Beyond the symptoms: Exploring attachment styles and reality-testing among schizophrenia clients from a nursing perspective.

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. ABSTRACT: 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.

Individual factors as predictors of secondary traumatic stress and burnout in forensic inpatient staff.

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). ABSTRACT: 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.

Changes in peripheral oxytocin and vasopressin during a silent month-long Insight meditation retreat.

Background: Given its putative roles in mediating prosocial behavior, attachment bonds, and stress physiology, oxytocin modulation has been hypothesized to be a biological correlate of the salubrious effects of meditation practice. Here we investigated the effects of a month-long silent meditation retreat on changes in oxytocin, and the related hormone and vasopressin, in relation to psychosocial changes in attachment style, anxiety, personality measures, and feelings of social connectedness with fellow meditators. Methods: Plasma oxytocin and vasopressin and self-report questionnaires were measured in retreat participants (n = 28) at the beginning of, and 3 weeks into, a residential meditation retreat. Control participants (n = 34), who were similar in age, gender, and meditation experience, were also assessed across a 3-week interval. Linear mixed effects models were used to assess outcomes. Results: The retreat group showed a small but significant decrease in oxytocin compared to controls who showed no change. In the retreat group, higher openness to experience at Time 1 predicted greater reductions in oxytocin during the retreat, and lower oxytocin at Time 2 was related to stronger feelings of personal connection with fellow meditators. The changes in oxytocin were not related to attachment style or anxiety. Vasopressin decreased over time across both groups, suggesting no specific effect of retreat. Conclusion: These preliminary findings suggest that meditation training in the context of a silent residential retreat may reduce circulating levels of oxytocin. We interpret this finding from multiple theoretical perspectives, discussing key measurement limitations and proposing future study designs that may help to differentiate the effects of different meditation practices and contexts on oxytocin signaling.

The risk and protective factors on the mental health of healthcare workers during the lockdown period due to covid-19 pandemic.

This study aimed to analyze the impact of the lockdown period due to COVID-19 pandemic on the mental health status of healthcare workers and identify the related risk factors of psychosomatic distress. We conducted an online questionnaire survey to investigate the general demographic characteristics, perceived stress level, adult attachment style (AAS), family cohesion and adaptability, social support, sleep state, emotional state, and physical health of healthcare workers during the lockdown period due to the pandemic in 2022. We compared the mental health status between doctors and nurses, and further analyzed the factors influencing sleep, emotions, physical symptoms, and severe psychosomatic distress separately. For factors that showed statistical significance in the univariate analysis, forward stepwise regression was used for logistic regression analysis to identify risk factors for the corresponding issues. A total of 622 healthcare workers participated in the survey. Among the participants, 121 (19.5%) reported sleep problems, 209 (33.6%) had negative emotional states, and 147 (23.6%) reported physical health problems. There were 48 (7.7%) healthcare workers with severe psychosomatic distress. Compared to the group of nurses, the group of doctors exhibit a higher prevalence of emotional issues, physical health problems and psychosomatic distress. Perceived stress was identified as a risk factor for sleep disturbance, while living with others during quarantine and family adaptability were identified as protective factors. Higher educational background and perceived stress were identified as risk factors for negative emotion, while subjective support was identified as a protective factor. Perceived stress and coming from a rural area were also identified as risk factors for physical health. Overall, for the comparison between the no psychosomatic distress and severe psychosomatic distress groups, perceived stress was identified as a risk factor for severe psychosomatic distress, while subjective support was identified as a protective factor. Healthcare workers' potential mental and physical health problems are related to their educational background, family cohesion and adaptability, perceived stress and social support. This makes it clearer on how to deal with and prevent adverse consequences when facing stressful situations.

Intimate Partner Violence and Attachment Styles as Factors Associated with Coping Stress Styles Among Iranian Women.

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 (ß = .229, p = .015) and anxious attachment (ß = .245, p = .008). Anxious attachment style was related to emotion-oriented coping (ß = .437, p = .000). There was a negative relationship between avoidant attachment and anxious attachment (ß = -.237, p = .032) with avoidance-oriented coping. Sexual IPV victimization and economic IPV victimization were associated with avoidance-oriented coping (ß = -.225, t = 0.816, p = .015; ß = .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.

Relational aggression in romantic relationship: empirical evidence among young female adults in Malaysia.

BACKGROUND: Aggressive behaviour in romantic relationship is a social problem of great concern. Studies related to the influence of psychosocial factors on relational aggression are still limited. Furthermore, these factors have not been widely studied in the local context, resulting in the issue of relational aggression among young female adults still not being addressed. This study aims to explore whether psychosocial factors such as big five personality traits, adult attachment style and loneliness could predict relational aggression in romantic relationships among young female adults in Malaysia. In addition, this study aims to identify the moderating effect of social support in the relationship between psychosocial factors and relational aggression in romantic relationship. METHODS: A quantitative research approach was used with 424 young female adults in Malaysia aged between 18 and 30 years old (mean age = 24.18) were recruited through multistage sampling design by completing a questionnaire consisting of the Big Five Inventory (BFI), Experiences in Close Relationships Scale II (ECRS-II), Revised UCLA Loneliness Scale, Measure of Relational Aggression and Victimization (MRAV) and Multidimensional Scale of Perceived Social Support (MSPSS). RESULTS: Multiple regression analysis predicted significant relationship between agreeableness personality, loneliness, avoidant attachment style and anxious attachment style with relational aggression in romantic relationships. Hierarchical regression analysis found a significant effect of social support as a moderator between loneliness with relational aggression in romantic relationships. CONCLUSIONS: Thus, the results show that young female adults with low level of agreeableness, high level of loneliness, avoidant attachment style and anxious attachment style are at a higher risk of engaging in relational aggression in romantic relationships. The implication of this study can help in understanding the psychosocial factors that form the basis of relational aggression in romantic relationships. Hence, the gap in knowledge warrants further research.

Social media addiction: associations with attachment style, mental distress, and personality.

BACKGROUND: Social media bring not only benefits but also downsides, such as addictive behavior. While an ambivalent closed insecure attachment style has been prominently linked with internet and smartphone addiction, a similar analysis for social media addiction is still pending. This study aims to explore social media addiction, focusing on variations in attachment style, mental distress, and personality between students with and without problematic social media use. Additionally, it investigates whether a specific attachment style is connected to social media addiction. METHODS: Data were collected from 571 college students (mean age = 23.61, SD = 5.00, 65.5% female; response rate = 20.06%) via an online survey administered to all enrolled students of Sigmund Freud PrivatUniversity Vienna. The Bergen Social Media Addiction Scale (BSMAS) differentiated between students addicted and not addicted to social media. Attachment style was gauged using the Bielefeld Partnership Expectations Questionnaire (BFPE), mental distress by the Brief Symptom Inventory (BSI-18), and personality by the Big Five Inventory (BFI-10). RESULTS: Of the total sample, 22.7% of students were identified as addicted to social media. For personality, it was demonstrated that socially media addicted (SMA) students reported significantly higher values on the neuroticism dimension compared to not socially media addicted (NSMA) students. SMA also scored higher across all mental health dimensions-depressiveness, anxiety, and somatization. SMA more frequently exhibited an insecure attachment style than NSMA, specifically, an ambivalent closed attachment style. A two-step cluster analysis validated the initial findings, uncovering three clusters: (1) secure attachment, primarily linked with fewer occurrences of social media addiction and a lower incidence of mental health problems; (2) ambivalent closed attachment, generally associated with a higher rate of social media addiction and increased levels of mental health problems; and (3) ambivalent clingy attachment, manifesting a medium prevalence of social media addiction and a relatively equitable mental health profile. CONCLUSIONS: The outcomes are aligned with previous research on internet and smartphone addiction, pointing out the relevance of an ambivalent closed attachment style in all three contexts. Therapeutic interventions for social media addiction should be developed and implemented considering these findings.

Job Burnout Among the Helping Professions: The Roles of Childhood Maltreatment, Attachment Styles and Perceived Supervisor Support.

Job burnout is a major predicament globally, especially among the helping professions. Based on the job demands-resources (JDR) theory and on attachment theory, this study explored the relations between a history of childhood maltreatment (CM), insecure attachment styles (avoidant and anxious), perceived supervisor support and job burnout. A sample of 320 helping professionals participated in the study, of which 35% reported experiencing CM. Findings confirmed the hypothesis that a history of CM was positively related to both avoidant and anxious attachment styles. Anxious attachment style partly mediated the relationship between CM and burnout. In addition, the relationship between CM and burnout was mediated by avoidant attachment style and perceived supervisor support, so that highly avoidant professionals perceived their supervisors as less supportive, reporting higher levels of burnout. Notably, there were no discernible variations in burnout levels when comparing professionals who had experienced maltreatment with those who had not. The study highlights the value of adopting an attachment perspective to better understand job burnout among the helping professions.

Corrigendum: Attachment style, emotional feedback, and neural processing: investigating the influence of attachment on the P200 and P400 components of event-related potentials.

[This corrects the article DOI: 10.3389/fnhum.2023.1249978.].

Group member attachment style interacts with actor and partner helping alliance to predict decreasing binge eating episodes.

OBJECTIVE: An individual's attachment style may impact how they interact with their therapy group. This study examined the moderating role of a group member's attachment on the dynamic relationships between that group member's (actor) and other group members' (partner) therapeutic alliances and symptom outcomes. Method: This is a secondary analysis of data from a trial testing the outcome of emotionally-focused group therapy for binge-eating disorder. The sample consisted of 2,360 sessions nested within 118 group members who attended a 20-session treatment. Patients recorded binge eating episodes (BEE), their body weight and an alliance measure session-by-session. RESULTS: Dynamic structural equation modelling showed decreases in BEE and weight over the therapy. When attachment style was not included in the model, higher-than-average partner's alliance scores in the previous session were related to decreases in BEE in the current session. Attachment style moderated these actor and partner effects. For patients with preoccupied attachments, higher-than-average actor alliance in the previous session was related to subsequent decreases in BEE. For patients with dismissing or disorganized attachments, higher partner alliance in the previous session was related to subsequent decreases in BEE. CONCLUSION: Group members' attachment characteristics can play a role in the development of alliance-outcome patterns in group therapy.

New Addictions in Late Adolescence and Emerging Adulthood: How Attachment Style May Predict Problematic Use of Social Networks and Binge-Watching.

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.

The Psychology of Kink: A Cross-Sectional Survey Investigating the Association Between Adult Attachment Style and BDSM-Related Identity Choice in China.

BDSM is a type of sexual preference that includes bondage and discipline, dominance and submission, and sadism and masochism. Research has identified three specific power exchange roles in the practice of BDSM: dominance, submission, and switch. It has also been suggested that attachment style potentially influences BDSM interests. This study investigated the potential roles of attachment style in driving BDSM identity. A questionnaire was completed by a cross-sectional Chinese sample (n = 3310, age range 18-30 years), including 1856 BDSM practitioners (436 men, 1420 women). To assess attachment style, the questionnaire included a Chinese translation of the Adult Attachment Scale as well as items surveying BDSM interests. Compared to non-BDSM practitioners, attachment styles were not significantly different from BDSM practitioners. However, practitioners with different BDSM identities showed a significant difference in their attachment styles. Secure and avoidant attachment styles were associated with dominance, whereas submissiveness recorded high average scores of separation anxiety in both males and females. BDSM identities based on gender revealed that 60.5% of female practitioners assumed the role of submissiveness and this group recorded the highest average scores of separation anxiety among all groups. These results show that BDSM identity is related to attachment style. However, the results did not support the hypothesis that attachment styles potentially drive BDSM identities. Further research is needed to explore other psychological processes that drive BDSM identities in order to provide guidance for BDSM practitioners in choosing suitable identities, thereby helping practitioners to choose suitable identity partners and avoid negative experiences during BDSM participation.

Perceptions of the effect of parental deportation on adult intimate relationships.

Research has shown that children of undocumented Latinx parents in the United States are at greater risk for negative long-term effects on their mental health and overall well-being. Chief among these concerns are the negative effects of disrupted attachment processes, as deported parents are often taken from their families by force and required to parent from afar, if they can continue parenting at all. Despite the ubiquity of deported families, little is known about the effects of deportation on the attachment of left-behind children and the subsequent potential disruptive effect of deportation on their adult relationships. This phenomenological study aims to understand how adults who have experienced parental deportation in their childhood describe the effects of that event on their adult intimate relationships. Themes of (1) ambiguous loss; (2) inability to trust others; (3) fear of separation from loved ones; and (4) shame emerged and are discussed considering existing literature on attachment theory, immigration, and the Latinx population. Treatment implications are also discussed.

Association between adult attachment and mental health states among health care workers: the mediating role of social support.

Background: To determine the relationships between attachment style, social support, and mental health states, as well as the mediation mechanism within this relationship, we conducted a survey among healthcare workers during the coronavirus disease 2019 (COVID-19) epidemic quarantine. Methods: The survey assessed their mental health states, adult attachment style, social support, and some other relevant information. Mental health states were represented by the overall state of sleep, physical and emotional assessment. A multiple mediator model was used to explain how social support could mediate the relationship between attachment and mental health states during COVID-19 quarantine. Results: Our findings revealed that 33.3% of the participants experienced emotional issues, 8.5% had sleep problems, and 24.9% reported physical discomfort. The direct effect of adult attachment styles on mental health states during COVID-19 quarantine was significant (c' = -0.3172; p < 0.01). The total indirect effect also showed statistical significance (ab = -0.1857; p < 0.01). Moreover, the total effect of adult attachment styles on mental health states was -0.5029 (c = -0.5029; p < 0.01). Subjective social support and utilization of social support play mediating roles in the relationship between attachment style and mental health states, respectively (ab1 = -0.1287, 95% CI: -0.9120 to -0.3341, ab2 = 0.0570, 95% CI: -0.4635 to -0.1132). Conclusion: These findings highlight social support played a mediation role between attachment style and mental health states. Thus, offering social support during a crisis might be useful for those individuals with an insecure attachment.

Trajectories of relationship and sexual satisfaction over 2 years in the Covid-19 pandemic: A latent class analysis.

OBJECTIVE: Previous research on the impact of the Covid-19 pandemic on romantic relationships has mainly concentrated on short-term effects and average trends of change. This study aimed to explore different trajectories of relationship and sexual satisfaction from April 2020 to March 2022. METHOD: Including a cross-national sample of 2859 individuals, a latent class approach was applied to identify subgroups of sexual and relationship satisfaction trajectories. Participants' satisfaction levels, attachment style, psychological symptoms, life satisfaction, and living arrangements were taken into account. RESULTS: Three latent classes were identified for both relationship and sexual satisfaction: (1) a group with high satisfaction levels but a slightly declining trajectory, (2) a group with low satisfaction levels but an ascending trajectory, and (3) a fluctuating group. Living apart, having children, psychological symptoms, low life satisfaction, and avoidant attachment characterized the two groups with low or fluctuating trajectories. CONCLUSIONS: The findings suggest that there were different trajectories of relationship and sexual satisfaction during the pandemic, which can be predicted by individual dispositions. Even 2 years after the pandemic, its effects had not disappeared.

Early maladaptive schema, attachment style, and parenting style in a clinical population with personality disorder and normal individuals: a discriminant analysis model.

INTRODUCTION: Researchers have shown various variables' role in forming personality disorders (PD). This study aimed to assess the role of early maladaptive schema (EMS), attachment style (AS), and parenting style (PS) in discriminating between personality disorders and normal individuals. METHODS: In this study, 78 personality disorder patients and 360 healthy volunteers aged 18-84 were selected using convenience sampling. They completed the Schema Questionnaire-Short Form (SQ-SF), Revised Adult Attachment Scale (RAAS), and Baumrind's Parenting Styles Questionnaire (PSI). Data were analyzed using discriminant analysis with IBM SPSS 25. RESULTS: The results showed higher mean scores in all early maladaptive schema domains, insecure attachment styles, and authoritarian parenting in the personality disorder group than in the normal group. Also, discriminant analyses revealed that the function was statistically significant and could distinguish between the two groups and a compound of essential variables, disconnection, impaired autonomy, and secure attachment, respectively, discriminating two groups. Given that all components were able to distinguish between the two groups. CONCLUSION: Therefore, intervention based on these factors early in life may help reduce the characteristics of personality disorders. Also, considering the role of these factors, treatment protocols can be prepared.

Attachment styles and healthcare utilization: exploring the role of the patient-doctor relationship.

BACKGROUND: With the purpose of improving healthcare, past research has examined the link between healthcare utilization and attachment. It is suggested that an individual's attachment style influences both the quality of their patient-physician relationship and healthcare utilization patterns. Nevertheless, most studies concentrate on the individual aspect, overlooking the dyadic dimension; specifically, the investigation of how insecure attachment relates to health behavior within patient-physician relationships. This gap leaves the role of the patient-doctor relationship in this process unclear. Therefore, to elucidate this complex interplay, we hypothesized that the correlation between attachment and healthcare utilization is mediated by the quality of the patient-physician-relationship. METHOD: Participant selection was based on electoral districts, a random-route procedure, and the Kish selection grid. The participants were visited by a trained interviewer who collected psychometric and sociodemographic information. Participants answered the Experiences in Close Relationships-Revised questionnaire (ECR-RD8) and the Patient-Doctor Relationship Questionnaire (PDRQ-9). Additionally, participants were asked about their healthcare utilization. The final sample consisted of N = 2.275 participants. RESULTS: In average the participants reported consulting their primary health care practitioner M(SD) = 4.44 (4.76) times in the past 12 months. Generally, the participants rated the quality of the relationship with their primary health care practitioner close to "totally appropriate" (M = 4.12 ± .69). The degree of insecure attachment manifested towards the lower extremity of the scale. The total effect of the mediation analyses was significant. Regardless, the indirect effect indicated a trend result with minimal effect sizes. CONCLUSION: The findings of the current study bridged the gap between attachment styles and healthcare utilization. Nonetheless, our results suggested insufficient support for the mediating role of the primary care physician in the relationship between attachment style and healthcare utilization. Considering the characteristics of the sample, this outcome may not apply in a clinical context. However, further research is needed to shed light in the revealed trends and indicate implications.

Prospective association of attachment style with suicide attempts among US Army soldiers.

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.

Friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors in times of COVID-19.

INTRODUCTION: This cross-sectional study used a convergent parallel mixed-method design to investigate friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors (UIMs) during the second wave of the COVID-19 pandemic in Italy. METHOD: Participants were 80 male UIMs (Mage = 17 years, standard deviation = 0.84) hosted in residential care communities. Individual interviews comprising questionnaires and open-ended questions assessed the constructs of interest. Qualitative data were analyzed through thematic content analysis, whereas descriptive statistics and regression analysis were computed on quantitative data. RESULTS: Several UIMs mentioned positive relationships with peers, but more than half also felt reluctant to trust others and build new friendships due to events experienced before and during migration. However, in quantitative data, 69% identified themselves with the secure friendship attachment style. Regarding intolerance of uncertainty, participants expressed feelings of worry about the pandemic, but also emphasized their resources in terms of confidence, optimism, and planning skills, as well as being accustomed to uncertainty; indeed, levels of this variable were low-to-medium. In regression analysis, insecure attachment and higher intolerance of uncertainty were each associated with greater psychological distress. Moreover, psychological distress was lower among securely attached UIMs with low (vs. high) levels of intolerance of uncertainty. CONCLUSION: The findings suggest that, even in conditions of societal insecurity, UIMs display resilience and employ effective coping strategies; however, a lack of trust in peer relationships and the inability to tolerate uncertainty may undermine their psychological adjustment. Implications for developmental theory and practice are discussed.

Relationship between Quality of Life and Adult Attachment Factors in Mothers of Children with and without Type 1 Diabetes.

The mothers of children with a specific clinical situation such as type 1 diabetes mellitus may have a higher level of stress, causing a worse perception of their quality of life, greater anxiety, and greater avoidance (adult attachment factors). The objective of this research was to verify if there is a relationship between the adult attachment factors of mothers of children with and without type 1 diabetes mellitus and the perception of the quality of life of these mothers. This survey was carried out from July to September 2022, with mothers of children aged 5 to 10 years, with and without diabetes. The data were collected through an online questionnaire, with socioeconomic data from the attachment scale Experience in Close Relationship-(Reduced), and the questionnaire on the quality of life, the WHOQOL-abbreviated questionnaire. For statistical analysis, the Statistical Package for Social Science 24 was used. A total of 45 mothers of children with DM1 and 55 mothers of healthy children were evaluated. The mothers of children with DM1 had a worse perception of their quality of life when compared to the mothers of healthy children (p < 0.05), with no difference in terms of the attachment style. Therefore, it is understood that actions aimed at improving the quality of life of these mothers are necessary.