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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Adult Attachment, Racial-Ethnic Identity, Racial-Ethnic Socialization, and Subjective Wellbeing

Toyama, Shiho 07 1900 (has links)
The current study aimed to explore the direct effect of insecure adult attachment on subjective wellbeing and its indirect effect via racial-ethnic identity. Additionally, the present study examined the extent to which racial-ethnic socialization practices may moderate adult attachment and racial-ethnic identity link. The final sample included 213 emerging adults (M = 20.94; SD = 2.96) with diverse racial-ethnic backgrounds. PROCESS Model 4 and 1 were used to examine the direct and indirect effect of insecure attachment on subjective wellbeing via racial-ethnic identity variables and the interaction effect between insecure attachment and racial-ethnic socialization on racial-ethnic identity variables. Results indicated the direct effect of insecure attachment on subjective wellbeing but did not support hypotheses for the indirect effect of insecure attachment on subjective wellbeing via the racial-ethnic identity variables. Additionally, results indicated that overt socialization buffered the negative impact of attachment avoidance on racial-ethnic identity exploration. Furthermore, racial-ethnic identity variables and subjective wellbeing significantly differed across racial-ethnic groups and socioeconomic statuses. Findings provide insight on the distinct concepts of attachment and racial-ethnic identity as they highlight inter- and intra-personal components, respectively. Mental health professionals may utilize overt socialization to help clients develop a sense of purpose and meaning related to their identity. Limitations, future research directions, and counseling implications are discussed.
32

Factors contributing to the long-term adjustment of college women abused as children

Augusto, Kerri Weise 06 June 2008 (has links)
The current study examines psychological correlates of childhood maltreatment, including adult attachment, attributional style, perceived family environment, and current social support and demonstrates their main effects and interactions for predicting long-term psychological distress. Further, this study expands upon past research by broadly defining childhood maltreatment to include sexual, physical, and psychological aspects of maltreatment. This perspective enables the examination of abuse main effects as well as the interactional effect of the various types of abuse. Three hundred and twenty college women completed the Family Experiences Survey, Conflict Tactics Scale, Childhood Maltreatment Interview - Revised, Social Support Questionnaire, Insecure Attachment Inventory, Bell Object Relations Reality Testing Inventory, Mental Health Inventory, and Brief Symptom Inventory. One hundred and twenty eight women reported a history of maltreatment. / Ph. D.
33

Socio-demography and Attachment-styles of Married and Cohabiting Individuals in a Representative Sample

Petrowski, Katja, Schurig, Susan, Schmutzer, Gabriele, Brähler, Elmar 10 October 2017 (has links) (PDF)
Cohabitation is becoming more prevalent in western society so that up to 7.5 million cohabiting couples were reported in the USA for the year 2010. The present study investigated whether the cohabitants’ attachment style might be one of the reasons for cohabitation gaining such popularity. Attachment styles as well as socio-demographic variables were compared in regard to the partnership status. A sample of 1,002 participants aged 18 to 60 were used as a representative sample (M = 43.5, SD = 10.9), of which 54% were female and 82% were married. The cohabitants were younger, more highly educated, and less frequently affiliated with a church. The cohabitants were more anxious-attached, especially those of a younger age. A one-point increase in value on the AAS anxiety scale almost doubled the possibility of cohabitation. Most of the variance can be explained by socio-demographic variables. However, based on these representative data, and after controlling for socio-demographic variables, attachment anxiety is still connected to cohabitation. The diverse results in the literature may be explained by differences in the socio-demographic characteristics of the sample.
34

Socio-demography and Attachment-styles of Married and Cohabiting Individuals in a Representative Sample

Petrowski, Katja, Schurig, Susan, Schmutzer, Gabriele, Brähler, Elmar 10 October 2017 (has links)
Cohabitation is becoming more prevalent in western society so that up to 7.5 million cohabiting couples were reported in the USA for the year 2010. The present study investigated whether the cohabitants’ attachment style might be one of the reasons for cohabitation gaining such popularity. Attachment styles as well as socio-demographic variables were compared in regard to the partnership status. A sample of 1,002 participants aged 18 to 60 were used as a representative sample (M = 43.5, SD = 10.9), of which 54% were female and 82% were married. The cohabitants were younger, more highly educated, and less frequently affiliated with a church. The cohabitants were more anxious-attached, especially those of a younger age. A one-point increase in value on the AAS anxiety scale almost doubled the possibility of cohabitation. Most of the variance can be explained by socio-demographic variables. However, based on these representative data, and after controlling for socio-demographic variables, attachment anxiety is still connected to cohabitation. The diverse results in the literature may be explained by differences in the socio-demographic characteristics of the sample.
35

Bindungsrepräsentation und Bindungsstil bei Patienten mit einer Panikstörung und/oder Agoraphobie sowie die Passung zum Therapeuten: Ein prädiktiver Wert für den Therapieerfolg?

Schurig, Susan 17 January 2024 (has links)
Hintergrund und Fragestellungen: Panikstörung und Agoraphobie zählen zu den verbreitetsten Angststörungen. Trotz leitliniengerechter Therapie profitieren ca. ein Drittel der Patienten nicht oder es kommt zu Rezidiven. Daher ist es umso wichtiger Faktoren zu finden, die einen Einfluss auf die Therapie haben und das Therapieergebnis vorhersagen könnten. Erkenntnisse der von John Bowlby entwickelten Bindungstheorie können hierbei genutzt werden. In der vorliegenden Arbeit wurde der prädiktive Einfluss von Bindungsmustern auf das Therapieoutcome bei Patienten mit der Primärdiagnose einer Panikstörung und/oder Agoraphobie untersucht. Aus bisherigen Studien ist bekannt, dass Patienten mit psychischen Störungen eine unsicherere Bindung haben als gesunde Kontrollprobanden. Zudem sollen bindungssichere Patienten besser von Psychotherapie profitieren. Allerdings gibt es auch Studien, die keine Zusammenhänge zwischen Bindungssicherheit und Therapieerfolg feststellten, so dass die Befunde insgesamt wenig eindeutig bleiben. Ursachen für diese widersprüchlichen Ergebnisse könnten sein, dass in den bisherigen Untersuchungen oft unterschiedliche Störungsbilder und die verschiedensten Therapieformen bzw. -settings vermischt sowie unterschiedliche Instrumente (Selbst- vs. Fremdeinschätzungsverfahren) zur Erfassung der Bindung genutzt wurden. Fraglich bleibt auch, ob der Einfluss der Bindung nur bei psychodynamischen Therapien zum Tragen kommt. Da der Goldstandard bei der Behandlung von Patienten mit Panikstörung bzw. Agoraphobie die Kognitive Verhaltenstherapie mit Fokus auf Konfrontationen ist, ist es umso wichtiger den Einfluss der Bindung bei dieser Therapieform zu untersuchen. Zudem zeigte sich, dass die Passung von Patient und Therapeut eine wichtige Rolle in der Therapie spielt. Allerdings ist die aktuelle Studienlage zur Passung hinsichtlich von Bindungsmerkmalen dürftig. Bisher wurden nur wenige Untersuchungen im tatsächlich klinisch-therapeutischen Kontext durchgeführt und es fehlen Studien, die den Einfluss der Bindungspassung auf die Symptomreduktion fokussieren. Die genannten methodischen Kritikpunkte bisheriger Studien wurden in der vorliegenden Dissertationsschrift berücksichtigt, um folgende Fragen zu beantworten: Unterscheiden sich Patienten mit einer Panikstörung und/oder Agoraphobie von gesunden Probanden mit vergleichbarem Alter, Geschlecht und Bildungsgrad hinsichtlich ihres Bindungsstils bzw. der Bindungsrepräsentation? Wie wirkt die durchgeführte, leitliniengerechte Therapie bei den Patienten kurz- und langfristig? Gibt es einen Zusammenhang zwischen dem Bindungsstil bzw. der Bindungsrepräsentation der Patienten und dem Therapieergebnis zum Therapieende, drei Monate bzw. ein Jahr nach Therapieende? Und welchen Einfluss hat die bindungsbezogene Patienten-Therapeuten-Passung auf das Therapieergebnis? Methoden: Es wurden 175 Patienten mit einer primären Panikstörung und/oder Agoraphobie sowie 143 gesunde Kontrollpersonen rekrutiert. Bei allen Probanden wurde mittels standardisierter Diagnostik das Vorliegen von Persönlichkeitsstörungen und verschiedenen anderen psychischen Störungen ausgeschlossen. Anschließend nahmen 103 Patienten die gleiche fünfwöchige Behandlung in der Angst-Tagesklinik der Klinik für Psychotherapie und Psychosomatik des Universitätsklinikums Dresden auf. Die behandelnden Therapeuten nahmen ebenfalls an der Untersuchung teil. Bei allen Probanden wurden die Bindungsrepräsentation (Fremdrating) mittels Adult Attachment Interview (AAI) sowie der Bindungsstil (Selbstbeurteilung) mittels Adult Attachment Scale und Bielefelder Fragebogen zu Partnerschaftserwartungen bzw. Klientenerwartungen erfasst. Zur Evaluation des Therapieergebnisses wurde zu Therapiebeginn (t1), Therapieende (t2) sowie zur 3-Monats- (t3) und 1-Jahreskatamnese (t4) die Depressionsschwere erhoben und die allgemeine psychische Belastung mittels des sogenannten GSI-Werts (global severity index) bestimmt. Außerdem wurde die angstspezifische Symptomatik mit verschiedenen Fragebögen zu körperbezogenen Ängsten, Kognitionen und agoraphober Vermeidung allein und in Begleitung erfasst. Ergebnisse: Erwartungskonform zeigten die Patienten sowohl bei den Selbstbeurteilungsinstrumenten als auch dem AAI eine unsicherere Bindung als die gesunden Kontrollprobanden. Die Unterschiede erreichten kleine Effekte bei der kategorialen Unterscheidung und kleine bis mittlere Effektstärken bei der Unterscheidung nach Bindungsskalen. Die Patienten zeigten im AAI vorrangig eine desorganisierte Bindungsrepräsentation, gefolgt von einer unsicher-distanzierten Bindung. Hypothesenkonform nahmen die Angstsymptomatik, die depressive sowie die allgemeine psychische Symptomatik zum Therapieende ab. Die Effektstärken lagen im mittleren bis hohen Bereich. Zudem blieben die Effekte in allen Therapieoutcomemaßen stabil bzw. verbesserten sich sogar zwischen Therapieende und 1-Jahreskatamnese. Zum Einfluss der Bindungsrepräsentation der Patienten auf das Therapieoutcome zeigten sich lediglich bei der agoraphoben Vermeidung zu den Katamnesezeitpunkten einzelne Trends, vorrangig für die AAI-Skala distanziert-verstrickt. Allerdings zeigten sich hypothesenkonforme Zusammenhänge zwischen einem unsichereren Bindungsstil (gekennzeichnet durch niedrige Öffnungsbereitschaft, hohe Akzeptanzprobleme und ein niedriges Zuwendungsbedürfnis) und einem höheren GSI-Wert zu t3. Darüber hinaus sagten höhere Akzeptanzprobleme und ein geringeres Zuwendungsbedürfnis eine stärkere agoraphobe Vermeidung allein zu t3 vorher. Höhere Akzeptanzprobleme gingen außerdem mit einer stärkeren Vermeidung in Begleitung zu t3 und t4 einher. Da am Ende der Untersuchung nur sieben Therapeuten in die Studie eingeschlossen wurden und diese zudem eine überwiegend sichere Bindung sowohl im AAI als auch in den Fragebögen zeigten, haben die Ergebnisse zur Patienten-Therapeuten-Passung rein explorativen Charakter. Für die AAI-Skala distanziert-verstrickt zeigten sich einige signifikante Zusammenhänge mit den Symptombereichen körperbezogene Ängste, Vermeidung und allgemeine psychische Belastung. Allerdings können diese lediglich als Trends bewertet werden, da die standardisierten Regressionsgewichte sehr gering ausfielen. Die Ergebnisse deuten darauf hin, dass eine verstricktere Bindung des Patienten in Kombination mit einem vermeidend gebundenen Therapeuten mit einem schlechteren Therapieoutcome einhergeht. Auch beim Bindungsstil zeigten sich lediglich Trends für die körperbezogenen Ängste und die agoraphobe Vermeidung allein: Je unähnlicher sich Patient und Therapeut hinsichtlich der Skala Akzeptanzprobleme waren, umso schlechter war das Therapieoutcome zur 3-Monats- bzw. 1-Jahreskatamnese. Zudem war die Vermeidung allein zur 3-Monatskatamnese umso höher, je unähnlicher sich beide hinsichtlich der Skala Zuwendungsbedürfnis waren. Schlussfolgerung: Zusammenfassend zeigte die Untersuchung, dass die Patienten eine unsicherere Bindung hatten als die gesunden Kontrollprobanden, die Therapie sehr gut gewirkt hat und dass der Bindungsstil der Patienten einen geringen prädiktiven Einfluss auf das Therapieoutcome hatte. Die Bindungsrepräsentation der Patienten zeigte dagegen keinen bedeutsamen Einfluss. Ebenso hatte die explorativ untersuchte bindungsbezogene Patient-Therapeuten-Passung kaum bedeutsame Vorhersagekraft für das Therapieergebnis. Eine höhere Symptomatik zu Therapiebeginn sagte dagegen bei allen Symptomschweremaßen ein schlechteres Therapieergebnis vorher. Die Bindungsmerkmale scheinen vorrangig beim agoraphoben Vermeidungsverhalten und erst zu den Katamnesezeitpunkten einen Einfluss zu haben. Dabei deuteten vor allem höhere Akzeptanzprobleme und eine verstrickte Bindungsrepräsentation auf ein schlechteres Therapieoutcome hin. Die Frage bezüglich des Einflusses der Passung konnte aufgrund der geringen Therapeuten-Stichprobe nur bedingt geklärt werden. Dennoch lohnt es sich, in diesem Hinblick weiter zu forschen und die vorliegenden Ergebnisse an einer größeren Stichprobe zu replizieren. Die gefundenen geringen Zusammenhänge hinsichtlich der AAI-Skala distanziert-verstrickt deuten darauf hin, dass die Passung möglicherweise erst bei der Kombination eines unsicher gebundenen Patienten mit einem unsicher gebundenen Therapeuten zum Tragen kommt. In zukünftigen Untersuchungen sollte sich daher vor allem auf die spezifischere Unterscheidung nach verstrickter bzw. distanzierter Bindung fokussiert werden.:Inhaltsverzeichnis I Abbildungsverzeichnis IV Tabellenverzeichnis V Abkürzungsverzeichnis VII 1 Einleitung 1 2 Theoretischer Hintergrund 4 2.1 Panikstörung und Agoraphobie 4 2.1.1 Leitsymptomatik 4 2.1.2 Epidemiologie und Verlauf 4 2.1.3 Ätiologie 6 2.1.4 Behandlung 10 2.2 Grundlagen der Bindungstheorie 12 2.2.1 Definition und Entwicklung von Bindung 12 2.2.2 Erfassung von Bindungsrepräsentationen und Bindungsstilen 13 2.3 Bindung und Angststörungen 18 2.4 Bindungsaspekte im Psychotherapieprozess 23 2.4.1 Therapeutische Beziehung als Bindungsbeziehung 23 2.4.2 Bindungsmerkmale der Patienten als Einflussfaktor 24 2.4.3 Bindungsmerkmale der Therapeuten als Einflussfaktor 26 2.4.4 Passung von Patient und Therapeut 27 2.5 Ziele der vorliegenden Arbeit 30 3 Fragestellungen und Hypothesen 33 4 Methoden 35 4.1 Studienbeschreibung 35 4.2 Ein- und Ausschlusskriterien 36 4.3 Studienablauf 40 4.4 Studiendesign der vorliegenden Arbeit 41 4.5 Ablauf der Therapie 42 4.6 Operationalisierung der Variablen 42 4.6.1 Diagnostik der Psychischen Störungen 44 4.6.2 Allgemeine psychische Symptomatik 45 4.6.3 Depressive Symptomatik 47 4.6.4 Angstspezifische Symptomatik 49 4.6.5 Bindung 51 4.6.5.1 Bindungsstil 51 4.6.5.2 Bindungsrepräsentation 55 4.7 Stichprobenbeschreibung 57 4.7.1 Gesamtstichproben der gesunden und erkrankten Probanden 58 4.7.2 Substichprobe der behandelten Patienten 62 4.7.3 Therapeuten 65 4.8 Analyse und Umgang mit fehlenden Werten 65 4.9 Statistisches Prozedere 68 4.9.1 Analyse der Bindungsunterschiede zwischen Patienten und Gesunden 68 4.9.2 Überprüfung der Therapiewirksamkeit 68 4.9.3 Vorüberlegungen zur Auswertung der dritten und vierten Fragestellung 69 4.9.4 Einfluss der Bindungsmerkmale der Patienten auf das Therapieergebnis 70 4.9.5 Einfluss der Patient-Therapeuten-Passung auf das Therapieergebnis 72 4.9.6 Signifikanz und Effektstärken 73 5 Ergebnisse 74 5.1 Bindungsunterschiede zwischen Patienten und Gesunden 74 5.2 Wirksamkeit der Therapie 77 5.3 Deskriptive Ergebnisse hinsichtlich der Bindung in der Therapie-Stichprobe 82 5.3.1 Patienten 82 5.3.2 Therapeuten 83 5.4 Einfluss der Bindungsmerkmale der Patienten auf das Therapieergebnis 84 5.4.1 Angstbezogene Kognitionen 84 5.4.2 Körperbezogene Ängste 85 5.4.3 Vermeidung 86 5.4.4 Allgemeine psychische Symptomatik 88 5.5 Einfluss der Patient-Therapeuten-Passung auf das Therapieergebnis 93 5.5.1 Angstbezogene Kognitionen 93 5.5.2 Körperbezogene Ängste 94 5.5.3 Vermeidung 94 5.5.4 Allgemeine psychische Symptomatik 95 6 Diskussion 97 6.1 Bindungsunterschiede zwischen Patienten und Gesunden 97 6.2 Wirksamkeit der Therapie 101 6.3 Einfluss der Bindungsmerkmale der Patienten auf das Therapieergebnis 103 6.4 Einfluss der Patient-Therapeuten-Passung auf das Therapieergebnis 108 6.5 Stärken und Limitierungen der Arbeit sowie Ausblick 112 6.6 Abschließende Bewertung 115 7 Zusammenfassung 116 8 Summary 119 9 Literaturverzeichnis 122 10 Anhang 140 10.1 Anhang A: Diagnostische Kriterien 141 10.2 Anhang B: Übersicht des Therapieablaufs in der Angst-Tagesklinik 144 10.3 Anhang C: Prüfung der Voraussetzungen 145 10.4 Anhang D: Weiterführende Berechnungen 149 11 Danksagung 156 12 Erklärungen zur Eröffnung des Promotionsverfahrens 158 13 Erklärung über die Einhaltung gesetzlicher Bestimmungen 159 / Background and Questions: Panic disorder and agoraphobia are among the most common anxiety disorders. Despite treatment according to guidelines, about one third of patients do not benefit from therapy or relapses occur. Therefore, it is all the more important to identify factors that might have an influence on the therapy and could predict therapy outcome. One of these factors might be derived from the findings based on the attachment theory developed by John Bowlby. In the present study we investigated the predictive influence of attachment patterns on therapy outcome in patients with panic disorder and/or agoraphobia (primary diagnosis). Results from previous studies suggest that patients with mental disorders have a less secure attachment than healthy control subjects. In addition, patients with a secure attachment showed a higher benefit from psychotherapy. However, there are also studies that did not find any correlation between attachment security and therapy outcome. Overall, the findings are ambiguous. Potential reasons for contradictory results regarding this matter could be that previous studies often mixed different disorders and varied in terms of type or setting of the therapy. Furthermore, different measures (self-assessment vs. third-party assessment) were used to assess attachment. It also remains questionable if the influence of attachment only shows in psychodynamic therapies. Since the gold standard in treating patients with panic disorder or agoraphobia is exposure-focused cognitive-behavioral therapy, it is all the more important to investigate the influence of attachment in this form of therapy. It has also been shown that the matching of patient and therapist plays an important role in therapy. However, there is only poor study evidence concerning the matching with regard to attachment. Up to now, only few studies have been conducted in an actual therapeutic context. There is a lack of studies focusing on the influence of attachment-related matching on symptom reduction. These methodological issues have been taken into account in this dissertation in order to answer the following questions: Do patients with a panic disorder and/or agoraphobia differ from healthy subjects of comparable age, gender and educational level with respect to their attachment style and/or attachment representation? How does guideline-adherent therapy affect the patients in the short and long term? Is there a correlation between the patients’ attachment style or attachment representation and therapy outcome at the end of therapy, 3 months or 1 year after end of therapy? How does attachment-related matching between patients and therapists influence therapy outcome? Methods: 175 patients with a panic disorder and/or agoraphobia (only primary diagnosis) and 143 healthy participants took part in the study. Using standardized diagnostics, subjects with personality disorders and various other mental disorders were excluded. Subsequently, 103 patients underwent standardized five-week treatment at the Day-Clinic for Anxiety Disorders of the Department of Psychotherapy and Psychosomatics at the University Hospital Dresden. The treating therapists also took part in the study. In all subjects, the attachment representation (external rating) was assessed with the Adult Attachment Interview (AAI). The attachment style (self-assessment) was measured with the Adult Attachment Scale and the Bielefeld Partnership Expectations Questionnaire, respectively the Bielefeld Client Expectations Questionnaire. Therapy outcome measures were the overall symptom distress, measured with the so-called Global Severity Index (GSI), and the severity of depression, each captured at therapy onset (t1), end of therapy (t2) and at a 3-month (t3) and 1-year follow-up (t4). In addition, anxiety-specific symptoms were assessed using various questionnaires on body-related anxieties, cognitions and agoraphobic avoidance behavior (alone and when accompanied). Results: In line with expectations, the patients showed a more insecure attachment than the healthy participants both in the self-assessment instruments and the AAI. The differences achieved small effect sizes in the categorical differentiation and small to medium effect sizes in the differentiation according to attachment scales. The patients primarily showed a disorganized, followed by an insecure-dismissing attachment representation in the AAI. In accordance with the hypothesis, the anxiety symptoms, the depressive and the overall symptom distress decreased towards end of therapy. Effect sizes ranged from medium to high. In addition, the effects remained stable in all therapy outcome measures and even improved in the time span between end of therapy and 1-year follow-up. Regarding the influence of the patients' attachment representation on therapy outcome, there were only some trends for the agoraphobic avoidance at the time of follow-up, mainly for the AAI scale dismissing-preoccupied. However, hypothesized correlations between an insecure attachment style (characterized by a low readiness for self-disclosure, high fear of rejection and a low need for care) and a higher GSI-score at t3 were found. Furthermore, higher fear of rejection and a lower need for care predicted a stronger agoraphobic avoidance alone at t3. Higher fear of rejection was also associated with greater avoidance when accompanied at t3 and t4. Only seven therapists, exhibiting a predominantly secure attachment in the AAI and the questionnaires, were included in the study. Hence, results for the attachment-related matching between patients and therapists are purely exploratory. For the AAI scale dismissing-preoccupied, significant correlations with the symptom domains body-related anxiety, avoidance and overall symptom distress were found. Standardized regression weights were very low, thus these results must still be interpreted only as trends. However, they might suggest that matching a more preoccupied patient with a more dismissing therapist is associated with a poorer therapy outcome. Also for the attachment style, only trends for body-related anxieties and the agoraphobic avoidance alone were found: dissimilarity between patient and therapist on the scale fear of rejection was associated with a poorer therapy outcome at t3 and t4. In addition, dissimilarity between patient and therapist with regard to the need for care scale was associated with higher avoidance alone at t3. Conclusion: Patients showed a more insecure attachment than healthy participants. The therapy had a beneficial effect on symptom severity and the patients’ attachment style had a low predictive influence on therapy outcome. In contrast, the patients’ attachment representation did not show a significant influence, and the exploratory analysis of the attachment-related matching between patient and therapists had very little predictive power regarding therapy outcome. Overall, the symptom severity at therapy onset played a major role in predicting the success of therapy for all symptom severity measures. The attachment characteristics seem to have an influence primarily on agoraphobic avoidance behavior at the time of follow-up. Higher fear of rejection and a more preoccupied attachment representation were associated with poorer therapy outcome. The question on whether attachment-related matching has an influence on therapy outcome remains elusive due to the small sample of therapists. Nevertheless, it is worthwhile to continue research in this regard and to replicate the present results on a larger sample. The small correlations found with regard to the AAI scale dismissing-preoccupied might indicate that matching may possibly only come into play if an insecurely attached patient is treated by an insecurely attached therapist. Future studies should therefore focus on a further differentiation between preoccupied and dismissing attachment.:Inhaltsverzeichnis I Abbildungsverzeichnis IV Tabellenverzeichnis V Abkürzungsverzeichnis VII 1 Einleitung 1 2 Theoretischer Hintergrund 4 2.1 Panikstörung und Agoraphobie 4 2.1.1 Leitsymptomatik 4 2.1.2 Epidemiologie und Verlauf 4 2.1.3 Ätiologie 6 2.1.4 Behandlung 10 2.2 Grundlagen der Bindungstheorie 12 2.2.1 Definition und Entwicklung von Bindung 12 2.2.2 Erfassung von Bindungsrepräsentationen und Bindungsstilen 13 2.3 Bindung und Angststörungen 18 2.4 Bindungsaspekte im Psychotherapieprozess 23 2.4.1 Therapeutische Beziehung als Bindungsbeziehung 23 2.4.2 Bindungsmerkmale der Patienten als Einflussfaktor 24 2.4.3 Bindungsmerkmale der Therapeuten als Einflussfaktor 26 2.4.4 Passung von Patient und Therapeut 27 2.5 Ziele der vorliegenden Arbeit 30 3 Fragestellungen und Hypothesen 33 4 Methoden 35 4.1 Studienbeschreibung 35 4.2 Ein- und Ausschlusskriterien 36 4.3 Studienablauf 40 4.4 Studiendesign der vorliegenden Arbeit 41 4.5 Ablauf der Therapie 42 4.6 Operationalisierung der Variablen 42 4.6.1 Diagnostik der Psychischen Störungen 44 4.6.2 Allgemeine psychische Symptomatik 45 4.6.3 Depressive Symptomatik 47 4.6.4 Angstspezifische Symptomatik 49 4.6.5 Bindung 51 4.6.5.1 Bindungsstil 51 4.6.5.2 Bindungsrepräsentation 55 4.7 Stichprobenbeschreibung 57 4.7.1 Gesamtstichproben der gesunden und erkrankten Probanden 58 4.7.2 Substichprobe der behandelten Patienten 62 4.7.3 Therapeuten 65 4.8 Analyse und Umgang mit fehlenden Werten 65 4.9 Statistisches Prozedere 68 4.9.1 Analyse der Bindungsunterschiede zwischen Patienten und Gesunden 68 4.9.2 Überprüfung der Therapiewirksamkeit 68 4.9.3 Vorüberlegungen zur Auswertung der dritten und vierten Fragestellung 69 4.9.4 Einfluss der Bindungsmerkmale der Patienten auf das Therapieergebnis 70 4.9.5 Einfluss der Patient-Therapeuten-Passung auf das Therapieergebnis 72 4.9.6 Signifikanz und Effektstärken 73 5 Ergebnisse 74 5.1 Bindungsunterschiede zwischen Patienten und Gesunden 74 5.2 Wirksamkeit der Therapie 77 5.3 Deskriptive Ergebnisse hinsichtlich der Bindung in der Therapie-Stichprobe 82 5.3.1 Patienten 82 5.3.2 Therapeuten 83 5.4 Einfluss der Bindungsmerkmale der Patienten auf das Therapieergebnis 84 5.4.1 Angstbezogene Kognitionen 84 5.4.2 Körperbezogene Ängste 85 5.4.3 Vermeidung 86 5.4.4 Allgemeine psychische Symptomatik 88 5.5 Einfluss der Patient-Therapeuten-Passung auf das Therapieergebnis 93 5.5.1 Angstbezogene Kognitionen 93 5.5.2 Körperbezogene Ängste 94 5.5.3 Vermeidung 94 5.5.4 Allgemeine psychische Symptomatik 95 6 Diskussion 97 6.1 Bindungsunterschiede zwischen Patienten und Gesunden 97 6.2 Wirksamkeit der Therapie 101 6.3 Einfluss der Bindungsmerkmale der Patienten auf das Therapieergebnis 103 6.4 Einfluss der Patient-Therapeuten-Passung auf das Therapieergebnis 108 6.5 Stärken und Limitierungen der Arbeit sowie Ausblick 112 6.6 Abschließende Bewertung 115 7 Zusammenfassung 116 8 Summary 119 9 Literaturverzeichnis 122 10 Anhang 140 10.1 Anhang A: Diagnostische Kriterien 141 10.2 Anhang B: Übersicht des Therapieablaufs in der Angst-Tagesklinik 144 10.3 Anhang C: Prüfung der Voraussetzungen 145 10.4 Anhang D: Weiterführende Berechnungen 149 11 Danksagung 156 12 Erklärungen zur Eröffnung des Promotionsverfahrens 158 13 Erklärung über die Einhaltung gesetzlicher Bestimmungen 159
36

Vuxen anknytning som prediktion av copingstrategier : En enkätstudie om vuxen anknytning och copingstrategier / Adult attachment as a predikton of copingstrategies : A survey study about adult attachment and copingstrategies

Wärme, Jesper January 2016 (has links)
En kvantitativ enkätstudie har genomförts med syfte att undersöka korrelationer och prediktioner mellan vuxen anknytning och copingstrategier. Urvalet till studien är 133 studenter från olika universitet och högskolor i Sverige som besvarade en enkät. För att mäta vuxen anknytning användes Experience in close relationship (ECR-R) och för att mäta copingstrategier användes Brief COPE. Insamlad data analyserades i SPSS med Pearsons korrelationskoefficient test och multipel regressionsanalys. Resultatet från föreliggande studie visade på ett negativt signifikant samband mellan ångestladdad anknytning och problemfokuserad coping. Resultatet visade även på ett negativt signifikant samband mellan undvikande anknytning och problemfokuserad coping. Resultatet visade på ett signifikant samband mellan ångestladdad anknytning och dysfunktionell coping. Resultatet visade även på ett signifikant samband mellan undvikande anknytning och dysfunktionell coping. Föreliggande studies resultat visade att det inte fanns något samband mellan ångestladdad anknytning och emotionsfokuserad coping. Resultatet från föreliggande studie visade även att det inte fanns något samband mellan undvikande anknytning och emotionsfokuserad coping. Resultatet visade på att ångestladdad anknytning var en signifikant prediktor av problemfokuserad coping där 15 % av variansen för problemfokuserad förklarades. Ångestladdad anknytning var en signifikant prediktor för dysfunktionell coping där 22 % av variansen förklarades. Slutsatserna är att studenter med ångestladdad och undvikande anknytning använder i lägre grad problemfokuserad coping. Studenter med ångestladdad och undvikande anknytning använder i högre grad dysfunktionella copingstrategier. Slutsatsen är även att andra variabler än vuxen anknytning påverkar användande av olika copingstrategier. / A quantitative survey study has been carried out to investigate possible correlations and predictions between adult attachment and coping strategies. The sample for the study was 133 students from various Universities and colleges in Sweden who answered a questionnaire. . To measure adult attachment this study used Experience in close relationship (ECR-R), and copingstrategies was measured by Brief COPE. Data collected were analyzed in SPSS using the Pearson correlationcoefficient test and multiple regression analysis. The results from the present study showed significant negative correlation between anxiety loaded attachment and problem focused coping. The results also showed a significant negative correlation between avoidance attachment and problem focused coping. The results from the present study showed a significant correlation between anxiety loaded attachment and dysfunctional coping. The results also showed a significant correlation between avoidance attachment and dysfunctional coping. The study results showed that there was no correlation between anxiety loaded attachment and emotion focused coping. The results also showed that there was no correlation between avoidance attachment and emotion focused coping. The result from the present study showed that anxiety loaded extension was a significant predictor of problem-focused coping where 15% of the variance of problem-focused was explained. Anxiety loaded attachment was a significant predictor of dysfunctional coping where 22% of the variance was explained. The conclusions are that students with anxiety loaded and avoidance attachment use lower grade of problem-focused coping. Students with anxiety and avoidance attachment uses increasingly dysfunctional coping strategies. It is concluded that variables other than adult attachment affects using various coping strategies.
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Distal and proximal relation factors, emotional capabilities and psychological health outcomes in substance users

Maka, Zoe January 2009 (has links)
This dissertation examined certain distal and proximal relational factors and emotional capabilities of individuals in therapeutic programs in Greece. The three studies aimed to extend existing work by examining links between distal (child abuse reports) and proximal (adult attachment, social support) relation factors with psychological health outcomes of substance users in addiction treatment programs. The results from the three studies supported the view that: a) distal (childhood maltreatment) and proximal (attachment organization) relational factors are important predictors of substance users’ well-being; b) proximal factors (anxious attachment) mediate effects of abusive experiences; c) emotional capabilities and specifically regulatory processes have a prominent role as mediators of relational factors on substance users’ well-being.
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Psychopathic Traits and Insecure Attachment Patterns in Community-based Subgroups

Carter, Rachel M. 08 1900 (has links)
There is a growing body of research on psychopathic traits in non-clinical populations. This emerging research has documented the prevalence of psychopathic traits in the general population and demonstrated that psychopathy has a similar latent structure as well as similar correlates (e.g., violent behavior, alcohol abuse, and lower intelligence) to forensic/offender samples. Relatedly, there is strong evidence insecure attachment patterns in adulthood are associated with many personality disorders, including psychopathy, but only a few studies have examined the relationship between attachment and psychopathic traits in non-clinical samples (albeit, convenience samples of college students). Thus, two aims of the current study are to: 1) describe and explore the manifestation and expression of psychopathic traits in a large, community-based sample and 2) examine associations between adult attachment disturbances and psychopathic traits in diverse sociodemographic subgroups. Using a cross-sectional design, results showed mean-level psychopathy factor score differences existed only when considering single sociodemographic factors (e.g., age), not an interaction of those factors. Psychopathy factor profiles were also consistent across groups, with higher levels of lifestyle followed by interpersonal, affective, and antisocial traits reported. Regarding the second aim, findings indicated support for the positive association between disturbed attachment patterns in adult relationships and psychopathic traits, although these associations differed in males and females of different age groups. Finally, there was some support for attachment processes acting as a social development pathway toward psychopathy, as insecure attachments in adulthood partially mediated the relationships between age and interpersonal, affective, and lifestyle traits of psychopathy.
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Shadows on the Cave Wall: The Cognitive Accuracy of Social Network Perception

Ouellette, David M. 30 July 2008 (has links)
How accurately people perceive interpersonal relationships, both among others and with themselves, forms the basis of social inferences about the structure of the social environment and one's place in it. Six hypotheses were tested using the cognitive social structures method from social network analysis with five independent but similar student networks from two universities. Results from all networks were meta-analyzed. Participants gave both their self-reported friendship ratings for every alter in their group and also gave their perceptions of the ratings the other member would give. Perception ratings were correlated to self-report ratings for each participant as a measure of accuracy of social network perception. Participants perceived more structural balance than was present in self-reports in four out of five networks and in the meta-analysis, providing evidence for the balance schema. Attachment anxiety correlated negatively with accuracy for one of the networks but was not statistically significant in the meta-analysis. Being located in a tightly-knit subgroup reduced overall network accuracy, consistent with the strength of weak ties (SWT) theory, in one network but not in the meta-analysis. In only one network did participants overestimated how central they were, though not significantly in the meta-analysis. Being more central in the social network was unrelated to accuracy, as was the mean social network distance between perceiver and targets. Results provide meta-analytic support for the balance schema and limited support for attachment, SWT, and egocentric bias in social network perception.
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The influence of neuroticism in the relation between stressful events and adult attachment / A influência do neuroticismo na relação entre eventos estressores e apego adulto

Teixeira, Rachel Coêlho Ripardo 28 August 2015 (has links)
Events in the life history of an individual such as childhood stressful events alter the strategies that guide behavior, specifically sexual strategies. Evolutionary Developmental Psychology suggests that development must be studied through the integration of various aspects, such as Attachment, Sexual strategies, and Personality. Important and stable part of psychology, personalitys factor Neuroticism reflects how people react to stress. Considering this, in the present thesis we analyzed the relationship between childhood stressful life events, neuroticism and adult attachment. We interviewed 173 people, 99 women and 74 men, aged from 18 to 45 years old (M= 29.51; SD= 7.3), that had a family income range from 1 to 3 Brazilian MW. We applied a Stressful Events Inventory, a Neuroticism Test, and an Attachment Scale. It was found an average of 16,59 of occurrence of stressful events (SD = 5.82). In addition to this high frequency, it was found that the greater the number of stressful events, the greater the perceived stress; and participants perceived the events as more stressful than expected. There were sex differences, with men experiencing more events related to violence and authority, and women, more events that are social. Women also tended to perceive all events as more stressful and to have higher Neuroticism. 42% of the sample had a secure attachment style, less than expected. Lastly, occurrence of stressful events, neuroticism, age, and income explained 46% of variance of this sample attachment style. A structural model analysis showed that neuroticism mediates the relationship between occurrence of stressful events and attachment, without the role of perception. This means that Neuroticism has a much larger role than previously credited, and its study in research on development can explain the high variation found when examining the relationship between childhood and adulthood / Eventos na história de vida de um indivíduo, tais como eventos estressores da infância alteraram as estratégias que orientam o comportamento, especificamente as estratégias sexuais. A Psicologia Evolucionista do Desenvolvimento sugere que o desenvolvimento deve ser estudado através da integração de vários aspectos, como apego, estratégias sexuais, e personalidade. Parte importante e estável da psicologia, o fator de personalidade Neuroticismo reflete como as pessoas reagem a eventos de vida. Considerando isso, na presente tese foi analisada a relação entre eventos estressores da infância, neuroticismo e apego adulto. Foram entrevistadas 173 pessoas, 99 mulheres e 74 homens, com idades entre 18 a 45 anos (M = 29,57; DP = 7,35), com renda familiar de 1 a 3 SM. Foi aplicado o Inventário de Percepção de Eventos Estressores, a Escala Fatorial de Neuroticismo, e a Escala de Estilo de Relacionamento. Foi encontrada uma média de 16,59 eventos estressores ocorridos (DP= 5,82). Além dessa alta frequência, encontrou-se que quanto maior o número de eventos estressores, maior foi o estresse percebido, e os participantes perceberam os eventos como mais estressantes do que o esperado. Houve diferenças sexuais, com homens relatando mais eventos ligados à violência e autoridade, e as mulheres, mais eventos sociais. Elas também tendiam a perceber todos os eventos como mais estressantes e a ter escores mais altos de Neuroticismo. 42% da amostra tinha um estilo de apego seguro, menos do que o esperado. Por fim, a ocorrência de eventos estressores, o neuroticismo, idade, e renda explicaram 46% da variância do estilo de apego desta amostra. Uma análise de modelo estrutural mostrou que o neuroticismo mediava a relação entre ocorrência de eventos estressores e apego. Isso significa que o Neuroticismo tem um papel muito maior do que o anteriormente creditado, e seu estudo em pesquisas com desenvolvimento pode explicar a alta variabilidade encontrada quando se examina as relações entre infância e vida adulta

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