Family Interventions (FI) are recommended in the treatment of psychosis. This is based on the robust finding that a high rating of Expressed Emotion (EE) is predictive of poor outcome. Research has looked to attachment and attribution theories to further develop our understanding of EE. This study sought to understand how the experience of FI helped family members to develop their thinking about their attachment experiences and the appraisals made about a relative, and how these discussions helped to inform their understanding about the interactional way in which difficulties could be maintained. Six master themes were identified: ‘the significance of the therapeutic relationship’, ‘understanding relationships with significant others’, ‘developing a sense of agency’, ‘making sense of psychosis/difficulties’, ‘exploring and understanding unhelpful patterns of interaction in the family’, and the ‘mechanisms of therapy that were helpful’. The FI was experienced as helpful in bringing about changes in the way family members construed each other and psychosis. This influenced patterns of relating which allowed for an emotional climate within the family that promoted a sense of agency and was experienced as healing.

The current research explores how adult attachment patterns present after an acquired brain injury (ABI) and possible associations with psychological distress, social isolation and health-related quality of life (HRQOL). It was hypothesised that attachment anxiety and attachment avoidance would explain additional variance in HRQOL and that this possible association would be mediated through psychological distress and social isolation. For this quantitative research a non-experimental, cross sectional cohort design was implemented. Forty individuals with ABI completed the Experiences in Close Relationships—Relationship Structures questionnaire, the Quality of Life in Brain Injury questionnaire, the EuroQol-5 Dimension Scale, the Hospital Depression and Anxiety Scale and the Friendship Scale. The results suggest that levels of attachment anxiety and attachment avoidance after an ABI are similar to those reported in healthy samples. Moreover, higher rates of attachment anxiety and attachment avoidance were associated with lower HRQOL, as well as increased levels of anxiety and social isolation. No association was found with depression. However, depression was shown to be the largest significant predictor of HRQOL after ABI (β = -.41, p < .005). Social isolation was also shown to predict HRQOL after ABI (β = .32, p < .05). Mediation analysis suggests that both attachment anxiety and attachment avoidance have an indirect relationship with HRQOL through social isolation, or through social isolation and psychological distress. It is concluded that adult attachment is an important theory to consider after ABI, due to its possible indirect relationship with HRQOL. These findings suggest that professionals should consider individuals' attachment patterns for treatment purposes and try to foster secure attachment patterns during rehabilitation.

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This study examined associations among romantic attachment anxiety and avoidance, positive and negative religious coping, and marital adjustment in a community sample of 81 heterosexual couples. Both spouses completed the Experiences in Close Relationships Scale (ECR), a brief measure of religious coping (Brief RCOPE), the Dyadic Adjustment Scale (DAS), and a demographic questionnaire as part of a larger study. Multilevel modeling (MLM) for the actor-partner interdependence model (APIM) was used. Attachment avoidance was inversely related to positive religious coping. In contrast, attachment anxiety was directly related to negative religious coping. Positive religious coping buffered the relationship between attachment avoidance and marital adjustment. In contrast, attachment anxiety was detrimental to marital adjustment regardless of positive religious coping, and positive religious coping was related to higher marital adjustment only in the context of low attachment anxiety. Surprisingly, the spouse's attachment anxiety was inversely related to the respondent's marital adjustment only when the respondent reported low levels of negative religious coping, whereas in the context of high negative religious coping, the partner's attachment anxiety was related to higher marital adjustment. Results support using attachment theory to conceptualize religious coping and the consideration of both attachment and religious coping constructs in counseling.

Abstract The aim of this study was to determine whether maternal sensitivity acts as a mediator in the associations between a mother‟s childhood history of care and her child‟s emotion regulation and attachment security at 2 ½ years of age. It was hypothesized that children of mothers who perceived their own childhood experiences with parents as caring and accepting would display more adaptive regulatory behaviors in fear-eliciting contexts and be more securely attached than children of mothers who recollected rejection in their own childhood experiences, with maternal sensitivity mediating these associations. Participants were 82 toddlers and their mothers. Mothers rated their childhood experiences of care and acceptance with their own parents prior to the laboratory procedure. Each child was presented with four novel stimuli, with mothers present, but not involved for the first two tasks and involved in the remaining two. Presentation of the novel stimuli was in pairs including one toy task (i.e., monster or robot) and one person task (i.e., clown or masks). Children‟s emotion regulation behaviors were coded continuously during the mother not involved condition, whereas observed maternal sensitivity was rated in the mother involved condition. Information about maternal sensitivity and children‟s attachment behaviors was reported by mothers using a diary technique. A path analysis was used to test the model examining the relationship between maternal history of care and sensitivity and children‟s attachment security and emotion regulation behaviors (i.e., distraction, withdrawal, contact with mother). Maternal sensitivity mediated the association between a mother‟s childhood history of care and acceptance and child attachment. Post-hoc analysis showed that this conditional indirect effect was significant only for children of mothers with less than a complete college education. In contrast, a childhood history of care and acceptance did not predict children‟s emotional regulation behaviors, although it interacted with education to predict distraction. Maternal sensitivity was associated positively with distraction and negatively with withdrawal, whereas children‟s attachment security was not associated with any emotion regulation behavior. Results are discussed in relation to attachment theory and continuities and discontinuities in the transmission process in mother-child relationships.

This dissertation explores the education of foster care children through the perspectives of classroom teachers. Numerous studies have found that foster youth experience depressed educational outcomes relative to their peers. A meta-analysis of such studies reported depressed educational outcomes in terms of standardized test scores, grade averages, retention rates, and suspension and expulsion rates (Scherr, 2007). Foster care is most often associated with maltreatment, which in turn has been linked to depressed educational outcomes (Runyan, 1985) and to insecure attachment (Howe, 1999). Attachment theory, which emphasizes the impact of relationships in early childhood on future relationships, informed this study. Purposeful sampling was used to identify classroom teachers in a rural Vermont high school that serves a large number of foster youth relative to its size. Participants were selected based on their high degree of experience with and perceived success in supporting students in foster care. In interviews, teachers were asked to describe distinguishing characteristics of foster youth as well as their relationships with peers and adults while at school. Teachers described several characteristics of foster youth, including the perceived impact of trauma on foster youth‟s ability to attend to school and school related tasks. Teachers also characterized intense relationships between foster youth and their peers, and between foster youth and adults at school. Participants also identified several strategies they believed to be effective in supporting this population, each of which emphasized the development of caring relationships between teachers and foster youth. Teachers shared concerns about the impact of frequent placement changes on the educational experiences of foster youth. Interviewees also noted that their support of foster youth was hampered by insufficient information about changes in students‟ status. Intersections between the characteristics of foster youth and selected literature on attachment theory and traumatic stress are explored in the interpretation of the findings. Finally, this study utilizes a feminist ethic of care to contextualize relationships between foster youth in schools and effective teacher strategies.

Expanding upon past research demonstrating that attachment orientation influences adult exploration, this thesis examined the impact of both actor and partner attachment anxiety and avoidance as well as real or imagined partner presence on outcomes of exploratory behavior (study 1a) and the desire to explore (study 1b). Eighty six couples were randomly assigned to explore (i.e., a meditation activity) with or without their partner in the lab, and to imagine exploring with or without their partner when rating their desire to complete potential exploratory behaviors. The effects of actor anxiety and avoidance on exploration were moderated by partner presence for both how long participants spent exploring and how they felt afterward. These are the first results demonstrating a direct effect of attachment and partner presence on exploration. These findings warrant future research to better understand the influence a partner can have on individuals’ exploration.

Background Within the context of developmental psychopathology and the psychological factors associated with the onset of severe mood instability, this thesis proposes that early attachment related interactions underlie the development of reflective functioning and effective emotional regulation necessary for optimal functioning. Both insecure attachment and poor reflective functioning have been linked to various mental disorders in which emotion dysregulation surfaces as a core feature. However, the underlying mechanisms by which these constructs interact to predict increased risk to develop bipolar disorder have yet to be considered. Objectives This project’s objectives were to investigate, through a quantitative cross sectional design, the following questions: 1) In what way are attachment, reflective function and emotion regulation associated with proneness to bipolar disorder? 2) Do reflective functioning, emotion regulation, depression and specific metacognitive patterns mediate the influence of attachment on increased likelihood of developing bipolar disorder? Method An online survey was used to ask 2325 participants to complete questionnaires measuring the variables of hypomanic traits, attachment relationship style, mood, emotion regulation, metacognitive patterns and reflective functioning. The survey was designed to give participants feedback immediately after entry completion, which proved to be a very successful recruitment strategy. For the analysis of the data, structural equation modeling (SEM), multivariate and univariate statistics were used. Results SEM analysis demonstrated that internal dysfunctional emotion regulation is the strongest predictor of bipolar disorder proneness, whilst anxious insecure attachment holds a strong direct relationship with internal dysfunctional emotion regulation not mediated by reflective functioning. Thus, anxious insecure attachment and reflective functioning emerged as indirect predictors to bipolar proneness, being fully mediated by internal dysfunctional emotion regulation strategies, depressive symptoms, perceived well being and negative metacognitive patterns. The use of dysfunctional emotion regulation strategies directly predicted low mood and indirectly predicted decreased well being and increased risk to develop bipolar disorder. Furthermore, in this sample the presence of hypomanic traits alone did not imply proneness to bipolar disorder, but it was the combination of hypomanic traits and depressive symptoms that best predicted increased likelihood of experiencing bipolar disorder. Discussion The results highlight the importance of investigating the underlying mechanisms of severe mood instability. The findings support the manic defense hypothesis, which suggests that manic symptoms emerge to offset underlying depressive mood. It was concluded that severe mood instability emerges and is maintained because of the influence of developmental interpersonal risk factors such as anxious insecure attachment. The latter fosters dysfunctional cognitive features that promote the use of maladaptive emotion regulation strategies, which in turn give rise to depressive mood, diminished well being and ultimately increased risk to develop bipolar disorder. Thus, to better understand and treat bipolar disorder it is important to focus on tackling these psychological aspects of the disorder.

What factors predict whether we perceive rejection from our heritage culture? Few studies have examined the antecedents and outcomes of intragroup marginalisation – perceived rejection due to not conforming to the expectations of one’s heritage culture – in spite of its implications for the psychological functioning of bicultural individuals. The broad aims of this thesis are twofold: to provide a holistic insight into the predictors of intragroup marginalisation and, in turn, to investigate its impact on psychological adjustment and functioning. The General Introduction reviews existing acculturation and marginalisation research and situates intragroup marginalisation within the Social Identity Theory framework. It is noted that previous research on the marginalised experiences of bicultural individuals has centred on either their choice of dis-identifying with their heritage culture, or being prevented from identifying with the heritage culture by the mainstream culture. The role of the heritage culture in-group in rejecting non-conforming members has largely been neglected. The predictors of this perceived rejection from one’s heritage culture were chosen because of their importance in shaping interpersonal interactions and goals: attachment orientations, selfconstrual, and conservation values. In addition, perceived cultural distance between the heritage and mainstream cultures was included as a factor which may heighten the tension between one’s cultural identities. To provide broad insight into the detrimental impact of intragroup marginalisation, outcome variables were chosen that represent general psychological functioning: psychological adjustment (conceptualised as acculturative stress, subjective well-being, and flourishing), an integrated bicultural identity, and extreme progroup behaviour. Study 1 found that anxious and avoidant attachment orientations were associated with greater intragroup marginalisation and, in turn, with lower psychological adjustment. Study 2 experimentally primed attachment representations; results further supported the link between chronic attachment orientations and decreased intragroup marginalisation. Study 3 further supported the link between attachment avoidance and anxiety and increased intragroup marginalisation. Furthermore, support was found for the indirect effects of avoidant attachment through intragroup marginalisation on greater endorsement of extreme pro-group behaviours. Study 4 increased the cognitive accessibility of independent and interdependent self-construals through a priming manipulation. Primed interdependent self-construal exerted a protective effect against the link between intragroup marginalisation and poor psychological adjustment and a conflicted bicultural identity, whilst primed independent self-construal was linked with increased intragroup marginalisation, and, in turn, decreased psychological adjustment. Study 5 indicated that valuing security and perceiving cultural distance decreased intragroup marginalisation, whilst valuing tradition marginally increased perceptions of intragroup marginalisation. Study 6 examined intragroup marginalisation experiences longitudinally. Results indicated that an increase in intragroup marginalisation from Time 1 to Time 2 was associated with an increase in acculturative stress. The General Discussion reviews the general findings, discusses implications for bicultural individuals, and sets further directions for research.