title: Attachment: developmental pathways to affective dysregulation in young people at ultra-high risk of developing psychosis.
abstract: OBJECTIVE
  Embedded in attachment theory is its association with affect regulation, which provides a framework for affective dysregulation in the emerging psychosis.
  
  
  METHODS
  Fifty-one participants meeting criteria for ultra-high risk (UHR) of developing psychosis were recruited from a youth mental health service within the United Kingdom. At intake baseline, prior to starting therapeutic intervention, all clients were assessed on measures of affective dysregulation and attachment.
  
  
  RESULTS
  A large proportion of our sample (N = 51) reported clinically significant levels of depression (78%), state anxiety (59%), and social anxiety (65%). Eighty per cent of the UHR sample was insecurely attached. Insecure attachment was significantly associated with elevated depression and social anxiety. Attachment styles were associated with anxiety, depression, and social anxiety. There was no support for a mediating role of social anxiety between attachment styles and depression.
  
  
  CONCLUSIONS
  Clinically significant levels of distress and anxiety experienced by the young people at high risk of psychosis. Clinical implications for the treatment of affective dysregulation in young people at UHR in relation to their attachment styles have been discussed.
authors.affiliation: School of Psychology, University of Birmingham, UK.
authors.forename: Ruchika
authors.initials: R
authors.lastname: Gajwani
authors.forename: Paul
authors.initials: P
authors.lastname: Patterson
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology*; D003863:Depression / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009769:Object Attachment; D011618:Psychotic Disorders / Q000523:psychology*; D018570:Risk Assessment; D012307:Risk Factors; D012919:Social Behavior; D012938:Social Perception; D006113:United Kingdom; D055815:Young Adult
keywords: Affective dysregulation; Attachment; Depression; Social anxiety; Ultra-high risk of psychosis