Department Early Psychosis, Academic Psychiatric Center, Amsterdam, The Netherlands.
School of Psychological Sciences, University of Manchester, Manchester, United Kingdom.
Psychiatry Res. 2015 Jul 30;228(1):83-8. doi: 10.1016/j.psychres.2015.04.018. Epub 2015 Apr 23.
Attachment theory is a powerful theoretical framework that complements and extents current models psychosis. We tested the hypothesis that attachment anxiety and avoidance are differentially associated with the severity of positive, negative and general psychopathology symptoms in patients with a diagnosis of psychosis. Five hundred patients with DSM-IV or ICD-10 diagnoses of psychotic disorders (schizophrenia, schizoaffective or non-affective psychosis) from independent samples from Netherlands, United Kingdom and Israel completed the Relationship Questionnaire. Psychopathology was assessed with the Positive and Negative Syndromes Scale. We used both categorical and dimensional approach to attachment data, which were analyzed using ANOVA with post-hoc tests, Pearson's correlations and multiple regression analysis. The conservative level of statistical significance was established (p < 0.001) to control for multiple testing. After adjustment for possible confounders, attachment anxiety predicted severity of positive symptoms as well as affective symptoms. Both attachment anxiety and avoidance were associated with severity of hallucinations and persecution Contrary to predictions, attachment avoidance was not associated with overall scores for negative symptoms, although there was some evidence of relatively weaker association between avoidance and social and emotional withdrawal.
依恋理论是一个强大的理论框架，它补充和扩展了当前的精神病学模型。我们测试了这样一个假设，即依恋焦虑和回避与精神病患者阳性、阴性和一般精神病症状的严重程度存在差异。来自荷兰、英国和以色列的独立样本中的 500 名被诊断为精神病障碍（精神分裂症、分裂情感或非情感性精神病）的患者完成了关系问卷。精神病症状采用阳性和阴性综合征量表进行评估。我们使用依恋数据的分类和维度方法，采用方差分析和事后检验、皮尔逊相关和多元回归分析进行分析。为了控制多重检验，建立了保守的统计显著性水平（p < 0.001）。在调整可能的混杂因素后，依恋焦虑预测阳性症状和情感症状的严重程度。依恋焦虑和回避均与幻觉和迫害的严重程度相关。与预测相反，依恋回避与阴性症状的总体评分无关，尽管回避与社会和情感退缩之间存在一些相对较弱的关联的证据。
