University of Cambridge, UK.
Charles University, Prague, Czech Republic.
Br J Psychol. 2018 Feb;109(1):45-62. doi: 10.1111/bjop.12249. Epub 2017 Apr 24.
Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.
有证据表明，依恋类型可能会影响亚临床精神病表型（精神分裂症特质）和情感障碍，并可能在精神病和儿童期逆境之间的关联中发挥作用。然而，依恋在精神病的初始阶段的作用仍知之甚少。我们的主要目的是描述和比较 60 名精神病超高风险（UHR）个体和 60 名健康对照者（HV）的依恋类型。HV 的焦虑和回避依恋得分低于 UHR 个体（p<.001）。69%的 UHR 组有一个以上的 DSM-IV 诊断，主要是情感和焦虑障碍。UHR 组经历了更多的创伤（p<.001）和更多的情绪和焦虑症状（p<.001）。有趣的是，在我们的 UHR 组中，只有偏执型精神分裂症特质与不安全依恋相关。在 HV 组中，抑郁、焦虑、偏执型精神分裂症特质和社交焦虑与不安全依恋相关。这种差异以及与涉及 UHR 的先前研究的一些差异表明，UHR 个体可能组成一个异质群体；一些人经历了显著的情绪和/或焦虑症状，这些症状可能无法用特定的依恋类型来解释。尽管如此，在 UHR 个体中测量依恋可能有助于最大限度地建立治疗关系，以促进康复。
