There is evidence that functions related to attachment may play an important role in the etiology and maintenance of eating disorders, particularly anorexia and bulimia nervosa (Kuipers & Bekker, 2012; Tasca & Balfour, 2014). However, there is little research available on attachment functioning in those with binge-eating disorder (BED). This dissertation consists of three studies that examine the role of attachment states of mind and attachment dimensions in understanding BED and co-morbid overweight, and to examine mechanisms related to group treatment response for those with BED. The first study assessed attachment state of mind classifications (i.e., attachment categories) to understand better: 1) the psychopathology and maintenance of BED and co-morbid overweight, and 2) the treatment response of women with BED who receive Group Psychodynamic Interpersonal Psychotherapy (GPIP; Tasca, Mikail, & Hewitt, 2005). Overweight women with BED (subsequently referred to as women with BED), overweight women without BED, and normal weight women without BED completed the Adult Attachment Interview (AAI; Main, Goldwyn, & Hesse, 2002). Those with BED completed the AAI pre- and six months post- GPIP and those without BED completed the AAI at one-time point. Women with BED have significantly higher rates of insecure (preoccupied) and unresolved/disorganized attachment states of mind compared to normal weight women without BED. Women with BED had similar rates of insecure and unresolved/disorganized attachment states of mind as overweight women without BED. With respect to treatment completers, changes in attachment states of mind were not statistically significant. However, follow-up analyses indicated clinically meaningful changes which are discussed in the study. The second study used attachment dimensions of coherence of mind and reflective functioning (measured using the AAI) to add to our understanding of the psychopathology and maintenance of BED and co-morbid overweight. Higher Reflective Functioning scores differentiated normal weight women from both women with BED and overweight women without BED, and the latter two groups did not differ from each other. Coherence of Mind scores did not differentiate the groups. The third study used attachment dimensions of coherence of mind and reflective functioning to understand better group psychotherapy response for those with BED who received GPIP. Greater reflective functioning at pre-treatment was associated with a decline in binge eating frequency at 12 months post-treatment. Pre-treatment levels of coherence of mind was not related to group treatment outcomes. Reflective Functioning scores significantly improved from pre- to six months post-treatment. Further, more than 39% of participants demonstrated clinically reliable improvement and almost 32% experienced clinically reliable recovery with respect to reflective functioning. These results were moderated by pre-treatment self-reported attachment anxiety. That is, those with lower attachment anxiety showed significant improvement in reflective functioning, whereas those with higher attachment anxiety did not show this improvement. A third of participants experienced clinically significant improvement in coherence of mind, but this change was not statistically significant. Overall, attachment dimensions and attachment state of mind classification contribute to our understanding of the etiology and maintenance of BED and co-morbid overweight, as well as to our understanding of the group treatment response of those with BED. Addressing attachment insecurity and low reflective functioning in those with BED may improve treatment outcomes.

M.A. / The purpose of this study is to illustrate the psychotherapeutic use of Attachment Theory. Attachment Theory is an interpersonal theory which refers to the way an individual internalises an emotional-cognitive model of his relationships with his various attachment figures. These models of ways of relating are reflected in the way an individual speaks. The methodology of the study entailed conducting the semi-structured Adult Attachment Interview to elicit a psychotherapy client's narrative about his attachment relationships. A discourse analysis technique was then conducted to analyse the client's mode of speaking. In the context of the psychotherapy relationship the client showed a capacity for greater integration of previously dissociated thoughts and was able to gain some emotional relief in talking about his attachment relationships. Furthermore, Attachment Theory with its sensitivity to discourse can be seen to provide a useful framework for therapeutic practise.

The marriage and family literature has identified a host of factors that contribute to a satisfactory marital union. For example, research on religious congruency has indicated that the more similar partners are in their religious beliefs the higher their reported marital satisfaction. Another construct studied in conjunction with marital satisfaction is adult attachment style. The attachment literature has consistently shown that secure couples tend to report higher marital satisfaction than couples with at least one insecure partner. The purpose of this study was to examine the combined role of religious commitment and attachment in marital satisfaction. Heterosexual couples (N = 184; 92 husbands, 92 wives) without children and married 1-5 years were administered a background information questionnaire, the Religious Commitment Inventory-10, the Dyadic Adjustment Scale, and the Experiences in Close Relationships Inventory. Results indicated that couples with congruent religious commitment reported higher marital satisfaction than couples with large discrepancies in religious commitment. Religious commitment did not mediate the relationship between attachment and marital satisfaction, but instead was found to moderate this relationship. Results of this study will benefit clinicians working in the field to help newly married couples negotiate the marital relationship.

Two hundred twenty individuals participated in the present study from a university population. The study examined the relationship among attachment styles to caregivers, relationship with God, depressive symptomology, and depressive experiences. Attachment theorists have suggested a connection between childhood attachment to caregivers and current attachment to God through the idea that individuals have "working models" that form how they interpret present relationships. For the most part, the results of the current study supported the idea of correspondence between attachment to caregiver and attachment to God. Individual attachment styles to caregivers matched their attachment style to God. However, when caregiver religiousness was included as a moderating variable, results supported the theory of combined compensation-correspondence for those with insecure attachments to caregivers. Individuals with insecure attachment to caregivers were more likely to compensate for their insecure attachment bonds through participation in religious activity, whereas their internal, private relationship with God corresponded with their previous insecure attachment bonds. Individuals with insecure attachment to caregivers were more likely to endorse symptoms of depression and report introjective, but not anaclitic, depressive experiences. With respect to attachment to God, introjective depressive experiences were positively related to both anxious and avoidant attachments, whereas, anaclitic depressive experiences were positively related only to anxious attachment to God. Anxious attachment to God was found to partially mediate the relationship between insecure attachment to caregivers and depression symptoms. Finally, attachment effects were similar across gender, ethnicity, and age, with some notable exceptions.

Posttraumatic growth, defined as positive psychological changes in the aftermath of adversity and suffering, is a relatively recent focus in psychological research. The addition of this concept to the literature has provided a new, more resiliency-based framework through which to view survivors of various forms of trauma. Despite estimates that over half of all sexual assaults are not reported to the authorities, current crime statistics indicate that 1 in 4 women are sexually assaulted in their lifetime (Campbell & Wasco, 2005). Given the large percentage of the population that is impacted by sexual assault, it is essential that professionals better understand the factors that influence the successful healing and growth that can occur post-trauma. The purpose of this study was to further expand the literature on posttraumatic growth in sexual assault survivors by considering this phenomenon through the lens of attachment theory. Specifically, this study tested a proposed model of the inter-relationships among subjective and objective perceptions of threat during the sexual assault, adult romantic attachment, and posttraumatic growth. It was hypothesized that adult romantic attachment and parent-child attachment would mediate the relationship between subjective, or perceived threat, defined as the victim's perception of life threat, and objective threat, defined as the severity of the sexually aggressive act perpetrated on the victim, and posttraumatic growth. Finally, it was hypothesized that subjective threat appraisal would better predict posttraumatic growth than objective threat appraisal. Contrary to hypotheses, results of the study indicated that adult romantic attachment and parent-child attachment did not mediate the relationship between subjective and objective threat appraisal and posttraumatic growth. Thus, both path analytic models were not viable. However, exploratory analysis indicated that both subjective and objective threat appraisal were directly related to posttraumatic growth, with subjective perceived threat appraisal accounting for more of the variance.

This study explored participants' experiences of being interviewed with the Adult Attachment Interview as a means of supporting counselor self-awareness and fostering effective counselor-client working alliances. A sample of first-year counselor education doctoral students (n = 7) completed an AAI interview and feedback session. Participants completed five reflective journals over three weeks and explored their experiences in individual, semi-structured interviews. Data were analyzed according to interpretative phenomenological analysis protocol. Four superordinate themes emerged from the analysis: (a) reactions to the AAI interview process, (b) process with AAI feedback, (c) AAI and intrapersonal process, and (d) AAI and interpersonal process. Additionally, there were eight subordinate themes: (a) surprised by AAI interview process, (b) interview process sparked reflection, (c) initial reaction to AAI feedback, (d) evolving process of integrating AAI feedback, (e) AAI process increased awareness, (f) increased self-awareness increased self-efficacy, (g) awareness from AAI process prompted relational shifts, (h) impact of AAI on clinical work, (i) importance of relationships, (j) importance of self-awareness, and (k) mutual influence of personal and professional. Findings in this study suggest that the AAI is an effective tool in supporting counselor self-awareness regarding attachment strategies. Additionally, findings suggest multiple personal and professional benefits, such as increased awareness of conflict and stress management strategies. Limitations to the study and further discussion of the results are presented. Implications for clinical practice, counselor education, and future research are also included.

The purpose of this study was to determine the extent to which insecure attachment formation and the laissez-faire of authoritarian parenting style predict violent or general delinquent behaviors in preadolescent youths. The present study analyzes archival data from the first wave of a longitudinal study on delinquent behaviors. Two hundred six male and female sixth grade students were surveyed. A correlation design was used to determine predictors of violent and general delinquent behaviors among these preadolescent youths. Regression analysis was used to determine which predictor offered the best explanation of violent and delinquent behavior. It was found that for boys and girls, insecure attachment was indeed significantly correlated with violent and general delinquent behaviors. However, parenting styles was not at all correlated with those behaviors in boys. Conversely, for girls, regression analysis indicated that the Laissez-faire parenting style was a more significant predictor of violent and general delinquent behaviors. These findings are important in that they may be used to help design programs to abate the rising tide of delinquency and violence among preadolescent youths. The results of this study indicate the need for parental involvment in such programs.

Close interpersonal relationships are the foundation of human society. The goal in this study was to investigate the relationships between forgiveness (self and others) and the two dimensions of attachment (anxiety and avoidance).

<p>Black Americans living in rural regions of the U.S. are an underserved and under-researched population in the mental health field. Health and wellness disparities in Black populations are consistently documented as far worse than in White populations. Yet, the effects of low density of Black people living in predominantly White rural communities is unknown to mental health professionals and researchers alike. This study aimed to fill gaps in the literature concerning effects of Black density and city population on community attachment, place attachment, and subjective well-being, as well as community and place attachment’s effects on subjective well-being. Using a secondary dataset titled Soul of the Community [in 26 Knight Foundation Communities in the United States] (Gallup International, Inc., 2009), it was discovered that Black density alone had no significant relationships with any other variables, but the interaction of Black density and city population negatively predicted place attachment. In addition, community and place attachment both positively predicted subjective well-being. These results indicate that where people live matters and has a significant impact on their attachment to their physical surroundings. In addition, one’s connection to community and place are vital contributors to subjective well-being. Clinical implications can be drawn from this study pointing to the importance of clinical awareness regarding rurality, racial density, and community and place attachment. Moreover, clinicians can assess for these factors in the therapy room and encourage clients to explore their own communities.</p>

This study was designed to explore the cognitive-perceptual roots of attrition from substance abuse treatment. Previous research on interpersonal issues among substance abusers and attachment theory suggested areas for investigation: the perception of early parental care, current interpersonal functioning, and perception of the substance abuse treatment program.