Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) as a measure of treatment effectiveness in an outpatient training clinic.

This study evaluated the validity of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER), a system that identifies target problems and monitors treatment outcomes. Pre- and posttreatment data were obtained from 78 clients and their therapists in an outpatient training clinic. CASPER scales were significantly correlated with the Brief Symptom Inventory (BSI) and with therapist ratings on the Global Assessment Scale (GAS) at both intake and posttreatment. These measures also showed significant pre- to posttreatment changes. The largest effect sizes were found on CASPER individualized outcome measures. Residual change scores and posttreatment improvement ratings derived from CASPER were significantly correlated with BSI and GAS change scores. There was moderate agreement between clients' and therapists' ratings; clients tended to rate their functioning higher than did therapists on several CASPER scales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of attachment styles on romantic relationships.

Examined the impact of secure, anxious, and avoidant attachment styles on romantic relationships in a longitudinal study involving 144 dating couples. For both men and women, the secure attachment style was associated with greater relationship interdependence, commitment, trust, and satisfaction than were the anxious or avoidant attachment styles. The anxious and avoidant styles were associated with less frequent positive emotions and more frequent negative emotions in the relationship, whereas the reverse was true of the secure style. 6-mo follow-up interviews revealed that, among those individuals who disbanded, avoidant men experienced significantly less post-dissolution emotional distress than did other people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in male partner abuser attachment styles in group treatment.

This study examined attachment pattern change of partner violent men over the course of 17 weeks of integrated cognitive-behavioral/psychodynamic group treatment. Results indicated a significant increase in the number of men reporting a secure attachment from pre- to posttreatment. Subsequent analysis indicated that secure-changed men reported significant increases in comfort with closeness and depending on others from pre- to posttreatment. From pre- to posttreatment, insecure and secure-unchanged men reported an increase in avoidance of closeness. Additionally, secure-changed men reported lower anxiety and depression than insecure men at posttreatment. Finally, the total sample reported significant reductions in partner violence from pre to posttreatment. Based on these results, it would be important for clinicians and researchers to distinguish between men who changed to a secure attachment pattern over the course of treatment and securely attached men who remained unchanged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in attachment anxiety is associated with improved depression among women with binge eating disorder.

The study examined if the relationship between change in attachment insecurity and target symptom outcomes was moderated by treatment type. Women (N = 66) with binge eating disorder (BED) were randomly assigned to two treatment types: group cognitive-behavioral therapy (GCBT) or group psychodynamic-interpersonal psychotherapy (GPIP). Results indicated significant positive pre- to posttreatment changes in all attachment insecurity scales, but no difference between GCBT and GPIP on these changes. Change in attachment anxiety was related to improved depression for women completing GPIP, but not for women completing GCBT. This indicated a moderating effect of treatment type in explaining the relationship between change in attachment anxiety and improved depression. Changes in attachment anxiety may be important for symptom outcomes related to psychodynamic-interpersonal therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality processes reflected in client vocal style and Rorschach performance.

Proposed vocal style as a useful variable with which to classify groups of clients in order to study the differential effects of various therapeutic maneuvers. Relationships between voice quality ratings in early psychotherapy interviews and pretherapy Rorschach and MMPI scores were investigated in order to explore the nature and generality of this variable. For 52 clients in time-limited, client-centered psychotherapy, significant relationships were found between 3 of the vocal styles and Rorschach variables developed to measure qualities commonly observed in creative individuals. Vocal styles were substantially unrelated to MMPI scores. Implications for differential prognosis are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult attachment styles: Their relations to family context and personality.

This study used a sample of 304 adults to examine mean differences in family climate and personality variables on the basis of individuals' attachment styles. Also examined was whether mean differences varied by age group. Findings showed significant main effects of attachment style, but no Attachment Style X Age Group interactions. Compared with adults with an insecure attachment style, persons with a secure attachment style described their family of origin and their current family more positively and scored higher on personality variables indicative of self-confidence, psychological well-being, and functioning in the social world. When the family climate and personality variables were included in a discriminant function analysis, 2 significant functions were obtained. The 1st function discriminated adults with a positive self-model from those with a negative self-model. The 2nd function contrasted participants with a positive other-model from those with a negative other-model. Thus, this study provided evidence in support of the self- and other-models as the fundamental dimensions of adults' attachment system. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Client attachment style and the psychotherapist's interpersonal stance.

Attachment style is proposed as an important client variable that psychotherapists may need to assess in order to tailor their interpersonal stance in psychotherapy. The authors draw on J. Bowlby's (1969, 1973, 1978) attachment theory and describe the therapeutic implications of 3 adult attachment styles: Anxious/Ambivalent, Avoidant, and Secure. Results are summarized from a psychotherapy research program, including the finding that attachment style was related to symptomatology and to therapists' perceptions of the therapeutic alliance. Case illustrations of clients displaying the 3 types of attachment style are presented to illustrate how therapists can productively alter their interpersonal stance to enhance treatment outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How do I love thee? Let me count the ways: Parenting during adolescence, attachment styles, and romantic narratives in emerging adulthood.

In this longitudinal study, a quantitative and qualitative examination of the associations among parent–child relations, adult attachment styles, and relationship quality and theme in romantic narratives was conducted. Parenting and adult attachment style were assessed through questionnaires, whereas overall quality of romantic relationships (regard and importance), intimacy, and romantic story theme were examined with a life story approach (McAdams, 1993). At ages 17 and 26 years, 100 participants completed a series of questionnaires and also, at age 26, told a story about a “relationship-defining moment” with a romantic partner. Parent–child relations when participants were 17 years old were related predictably to all three attachment styles. About 70% of the sample told romantic stories with a “true love” type of theme. Associations between parent–child relations when the child was 17 and this type of theme in the story told when the participant was 26 were mediated by a more secure (and a less avoidant) attachment style when the participant was 26, as predicted. The implications of these findings for links between attachment models and the life story are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Attachment style and relationship satisfaction: Test of a self-disclosure explanation.

[Correction Notice: An erratum for this article was reported in Vol 30(2) of Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement (see record 2009-19933-001). Some figures were inadvertently omitted in two tables. The correct tables are provided in the erratum.] Explored a self-disclosure explanation for why those with a secure attachment style report greater relationship satisfaction than those with insecure attachment styles. Ss were 99 17–36 yr old students who were in ongoing relationships and who had different attachment styles. Ss were compared in terms of the self-disclosures they directed toward their partner vs a stranger, using questionnaire and behavioural measures. Behavioural self-disclosure was assessed by having Ss give talks on different topics, while anticipating that either their current partner or an opposite-sex stranger would later hear it. Results show that Ss with a secure attachment style disclosed more intimately to their partners than to strangers; whereas those with insecure attachment styles did not. Moreover, secures disclosed more personal facts to their partners than to strangers and were also perceived as more comfortable while self-disclosing to partners than to strangers. Finally, support for the hypothesis that self-disclosure mediates the relation between attachment style and relationship satisfaction was found on one component of self-disclosure, facilitative disclosure, a component which included both reported self-disclosure to one's partner and self-rated ability to elicit disclosure from others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal attachment: Experiencing, expressing, and coping with stress.

From a sample of 1,157 prescreened individuals, a sample of 193 participants with clearly identifiable attachment styles completed a stress narrative, a measure of coping styles, and a measure of emotional distress. Results of the 4 (attachment style: secure, fearful, preoccupied, and dismissing)?×?2(gender) study provided general support for predictions. Compared with severe attachment, for example, preoccupied attachment was associated with higher levels of intrusive psychological symptoms and higher levels of overall psychological distress, although specific predictions concerning characteristic styles of coping received mixed support. The nature and limitations of these findings are discussed in relation to contemporary issues in attachment theory, research, and measurement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The real relationship in psychotherapy: Relationships to adult attachments, working alliance, transference, and therapy outcome.

The purpose of this study was to understand how the real relationship (RR) relates to important process and outcome variables from both the clients’ and therapists’ perspectives. Using a sample of 31 therapist/client dyads at a university counseling center, the authors examined the RR at the 3rd session of therapy and at termination. The results revealed that client adult attachment avoidance was negatively correlated with client RR, while client adult attachment anxiety was uncorrelated. Therapists’ ratings of negative transference were negatively correlated with therapist-rated RR and were uncorrelated with client-rated RR. Hierarchical linear modeling analyses were conducted to predict postintervention outcome from client and therapist perceptions of the RR. Therapists’ ratings of the RR accounted for a significant amount of variance in client posttreatment symptoms while controlling pretreatment symptoms. Client-rated RR total scores and client and therapist 3rd-session alliance scores were not significant predictors of postsymptom ratings. Implications of the usefulness of measuring the RR in psychotherapy are discussed, as are recommendations for future study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary on Dinger et al.: Therapist’s attachment, interpersonal problems and alliance development over time in inpatient psychotherapy.

This short article is a commentary on a research study investigating therapist and client attachment styles and their relationship to alliance development in a 12-week psychodynamic psychotherapy program for nonpsychotic inpatients. The relationship is complex; unsurprisingly, securely attached therapists with less distressed clients formed the strongest alliances. A significant proportion of therapists were insecure, almost entirely in the preoccupied or hyperactivating mode. It is argued that collusive relationships between such therapists and similarly overaroused clients may be common. Therapists need both to accommodate to their client’s attachment style and to confound it if positive change is to result. Therapist self-scrutiny is likely to be a precondition for such positive outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder.

Changes in attachment organization and reflective function (RF) were assessed as putative mechanisms of change in 1 of 3 year-long psychotherapy treatments for patients with borderline personality disorder (BPD). Ninety patients reliably diagnosed with BPD were randomized to transference-focused psychotherapy (TFP), dialectical behavior therapy, or a modified psychodynamic supportive psychotherapy. Attachment organization was assessed with the Adult Attachment Interview and the RF coding scale. After 12 months of treatment, participants showed a significant increase in the number classified secure with respect to attachment state of mind for TFP but not for the other 2 treatments. Significant changes in narrative coherence and RF were found as a function of treatment, with TFP showing increases in both constructs during treatment. No changes in resolution of loss or trauma were observed across treatments. Findings suggest that 1 year of intensive TFP can increase patients' narrative coherence and RF. Future research should establish the relationship between these 2 constructs and relevant psychopathology, identify treatment components responsible for effecting these changes, and examine the long-term outcome of these changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Attachment style and relationship satisfaction: Test of a self-disclosure explanation": Erratum.

Reports an error in "Attachment style and relationship satisfaction: Test of a self-disclosure explanation" by J. Patrick R. Keelan, Karen K. Dion and Kenneth L. Dion (Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 1998[Jan], Vol 30[1], 24-35). Some figures were inadvertently omitted in two tables. The correct tables are provided in the erratum. (The following abstract of the original article appeared in record 1998-01141-003.) Explored a self-disclosure explanation for why those with a secure attachment style report greater relationship satisfaction than those with insecure attachment styles. Ss were 99 17–36 yr old students who were in ongoing relationships and who had different attachment styles. Ss were compared in terms of the self-disclosures they directed toward their partner vs a stranger, using questionnaire and behavioural measures. Behavioural self-disclosure was assessed by having Ss give talks on different topics, while anticipating that either their current partner or an opposite-sex stranger would later hear it. Results show that Ss with a secure attachment style disclosed more intimately to their partners than to strangers; whereas those with insecure attachment styles did not. Moreover, secures disclosed more personal facts to their partners than to strangers and were also perceived as more comfortable while self-disclosing to partners than to strangers. Finally, support for the hypothesis that self-disclosure mediates the relation between attachment style and relationship satisfaction was found on one component of self-disclosure, facilitative disclosure, a component which included both reported self-disclosure to one's partner and self-rated ability to elicit disclosure from others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment style as a predictor of behavior in group counseling with preadolescents.

This study investigated the role that attachment style plays in preadolescent behavior in group counseling. The study population consisted of 77 preadolescents referred to counseling services in their schools in Israel. They were treated in 11 small counseling groups led by novice counselors. Variables included self-disclosure, client behavior in therapy, and responsiveness to other group members--all assessed based on transcribed sessions. Participants also completed attachment questionnaires. The analyses were performed with hierarchical modeling (mixed) nesting individuals within groups. Results indicated differences on all dependent variables among the three attachment styles: secure, preoccupied, and avoidant. Secure adolescents showed the highest rates of self-disclosure, productive client behavior, and responsiveness to others, whereas avoidant participants showed the lowest scores on all measures. Gender, age, and group size showed little effect. The discussion focuses on implications for group therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of adult attachment styles on the association between marital adjustment and depressive symptoms.

This study tested the hypothesis that attachment styles moderate the relationship between marital adjustment and depressive symptoms among husbands and wives. In a sample of 91 married couples, ratings of the anxious-ambivalent attachment style moderated the relationship between marital adjustment and depressive symptoms for both husbands and wives. Additionally, ratings of the secure attachment style moderated the relationship between marital adjustment and depressive symptoms for wives, with a trend for husbands. These findings suggest a relationship between insecurity and a predisposition to depressive symptoms in marital relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The moderating effects of attachment style on students' experience of a transition to university group facilitation program.

This study investigated how attachment style predicted first-year students' responses to a transition to university group facilitation program. Participants (N = 148) at three universities were randomly assigned to a control or facilitation group. Each group consisted of on average six first-year students and two facilitators who met weekly for nine weeks at the beginning of the first semester to discuss issues relevant to the transition to university. Attachment styles (preoccupied, secure, dismissing, and fearful), feelings toward group experiences, and adjustment were assessed by questionnaire at the end of the program in November and again in March. Results indicated that, as hypothesised, dismissing style scores were generally negatively correlated with student attendance and feelings toward the group. Secure style ratings tended to be positively correlated with reports of group feelings. Adjustment measures collected in March indicated a potential buffering effect of the facilitation program for the preoccupied students in that the preoccupied students in the control group indicated more depression and loneliness, plus poorer adjustment to university, than the preoccupied students in the intervention groups. However, all other styles, including the dismissing style, did not show differences between intervention and control groups on subsequent adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How do people with different attachment styles balance work and family? A personality perspective on work–family linkage.

This study explored whether different models of work–family relationship were possible for individuals with different attachment styles. A mail survey was conducted using employees (N?=?481) at a midwestern university in the United States. Results suggested that (a) individuals with a preoccupied attachment pattern were more likely to experience negative spillover from the family/home to the work domain than those with a secure or dismissing style, (b) securely attached individuals experienced positive spillover in both work and family domains more than those in the other groups, and (c) preoccupied individuals were much less likely to use a segmentation strategy than the other 3 attachment groups. However, when the conventional job satisfaction–life satisfaction relationship was examined, the data provided unique support for the spillover model. Implications of the findings for both attachment and work–family relationship literatures are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult attachment styles and group psychotherapy attitudes.

The current study examined the relationship between 63 intake clients’ and 28 college student’s attachment styles and their attitudes of group psychotherapy. The authors examined the relationship between attachment anxiety and avoidance and the subscales of the Group Therapy Survey-R (Carter, Mitchell, & Krautheim, 2001). Results revealed a significant relationship between attachment avoidance in adult romantic relationships and increased fears of being vulnerable in group psychotherapy. As hypothesized, avoidance in romantic relationships was related to fears of shame and humiliation in group therapy. Contrary to predictions, clients’ anxiety ratings were negatively related to negative myths of group psychotherapy. The greater the clients rated fears of being rejected and abandoned, the less they rated negative myths about group treatment. Neither attachment anxiety nor avoidance was related to ratings of group therapy efficacy. Implications of the findings for future research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Romantic love conceptualized as an attachment process.

This article explores the possibility that romantic love is an attachment process—a biosocial process by which affectional bonds are formed between adult lovers, just as affectional bonds are formed earlier in life between human infants and their parents. Key components of attachment theory, developed by Bowlby, Ainsworth, and others to explain the develoment of affectional bonds in infancy, were translated into terms appropriate to adult romantic love. The translation centered on the three major styles of attachment in infancy—secure, avoidant, and anxious/ambivalent—and on the notion that continuity of relationship style is due in part to mental models (Bowlby's "inner working models") of self and social life. These models, and hence a person's attachment style, are seen as determined in part by childhood relationships with parents. Two questionnaire studies indicated that (a) relative prevalence of the three attachment styles is roughly the same in adulthood as in infancy, (b) the three kinds of adults differ predictably in the way they experience romantic love, and (c) attachment style is related in theoretically meaningful ways to mental models of self and social relationships and to relationship experiences with parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)