Influence of anxious attachment on the relationship between primary emotions and substance-related addictive behaviors.

Objectives: To date there is no universally accepted model that describes the development of substance related addictive behavior. In order to address this gap, the study sought to examine whether the association between primary emotions and the inclination toward addictive behavior is mediated by an anxious attachment style. Methods: The total sample consisted of 900 German speaking non-clinical adults (age: M = 27; SD = 9.60; 71.6% female). Structural Equation Modeling (SEM) was applied to examine the connection between the primary emotions (SADNESS and ANGER), and the latent variables attachment anxiety and symptoms of addictive behavior. Results: Substance use symptomatology was correlated with higher attachment anxiety (r = 0.15), SADNESS (r = 0.15), and ANGER (r = 0.11). The effect of SADNESS on addictive behavior is mediated by attachment anxiety (p < 0.01) whereas ANGER had a direct effect on addictive behavior (p < 0.01). The final SEM explains 4% of the variance of addictive behaviors and 22% of attachment anxiety. Conclusion: Our findings suggest that both SADNESS and ANGER, along with attachment anxiety, are dispositions that contribute to the risk of engaging in addictive behavior. However, while ANGER directly influences addictive behavior, SADNESS acts through its impact on attachment anxiety.

The relationship between attachment, primary emotions and positive/negative spirituality: a path analysis.

Objective: The present study investigates what may influence individuals to experience their religiosity/spirituality as either subjectively positive [religious or spiritual (r/s) wellbeing] or as negative (r/s struggles). Drawing on existing literature attachment insecurity and the seven primary emotions as outlined by Jaak Panksepp in Affective Neuroscience are identified as likely influences. Methods: The final sample consisted of 340 participants (age: M = 36, SD = 14.2; 68.5% = female), among which 65% self-identified as religious/spiritual. A path analysis was conducted to test a proposed mediation model in which the expected effects of primary emotions (B-ANPS) on r/s wellbeing (MI-RSWB) and r/s struggles (RSSS) were mediated through attachment insecurity (ECR-RD8). Results: The data indicated that attachment insecurity fully mediated the relationships between the primary emotions SADNESS and LUST with r/s struggles. Furthermore, the primary emotions FEAR and ANGER displayed small direct effects on both r/s struggles and r/s wellbeing. Overall, the model, which demonstrated excellent model fit, was able to explain 30% of the variance of r/s struggles, 24% of attachment insecurity and 5% of r/s wellbeing. Conclusions: The findings suggest that primary emotions such as SADNESS and LUST substantially explain r/s struggles and that these relationships seem to be mediated through attachment. Moreover, r/s struggles seem to be qualitatively distinct from r/s wellbeing. Finally, a moderate link between LUST and attachment suggests that sexuality plays a significant role in (adult) attachment processes.

Adult attachment assessed via the ASA and AAI: Empirical convergence and links with autonomic physiological responding during attachment assessments.

This study examined the empirical convergence of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous scripts with conceptually corresponding attachment patterns assessed via the Adult Attachment Interview (AAI), and the significance of ASA dimensions for autonomic physiological reactivity during adult attachment assessments. Young adults' (50% male; Mage = 19 years; 80% White/European American) ASA deactivation, hyperactivation, and anomalous content were significantly associated with AAI dismissing (r = .26-.38), preoccupied (r = .31-.35), and unresolved (r = .37) states of mind, respectively. ASA hyperactivation and anomalous content were associated with heightened RSA reactivity to the AAI and ASA, aligning with expectations that these attachment patterns capture the tendency to heighten expressions of negative, traumatic experiences. ASA deactivation was associated with smaller increases in electrodermal activity to the ASA-indicative of less sympathetic arousal-converging with the tendency of individuals higher in deactivation to avoid discussing attachment themes in the ASA.

Deactivation, hyperactivation, and anomalous content in the attachment script assessment: stability over time and significance for parenting behavior and physiology.

This study examined the stability of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous content and their significance for parenting outcomes in mothers (Mage = 31 years; 78% White/European American) and 6-month-old infants. Comparable to ASA secure base script knowledge (SBSK), mothers' ASA deactivation, hyperactivation, and anomalous content were significantly, moderately stable over two years (r's = .40 - .43). Mothers' ASA hyperactivation and anomalous content were associated with greater maternal intrusiveness, whereas ASA deactivation was associated with greater detachment and less intrusiveness. Only ASA anomalous content was associated with lower maternal sensitivity. Mothers' ASA deactivation was associated with less dynamic change in respiratory sinus arrhythmia during the Still-Face Procedure-reflective of limited mobilization of physiological resources to support responding to infants. Findings support the validity of ASA deactivation, hyperactivation, and anomalous content scripts, and demonstrate their utility in examining adult attachment stability and predictive significance for parent-child outcomes.

The predictive significance of attachment script assessment hyperactivation and deactivation: evidence of associations with romantic relationship functioning.

This study examined the significance of a novel coding system for evaluating hyperactivation, deactivation, and anomalous content in the Attachment Script Assessment for romantic relationship functioning. In a sample of 208 couples (69% White, Mage 28.7 years), we tested whether ASA hyperactivation and deactivation were associated with theoretically relevant correlates, including observed behavior, parasympathetic reactivity, self-reported affective reactivity to conflict, and relationship satisfaction. Exploratory analyses examined associations of secure base script knowledge (SBSK) and anomalous content with these outcomes. ASA hyperactivation and deactivation were associated with behavioral, physiological, and self-reported functioning in theory-consistent ways. Anomalous content was not associated with romantic functioning. SBSK was associated with satisfaction, but this was not robust to covariates. Findings support the predictive validity of the hyperactivation and deactivation dimensions and suggest that these scales complement SBSK, enabling researchers to assess a wider range of behavioral and physiological indicators associated with distinctive forms of attachment insecurity.

The Attachment Script Assessment: Introduction of a coding system to evaluate deactivation, hyperactivation, and anomalous content.

Although research on adult attachment has yielded insight into the legacy of attachment for functioning in adulthood, methodological challenges persist in the assessment of adult attachment. The Adult Attachment Interview (AAI) offers a rich assessment of secure, insecure, and unresolved states of mind. However, it is resource intensive to administer and code. Attachment Script Assessment (ASA) offers a resource-effective alternative to the AAI. However, the ASA coding system only yields a single, security-like dimension: secure base script knowledge. Here, we introduce a complementary coding system for the ASA to assess attachment deactivation (i.e. script characterized by limited interpersonal connection and minimization of attachment problems/emotions), hyperactivation (i.e. script in which attachment-relevant problems and negative emotions are heightened), and anomalous content (i.e. script in which attachment problems contain elements of fear and/or disorientation); and we discuss the conceptual convergence of these scripts with corresponding patterns of attachment insecurity and disorganization.

Natural clues to danger: attachment behavior in threatening situations.

A fundamental principle of attachment theory is that threatening situations give rise to individual differences in the extent to which people seek proximity to close others. The current research examines the way in which attachment styles predict individual differences in attachment-relevant behavior during threatening events. We tested alternative theoretical perspectives concerning the association between adult attachment (specifically, attachment avoidance) and attachment behavior in the presence of natural clues to danger by observing couples (N = 204) when they were watching horror vs. control film excerpts. Results suggest that highly avoidant people engaged in less attachment behavior across both threatening and non-threatening situations. These findings have implications for the understanding of attachment-related processes and how working models of the self and others facilitate (or inhibit) the expression of attachment behavior.

Attachment and inter-individual differences in empathy, compassion, and theory of mind abilities.

Social processing, namely the ability to understand others' cognitive and affective states, is crucial for successful social interaction. It encompasses socio-affective abilities such as empathy and compassion, as well as socio-cognitive abilities such as theory of mind (ToM). This study examined the link between social processing and attachment. Our study goes beyond previous research in that social processing abilities were assessed in a single, state-of-the-art behavioral paradigm using video narratives, the EmpaToM. Attachment was captured with the Adult Attachment Interview (N = 85; 50.60% women, Mage = 25.87 ± 4.50 years) measuring participants' present-day capacity to think about and communicate attachment-relevant information about the past. Additionally, a self-report attachment questionnaire was employed (N = 158). We found that AAI-based attachment security (vs. insecurity) was associated with higher behavioral ToM abilities. Furthermore, self-reported attachment avoidance was negatively correlated with behavioral compassion abilities. Our findings provide further evidence that interview-based and self-reported attachment measures do not converge, but may rather be understood as capturing different facets of attachment that relate to different components of social processing. We conclude that individuals with secure, non-avoidant attachment show social abilities that allow them to better understand others' thoughts and generate positive, caring emotions in face of others' distress.

Attachment is differentially associated with distinct behavioral social processing abilities, that is, compassion and theory of mind.Higher attachment security in the Adult Attachment Interview (AAI) is linked to higher behavioral theory of mind abilities.Increased self-reported attachment avoidance is linked to lower behavioral compassion.

Domestication and exposure to human social stimuli are not sufficient to trigger attachment to humans: a companion pig-dog comparative study.

Dogs exhibit human-analogue attachment to their owners, with similar function and mechanisms to that of infant-mother bond, but its origin is unclear. Comparative studies on socialised wolves and dogs emphasise genetic influence in dogs' preparedness for attachment to humans. We aimed to reveal if this genetic effect stems from general domestication or artificial selection that increased dogs' dependence on humans. We assessed and compared behavioural patterns of young companion pigs and dogs using a Strange Situation Test. Dogs but not pigs exhibited distinct behaviours towards their owner and a stranger along attachment-specific variables, so only dogs' relevant behaviours fulfilled attachment criteria. From the observed behaviours, three factors were formed: Attachment (to the owner), Anxiety (in a strange situation), and Acceptance (of a stranger). Results indicate (1) higher Attachment scores in dogs than pigs, (2) greater Acceptance scores in pigs, (3) positive correlation of Attachment and Anxiety in both, (4) similar time tendency of pigs' Attachment and Acceptance scores. These suggest that in pigs, domestication and early exposure to human social stimuli did not trigger attachment to humans. Thus, along with species predispositions, the unique dog-owner attachment can be facilitated by artificial selection that increased dogs' dependence on humans.

Maternal insecure attachment representation as a long-term risk factor for disrupted mother-child-interaction and child mental health.

Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother-child-interaction und maternal helplessness and fear. N = 103 mother-child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p = .060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p < .001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p < .001) and fear (F(9, 93) = 7.40, p < .001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p < .001; F(10, 92) = 3.87, p < .001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families.

The Role of Attachment Anxiety and Avoidance in Predicting Proximal Minority Stressors among Gay and Lesbian People in Italy.

As has been widely documented, minority stress affects the psychosocial well-being of gay and lesbian people. Recently, researchers have turned their attention to psychological factors that may influence the level of minority stress experienced, in order to explain individual differences in perceptions of proximal minority stressors. The present research aimed at assessing the effect of attachment avoidance and anxiety on levels of perceived stigma and internalized homonegativity. A total of 163 participants who self-identified as lesbian or gay (Mage = 32.56, SD = 10.87) were recruited and responded to the self-report questionnaires. Two multiple regression models were applied to assess the association between adult attachment and perceived stigma and internalized homonegativity. Results showed a positive association between attachment anxiety and avoidance and internalized homonegativity, as well as between attachment avoidance and perceived stigma. The emerging results demonstrate the impact of attachment anxiety and avoidance on proximal minority stressors and provide useful data for interventions addressing lesbian and gay people aimed at promoting security-based strategies of affect regulation and positive representations of self and others, which in turn may reduce the level of proximal minority stressors experienced and promote psychosocial well-being.

Prevalence and Factors Associated with Impaired Maternal-Infant Bonding among Mothers Attending Young Child Clinic in Kampala, Uganda.

Impaired maternal-infant bonding can have a negative impact on the mother-infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal-infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence and factors associated with impaired maternal-infant bonding. Postnatal mothers (n = 422) attending the Young Child Clinic at Kawempe National Referral Hospital participated in the study. Maternal-infant bonding was measured using the Postpartum Bonding Questionnaire (PBQ). Participants with a score ≥ 13 on the PBQ were considered to have impaired maternal-infant bonding. The prevalence of impaired maternal-infant bonding among mothers was 45% (190/422). Logistic regression was used to determine factors associated with impaired maternal-infant bonding. Unmarried mothers (AOR = 2.05, 95% [CI = 1.03-4.09], p = 0.041), unplanned pregnancy (AOR = 5.19, 95% [CI = 3.07-8.82], p < 0.001), first-time mothers (AOR = 2.46, 95% [CI = 1.37-4.43], p = 0.003), female infant (AOR = 1.80, 95% [CI = 1.13-2.86], p = 0.013), mothers with no/low education levels (AOR = 2.29, 95% [CI = 1.05-4.50], p = 0.036), and those who delivered post term (AOR = 2.49, 95% [CI = 1.10-5.67], p = 0.028) were more likely to have impaired maternal-infant bonding. Nurses and midwives in postnatal care should include maternal-infant bonding within their client's assessment and provide supportive mother-centered care. Interventions to improve maternal-infant bonding should be created and implemented in clinical practice.

Secure attachment priming inhibits the generalization of conditioned fear.

BACKGROUND: Fear overgeneralization constitutes a susceptibility factor contributing to the development and maintenance of anxiety spectrum disorders. Extant research has demonstrated that exposure to positive and supportive social relationships attenuates fear acquisition and promotes the extinction of conditioned fear responses. However, the literature lacks investigation into the effect of secure attachment priming on inhibiting the generalization of conditioned fear. METHODS: In this study, college students were recruited via online platforms to voluntarily engage in the experimental procedures, resulting in 57 subjects whose data were deemed suitable for analysis. The experimental protocol consisted of four consecutive phases: pre-acquisition, acquisition, priming, and generalization. The priming phase consisted of two experimental conditions: secure attachment priming (experimental group) and positive emotion priming (control group). This study adopted the perceptual discrimination fear conditioning paradigm, employing subjective expectancy of shock ratings and skin conductance responses as primary assessment indices. Individual difference variables were measured using corresponding psychological measurement scales. RESULTS: In terms of generalization degree, a notable divergence surfaced in the skin conductance responses across various generalization materials between the secure attachment priming group and the control group. Similarly, during generalization extinction, a significant disparity emerged in the skin conductance responses across different generalization phases between the secure attachment priming group and the control group. In addition, individual differences analyses revealed that the inhibitory effect of secure attachment priming on fear generalization was not affected by intolerance of uncertainty and attachment orientations. Conversely, slope analyses confirmed that as intolerance of uncertainty increased, the inhibitory effect of positive emotion priming on fear generalization was attenuated. CONCLUSION: The findings suggest that activating participants' representations of secure attachment via imagination effectively attenuates the generalization of perceptual fear at the physiological level. The inhibitory effect of secure attachment priming appears to be distinct from positive emotional modulation and remains unaffected by individual trait attachment styles. These results offer novel insights and avenues for the prevention and clinical intervention of anxiety spectrum disorders.

Mediation role of interpersonal problems between insecure attachment and eating disorder psychopathology.

PURPOSE: Although insecure attachment and interpersonal problems have been acknowledged as risk and maintaining factors of eating disorders (EDs), the mediating role of interpersonal problems between attachment style and ED psychopathology has been poorly explored. The purpose of this study was to investigate the mediating role of interpersonal problems between insecure attachment and ED psychopathology. METHODS: One-hundred-nine women with anorexia nervosa and 157 women with bulimia nervosa filled in the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships (ECR) revised scale to assess ED core symptoms and attachment styles, respectively. Interpersonal difficulties were evaluated by the Inventory of Interpersonal Problems (IIP-32). A mediator's path model was conducted with anxious and avoidant attachment subscores as independent variables, ED core symptoms as dependent variables and interpersonal difficulties as mediators. The diagnosis was entered in the model as a confounding factor. RESULTS: The socially inhibited/avoidant interpersonal dimension was a mediator between avoidant attachment and the drive to thinness as well as between avoidant attachment and body dissatisfaction. An indirect connection was found between attachment-related anxiety and bulimic symptoms through the mediation of intrusive/needy score. CONCLUSIONS: Social avoidance and intrusiveness mediate the relationships between avoidant and anxious attachment styles and ED psychopathology. These interpersonal problems may represent specific targets for psychotherapeutic treatments in individuals with EDs and insecure attachment. LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Neonatal transfer and duration of hospitalization of newborns as potential risk factors for impaired mother-infant bonding: The Japan Environment and Children's Study.

BACKGROUND: Currently, there is no consensus regarding the relationship between neonatal transfer and duration of hospitalization in cases of impaired mother-infant bonding (MIB). This study aimed to determine whether neonatal transfer and duration of hospitalization of newborns increase the risk for impaired MIB. METHODS: The MIB Scale was used to assess impaired MIB 1 year after delivery, using data from the Japan Environment and Children's Study. A score ≥ 5 points indicated impaired MIB. Multiple logistic regression analyses were performed to estimate the association between neonatal transfer and duration of hospitalization of newborns with the risk of impaired MIB. RESULTS: A total of 66,402 pregnant women were included in the study. The overall incidence rate of impaired MIB was 11.2 %. The mean duration of hospitalization of newborns was 7.1 ± 6.4 days. After adjusting for potential confounders, neonatal transfer (adjusted odd ratio (OR): 1.13 [95 % confidence interval (CI)), 1.01-1.27]) and duration of hospitalization of newborns (adjusted OR 1.007; 95 % CI 1.003-1.010) were associated with impaired MIB. The area under the receiver operating characteristic curve for the duration of hospitalization of newborns for impaired MIB was 0.53. LIMITATIONS: Maternal childhood abuse and neglect history were not evaluated, and information regarding whether the infants were admitted to the neonatal intensive care unit was unavailable. CONCLUSIONS: Japanese women whose newborns underwent neonatal transfer should be followed up for at least 1 year after delivery, regardless of the duration of hospitalization of newborns.

The effect of the separation of mother-preterm newborn infants hospitalized during the COVID-19 pandemic on maternal depression and stress levels, infant development, and bonding quality on Chilean dyads.

Early infant development is a maturation process critically depends on the infant's interaction with primary caregivers. Hence, neonatal units prioritize their proximity. In COVID-19, parental visitation hours were limited, reducing caregivers time with their infants. This follow-up study analyzes and compares levels of maternal depression and stress, infant development, and bonding quality in preterm mother-infant dyads hospitalized, before and during the pandemic. Out of 66 dyads participated, 36 were admitted before COVID-19, and 30 during COVID-19. The assessed was two video-call sessions in which mothers completed selected questionnaires. No significant differences between mothers' levels of depression and stress. However, low birth weight was associated with greater difficulties in children's communication and interpersonal relationships. Furthermore, infants hospitalized in COVID-19 had a higher risk of experiencing delayed communication. No significant differences were observed in bonding quality. Lower infant gestational age and longer breastfeeding time were associated with better bonding quality in both groups. Psychosocial intervention is considered a valuable tool, capable of preventing maternal mental health difficulties and protecting bonding in premature infants and in highly complex healthcare settings. Nevertheless, it is essential to more actively address the socio-affective needs of newborns during their hospital stay to promote adequate development.

El desarrollo infantil temprano es un proceso de maduracion que depende críticamente de la interacción del infante consus cuidadores primarios. Por tal razón, en las unidades neonatales priorizan su proximidad. Durante el COVID­19, se limitaron las horas de visitas de los progenitores, lo que redujo el tiempo que los cuidadores con sus bebés. Este estudio de seguimiento analiza y compara el nivel de depresión y estrés materno, el desarrollo infantil y la calidad del vínculo afectivo en díadas madre­bebé prematuro hospitalizado al nacer, antes y durante la pandemia. De las 66 díadas participantes, 36 fueron admitidas antes del COVID­199 y a 30 durante el COVID­19. Se realizaron dos sesiones de vídeo­llamada, en las que las madres completaron los cuestionarios seleccionados. No se encontró ninguna diferencia significativa entre los niveles de depresión y estrés en las madres. Sin embargo, un bajo peso al nacer se asoció con mayores dificultades en la comunicación y las relaciones interpersonales en los niños. Además, los infantes hospitalizados durante el COVID­19 presentaron mayor riesgo de experimentar retrasos en la comunicación. No se observaron diferencias significativas en la calidad del vínculo afectivo. Una menor edad gestacional del infante y mayor tiempo de lactancia materna se asociaron con una mejor calidad del vínculo afectivo en ambos grupos. Se considera la intervención psicosocial como una herramienta de valor, capaz de prevenir dificultades en la salud mental materna y de proteger el vínculo afectivo en infantes nacidos prematuramente y en entornos sanitarios altamente complejos. Sin embargo, es esencial abordarmás activamente las necesidades socioafectivas de los recién nacidos durante su estadía en el hospital para promover un desarrollo adecuado.

A longitudinal study of child adjustment during the COVID-19 pandemic: the protective role of the parent-child relationship in middle childhood.

This longitudinal study assessed how parent-child relationship quality during the first COVID-19 lockdown was related to changes in internalizing, externalizing, and sleep problems during the first months of the pandemic: during lockdown, partial deconfinement, and total deconfinement. Participants included 167 children (9-12 year) and their parents recruited in the province of Quebec, Canada. Child behavior problems decreased between lockdown and the two deconfinement assessments, but more sleep and behavior problems were associated with lower levels of relationship quality (more conflict, less closeness, and more insecure attachment). Significant interaction effects showed that changes in externalizing and sleep problems varied as a function of parent-child relationship. Results support the critical importance of the parent-child relationship with regard to child adjustment in middle childhood in times of crisis such as a pandemic. They also highlight resilience in children aged 9 to 12, with a decrease in problems over time.

Fathers' contributions to attachment in adolescence and adulthood: the moderating role of race, gender, income, and residential status.

Fathers play a critical yet underappreciated role in adolescent development. To examine contributions of fathers' parenting to attachment in adolescence and adulthood, this longitudinal study followed 184 adolescents from ages 13-24. At age 13, adolescents reported on their fathers' parenting behavior and were observed in a father-teen conflict task; at ages 14 and 24, they completed the Adult Attachment Interview. Adolescents who lived with their father showed higher attachment security at age 14 (Cohen's d = .72), compared to those with non-residential fathers. Fathers' positive relatedness and support for teens' psychological autonomy predicted attachment security at age 14. Fathers' physical aggression predicted attachment insecurity in adolescence, whereas fathers' verbal aggression predicted insecurity in adulthood, illuminating developmental shifts. Pathways to security were moderated by father residential status, adolescent gender, and race. Findings underscore the importance of fathers' presence, autonomy support, and non-aggression in predicting adolescents' state of mind in close relationships.

The role of attachment and personality traits in choosing opiate addiction replacement therapy.

Contemporary medical approaches for opioid addiction often include medication-assisted therapy, utilizing methadone and buprenorphine. However, factors influencing patient preferences for starting buprenorphine or methadone therapy are poorly understood. This study aims to explore whether variances in personality traits and attachment styles are related to treatment preferences among individuals undergoing buprenorphine and methadone maintenance therapies. 300 participants completed the Big Five Questionnaire for personality traits and sub-dimensions and the Experiences in Close Relationship Scale for assessing attachment styles. The results indicated that patients with higher levels of Dynamism, Conscientiousness, and Perseverance personality traits were more likely to choose buprenorphine over methadone for achieving and maintaining abstinence. Although attachment styles showed a greater ability to differentiate between groups compared to personality traits, the differences were not significant. However, Conscientiousness stood out for its high discriminant validity, suggesting that scores in this personality dimension could significantly distinguish between groups, with individuals in the buprenorphine group showing higher levels of Conscientiousness compared to the methadone group. The study suggests a partial association between individuals' preference for abstinence therapy and their personality traits. These findings could be considered useful indicators when choosing maintenance therapy to help opiate-addicted patients achieve and maintain abstinence.

Selected for Solitude: A Case Report of Loneliness.

The U.S. Surgeon General, Vivek Murthy, recently declared loneliness a public health epidemic. For therapists, that is not likely to be a surprise: Loneliness is so common in people who seek therapy that it might be seen as the bread and butter of our work. Despite that, there has not been much serious examination of intrapsychic factors that may contribute to this painful condition. Public discourse has focused instead on cultural and societal causes of loneliness, and on practical steps that might be taken to decrease it. But practical advice is not always sufficient for people with longstanding loneliness. Longstanding loneliness may be fueled by intrapsychic dynamics and become embedded in character. In some cases, patients may relish companionship yet steadfastly avoid it in an attempt to master early childhood experiences of being emotionally neglected and deprived of love. They were starved of love as children and now choose to starve themselves in an unconscious attempt to master early deprivation by identifying with the aggressor. For patients like this, chronic loneliness may signal a certain kind of attachment disorder, for it is the visible sign of early attachment to a distant or rejecting parental figure. Loneliness of that kind can be a stubborn problem and one that poses a considerable therapeutic challenge.