title: Attachment in psychosis: A latent profile analysis of attachment styles and association with symptoms in a large psychosis cohort.
abstract: Attachment has been identified as one of various possible mechanisms involved in understanding models of psychosis, but measures that reliably and validly assess attachment styles in psychosis are limited. The aim of this study was to identify attachment patterns in psychosis and examine demographic and clinical correlates across attachment groups. Latent profile analysis on attachment data from 588 participants who met criteria for non-affective psychosis was used to classify people into attachment classes. Four latent classes of attachment were identified: secure, insecure-anxious, insecure-avoidant and disorganised. Secure attachment was the most common attachment style, suggesting that a significant number of clients with psychosis are inherently resilient. Disorganised attachment was associated with a higher proportion of sexual and physical abuse and more severe positive symptoms compared to other attachment classes. This is not only the largest study to examine attachment styles, their demographic and clinical profile, and the clinical profile of disorganised attachment more specifically, in psychosis, but also the first study to use a validated self-report measure of attachment in psychosis to identify four classes of attachment style. Findings advance developmental models of attachment and psychosis; participants with disorganised attachment report more frequent trauma history and more severe psychotic symptoms.
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, 22nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom. Electronic address: sandra.bucci@manchester.ac.uk.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bucci
authors.affiliation: Division of Population Health, Health Services Research & Primary Care, Centre for Biostatistics, Institute of Population Health, The University of Manchester, 1.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, United Kingdom. Electronic address: richard.emsley@manchester.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Emsley
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, 22nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom.
authors.forename: Katherine
authors.initials: K
authors.lastname: Berry
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D011618:Psychotic Disorders / Q000523:psychology*; D006113:United Kingdom