Department of Behavioural Sciences and Learning, Linköping University, Sweden.
Department of Dependency Disorders, Vrinnevi Hospital, Norrköping, Sweden.
Psychol Psychother. 2018 Dec;91(4):490-508. doi: 10.1111/papt.12172. Epub 2018 Feb 5.
To explore the associations between self-rated attachment style, psychological distress and substance use among substance use disorder (SUD) outpatients in psychological treatment.
In this practice-based study, 108 outpatients were asked to fill in the Experiences in Close Relationships - Short form, the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), the Alcohol Use Disorders Identification Test (AUDIT), and the Drug Use Disorders Identification Test (DUDIT) at treatment start and end. Patients were given psychological treatments with a directive, reflective or supportive orientation.
An insecure attachment style was more common among the SUD outpatients, compared to non-clinical groups. Patients with a fearful attachment style scored higher on psychological distress than patients with a secure attachment style. The associations between the attachment dimensions and psychological distress were stronger than those between attachment and SUD. Significantly more patients had a secure attachment style at treatment end.
This study shows significant relations between patients' attachment style and their initial psychological distress. The causal relationship between attachment style and psychological distress is, however, not clear and can likely go in both directions. The psychological treatment of patients with SUD contributed significantly to changes from insecure to secure attachment style.
We found among patients with SUD a strong relation between patients' attachment style and their psychological distress. Knowledge of the patient's attachment style may help the therapist to tailor the treatment to the patient's needs. A change from insecure to secure attachment style can be an important goal for a SUD treatment, as it may prevent the patient from using defence strategies involving substance use for regulating emotions and interpersonal relationships.
探讨物质使用障碍（SUD）门诊心理治疗患者的自感依恋风格、心理困扰与物质使用之间的关系。
在这项基于实践的研究中，108 名门诊患者在治疗开始和结束时被要求填写亲密关系经历量表-短式（ECR-S）、临床结局在常规评估中的测量（COREM）、酒精使用障碍识别测试（AUDIT）和药物使用障碍识别测试（DUDIT）。患者接受指令性、反思性或支持性心理治疗。
与非临床组相比，SUD 门诊患者更常见不安全依恋风格。与安全依恋风格的患者相比，恐惧依恋风格的患者心理困扰得分更高。依恋维度与心理困扰之间的相关性强于依恋与 SUD 之间的相关性。治疗结束时，有更多的患者具有安全依恋风格。
本研究显示患者依恋风格与初始心理困扰之间存在显著关系。依恋风格与心理困扰之间的因果关系尚不清楚，可能是双向的。SUD 患者的心理治疗显著促进了从不安全依恋到安全依恋风格的转变。
我们在 SUD 患者中发现，患者的依恋风格与他们的心理困扰之间存在强烈的关系。了解患者的依恋风格可能有助于治疗师根据患者的需求调整治疗方案。从不安全依恋到安全依恋风格的转变可以是 SUD 治疗的一个重要目标，因为它可以防止患者使用涉及物质使用的防御策略来调节情绪和人际关系。
