An investigation of associations between attachment, dissociation, and psychotic type experiences

Abstract

Psychosis is characterized by several different symptoms, particularly auditory hallucinations and paranoia. These symptoms are recognized to occur across a continuum from healthy, non-clinical individuals to clinical populations. Research has begun to consider what psychological mechanisms may explain these symptoms and be targeted for treatment. Theory suggests early relational trauma leads to insecure attachment styles which predisposes dissociation and, which in turn, leads to psychotic symptoms. Insecure attachment styles and dissociation are associated with psychotic-type symptoms, but little research has considered them together in studies. Furthermore, limited experimental research has considered how they relate to each other and, in turn, to psychotic experiences. This thesis incorporates a systematic review investigating the role of attachment styles and dissociation in psychotic symptoms. A small number of studies examined the associations between these factors, several of which were unpublished, and nearly all taking a correlational approach. The main finding of this systematic review was that dissociation and psychotic symptoms are associated, with some evidence that dissociation served a mediating and possibly moderating role between both early trauma and insecure attachment styles and the development of psychotic symptoms. An experimental study aimed to test the proposed theoretical relationship between disorganized attachment, dissociation and auditory hallucinations using attachment imagery priming and to explore the possible benefits of secure imagery priming. One-hundred and twenty-eight individuals highly predisposed to auditory hallucinations were recruited online and randomized into two conditions and exposed to either secure or disorganized attachment imagery. This study hypothesized disorganized attachment imagery would increase dissociation and hallucinatory experiences, while secure imagery would decrease them. This study found dissociation increased across conditions, but auditory hallucinatory experiences did not increase as expected. Secure imagery priming decreased paranoia, suggesting that it may have clinical value in managing distress for people who hear voices.

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Identifiers

ORCID for Katherine Newman-Taylor: orcid.org/0000-0003-1579-7959

ORCID for Tim Minshull: orcid.org/0000-0002-8202-1379

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