Relatives’ attachment anxiety mediates the association between perceived loss and expressed emotion in early psychosis


Autoři: Lídia Hinojosa-Marqués aff001;  Tecelli Domínguez-Martínez aff002;  Tamara Sheinbaum aff003;  Paula Cristóbal-Narváez aff004;  Thomas R. Kwapil aff005;  Neus Barrantes-Vidal aff001
Působiště autorů: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain aff001;  Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Mexico City, Mexico aff002;  Department of Psychology, University of Southern California, Los Angeles, California, United States of America aff003;  Unitat de Recerca, Docència i Innovació, Parc Sanitari Sant Joan de Déu, San Boi de Llobregat, Barcelona, Spain aff004;  Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America aff005;  Sant Pere Claver- Fundació Sanitària, Barcelona, Spain aff006;  Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain aff007
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223425

Souhrn

A common reaction experienced by family members of patients with psychosis is grief for the loss of their healthy relative. Importantly, high levels of perceived loss have been related to the manifestation of high expressed emotion (EE), which includes the negative attitudes expressed by relatives toward an ill family member. However, the mechanisms underlying the relationship between relatives’ perceived loss and EE attitudes in the early stages of psychosis are still not fully understood. In this regard, attachment theory has been suggested as a useful framework for understanding this link. The current study aimed to examine: (1) whether relatives’ perceived loss was associated with relatives’ EE dimensions (i.e., criticism and emotional over-involvement (EOI)), and (2) whether such associations were mediated by relatives’ attachment dimensions (i.e., anxiety and avoidance). Seventy-eight relatives of patients with early psychosis completed the Mental Illness Version of the Texas Inventory of Grief for the assessment of loss reactions. Attachment dimensions and EE attitudes were assessed by the Psychosis Attachment Measure and the Family Questionnaire, respectively. Findings indicated that relatives’ perceived loss was associated with EE dimensions. Relatives’ attachment anxiety, but not avoidance, mediated the relationship of perceived loss with both criticism and EOI. Findings highlight the importance of examining the role of relatives’ attachment characteristics for understanding how perceptions of loss might impact the manifestation of EE attitudes in the early stages of psychosis. Family interventions aimed at assisting relatives to improve their management of negative emotional reactions to loss are fundamental to prevent impairing loss reactions and the entrenchment of high-EE attitudes.

Klíčová slova:

Anxiety – Emotions – Memory – Mental health and psychiatry – Psychological stress – Psychometrics – Psychoses – Questionnaires


Zdroje

1. Davis DJ, Schultz CL. Grief, parenting, and schizophrenia. Soc Sci Med. 1998;46: 369–379. doi: 10.1016/s0277-9536(97)00167-6 9460818

2. Miller F, Dworkin J, Ward M, Barone D. A preliminary study of unresolved grief in families of seriously mentally ill patients. Hosp Community Psychiatry. 1990;41: 1321–1325. doi: 10.1176/ps.41.12.1321 2276725

3. Osborne J, Coyle A. Can parental responses to adult children with schizophrenia be conceptualized in terms of loss and grief? A case study analysis. Couns Psychol Q. 2002;15: 307–323.

4. Miller F. Grief therapy for relatives of persons with serious mental illness. Psychiatr Serv. 1996;47: 633–637. doi: 10.1176/ps.47.6.633 8726492

5. Parker BA. Living with mental illness: the family as caregiver. J Psychosoc Nurs Ment Heal Serv. 1993;31: 19–21.

6. Young J, Bailey G, Rycroft P. Family grief and mental health: a systemic, contextual and compassionate analysis. Aust N Z J Fam Ther. 2004;24: 188–197.

7. Geraghty K, McCann K, King R, Eichmann K. Sharing the load: parents and carers talk to consumer consultants at a child and youth mental health inpatient unit. Int J Ment Health Nurs. 2011;20: 253–262. doi: 10.1111/j.1447-0349.2011.00730.x 21362120

8. Richardson M, Cobham V, McDermott B, Murray J. Youth mental illness and the family: parents’ loss and grief. J Child Fam Stud. 2013;22: 719–736.

9. MacGregor P. Grief: The unrecognized parental response to mental illness in a child. Soc Work. 1994;39: 160–166. 8153758

10. Jones DW. Families and serious mental illness: working with loss and ambivalence. Br J Soc Work. 2004;34: 961–979.

11. Ozgul S. Parental grief and serious mental illness: a narrative. Aust. N. Z. J. Fam. Ther. 2004; 25: 183–187.

12. Richardson M, Cobham V, Murray J, McDermott B. Parents’ grief in the context of adult child mental illness: a qualitative review. Clin Child Fam Psychol Rev. 2011;14: 28–43. doi: 10.1007/s10567-010-0075-y 20645000

13. Mulligan J, Sellwood W, Reid GS, Riddell S, Andy N. Informal caregivers in early psychosis: evaluation of need for psychosocial intervention and unresolved grief. Early Interv Psychiatry. 2013;7: 291–299. doi: 10.1111/j.1751-7893.2012.00369.x 22741743

14. Patterson PJ, Birchwood M, Cochrane R. Preventing the entrenchment of high expressed emotion in first episode psychosis: early developmental attachment pathways. Aust N Z J Psychiatry. 2000;34 Suppl: S191–S197.

15. Patterson P, Birchwood M, Cochrane R. Expressed emotion as an adaptation to loss: prospective study in first-episode psychosis. Br J Psychiatry. 2005;187 Suppl: S59–S64.

16. Raune D, Kuipers E, Bebbington PE. Expressed emotion at first-episode psychosis: investigating a carer appraisal model. Br J Psychiatry. 2004;184: 321–326. doi: 10.1192/bjp.184.4.321 15056576

17. Stirling J, Tantam D, Thomas P, Newby D, Montague L, Ring N, et al. Expressed emotion and schizophrenia: the ontogeny of EE during an 18-month follow-up. Psychol Med. 1993;23: 771–778. doi: 10.1017/s003329170002554x 8234583

18. Bowlby J. Attachment and loss: Vol. 2. Separation: Anxiety and anger. New York: Basic Books; 1973.

19. Bowlby J. Attachment and loss: Vol. 3. Sadness and depression. New York: Basic Books; 1980.

20. Bowlby J. Attachment and loss: Vol. 1. Attachment. 2nd ed. New York: Basic Books; 1982.

21. Birchwood M. Familial factors in psychiatry. Curr. Opin. Psychiatry. 1992;5: 295–299.

22. Birchwood M, Spencer E. Psychotherapies for schizophrenia: a review. In: Maj M, Sartorius N, editors. Schizophrenia. Chichester: Wiley; 1999. pp. 139–241.

23. Patterson P. Attachment, loss and expressed emotion: developmental processes in psychosis. In: Gumley A, Gillham A, Taylor K, Schwannauer M, editors. Psychosis and emotion: the role of emotions in understanding psychosis, therapy and recovery. London: Routledge; 2013. pp. 136–148.

24. Shaver PR, Fraley RC. Attachment, loss, and grief: Bowlby's views and current controversies. In: Cassidy J, Shaver PR, editors. Handbook of attachment: theory, research, and clinical applications. New York: Guilford Press; 2008. pp. 48–77.

25. Shear K, Shair H. Attachment, loss, and complicated grief. Dev Psychobiol. 2005;47: 253–267. doi: 10.1002/dev.20091 16252293

26. Stroebe M, Schut H, Stroebe W. Attachment in coping with bereavement: a theoretical integration. Rev Gen Psychol. 2005;9: 48–66.

27. Fraley RC, Bonanno GA. Attachment and loss: a test of three competing models on the association between attachment-related avoidance and adaptation to bereavement. Personal Soc Psychol Bull. 2004;30: 878–90.

28. Neimeyer RA, Prigerson HG, Davies B. Mourning and meaning. Am Behav Sci. 2002;46: 235–251.

29. Bartholomew D, Horowitz LM. Attachment styles among young adults: A test of a four-category model. J Pers Soc Psychol. 1991;61: 226–244. doi: 10.1037//0022-3514.61.2.226 1920064

30. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press; 2007.

31. Burke LA, Neimeyer RA. Prospective risk factors for complicated grief: a review of the empirical literature. In: Stroebe MS, Schut H, van der Bout J, Boelen P, editors. Complicated grief. New York: Routledge; 2012. pp. 145–161.

32. Meier AM, Carr DR, Currier JM, Neimeyer RA. Attachment anxiety and avoidance in coping with bereavement: two studies. J Soc Clin Psychol. 2013;32: 315–34.

33. Godress J, Ozgul S, Owen C, Foley-Evans L. Grief experiences of parents whose children suffer from mental illness. Aust N Z J Psychiatry. 2005;39: 88–94. doi: 10.1111/j.1440-1614.2005.01518.x 15660710

34. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. 2nd ed. New York: Guilford Press; 2016.

35. Cassidy J, Kobak RR. Avoidance and its relationship with other defensive processes. In: Belsky J, Nezworski T, editors. Clinical implications of attachment. Hillsdale: Erlbaum; 1988. pp. 300–323.

36. Main M. Cross-cultural studies of attachment organization: recent studies, changing methodologies, and the concept of conditional strategies. Hum Dev. 1990;33: 48–61.

37. Mikulincer M, Shaver PR. Adult attachment and affect regulation. In: Cassidy J, Shaver PR, editors. Handbook of attachment: theory, research, and clinical applications, 2nd ed. New York: Guilford Press; 2008. pp. 503–531.

38. Mikulincer M, Shaver PR. Attachment insecurities and disordered patterns of grief. In: Stroebe M, Schut H, Boelen P, van den Bout J, editors. Complicated grief: scientific foundations for health care professionals. New York: Routledge; 2012. pp. 190–203.

39. Collins NL, Ford MB. Responding to the needs of others: the caregiving behavioral system in intimate relationships. J Soc Pers Relat. 2010;27: 235–244.

40. George C, Solomon J. The caregiving system: a behavioral systems approach to parenting. In: Cassidy J, Shaver PR, editors. Handbook of attachment: theory, research, and clinical applications. New York: Guilford Press; 2008. pp. 833–857.

41. Jones JD, Cassidy J, Shaver PR. Parents’ self-reported attachment styles: a review of links with parenting behaviors, emotions, and cognitions. Personal Soc Psychol Rev. 2015;19: 44–76.

42. Kunce LJ, Shaver PR. An attachment theoretical approach to caregiving. In: Bartholomew K, Perlman D, editors. Attachment processes in adulthood. Advances in personal relationships. London: Jessica Kingsley; 1994. pp. 205–237.

43. Canterberry M, Gillath O. Attachment and caregiving functions, interactions, and implications. In: Noller P, Karantzas GC, editors. The Wiley-Blackwell handbook of couples and family relationships. Chichester: Wiley-Blackwell; 2012. pp. 207–219.

44. Feeney BC, Collins NL. Predictors of caregiving in adult intimate relationships: an attachment theoretical perspective. J Pers Soc Psychol. 2001;80: 972–994. 11414378

45. Karantzas GC, Simpson JA. Attachment and aged care. In: Simpson JA, Rholes WS, editors. Attachment theory and research: new directions and emerging themes. New York: Guilford; 2012. pp. 319–345.

46. Chen CK. The relationship between attachment quality and expressed emotion among adult children caring for parents with dementia. Thesis, The University of North Carolina at Chapel Hill. 2006. Available from: https://cdr.lib.unc.edu/indexablecontent/uuid:ef702a96-6796-4067-9960-06057adb5292

47. Diamond D, Doane JA. Disturbed attachment and negative affective style: an intergenerational spiral. Br J Psychiatry. 1994;164: 770–781. doi: 10.1192/bjp.164.6.770 7952983

48. Paley G, Shapiro DA, Worrall-Davies A. Familial origins of expressed emotion in relatives of people with schizophrenia. J Ment Health. 2000;9: 655–663.

49. Adam EK, Gunnar MR, Tanaka A. Adult attachment, parent Emotion, and observed parenting behavior: mediator and moderator models. Child Dev. 2004;75: 110–122. doi: 10.1111/j.1467-8624.2004.00657.x 15015678

50. Bosquet M, Egeland B. Associations among maternal depressive symptomatology, state of mind and parent and child behaviors: implications for attachment-based interventions. Attach Hum Dev. 2001;3: 173–199. doi: 10.1080/14616730010058007 11708736

51. García-Ruiz M, Rodrigo MJ, Hernández-Cabrera JA, Máiquez ML. Contribution of parents’ adult attachment and separation attitudes to parent-adolescent conflict resolution. Scand J Psychol. 2013;54: 459–67. doi: 10.1111/sjop.12077 24117437

52. Millings A, Walsh J, Hepper E, O’Brien M. Good partner, good parent. Personal Soc Psychol Bull. 2013;39: 170–180.

53. Berry K, Barrowclough C, Wearden A. A review of the role of adult attachment style in psychosis: unexplored issues and questions for further research. Clin Psychol Rev. 2007;27: 458–475. doi: 10.1016/j.cpr.2006.09.006 17258365

54. Domínguez-Martínez T, Vainer E, Antonia Massanet M, Torices I, Jané M, Barrantes-Vidal N. The need-adapted integrated treatment in Sant Pere Claver-Early Psychosis Program (SPC-EPP) in Barcelona, Spain. Salud Ment. 2011;34: 517–24.

55. Yung AR, Yuen HP, McGorry PD, Phillips LJ, Kelly D, Dell'Olio M, et al. Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry. 2005;39: 964–971. doi: 10.1080/j.1440-1614.2005.01714.x 16343296

56. Schultze-Lutter F, Addington J, Ruhrmann S, Klosterkötter J. Schizophrenia proneness instrument–adult version (SPI-A). Rome: Giovanni Fioriti; 2007.

57. American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.

58. First MB, Spitzer RL, Gibbon M, Williams JB. Structured clinical interview for DSM-IV Axis I Disorders-Patient ed. (SCID-I/P, Version 2.0). New York: Biometrics Research Department; 1995.

59. Berry K, Wearden A, Barrowclough C, Liversidge T. Attachment styles, interpersonal relationships and psychotic phenomena in a non-clinical student sample. Pers Individ Dif. 2006;41: 707–718.

60. Wiedemann G, Rayki O, Feinstein E, Hahlweg K. The Family Questionnaire: Development and validation of a new self-report scale for assessing expressed emotion. 2002;109: 265–279.

61. Cohen J. A power primer. Psychol Bull. 1992; 112: 155–159. doi: 10.1037//0033-2909.112.1.155 19565683

62. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press; 2013.

63. Collins NL, Feeney BC. A safe haven: An attachment theory perspective on support seeking and caregiving in intimate relationships. J Pers Soc Psychol. 2000;78: 1053–1073. doi: 10.1037//0022-3514.78.6.1053 10870908

64. Álvarez-Jiménez M, Gleeson JF, Cotton SM, Wade D, Crisp K, Yap MBH, et al. Differential predictors of critical comments and emotional over-involvement in first-episode psychosis. Psychol Med. 2010;40: 63–72. doi: 10.1017/S0033291708004765 19079825

65. Wynne LC. Current concepts about schizophrenics and family relationships. J Nerv Ment Dis. 1981;169: 82–89. doi: 10.1097/00005053-198102000-00003 7009785

66. O’Connell Corcoran K, Mallinckrodt B. Adult attachment, self-efficacy, perspective talking, and conflict resolution. J Couns Dev. 2000;78: 474–483.

67. Simpson JA, Rholes WS, Phillips D. Conflict in close relationships: an attachment perspective. J Pers Soc Psychol. 1996;71: 899–914. doi: 10.1037//0022-3514.71.5.899 8939040

68. Feeney AJ. Parental attachment and conflict behavior: Implications for offspring’s attachment, loneliness, and relationship satisfaction. Pers Relatsh. 2006;13: 19–36.

69. Mikulincer M, Shaver PR. An attachment perspective on bereavement. In: Stroebe M, Hansson RO, Stroebe W, editors. Handbook of bereavement research and practice: 21st century perspectives. Washington, DC: American Psychological Association; 2008. pp. 87–110.

70. Currier JM, Irish JEF, Neimeyer RA, Foster JD. Attachment, continuing bonds, and complicated grief following violent loss: testing a moderated model. Death Stud. 2015;39: 201–10. doi: 10.1080/07481187.2014.975869 25551174

71. Jerga AM, Shaver PR, Wilkinson RB. Attachment insecurities and identification of at-risk individuals following the death of a loved one. J Soc Pers Relat. 2011;28: 891–914.

72. Wijngaards-De Meij L, Stroebe M, Schut H, Stroebe W, Van Den Bout J, Van Der Heijden PGM, et al. Patterns of attachment and parents’ adjustment to the death of their child. Personal Soc Psychol Bull. 2007;33: 537–548.

73. Bowlby J. A secure base: parent-child attachment and healthy human development. New York: Basic Books; 1988.

74. Miklowitz DJ. The role of family systems in severe and recurrent psychiatric disorders: A developmental psychopathology view. 2004;16: 667–688. 15605631

75. Koutra K, Triliva S, Roumeliotaki T, Basta M, Simos P, Lionis C, et al. Impaired family functioning in psychosis and its relevance to relapse: a two-year follow-up study. Compr Psychiatry 2015;62: 1–12. doi: 10.1016/j.comppsych.2015.06.006 26343461

76. Zanetti ACG, Ciol MA, Wiedemann G, de Azevedo-Marques JM, Dantas RAS, da Silva Gherardi-Donato EC, et al. Predictive Validity of the Brazilian Portuguese Version of the Family Questionnaire for Relapse in Patients With Schizophrenia. J Nurs Meas. 2017;25: 559–572. doi: 10.1891/1061-3749.25.3.559 29268835

77. Crisp K, Gleeson J. Working with families to prevent relapse in first episode psychosis. In: Lobban F, Barrowclough C, editors. A casebook of family interventions for psychosis. Chichester: John Wiley & Sons; 2009. pp. 67–90.

78. Lobban F, Postlethwaite A, Glentworth D, Pinfold V, Wainwright L, Dunn G, et al. A systematic review of randomised controlled trials of interventions reporting outcomes for relatives of people with psychosis. Clin Psychol Rev. 2013;33: 372–382. doi: 10.1016/j.cpr.2012.12.004 23410719

79. Harris T. Implications of attachment theory for working in psychoanalytic psychotherapy. Int Forum Psychoanal. 2004;13: 147–56.


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