Pathways from insecure attachment to paranoia: the mediating role of emotion regulation
Pathways from insecure attachment to paranoia: the mediating role of emotion regulation
Background: paranoia is common across the clinical and non-clinical spectrum. Cognitive behavioural therapy for psychosis currently yields modest results, warranting research into symptom-specific maintenance factors to improve outcomes. There is strong evidence of a relationship between insecure attachment and increased paranoia, but little is known about the mediating mechanisms. Emotion dysregulation is associated with both insecure attachment and paranoia, and a candidate causal mechanism.
Aims: this study aimed to determine if emotion dysregulation mediates the association between attachment and paranoia.
Method: sixty-two individuals with elevated paranoia were recruited from NHS services and community settings across the South of England. Mediation analyses were conducted on trait attachment, emotion regulation and paranoia variables, which were collected at one time point.
Results: as predicted, emotion dysregulation mediated the relationship between attachment avoidance and paranoia, and between attachment anxiety and paranoia. Emotion suppression did not mediate the relationship between attachment avoidance and paranoia, possibly due to power. Attachment avoidance correlated with deactivating emotion regulation strategies (e.g. lack of emotional awareness) and attachment anxiety correlated with hyperactivating emotion regulation strategies (e.g. impulse control difficulties). Both deactivating and hyperactivating strategies correlated with paranoia.
Conclusion: emotion dysregulation is not routinely targeted in cognitive behavioural therapy for psychosis. This study suggests that incorporating emotion regulation strategies in therapy may improve clinical outcomes. Experimental studies are now required to support a causal argument, and pilot intervention studies should investigate if emotion regulation skills development (aligned with attachment style) is effective in reducing non-clinical and clinical paranoia.
affect regulation, attachment, emotion regulation, mediation, paranoia, psychosis
404-417
Partridge, Olivia, Josephine
e7fd8a4a-4931-4639-ab03-1f05c1dd8b0a
Maguire, Tessa
f720bf11-2227-470f-b9bf-b323a59e176c
Newman-Taylor, Katherine
e090b9da-6ede-45d5-8a56-2e86c2dafef7
July 2022
Partridge, Olivia, Josephine
e7fd8a4a-4931-4639-ab03-1f05c1dd8b0a
Maguire, Tessa
f720bf11-2227-470f-b9bf-b323a59e176c
Newman-Taylor, Katherine
e090b9da-6ede-45d5-8a56-2e86c2dafef7
Partridge, Olivia, Josephine, Maguire, Tessa and Newman-Taylor, Katherine
(2022)
Pathways from insecure attachment to paranoia: the mediating role of emotion regulation.
Behavioural and Cognitive Psychotherapy, 50 (4), .
(doi:10.1017/S1352465822000029).
Abstract
Background: paranoia is common across the clinical and non-clinical spectrum. Cognitive behavioural therapy for psychosis currently yields modest results, warranting research into symptom-specific maintenance factors to improve outcomes. There is strong evidence of a relationship between insecure attachment and increased paranoia, but little is known about the mediating mechanisms. Emotion dysregulation is associated with both insecure attachment and paranoia, and a candidate causal mechanism.
Aims: this study aimed to determine if emotion dysregulation mediates the association between attachment and paranoia.
Method: sixty-two individuals with elevated paranoia were recruited from NHS services and community settings across the South of England. Mediation analyses were conducted on trait attachment, emotion regulation and paranoia variables, which were collected at one time point.
Results: as predicted, emotion dysregulation mediated the relationship between attachment avoidance and paranoia, and between attachment anxiety and paranoia. Emotion suppression did not mediate the relationship between attachment avoidance and paranoia, possibly due to power. Attachment avoidance correlated with deactivating emotion regulation strategies (e.g. lack of emotional awareness) and attachment anxiety correlated with hyperactivating emotion regulation strategies (e.g. impulse control difficulties). Both deactivating and hyperactivating strategies correlated with paranoia.
Conclusion: emotion dysregulation is not routinely targeted in cognitive behavioural therapy for psychosis. This study suggests that incorporating emotion regulation strategies in therapy may improve clinical outcomes. Experimental studies are now required to support a causal argument, and pilot intervention studies should investigate if emotion regulation skills development (aligned with attachment style) is effective in reducing non-clinical and clinical paranoia.
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Attachment, Emotion Regulation, Paranoia - Revised Main Document - accepted ms
- Accepted Manuscript
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pathways-from-insecure-attachment-to-paranoia-the-mediating-role-of-emotion-regulation (1)
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More information
Accepted/In Press date: 9 December 2021
e-pub ahead of print date: 24 January 2022
Published date: July 2022
Additional Information:
Publisher Copyright:
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies.
Keywords:
affect regulation, attachment, emotion regulation, mediation, paranoia, psychosis
Identifiers
Local EPrints ID: 454087
URI: http://eprints.soton.ac.uk/id/eprint/454087
ISSN: 1352-4658
PURE UUID: 7a47bef4-997b-4041-ad30-35e7135aafe2
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Date deposited: 31 Jan 2022 17:32
Last modified: 17 Mar 2024 03:59
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Author:
Olivia, Josephine Partridge
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