Brandt, P.-Y.

Huguelet, P.

Lopes, F.

Mohr, S.

Rieben, I.

Serveur académique lausannois

Quality of Attachment in Psychosis and Spiritual FiguresIsabelle Rieben1  PhD, Philippe Huguelet2 MD, Francesco Lopes3 MSc, Sylvia Mohr2  PhD, Pierre-Yves Brandt4 PhD1 : Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, 2 : Department of Psychiatry, University Hospitals of Geneva ; 3 : Faculty of Psychology and Educational Sciences, University of Geneva ; 4 : Faculty of Theology and Religious Studies, University of Lausanne .POPULATION 28 outpatients with chronic psychosis, The Psychiatric Consultation Service, des Eaux-Vives, Geneva, Switzerland (20 males and 8 females) ; Age  (M=41.61, SD = 10.05)18 controls (snow-ball method), regions of Geneva and Lausanne, Switzerland) (10 males and 7 females).  Age (M = 41.28, SD = 12.01). All participants reported that their religious beliefs and practices are important for them.Christians Muslims Jews Buddhists WithoutPatients 19 4 2 1 2Controls 13 1 - - 4.              MEASURES • AAI :   Adult Attachment Interview (George, Kaplan, & Main 1986 ; Main, Goldwyn & Hesse,2003; French version by Blaise Pierrehumbert) ; coding by F. Lopes.• SCID :  Structured clinical interview for DSM-IV Axis I Disorders (First et al. 1997 ; patient andnon-patient French versions) : diagnostic evaluation.• BPRS : Brief psychiatric rating scale (Lukoff et al. 1986 ; French version) : symptomaticevaluation only with the patients subgroup.• Semi-structured interview on religious beliefs, practices and spiritual figures (following the AAIstructure, elaborated  by I. Rieben).Secure Avoidant PreoccupiedPatient 6 21% 19 68% 3 11%Controls 13 72% 3 17% 2 11%Generalpopulation*339 58% 140 24% 105 18%THEORETICAL FRAMEWORKAttachment theory provides a framework necessary for conceptualizing the role of social cognition, interpersonal experience and regulation of affect in the development of both interpersonal functioning and psychological distress. Importance of religion/spirituality for persons suffering from schizophreniaReligion/spirituality is important for patients with psychosis to cope with their disease in daily life (60% patients in Geneva, 73% in Québec). Geneva’s four public psychiatric ambulatory facilities (Mohr et al., 2006), n=115Trois-Rivières, Quebec, outpatients from the Assertive Community Treatment program (Borras et al., 2010), n=121. Religious attachmentIn an evolutionary perspective, previous studies on religious attachment (Kirkpatrick 1997, 1998, 1999; Granqvist, 1998; Granqvist et al 1999, 2007, 2010) suggested the adaptive value of religious commitment. According to this approach, there are two general hypotheses: The correspondence hypothesis states that securely attachment to primary caregivers could be transposed on  a spiritual figure. The compensation hypothesis suggests that the relationship to God can compensate for deficient primary caregiver.OBJECTIVESUsing the "Adult Attachment Interview" to study attachment styles in patients with chronic psychosis. No study to date has assessed attachment in this population with such instruments. Given the fact that there are no data about religious attachment in a population of people suffering from psychosis, the present study aims to investigate this population and the role of religion and spirituality to cope with their disease. Research questionIs attachment to spiritual figures a good explanation for coping strategies in patients with psychosis?RESULTS1. Attachment styles in patients with psychosisResults revealed a high prevalence of insecure avoidant attachment in patients with psychosis. The distribution of different attachment styles in the control group is quite similar to that in the general population (ajusted chi-square : 2.11 ; p=0.35) while the difference is highly significant between the patient group and the general population(chi-square = 29.72 ; p=0.00000035). * Distribution of attachment styles in a large non-clinical sample (Van IJzendoorn & Bakermans-Kranenburg 1996). 2. Traumatic experiences in infancy                  DISCUSSIONAttachment to spiritual figures is a good explanation for the religious coping strategies in 64% of the patients and 78% of controls. Among the 32 participants for whom attachment to a spiritual figure is important, the compensation hypothesis  is certainly verified for 7 (5 patients and 2 controls) of them : 4 preoccupied and 3 avoidant. These participants have replaced an insecure attachment with the primary caregivers figure by a secure attachment with a spiritual figure. Transposing on a spiritual figure the same model of attachment than the model built with the first caregivers (pattern secure/secure) can also be interpreted as adaptive if it was a secure one (n=13).The fact that insecure/insecure correspondence is observed mainly in patients probably explains why studies on religious attachment, conducted exclusively with a non-clinical population, have missed this type of correspondence. These results invite to consider insecure attachment not as an inferior attachment, but simply as another style of attachment.RESULTS3. Intersection of attachment to the spiritual figure and attachment to the primary attachment figure   REFERENCESBorras, L., Mohr, S., Gillièron, C., Brandt, P.-Y., Rieben, I., Leclerc, C. & Huguelet, P. (2010). Religion and spirituality: How clinicians in Quebec and Geneva cope with the issue when faced with patients suffering from chronic psychosis, Community Mental Health Journal, 46, 77-86.First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.W. (1997). Structured Clinical Interview for DSM-IV-TR Axis I Disorders - Patient Edition (SCID-I/P, 2/2001 revision). Washington D.C.: American Psychiatric Press.Georges, C., Kaplan, N., Main, M. (1996). Adult Attachment Interview Protocol, 3rd edition. (Unpublished manuscript). Berkeley: University of California.Granqvist, P. (1998). Religiousness and perceived childhood attachment: On the question of compensation or correspondence. Journal for the Scientific Study of Religion, 37, 350-367.Granqvist, P. (2010). Religion as attachment: the Godin Prize lecture. Archive for the Psychology of Religion, 32, 5-24.Granqvist, P., & Hagekull, B. (1999). Religiousness and perceived childhood attachment: Profiling socialized correspondence and emotional compensation. Journal for the Scientific Study of Religion, 38, 254-273.Granqvist, P., Ivarsson, T., Broberg, A.G., & Hagekull, B. (2007). Examining relations between attachment, religiosity, and New Age spirituality using the Adult Attachment Interview. Developmental Psychology, 43, 590-60Kirkpatrick, L. A. (1997) A longitudinal study of changes in religious belief and behavior as a function of individual differences in adult attachment style, Journal for the Scientific Study of Religion, 36, 207-217.Kirkpatrick, L. A. (1998). God as a substitute attachment figure: A longitudinal study of adult attachment style and religious change in college students. Personality and Social Psychology Bulletin, 24, 961 – 973.Kirkpatrick L.A. (1999). Attachment and religious representations and behavior. In J. Cassidy & P. R. Shaver (Eds.),. Handbook of attachment: Theory, research, and clinical applications (pp.803-822). New-York: Guilford Press.Lukoff, D., Nuechterlein, K.H., Ventura, J. (1986). Appendix A. Manual for Expanded Brief Psychiatric Rating Scale (BPRS), Schizophrenia Bulletin, 12, 594–602.Main, M., Goldwyn, R., & Hesse, E. (2003). Adult attachment scoring and classification system, Version 7.2. Unpublished manuscript, University of California at Berkeley.Mohr, S., Brandt, P.-Y., Borras, L., Gillièron C., & Huguelet, P. (2006). Toward an integration of spirituality and religiousness into the psychosocial dimension of schizophrenia, The American Journal of Psychiatry, 163, 1952-1959.Rieben, I. (2012). Qualité de l’attachement dans la psychose et figures spirituelles. PhD dissertation, University of Lausanne. Open-access: http://serval.unil.ch?id=serval:BIB_4CB51B148384Van IJzendoorn, M.H., & Bakermans-Kranenburg, M.J. (1996). Attachment representations in mothers, fathers, adolescents, and clinical groups: A meta-analytic search for normative data. Journal of Consulting and Clinical Psychology, 64, 8-21.          Attachement to the spiritual figurePatients (AAI) Controls (AAI)Secure Avoidant Preoccupied Total Secure Avoidant Preoccupied TotalSecure 3 2 3 8 (29%) 10 1 1 12 (67%)Avoidant - 5 - 5 (18%) - - - -Preoccupied 1 4 - 5 (18%) 2 - - 2 (11%)No spiritual figure2 8 - 10 (35%) 1 2 1 4 (22%)6 19 3 18 13 3 2 18Figure: Difference of the mean of symptoms measured by the BPRS in patients with a secure attachment (n = 6) and the those with an insecure attachment (n = 22) out of 28 patientsThe present figure shows that symptoms such as anxiety: T(28) = 4.18, p<0.001, depression : T(28) = 3.00, p<0.01, suspiciousness : T(28) = 4.11, p<0.001, and unusual though content: T (28) = 2.30, p < 0.05 were significantly lower in patients with a secure attachment model. (snow-ball method), regions of Geneva and Lausanne, Switzerland) (10 males and 7 females).  Age (M = 41.28, SD = 12.01). All participants reported that their religious beliefs and practices are important for them.AKNOWLEDGEMENT       This study was supported by grant CR13I1_124772  from the Swiss National Science Foundation 

Quality of Attachment in Psychosis and Spiritual Figures

https://serval.unil.ch/resource/serval:BIB_FD68802639A7.P001/REF.pdf

Quality of Attachment in Psychosis and Spiritual Figures

Abstract

Similar works

Full text

Available Versions

Serveur académique lausannois