Pathways from insecure attachment dimensions to paranoia: The mediating role of hyperactivating emotion regulation versus blaming others

Abstract

Objectives There is evidence of associations between insecure attachment and paranoia, but we do not yet fully understand the mediating mechanisms. Attachment theory emphasizes differential relatedness of insecure attachment dimensions (i.e., anxiety vs. avoidance) with specific emotion regulation styles (ER). We tested whether the associations between attachment anxiety versus avoidance and paranoia were mediated specifically by hyperactivating (i.e., the use of emotion‐amplifying strategies: self‐blame, rumination, catastrophization) versus blaming others ER, respectively. In addition, we explored whether self‐blame versus blaming others ER differentially mediated the associations between attachment anxiety versus avoidance and paranoia. Method We included 60 patients with psychosis and 40 healthy controls (HCs) with whom we conducted standardized diagnostic interviews. We assessed paranoia, attachment, and ER via questionnaires. A structural equation mediation model including attachment anxiety and avoidance (predictor), the ER styles (mediators), and paranoia (outcome) was calculated. Results Compared with HCs, patients exhibited significantly more attachment anxiety and avoidance, and used more hyperactivating ER as well as strategies of blaming others. We found a significant indirect effect between attachment anxiety and paranoia via hyperactivating ER in patients with psychosis. However, no significant indirect effects involving blaming others or self‐blame in any of the groups were found. Conclusions Our study provides a starting point for further investigation of how paranoid delusions in psychosis could emerge from insecure attachment via ER. This might inspire further research into attachment theories of ER in paranoia. In the long term, this could provide a basis to develop interpersonally oriented interventions for this target group. Practitioner points In individuals with psychosis, there appears to be an attachment‐specific emotion regulation (ER) pathway from attachment anxiety via hyperactivating ER to paranoia. Blaming others did not explain the significant association between attachment avoidance and paranoia. Attachment‐specific therapeutic approaches to paranoia, that focus on hyperactivating ER, could be a valid way to ameliorate paranoid delusions.

Coach–Athlete Attachment and the Subjective Well-Being of Athletes: A Multiple-Mediation Model Analysis

“…Based on existing attachment theories and targeting athletes, this study was conducted to investigate the effects of coach–athlete attachment on the SWB of athletes, as well as their underlying mechanisms, and some constructive results were acquired. First, it was found that attachment anxiety and attachment avoidance toward coaches were negatively correlated with the SWB of athletes, which is an interesting result that is consistent with the conclusions of other researchers [ 4 , 12 , 13 , 14 ]. In the Chinese cultural context, the coach–athlete relationship is an important source of attachment for athletes and has an inevitable effect on the SWB of athletes; as the proverb goes, “one day as a teacher, a life as a father.” Unlike for the typical coach–athlete relationship [ 28 ] in which the athlete spends time at their own home and sees the coach for a smaller portion of the day (save for when the team travels), Chinese athletes considered in the current study live together with their coaches all day, and the coach–athlete relationship can also moderately affect the life satisfaction and emotional experience of athletes [ 21 ].…”

“…The two dimensions can be categorized into high and low levels; the attachment style, including low attachment anxiety and low attachment avoidance, is called secure attachment, while all other combinations are considered insecure attachment [ 13 , 14 ]. As has been previously reported, attachment is closely related to SWB [ 4 , 12 , 13 , 14 ]. For instance, Guardia found secure attachment to be positively correlated with SWB [ 15 ].…”

“…Brennan et al divided adult attachment into two dimensions: attachment avoidance and attachment anxiety [ 11 ]. The former refers to the feeling of inadaptation caused by intimacy with an attached subject, as well as the degrees of psychological and emotional independence, and the latter is defined as the degree of worry about being separated from or abandoned by the attached subject [ 11 , 12 ]. The two dimensions can be categorized into high and low levels; the attachment style, including low attachment anxiety and low attachment avoidance, is called secure attachment, while all other combinations are considered insecure attachment [ 13 , 14 ].…”

Emotion-Regulation in Psychosis: Patients with Psychotic Disorders Apply Reappraisal Successfully

“…All participants were paid for participating in the study. Data related to the social exclusion paradigm (Lincoln et al 2018;Sundag et al 2018) and questionnaire data (Ascone et al, 2020) have been published elsewhere. Here, we analyze the data from the questionnaires and from the experimental paradigm on emotion-regulation.…”

“…Problems in identifying and describing one´s emotions were assessed with the German version of the Toronto Alexithymia Scale (TAS-20;Bach et al 1996). It consists of 20 items that are rated on a 5-point scale ranging from 1 (not applicable) to 5 (always applicable).…”