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Changes in attachment styles and interpersonal problems after different forms of psychotherapy
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. (Psykiatriskt forskningscenrum, PFC)
Department of Psychology, Umeå university, SE-901 87 UMEÅ.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. (Psykiatriskt forskningscenrum, PFC)
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Attachment theorists and researchers have argued that psychotherapy may be an opportunity to revise insecure attachment styles, enabling more flexibility in interpersonal relationships. Attachment theory was developed to understand human reactions to life stressors, such as loss and separation. The term attachment style reflects a person’s most typical internal working models to seek proximity in relationships. This study examines whether self-reported attachment styles measured by the Attachment Style Questionnaire (ASQ) changed after a course of either cognitive behavioural (CBT) or psychodynamic oriented psychotherapy (PDT) in a clinical sample of psychotherapy patients (n= 111). One aim was to examine changes related to differences in gender, age, diagnoses, therapy method and number of sessions. Another aim was to examine whether changes correlated with changes in interpersonal problems measured by the Inventory of Interpersonal Problems (IIP). Results showed an increase in security in attachment styles that correlated with a decrease in interpersonal problems. No differences between therapy methods were found. The age group 26 to 39 reported greater security and less avoidance compared to patients over 40. Patients who attended between 11 and 25 sessions scored higher as regards security compared to those with 1-10 sessions but there was no difference for those with more than 25 sessions. The study supports results from a few other studies that psychotherapy increases the attachment-related security of patients. As an increase in security is associated with a decrease in interpersonal problems, attachment styles can be perceived as mediating factors in psychotherapy outcome irrespective of psychotherapy orientation.

Keywords [en]
Attachment styles, interpersonal problems, psychotherapy outcome, therapeutic alliance
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-34002OAI: oai:DiVA.org:oru-34002DiVA, id: diva2:699728
Available from: 2014-02-28 Created: 2014-02-28 Last updated: 2017-10-17Bibliographically approved
In thesis
1. Psychotherapy patients in mental health care:: attachment styles, interpersonal problems and therapy experiences
Open this publication in new window or tab >>Psychotherapy patients in mental health care:: attachment styles, interpersonal problems and therapy experiences
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Mona Wilhelmsson Göstas, School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden, mona.vilhelmsson gostas@orebroll.se Attachment styles are relevant to psychotherapy since they highlight the way a person handles interpersonal and emotional stress. This thesis aimed to examine how psychotherapy patients in the public mental health care system report attachment styles related to interpersonal problems and diagnosis before and after psychotherapy and to examine problems and changes and psychotherapy contract and process from patients’ experiences of cognitive behavioural oriented therapy (CBT) and psychodynamic oriented psychotherapy (PDT).

The studies are based on data from patients admitted to psychotherapy within the public psychiatric services in Örebro County Council. Studies I and IV were quantitative and used self-reports to examine attachment styles and interpersonal problems before and after psychotherapy. Studies II and III were qualitative interview studies examining patients experiences of problems, changes and psychotherapy process. The patients were diagnosed with mood disorders, anxiety disorders, adjustment disorders and personality disorders and reported insecure avoidant and anxious attachment styles that correlated positively with interpersonal problems when they started therapy. Psychotherapy with CBT or PDT enabled them to turn attachment styles into more secure ones and decrease interpersonal problems Patients aged between 26 and 39, patients who attended 11-25 sessions and patients diagnosed with a personality disorder reported greater changes in secure related attachment than others. Patients described their problems as emotions that could not be regulated, as cognitive disabilities and as problematic behaviours that implied a self-centredness. During the course of psychotherapy, the patients gained abilities to handle their problems. The perceived self-centeredness changed which increased their participation in their life-context.

Similarities across the therapy orientations showed that the creation of a new context was essential to pay full attention to the patient’s problems, and that the working method and cooperation with the psychotherapist made up a whole. To make the therapy effective, it is important to build up confidence in cooperation and secure base functions like offering predictability and shaping interventions according to the needs of the patient and their ability to use them.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2014. p. 91
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 103
Keywords
attachment styles, interpersonal problems, psychotherapy, psychiatric patients, qualitative analysis
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-33935 (URN)978-91-7529-014-0 (ISBN)
Public defence
2014-05-09, Hörsal C2, Campus USÖ, (Universitetssjukhuset), Södra Grev Rosengatan, 703 62 Örebro, 08:35 (Swedish)
Opponent
Supervisors
Available from: 2014-02-26 Created: 2014-02-26 Last updated: 2017-10-17Bibliographically approved

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Wilhelmsson Göstas, MonaEngström, IngemarKjellin, Lars

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