Does insecure attachment mediate the relationship between trauma and voice-hearing in psychosis?
This study extends existing research and theoretical developments by exploring the potential mediating role of insecure attachment within the relationship between trauma and voice-hearing. Fifty-five voice hearers with a psychosis-related diagnosis completed comprehensive assessments of childhood trauma, adult attachment, voice-related severity and distress, beliefs about voices and relationships with voices. Anxious attachment was significantly associated with the voice-hearing dimensions examined. More sophisticated analysis showed that anxious attachment mediated the relationship between childhood sexual and emotional abuse and voice-related severity and distress, voice-malevolence, voice-omnipotence, voice-resistance and hearer-dependence. Anxious attachment also mediated the relationship between childhood physical neglect and voice-related severity and distress and hearer-dependence. Furthermore, consistent with previous research, the relationship between anxious attachment and voice-related distress was mediated by voice-malevolence, voice-omnipotence and voice-resistance. We propose a model whereby anxious attachment mediates the well-established relationship between trauma and voice-hearing. In turn, negative beliefs about voices may mediate the association between anxious attachment and voice-related distress. Findings presented here highlight the need to assess and formulate the impact of attachment patterns upon the voice-hearing experience in psychosis and the potential to alleviate voice-related distress by fostering secure attachments to therapists or significant others.
School of Psychological Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom.
Marie
M
Pilton
School of Psychological Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom.
Sandra
S
Bucci
School of Psychological Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom.
James
J
McManus
School of Psychology, University of Sussex, United Kingdom; Department of Research and Development, Sussex Partnership NHS Foundation Trust, United Kingdom.
Mark
M
Hayward
Institute of Population and Health, University of Manchester, United Kingdom.
Richard
R
Emsley
School of Psychological Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom. Electronic address: katherine.berry@manchester.ac.uk.
Katherine
K
Berry
D000328:Adult; D000368:Aged; D005260:Female; D006212:Hallucinations / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D011618:Psychotic Disorders / Q000503:physiopathology*; D013067:Speech Perception / Q000502:physiology*; D055815:Young Adult
Attachment theory; Auditory hallucinations; Interpersonal theory; Voices