Disorganized attachment and personality functioning in adults: A latent class analysis.

Abstract

Though researchers have attended to disorganized attachment in infants and children, they have infrequently focused on the character of disorganized attachment in adults. In this study, we aimed to identify clusters of participants based on attachment levels and styles, seeking to better delineate severity and stylistic differences in disorganized attachment than has been previously articulated. We used a new assessment approach focused on a hierarchy of attachment organization, including secure, insecure (dismissive and preoccupied), rigid-controlling (hostile control and compulsive caregiving) and disorganized (contradictory, impoverished and unresolved) levels of attachment. Clinical evaluators used information from diagnostic and attachment-based interviews to rate participants on each of these aspects of attachment. Latent class analysis revealed a 4-class solution, including a secure (n = 33), insecure (n = 110) and two disorganized classes. One disorganized class (disorganized-oscillating) was characterized by elevations on contradictory and preoccupied styles (n = 77) and another (disorganized-impoverished) showed elevations on impoverished and dismissive styles (n = 53). The disorganized-oscillating class exhibited elevated PD severity and general symptom severity, BPD, histrionic and antisocial dimensional scores, and the most severe identity disturbance compared to the other classes. The impoverished-dismissive class exhibited the highest avoidant and schizoid PD dimensional scores of the classes, and higher PD severity compared to the insecure and secure classes. These results highlight the possibility of identifying distinct classes of attachment organization, differentiated both by aspects of severity and interpersonal style. They also shed light on the manifestation of attachment disorganization in adults.

Infant disorganized attachment: Clarifying levels of analysis

“…Yet as is common in the history of science ( Hacking, 2004 ), subsequent findings and usages point to the need for clarifications to avoid reification of the original construct. The need for such clarifications of the account presented in the Main and Solomon chapters is especially pressing in the context of calls in recent years from attachment researchers and clinicians for further consideration of what has been captured by the concept of “disorganized” attachment (see, for example, Beeney et al, 2017 ; Bernier & Meins, 2008 ; Hollidge & Hollidge, 2016 ; Lyons-Ruth et al, 2013 ; Padrón, Carlson, & Sroufe, 2014 ; Slade, 2014; Spieker & Crittenden, 2010 ). Tarren-Sweeney (2014) has argued that “further research is needed to understand the nature and clinical meaning of the disorganised attachment category” (p. 334).…”

Art therapy for patients diagnosed with personality disorders cluster B/C: A thematic analysis of emotion regulation from patient and art therapist perspectives

“…Disorganised or anxious attachment due to childhood maltreatment has been hypothesised as a mediator between childhood maltreatment and adult PDs (e.g. Beeney et al, 2017;Levy, Johnson, Scala, Temes, & Clouthier, 2015). PDs are defined as long-standing and typically inflexible maladaptive patterns of thought, behaviour and emotion that cause distress and interfere with individuals' ability to relate to others and function in the world.…”

Unresolved Attachment Mediates the Relationship Between Childhood Trauma and Impaired Personality Functioning in Adolescence

“…It might be hypothesized that the unresolved attachment representation provides a fertile ground for adolescent psychopathology and personality pathology in response to childhood maltreatment experiences (Levy, 2005). In support of this view, a large research base suggests that the unresolved classification predominates in adolescent and adult patients with severe psychopathology, especially in those with PD (Beeney et al, 2017;Buchheim et al, 2017;Levy, 2005;Nakash-Eisikovits et al, 2002). The majority of studies in this field were conducted in patients with borderline PD Hengartner et al, 2015).…”

“…Criterion A refers to impairments in self-related (identity and self-direction) and interpersonal (empathy and intimacy) domains of functioning that allow assessing the severity of a PD and a more specified evaluation of the core impairment (i.e., more intra-or more interpersonal) (APA, 2013;Benzi, Preti, Di Pierro, Clarkin, & Madeddu, 2019;Goth, Birkhölzer, & Schmeck, 2018a). The concept of personality functioning might be very useful for adolescent age groups as it considers fluctuations in personality (Benzi et al, 2019) and allows detecting and describing the central impairments of personality pathology during the transitional period of adolescence (Beeney et al, 2017;Benzi et al, 2019;Goth et al, 2018a). Further, this approach has proven to be crucial in specifying developmental models of adolescent PD (Benzi et al, 2019).…”