Skip to main content
    • Aa
    • Aa

Attachment organization and treatment use for adults with serious psychopathological disorders

  • Mary Dozier (a1)

Individual differences in attachment organization among adults with serious psychopathological disorders were related to strategies of treatment use. Forty young adults with serious psychopathological disorders were administered the Adult Attachment Interview (George, Kaplan, & Main, 1984), and their clinicians completed ratings of treatment use. Attachment organization was assessed using the Attachment Q-set (Kobak, 1989), yielding ratings of security/anxiety and avoidance/preoccupation. In preliminary analyses, diagnosis was found to be related to security, with greater security associated with affective rather than thought disorders. Gender was related to avoidance/preoccupation, with males having stronger avoidant tendencies than females. The effects of diagnosis and gender were partialled out of subsequent analyses. As predicted, greater security was associated with more compliance with treatment, as rated by clinicians. Stronger avoidant tendencies were associated with greater rejection of treatment providers, less self-disclosure, and poorer use of treatment. These findings suggest that attachment organization may be an important determinant of how individuals with serious psychopathological disorders approach attachment figures.

Hide All
Ainsworth M. D. S., Blehar M. C., Waters E., & Wall S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.
American Psychiatric Association [APA]. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
Arend R., Gove F. L., & Sroufe L. A. (1979). Continuity of individuel adaptation from infancy to kindergarten: A predictive study of ego resiliency and curiosity in preschoolers. Child Development, 50, 950959.
Benedek T. (1938). Adaptation to reality in early infancy. Psychoanalytic Quarterly, 7, 200214.
Block J. H., & Block J. (1980). The role of egocontrol and egoresiliency in the organization of behavior. In Collins W. A. (Ed.), Minnesota symposium on childpsychology. (Vol. 13, pp. 39101). Hillsdale, NJ: Erlbaum.
Bowlby J. (1969). Attachment and loss. Vol. 1: Attachment. New York: Basic.
Bowlby J. (1973). Attachment and loss. Vol. 2: Separation. New York: Basic.
Bowlby J. (1980). Attachment and loss. Vol. 3: Loss, sadness, and depression. New York: Basic.
Bowlby J. (1988). Developmental psychiatry comes of age. American Journal of Psychiatry, 145, 110.
Brown G. W., Birley J. L. T., & Wing J. K. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241258.
Cairns R. B. (1979). Social development: The origins and plasticity of interchanges (pp. 100124). San Francisco: Freeman.
Cicchetti D., Cummings E. M., Greenberg M. T., & Marvin R. S. (1990). An organizational perspective on attachment beyond infancy: Implications for theory, measurement, and research. In Greenberg M. T., Cicchetti D., & Cummings E. M. (Eds.). Attachment in the preschool years: Theory, research, and intervention (pp. 349). Chicago: University of Chicago Press.
Cicchetti D., & Schneider-Rosen K. (1984). Theoretical and empirical considerations in the investigation of the relationship between affect and cognition in atypical populations of infants: Contributions to the formulation of an integrative theory of development. In Izard C., Kagan J., & Zajonc R. (Eds.), Emotions, cognitions, and behavior (pp. 366406). New York: Cambridge University Press.
Coie J. D., & Kupersmidt J. B. (1983). A behavioral analysis of emerging social status in boys' groups. Child Development, 54, 14001416.
Crowell J. A., & Feldman S. S. (1988). Mothers' internal models of relationships and children's behavioral and developmental status: A study of mother–child interaction. Child Development, 59, 12731285.
Cummings E. M., & Cicchetti D. (1990). Toward a transactional model of relations between attachment and depression. In Greenberg M. T., Cicchetti D., & Cummings E. M. (Eds.), Attachment in the preschool years: Theory, research, and intervention. Chicago: University of Chicago Press.
Dodge K. A. (1980). Social cognition and children's aggressive behavior. Child Development, 54, 13861399.
Dozier M., Harris M., & Bergman H. (1987). Social network density and rehospitalization among young adult patients. Hospital and Community Psychiatry, 38, 6165.
Dozier M., & Kobak R. (1989). Individual differences in physiological responsiveness to the Adult Attachment Interview. Unpublished manuscript.
Edwards A. L. (1967). Statistical methods (2nd ed.). New York: Holt, Rinehart & Winston.
Egeland B., Jacobvitz D., & Sroufe L. A. (1988). Breaking the cycle of abuse. Child Development, 59, 10801088.
Egeland B., & Sroufe L. A. (1981). Attachment and early maltreatment. Child Development, 52, 4452.
Elicker J. (1989, 04). The role of attachment in children's understanding of peer relationships in middle childhood. Paper presented at the meeting of the Society for Research in Child Development, Kansas City, MO.
Erickson M., Sroufe L. A., & Egeland B. (1985). The relationship between quality of attachment and behavior problems in preschool in a high risk sample. In Bretherton I. & Waters E. (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, 147186.
George C., Kaplan N., & Main M. (1984). Attachment interview for adults. Unpublished manuscript, University of California, Berkeley.
Gottesman I. I., & Shields J. (1976). A critical review of recent adoption, twin, and family studies of schizophrenia: Behavioral genetics perspectives. Schizophrenia Bulletin, 2, 360401.
Greenberg M. R., & Speltz M. L. (1988). Attachment and the ontogeny of conduct problems. In BeIsky J. & Nezworski T. (Eds.), Clinical implications of attachment (pp. 177218). Hillsdale, NJ: Erlbaum.
Henderson R. W. (1978). Forgetting of conditioned fear inhibition. Learning and Motivation, 8, 1630.
Kobak R. (1989). The Attachment Interview Q-Set. Unpublished document, University of Delaware.
Kobak R. R., Cole H., Ferenz-Gillies R., & Fleming W. (1989). A component process analysis of adolescent attachment patterns. Unpublished manuscript.
Kobak R. R., & Hazan C. (1989). Parents and spouses: Working models of attachment and marital satisfaction. Unpublished manuscript.
Kobak R. R., & Sceery A. (1988). Attachment in late adolescence: Working models, affect regulation and representations of self and others. Child Development, 59, 135146.
Main M., & Goldwyn R. (in press-a). Adult attachment classification system. In Main M. (Ed.), Behavior and the development of representational models of attachment: Five methods of assessment. Cambridge: Cambridge University Press.
Main M., & Goldwyn R. (in press-b). Interviewbased adult attachment classifications: Related to infant–mother and infant–father attachment. Developmental Psychology.
Main M., Kaplan N., & Cassidy J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. In Bretherton I. & Waters E. (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, 66104.
Matas L., Arend R. A., & Sroufe L. A. (1978). Continuity of adaptation in the second year. The relationship between quality of attachment and later competence. Child Development, 49, 547556.
Pennebaker J. W., Hughes C., & O'Heeron R. C. (1987). The psychophysiology of confession: Linking inhibitory and psychosomatic processes. Journal of Personality and Social Psychology, 52, 781793.
Pennebaker J. W., Kiecolt-Glaser J. K., & Glaser R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239245.
Pepper B., Kirshner M., & Ryglewicz H. (1981). The young adult chronic patient: A new breed of psychiatric patient. In Pepper B. & Ryglewicz H. (Eds.), New directions in mental health services: The young adult chronic patient. No. 14. (pp. 314). San Francisco: Jossey-Bass.
Pianta R. C., Sroufe L. A., & Egeland B. (1989). Continuity and discontinuity in maternal sensitivity at 6, 24, and 42 months in a high-risk sample. Child Development, 60, 481487.
Radke-Yarrow M., Cummings E. M., Kuczynski L., & Chapman M. (1985). Patterns of attachment in two- and three-year-olds in normal families and families with parental depression. Child Development, 56, 884893.
Rieder C., & Cicchetti D. (1989). Organizational perspective on cognitive control functioning and cognitive-affective balance in maltreated children. Developmental Psychology, 25, 382393.
Ritter J. M., & Langlois J. H. (1988). The role of physical attractiveness in the observation of adultchild interactions: Eye of the beholder or behavioral reality? Developmental Psychology, 24, 254263.
Schneider-Rosen K., Braunwald K. G., Carlson V., & Cicchetti D. (1985). Current perspectives in attachment theory: Illustration from the study of maltreated infants. In Bretherton I. & Waters E. (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, 194210.
Sheets J. L., Prevost J. A., & Reihman J. (1981). Young adult chronic patients: Three hypothesized subgroups. Hospital and Community Psychiatry, 33, 197203.
Snyder M. (1981). On the self-perpetuating nature of social stereotypes. In Hamilton D. L. (Ed.). Cognitive processes in stereotyping and intergroup behavior. Hillsdale, NJ: Erlbaum.
Snyder M., Tanke E. D., & Berscheid E. (1977). Social perception and interpersonal behavior: On the self-fulfilling nature of social stereotypes. Journal of Personality and Social Psychology, 35, 656666.
Snyder M., & Uranowitz S. W. (1978). Reconstructing the past: Some cognitive consequences of person perception. Journal of Personality and Social Psychology, 36, 941950.
Sroufe L. A. (1983). Infant–caregiver attachment and patterns of adaptation in pre-school: The roots of maladaption and competence. In Perlmutter M. (Ed.), Minnesota symposium on child psychology (Vol. 16, pp. 4181). Hillsdale, NJ: Erlbaum.
Sroufe L. A. (1988). The role of infant-caregiver attachment in development. In Belsky J. & Nezworski T. (Eds.), Clinical implications of attachment (pp. 1840). Hillsdale, NJ: Erlbaum.
Sroufe L. A., & Waters E. (1977). Attachment as an Organizational construct. Child Development, 48, 11841199.
Surtees P. G. (1980). Social support, residual adversity and depressive outcome. Social Psychiatry, 15, 7180.
Turner R. J. (1981). Social support as a contingency in psychological well-being. Journal of Health and Social Behavior, 22, 357367.
Vaughn B., Egeland B., Sroufe L. A., & Waters E. (1979). Individual differences in infant–mother attachment at twelve and eighteen months: Stability and change in families under stress. Child Development, 50, 971975.
Waters E. (1978). The reliability and stability of individual differences in infant–mother attachment. Child Development, 48, 11841199.
Weiss R. S. (1982). Attachment in adult life. In Parkes C. M. & Stevenson-Hinde J. (Eds.), The place of attachment in human behavior (pp. 171184). New York: Basic.
Wilcox B. L. (1981). Social support, life stress, and psychological adjustment: A test of the buffering hypothesis. American Journal of Community Psychology, 8, 371386.
Winer B. J. (1971). Statistical principles in experimental design. New York: McGraw-Hill.
Zigler E., and Glick M. (1986). A developmental approach to adult psychopathology. New York: Wiley.
Zigler E., Glick M., and Marsh A. (1979). Premorbid social competence and outcome among schizophrenie and nonschizophrenic patients. Journal of Nervous and Mental Disease, 167, 478483.
Zigler E., & Levine J. (1981). Premorbid competence in schizophrenia: What is being measured? Journal of Consulting and Clinical Psychology, 49, 96105.
Zigler E., & Phillips L. (1960). Social effectiveness and symptomatic behaviors. Journal of Abnormal and Social Psychology, 61, 231238.
Zigler E., & Phillips L. (1961). Case history data and psychiatric diagnosis. Journal of Consulting Psychology, 25, 258.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Development and Psychopathology
  • ISSN: 0954-5794
  • EISSN: 1469-2198
  • URL: /core/journals/development-and-psychopathology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 71 *
Loading metrics...

Abstract views

Total abstract views: 1614 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th October 2017. This data will be updated every 24 hours.