Monica Sood, Katherine B. Carnelley, Katherine Newman-Taylor
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引用次数: 9
Abstract
Background
The relationship between attachment and paranoia is now well established. There is good theoretical reason and evidence to indicate that attachment style affects cognitive, affective, and behavioural processes which, in turn, contribute to the maintenance of paranoia, but this research has not been integrated. We critically and systematically review research that examines relevant cognitive, affective, and behavioural processes, which may explain how attachment insecurity leads to paranoia and constitute key targets in psychotherapeutic interventions for people with psychosis.
Method
We conducted three systematic searches across six databases (PsycINFO, CINAHL, Medline, Web of Science, Embase, and Google Scholar), from inception to September 2021, to investigate key cognitive, affective, and behavioural processes in the attachment–paranoia association.
Results
We identified a total of 1930 papers and critically reviewed 16. The literature suggests that negative self- and other-beliefs, inability to defuse from unhelpful cognitions, and use of maladaptive emotion regulation strategies mediate the association between attachment insecurity and paranoia in people with psychosis/psychotic experience. Attachment-secure people with psychosis are more likely to seek help and engage with services than attachment-insecure people.
Conclusions
Attachment styles impact help-seeking behaviours in people with psychosis and are likely to influence paranoia via self- and other-beliefs, cognition fusion, and emotion regulation – these candidate mechanisms may be targeted in psychological therapy to improve clinical outcomes for people with psychosis, characterized by paranoia.
Practitioner points
Insecure attachment is likely to lead to paranoia via negative beliefs about self and others, cognitive fusion, and use of maladaptive emotion regulation strategies. These mechanisms can be targeted in psychotherapeutic interventions for psychosis, such as cognitive behaviour therapy, to improve clinical and recovery outcomes.
People with psychosis who are attachment-secure are more likely to seek help and engage with services than those who are attachment-insecure (particularly avoidant). Attachment style can be assessed to predict service engagement and help-seeking behaviours in people with psychosis.
Attachment styles are important predictors of key cognitive, affective, and behavioural processes in people with psychosis. These processes can be assessed and incorporated into individualised formulations, and then targeted in therapy to effect psychotherapeutic change.
依恋和偏执之间的关系现在已经得到了很好的证实。有很好的理论依据和证据表明,依恋类型影响认知、情感和行为过程,而这些过程反过来又有助于偏执的维持,但这一研究尚未得到整合。我们批判性地、系统地回顾了有关认知、情感和行为过程的研究,这些研究可以解释依恋不安全感如何导致偏执,并构成精神病患者心理治疗干预的关键目标。方法:从成立到2021年9月,我们对六个数据库(PsycINFO, CINAHL, Medline, Web of Science, Embase和谷歌Scholar)进行了三次系统搜索,以调查依恋-偏执关联中的关键认知、情感和行为过程。结果我们共收录了1930篇论文,并对其中16篇进行了批判性审查。文献表明,消极的自我和他人信念,无法从无益的认知中解脱,以及使用适应不良的情绪调节策略介导了精神病/精神病经历患者依恋不安全感与偏执之间的联系。依恋安全型精神病患者比依恋安全型精神病患者更有可能寻求帮助和参与服务。结论依恋类型影响精神病患者的求助行为,并可能通过自我和他人信念、认知融合和情绪调节影响偏执,这些可能的机制可以作为心理治疗的目标,以改善偏执精神病患者的临床结果。从业人员指出,不安全依恋可能通过对自我和他人的消极信念、认知融合和使用适应不良的情绪调节策略而导致偏执。这些机制可以作为精神病心理治疗干预的目标,如认知行为治疗,以改善临床和康复结果。依恋安全型精神病患者比依恋安全型精神病患者(尤其是回避型精神病患者)更有可能寻求帮助并参与服务。依恋类型可以通过评估来预测精神病患者的服务投入和求助行为。依恋类型是精神病患者关键认知、情感和行为过程的重要预测因子。可以对这些过程进行评估,并将其纳入个体化方案,然后在治疗中进行针对性治疗,以实现心理治疗的改变。
期刊介绍:
The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups