Dr Katherine Newman-Taylor

2022

Background

Previous research suggests that there is a relationship between attachment and paranoia. Attachment refers to the bond between the patient and caregiver. A larger proportion of patients with psychosis have insecure attachments compared to the general population. Those with insecure attachments tend to experience uncertainty and fear in their relationships. Research suggests that an individual’s attachment style affects cognitive, emotional and behavioural processes. Effects on these processes may lead to the continuation of paranoia in patients with psychosis.

This research

We reviewed research that examines relevant cognitive, emotional and behavioural processes in detail. These may explain how attachment insecurity affects paranoia and why attachment insecurity is a target in interventions for people with psychosis. 

Some things mediate (have an effect on) the association between attachment insecurity in paranoia for people with psychosis. These include negative self-belief, not being able to defuse unhelpful cognitions and using maladaptive emotion regulation strategies. People with insecure attachments are less likely to ask for help, or engage with help than those with secure attachments. 

These could be addressed in therapy. For example, psychological therapies could help people with psychosis understand when thoughts may alter reality (cognitive fusion) and emotion regulation (responses to emotional experiences which seem to mediate the effect of attachment on psychosis). Furthermore, attachment styles impact how likely an individual is to seek help with psychosis and may influence paranoia. 

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More from Katherine

Hope, Agency & Opportunity measure of Recovery

The Hope, Agency and Opportunity (HAO) tool was developed jointly by researchers at the University of Southampton and people with lived experience of mental ill-health at the Southern Health NHS Recovery College. This aimed to develop a brief, reliable measure of personal and social recovery that can be used to assess people’s recovery, support collaborative care planning, and evaluate services.

The tool is freely available for any use that prioritises the principles and practice of recovery in mental health services.