were found for 32 of 37 scales on the ACL. Conclusion: Attachment style exerts influence upon a mother's selfimage, the image of one's own mother as a mother and the bond with the unborn child. [ABSTRACT FROM AUTHOR]

Objective:The study aimed at (a) gaining a better understanding of how fertility history (ART/spontaneous) is associated with life satisfaction among new fathers; and (b) identifying personal and interpersonal risk factors for lower satisfaction in life during the transition to fatherhood. Design:This cross-sectional study comprised 172 Israeli fathers (76 who became fathers following ART and 96 following spontaneous pregnancy), who completed a series of self-report questionnaires 5–18 months after the birth of their first child. Results:No differences were found in life satisfaction between fathers in the two fertility history groups. Regression analysis indicated that younger age and higher economic status, as well as lower attachment anxiety and avoidance and better marital relationship, were associated with a higher level of life satisfaction among new fathers. Conclusion:Although the life satisfaction of new fathers does not appear to be affected by their fertility history, it may be hampered by personal and interpersonal risk factors. These results have practical implications for professionals who come into contact with this population. [ABSTRACT FROM AUTHOR]

Background: There is evidence that both a past history of psychiatric illness and insecure attachment put women at risk for mood disturbances in the postpartum period. The aim of this study was to ascertain whether maternal insecure attachment is a risk factor for mood symptoms in the immediate postpartum period independently of the confounding effect of maternal psychiatric history.Methods: A convenience sample of 120 mothers was assessed prenatally with the Maternal History of Mood Disturbances (MHMD), the Relationship Questionnaire (RQ), and in the first week after delivery with the Profile of Mood States (POMS).Results: Mothers with higher scores on the preoccupied and fearful attachment scales had more severe postpartum anxiety and depression symptoms but only fearful attachment remained a significant predictor of postpartum anxiety when the significant effect of maternal history of mood disturbances was included in the model.Limitations: Our diagnostic assessment focused on mood symptoms, not disorders, and we limited psychometric assessment to the immediate postpartum period and did not collect longitudinal data to ascertain whether the relationship between maternal insecure attachment and postpartum mood disturbances changed over time.Conclusions: Our results show the necessity to assess prior psychiatric symptoms in studies of maternal attachment style and postpartum mood disturbances. The finding that a mother's recall of her own psychiatric history emerged as significant predictor of postpartum mood symptoms suggests that antenatal assessment based on maternal self-report can be used in those settings where structured diagnostic interviews are not feasible. [ABSTRACT FROM AUTHOR]

Objective We aimed to study the role of attachment style on headache severity and psychological symptoms in migraineurs children/adolescents. Moreover, we investigated the association between attachment style, migraine severity, and psychological symptoms. Background Attachment theory suggests that early interpersonal relationships may be important determinants of psychopathology and pain management. In particular, individuals with insecure attachment styles have been shown to experience more pain than people with secure attachment style. Few studies focused on headache and data on attachment style in pediatric headache are scarce. Methods We studied 90 migraineurs (mean age 12.2 ± 2.6 years; female: 54, male: 36). Patients were divided in two groups according to headache attack frequency: (1) high frequency (HF) patients, having from weekly to daily episodes and (2) low frequency (LF) patients, showing ≤3 episodes per month. According to headache attack intensity, patients were classified in two groups: (1) mild pain (MP), allowing the patient to continue his/her daily activities and (2) severe pain (SP), leading to interruption of patient activities or forcing the child to go to bed. The psychological screening was assessed by SAFA Anxiety, Depression, and Somatization questionnaires. Attachment style was measured by the semi-projective test Separation Anxiety Test. Patients were divided into 'secure,' 'avoidant,' 'ambivalent,' and 'disorganized/confused' attachment patterns. Results We found a significant relationship between the attachment style and migraine features. The ambivalent attachment was the most common style among patients reporting high attack frequency (51%) and severe pain intensity (50%). Anxiety (SAFA-A Tot: F = 23.3, P < .001), depression (SAFA-D Tot: F = 11.8, P < .001), and somatization (SAFA-S Tot: F = 10.1, P < .001) were higher in patients with ambivalent attachment style. Moreover, our results showed an association between high attack frequency and high anxiety levels, in children with ambivalent attachment style ( F = 6.7, P < .002). Conclusions Ambivalent attachment style may be a common vulnerability factor that impacts on pain severity, anxiety, depression, and somatization symptoms in young migraineurs. In particular, the present study provides the first evidence of the role of insecure attachment on the relationship between pain severity and psychological symptoms in migraine children. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Ulcerative colitis (UC) is a chronic inflammatory disorder associated with high perceived psychological stress., The attachment theory provides a psychodynamic perspective to investigate the relationship between close interpersonal relationships and stress in UC., Researchers have hypothesized that the chronic illness might affect personality trait as the attachment style of patients., What this paper adds to existing knowledge? UC patients exhibit a more pronounced attachment insecurity that, in turn, resulted as a determinant of psychological stress., This study suggests that UC could determine a shift towards insecurity in the attachment style that, in turn, promotes psychological stress and increases the risk of psychopathologies., What are the implications for practice? The more accurate knowledge of attachment insecurity in patients with chronic disorders such as UC may help the nurses to face with often dysfunctional patients' styles of manifesting distress, patterns of help seeking and expectations of health professionals., The knowledge of psychopathological mechanisms in patients with UC could improve the prevention and treatment of psychological disorders in affected patients., Abstract Introduction Ulcerative colitis (UC) is a chronic disorder characterized by recurrent intestinal symptoms. The attachment theory provides a psychodynamic perspective to investigate the relationship between interpersonal relationships and stress in UC. Aim The aim of this study was to compare the attachment dimensions between UC patients and controls and to evaluate the impact of these dimensions on perceived stress in patients. Method In all, 101 patients with UC completed the attachment style questionnaire and the perceived stress questionnaire (PSQ). Clinical and psychometric parameters were added as predictor variables in a regression with the PSQ score as dependent variable. One hundred and five healthy subjects took part in the study as controls. Results Compared to controls, UC patients exhibited greater scores in relationships as secondary, need for approval and preoccupation with relationships. In UC, disease activity, confidence and preoccupation with relationships resulted predictors of perceived stress. Discussion Compared to healthy controls, UC patients exhibited more pronounced attachment insecurity that, in turn, was a significant predictor of the perceived stress. Implications for practice The knowledge of attachment insecurity may help the nurses and all health care providers to face with dysfunctional patients' styles of manifesting distress, help seeking and expectations of health professionals. [ABSTRACT FROM AUTHOR]

Attachment style is a person's approach to interpersonal relationships, which develops from early experiences with primary caregivers and can remain stable into adulthood. Depending on a person's attachment style, the amount of trust one has in others can vary when forming relationships, and trust is important in formation of the patient-physician relationship. The purpose of this study was to see if there is an association between attachment style and trust in physicians in general. Participants were recruited from an emergency department (ED) and an online university participant pool, and completed short questionnaires assessing attachment style and trust in the medical profession. Results revealed that individuals with a fearful attachment style reported significantly lower levels of trust in the medical profession than those with a secure attachment style. ED participants also reported higher levels of trust in the medical profession in comparison to student participants. This study provides a better understanding of trust in the medical profession, and insight into future care for patients who have low trust. [ABSTRACT FROM AUTHOR]

This paper explores the concordance of mind-mindedness across descriptions of different people and construct validity by examining associations between mind-mindedness and psychological mindedness. Mothers of preschoolers ( N = 103) completed online questionnaires assessing attachment style, psychological mindedness and mind-mindedness via three written descriptions (child, partner/close friend and a famous person), which were used to derive two scores (frequency and proportional) for mental state descriptors. Frequency scores for mind-minded comments were significantly correlated for child and partner descriptions. Famous person scores (frequency and proportional) were significantly lower than child and partner scores, further supporting specificity to relationship closeness. Mind-mindedness scores (frequency and proportional) were positively related to an interest in the psychological processes of oneself and others (psychological mindedness) but not associated with attachment style. This study supports the proposition that mind-mindedness is an orientation to mental states particular to close relationships and that mind-mindedness is linked to a broader capacity for self-awareness (psychological mindedness). Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We aimed to determine the association between attachment style and health problems during pregnancy, as well as perinatal health variables. In 122 mothers who were 2–18 months postpartum, hot flushes, vaginal discharge, back pain, breast tenderness, hair changes, and psychological problems were shown to be associated with insecure attachment as measured by the Adult Attachment Style Questionnaires. Babies born to mothers with insecure attachment were more likely to have a low birth weight. It is vital to increase awareness of insecure attachment style as a risk factor among perinatal health care providers to optimize services. [ABSTRACT FROM AUTHOR]

Attachment theories have recently been applied to adult romantic relationships, and more specifically, sexuality within these relationships. However, few studies have examined the influence of attachment-related avoidance and anxiety on sexual communication, gender role ideology, sexual satisfaction or the relations between these constructs. Men (n= 106) and women (n= 349) undergraduate students and young adults from the community completed an online questionnaire measuring attachment style, sexual communication, gender role ideology, and sexual satisfaction. Multiple mediation and path analyses showed several interrelations between these variables among women. Additionally, gender role ideology and sexual communication together were found to totally mediate the relation between attachment-related anxiety and sexual satisfaction in women. Sexual communication partially mediated the relation between attachment-related avoidance and sexual satisfaction in women. Among men, the only significant finding was that attachment-related anxiety and avoidance were related to lower sexual communication. These results indicate that there is disparity in sexual communication, gender role ideology, and sexual satisfaction among individuals with differing attachment orientations and that these effects may be more prominent in women than men. [ABSTRACT FROM PUBLISHER]

Guided by pain-related attachment models and coping theory, we used structural equation modeling to test an appraisal-based coping model of how insecure attachment was linked to arthritis adjustment in a sample of 365 people with arthritis. The structural equation modeling analyses revealed indirect and direct associations of anxious and avoidant attachment with greater appraisals of disease-related threat, less perceived social support to deal with this threat, and less coping efficacy. There was evidence of reappraisal processes for avoidant but not anxious attachment. Findings highlight the importance of considering attachment style when assessing how people cope with the daily challenges of arthritis. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to focus on a unique population of airport security guards who work for a specific airline and are frequently sent abroad with short advance notice. The current study deals with the job burnout of these employees. Design/methodology/approach – In total, 100 airport security guards, employees of a specific airline completed the Attachment Style Questionnaire, the Burnout Questionnaire and Demographic Questions. Findings – Results indicated that the employees with the preoccupied style suffered more burnout than did those with secure and dismissive-avoidant styles. One of the possible explanations is that people with dismissive-avoidant style enjoy these multiple travels which enable them to be uninvolved with people surrounding them. Research limitations/implications – This study was based mainly on self-report of both the independent and the dependent variables, with all the disadvantages known to self-report methods. Practical implications – Points for practitioners are: first, it is recommended to use a selection tool for airport security guards in line with the results of this study; and second, people with avoidance attachment style should potentially be suitable employees for short and multiple travel abroad. Originality/value – Theoretically, this study contributes a new perspective of the Job Demands-Resources model, that is, the notion that in certain jobs and in specific situations (job demands) insecure attachment style may serve as a job resource rather than as an obstacle. [ABSTRACT FROM AUTHOR]

The purpose of this research was to examine the validity of an adult attachment style questionnaire, to understand the relationships between the type of attachment style in relation to self-perceived stress and social support, and to investigate the influence of gender, ethnicity and religion on the above constructs. The participants were 308 university students from Malaysia. A demographic questionnaire and three self-report inventories were administrated in this study. The data indicated that the Relationship Scales Questionnaire (RSQ) is a multidimensional construct with nine factors: "dismissing," "preoccupied with romance," "preoccupied with close relationships," "fearful," "preoccupied with dependency," "secure emotional," "comfortable depending," "preoccupied with mistrust" and "mutual secure." Different attachment styles were positively or negatively correlated at a significant level with perceived stress and social support. Attachment styles were explained by 20 and 33% of the total variance in self-perceived stress and perceived social support, respectively. There were significant gender, ethnic and religious differences in attachment styles, perceived stress and social support. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the present cross-sectional study was to investigate the prevalence of intimate partner physical violence among depressive Turkish women, as well as the association of intimate partner physical violence with attachment patterns, childhood traumas, and sociodemographic factors. Methods: The study included 100 women diagnosed with depressive disorder and 30 healthy women. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV axis I disorders, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Adult Attachment Style Questionnaire (AASQ), and Childhood Trauma Questionnaire (CTQ) were used for clinical assessment. Results: It was found that 64% of the women diagnosed with depression were suffering from intimate partner physical violence. In these women, the severity of depression and anxiety symptoms was higher, suicidal ideation and suicide attempts were more common, and the diagnosis of double depression was more prevalent. These women also achieved higher scores in the avoidant and ambivalent subscales of AASQ and higher total scores and higher scores in the physical abuse subscale of CTQ. The partner's and the woman's experiences of physical violence in their families during their childhood predicted intimate partner physical violence for women suffering from depression. Conclusion: The investigation of domestic violence contributes to the treatment of depression and also to the recognition and prevention of domestic violence that has profound effects on successive generations. [ABSTRACT FROM AUTHOR]