title: Interview Investigation of Insecure Attachment Styles as Mediators between Poor Childhood Care and Schizophrenia-Spectrum Phenomenology.
abstract: BACKGROUND
  Insecure attachment styles have received theoretical attention and some initial empirical support as mediators between childhood adverse experiences and psychotic phenomena; however, further specificity needs investigating. The present interview study aimed to examine (i) whether two forms of poor childhood care, namely parental antipathy and role reversal, were associated with subclinical positive and negative symptoms and schizophrenia-spectrum personality disorder (PD) traits, and (ii) whether such associations were mediated by specific insecure attachment styles.
  
  
  METHODS
  A total of 214 nonclinical young adults were interviewed for subclinical symptoms (Comprehensive Assessment of At-Risk Mental States), schizophrenia-spectrum PDs (Structured Clinical Interview for DSM-IV Axis II Disorders), poor childhood care (Childhood Experience of Care and Abuse Interview), and attachment style (Attachment Style Interview). Participants also completed the Beck Depression Inventory-II and all the analyses were conducted partialling out the effects of depressive symptoms.
  
  
  RESULTS
  Both parental antipathy and role reversal were associated with subclinical positive symptoms and with paranoid and schizotypal PD traits. Role reversal was also associated with subclinical negative symptoms. Angry-dismissive attachment mediated associations between antipathy and subclinical positive symptoms and both angry-dismissive and enmeshed attachment mediated associations of antipathy with paranoid and schizotypal PD traits. Enmeshed attachment mediated associations of role reversal with paranoid and schizotypal PD traits.
  
  
  CONCLUSIONS
  Attachment theory can inform lifespan models of how adverse developmental environments may increase the risk for psychosis. Insecure attachment provides a promising mechanism for understanding the development of schizophrenia-spectrum phenomenology and may offer a useful target for prophylactic intervention.
authors.affiliation: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: Sheinbaum
authors.affiliation: Department of Psychology, Middlesex University, London, United Kingdom.
authors.forename: Antonia
authors.initials: A
authors.lastname: Bifulco
authors.affiliation: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Ballespí
authors.affiliation: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Mitjavila
authors.affiliation: Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States of America.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kwapil
authors.affiliation: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States of America; Sant Pere Claver-Fundació Sanitària, Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Barrantes-Vidal
mesh_terms: D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D054541:Family Conflict; D005260:Female; D006801:Humans; D008297:Male; D009769:Object Attachment; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult