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Attachment Style and Insight in Schizophrenia: a Cross-Sectional Study

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Abstract

Attachment theory provides a model for understanding impairments in social and interpersonal functioning. Schizophrenia is a neuropsychiatry disorder frequently associated with compromised social functioning and limited social support networks. However, the relationship between attachment style and psychopathology dimensions, including insight, isn’t fully understood To determine whether there is a relationship between the attachment style and markers for severity of schizophrenia and insight. We conducted a cross-sectional study of 41 patients with schizophrenia and 34 patients with non-psychotic disorders used as a control group. Patients were assessed using semi-structured diagnostic interviews and self-reporting questionnaires, including Adult Attachment Scale-Revised. The schizophrenia group was also given the Positive and Negative Syndrome Scale and the Markova and Berrios Insight Scale. Insecure attachment was overrepresented in the schizophrenic group, and this difference was mainly accounted for lower levels of dependence, representing a moderate effect size (Cohen’s d = 0.32). In the schizophrenia group, the closeness and the dependence subscale were negatively correlated with psychopathology severity. Using a multiple regression analysis, the insight was predicted by attachment anxiety, accounting for 20% of the total variance (R2 = 0.199, p <0.05). Our data confirm previous evidence that insecure attachment is associated with schizophrenia and suggest that the less comfortable the patient is with closeness and intimacy the greater the severity of symptoms. Furthermore, our findings indicate that higher separation anxiety might predict a better insight.

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Authors and Affiliations

  1. Adult Psychiatry Department, Hospital de Magalhães Lemos, R. Prof. Álvaro Rodrigues, 4149-003, Porto, Portugal

    Gustavo França, Fabio Silva, Lília Monteiro, Ana Maria Moreira & Serafim Carvalho

  2. Center for Economics and Finance, Oporto University, Porto, Portugal

    Erika Laranjeira

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  1. Gustavo França
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Correspondence to Gustavo França.

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Gustavo França declares that he has no conflict of interest. Erika Laranjeira declares she has no conflict of interest. Fábio Silva declares that he has no conflict of interest. Lília Monteiro declares that she has no conflict of interest. Ana Moreira declares that she has no conflict of interest. Serafim Carvalho declares that he has no conflict of interest.

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França, G., Laranjeira, E., Silva, F. et al. Attachment Style and Insight in Schizophrenia: a Cross-Sectional Study. Psychiatr Q 91, 31–43 (2020). https://doi.org/10.1007/s11126-019-09675-8

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