Social anxiety in first-episode psychosis: The role of childhood trauma and adult attachment

Abstract

Michail, Maria and Birchwood, Max (2014) Social anxiety in first-episode psychosis: the role of childhood trauma and adult attachment. Journal of Affective Disorders, 163 . pp. 102-109. ISSN 1573-2517 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/35476/1/Accepted%20manuscript.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial No Derivatives licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc-nd/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Method: This is a cross-sectional study. A sample of individuals with social anxiety disorder (with or without psychosis) was compared with a sample with psychosis only and healthy controls on childhood trauma, dysfunctional parenting and adult attachment.Results: Childhood trauma and dysfunctional parenting (p<0.05) were significantly elevated in people with social anxiety (with or without psychosis) compared to those with psychosis only and healthy controls. There were no differences in childhood trauma and dysfunctional parenting between socially anxious people with and without psychosis. Higher levels of insecure adult attachment (x 2 1 =38.5, p<0.01) were reported in the social anxiety group (with or without psychosis) compared to the psychosis only and healthy controls. Childhood adversities were not associated with insecure adult attachment in people with social anxiety (with or without psychosis).Limitations: Due to the cross-sectional nature of the study we cannot infer causal relationships between early risk factors, including childhood trauma and dysfunctional parenting, and social anxiety. Also, the use of self-report measures of attachment could be subject to biases. Conclusion:Shared developmental risk factors are implicated in the emergence of affective disorders in psychosis and non-psychosis. Social anxiety in psychosis is associated with insecurity in adult attachments which does not arise a result of adverse developmental pathways. Understanding the bio-psycho-social risk factors for...

A systematic review of adult attachment and social anxiety

“…Six studies compared attachment across groups defined by clinical 'caseness' for social anxiety. In five of these, people meeting diagnostic criteria for social anxiety were significantly more likely to be insecurely attached in comparison with healthy control groups (OR = 18.5; d = 0.49 -1.38; Eng et al 2001;Lionberg, 2003;Weisman et al, 2011;Michail & Birchwood, 2014). However, Kashdan and Roberts (2011) observed no difference in attachment to therapeutic group and therapist between depressed service-users with or without social anxiety.…”

“…In particular, people with social anxiety reported higher attachment anxiety (d = 1.15 -1.45), lower comfort in closeness with attachment figures (d = 1.15 -1.44) and lower ability to trust and depend on attachment figures than healthy controls (d = 0.45 -1.02). A large effect size (OR = 18.5) was found in a small sample of individuals at ultra-high risk for psychosis (Michail & Birchwood, 2014). This estimate was based on a low cell count and so lacks precision and may not be reliable.…”

The Psychological Implication of Learning Disabilities

“…For example, an epidemiological study [28] showed childhood relationship traumas of loss of a parent and adverse parenting practices predicted a variety of anxiety, mood, and substance-use disorders in adulthood, and these effects were greater when the loss was at a younger than older childhood age. Another study [29] found that a history of childhood trauma and particularly emotional and sexual abuse was higher for those adults with social anxiety compared to psychiatric and healthy controls. Kaehler and Freyd [16] examined physical abuse history and found that this kind of significant relationship betrayal predicted BPD features in women, and mothers with diagnosed BPD were more likely to have preoccupied/unresolved attachment status but not more likely to be dismissive [30].…”

Subjective distress in a representative sample of outpatients with psychotic disorders

“…It is expressed in terms of non-specific affective manifestations, but often only indirectly assessed through measures of depression and/or anxiety symptomatology. These symptoms constitute a highly prevalent comorbidity in non-affective psychosis, associated with poorer prognosis (Hartley et al, 2013;Lako et al, 2012;Michail and Birchwood, 2014). However, the distress, though highly correlated with anxiety and depression, is a distinct affective feature, being more comprehensive and transient (Ritsner et al, 2012).…”