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Previous literature has identified links between psychopathic trait severity and disturbed styles of attachment on sexual outcomes in adulthood. However, few studies have investigated these domains within one design. Therefore, it is unclear how they may influence each other, given that an association between attachment styles and psychopathic traits has also been previously documented. This study sought to explore the possible role of psychopathic traits upon the association between attachment and sexual outcomes. Participants were sampled from an undergraduate student population at a large university. Data were analyzed using correlational and hierarchical regression analyses, as well as two exploratory path models. Analyses suggested that aspects of attachment and psychopathic trait severity were significantly associated with each other and differentially predicted certain sexual outcomes. Furthermore, results indicated that the effects of attachment avoidance on sexual outcomes were mediated by Factor 1 traits of psychopathy, while the effects of attachment anxiety were mediated by Factor 2 traits. Additionally, it was found that attachment style was linked with contempt, and this was further linked to disturbances in sexual outcomes, which is a novel finding. Implications of the findings, limitations, and future directions are discussed.

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.

The process by which earned-secures achieve attachment security in adulthood, despite having insecure parent-child relationships in childhood, was the focus of the current study. As internal working models are thought to be formed within relationships, specifically primary attachment bonds (Bowlby, 1969), it was postulated that secondary attachment relationships, specifically those that were positive, had the capacity to revise insecure models of self and other. In the current study, the secondary attachment histories of undergraduates who were earned-secure and continuously-insecure, or insecurely attached since childhood, were compared. A new measure of secondary attachment quality was developed (Questionnaire About Secondary Attachment Figures (Q-SAF)), which was used to measure undergraduates' perceptions of their past and current secondary attachment figures. Findings indicated that in comparison to continuous-insecures, earned-secures perceived their negative secondary attachment figures in adolescence as less mean. Earned-secures also reported being less dependent upon these figures' approval of them for their self-worth and more secure within these relationships. In adulthood, earned-secures reported more trust and intimacy with their positive secondary attachment figures. Compared to continuous-insecures, earned-secures described their peers as being more empathic and altruistic during childhood and more warm during adolescence; earned-secures also reported less dependency and greater closeness with their peers throughout development. Grandparents were listed the most frequently by earned-secures as positive secondary attachment figures during childhood and this number was more than double that for continuous-insecures. Further, earned-secures described their grandparents in childhood as being more altruistic and they reported being less concerned with receiving their acceptance. Siblings from childhood were described by earned-secures as being more empathic than those of continuous-insecures, yet earned-secures also reported greater dismissing attachment to their siblings and cousins in childhood. Significant others from adolescence were rated by earned-secures as being less mean than those of continuous-insecures and earned-secures reported being more securely attached to these relationships in both adolescence and adulthood. Implications of the current study and directions for future research are presented.

Lilja, A. & Topilina, G. “Att jobba manualstyrt kräver en god kompetens”. En intervjustudie om Intervju om anknytningsstil i Sverige. Examensarbete i socialt arbete 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, institutionen för socialt arbete, 2019. Standardiserade bedömningsmetoder är en del av socialarbetares vardag. Enligt Socialstyrelsen ökar intresset för att använda standardiserade metoder och ett evidensbaserat arbetssätt inom socialt arbete i Sverige. Samtidigt finns bristfällig information om vilka metoder som anses vara evidensbaserade och vilka som inte är det. Denna studie fokuserar på Intervju om anknytningsstil (IAS) - en standardiserad bedömningsmetod som syftar till att kartlägga och mäta kvalitet på klientens nära relationer. IAS saknar enligt Socialstyrelsen evidens och utvärdering men används i barn- och familjehemsutredningar. Syftet med studien är att ur ett organisationsteoretiskt perspektiv undersöka hur socialarbetare använder IAS i det praktiska sociala arbetet med fokus på de yrkesverksammas uppfattning av metoden och metodens roll i arbetsprocessen. Studien syftar även till att undersöka vilken tilltro socialarbetare har till metoden och resultatet samt om metoden har någon påverkan på kontakten med klienten. För att uppfylla studiens syften har sju socialarbetare intervjuats som använder IAS i sitt arbete. Studiens resultat visar att trots metodens standardiserade utformning skiljer sig användandet både gällande syfte och utförande. Informanterna har skilda uppfattningar om vilka slutsatser som kan dras av IAS och hur metoden påverkar relationen till klienten. De flesta respondenter betvivlar att IAS är knuten till forskning och uttrycker att metoden inte är tillräckligt effektiv och tidsenlig. Samtidigt ser flera av informanterna tydliga fördelar med att använda IAS i sitt arbete. / Lilja, A. & Topilina, G. “You Need to Be Very Competent to Use the Standardised Methods”. An Interview Study of Adult Attachment Interview in Sweden. Degree project in Social Work. 15 högskolepoäng. Malmö University: Faculty of Health and Society, Department of Social Work, 2019. Standardized assessment methods are part of the everyday lives of social workers. According to Socialstyrelsen, the interest in using standardized methods and an evidence-based approach in social work in Sweden is increasing. At the same time there is insufficient information about which methods are considered to be evidence-based and which are not. This study focuses on Attachment Style Interview (ASI) - a standardized assessment method that aims to map out and measure the quality of the client's close relationships. According to Socialstyrelsen, ASI is lacking in both evidence and evaluation, yet is used in home assessments where children are concerned. The purpose of the study is to investigate, from an organizational theoretical perspective, how social workers use ASI in their practical work, focusing on the perception of professionals regarding the method and the role of the method within the work process itself. The study also aims to investigate what trust social workers have regarding the method and its results, and whether the method has any influence over/on the contact with the client. To fulfill the aims of the study seven social workers currently using ASI in their daily work have been interviewed. The results of the study show that, despite the standardized design of the method, the use differs both in terms of purpose and design. The informants have different opinions about what conclusions can be drawn from the ASI, and how the method affects the relationship with the client. Most respondents doubt that the ASI is linked to research, and state that the method is not sufficiently effective nor contemporary. Nevertheless, several of the informants agree on clear advantages in using ASI in their work.

Although the overall quantity of international research has increased, existent studies tend to adopt an instrument developed in one culture to use in the other, leading to measurement bias. In addition, previous cross-cultural research mainly focuses on comparisons between collectivist and individualistic backgrounds (e.g., American vs. Chinese) without considering the similarities and differences within the collectivist societies (e.g., China vs. Mexico). This dissertation project has two purposes, with Study 1 aiming to examine measurement equivalence of two widely used instruments while Study 2 investigating if an attachment-based two-serial mediation model remained constant among three cross-cultural samples collected from the US, Mexico, and China. A total of 1211 participants, including 360 American university students, 441 Mexican students, and 410 Chinese students participated in the study. Differential item functioning (DIF) in lordif package in R and structural equation modeling (SEM) in Mplus 8.1 were adopted for Study 1 and 2, respectively. The results of Study 1 indicated the proposed instruments were culturally invariant in English, Spanish, and Chinese with some modifications. Study 2 showed that assertiveness/self-conscious emotions mediated the association between adult attachment and depression/aggression only in the US group. However, the two-serial mediation model in which the link between adult attachment and depression/aggression via assertiveness to self-conscious emotions was supported in Mexican and Chinese groups, not in the US group. Findings from these two cross-cultural adult attachment studies provide additional insights for future attachment research and useful implications for psychologists working with diverse individuals from the US, Mexico, and China.

Intimate partner violence (IPV) is a well-recognized public health issue with significant consequences for victims, families, communities, and society at large. Although IPV was once thought to be an almost exclusively male-to-female problem, in recent years it has become more widely understood that IPV also occurs in the context of women’s LGBTQ+ relationships. LGBTQ+ individuals experience ongoing stress because they live in a heterosexist society, termed minority stress, which has been associated with many negative sequelae including attachment insecurity and IPV. Thus, it is pertinent to examine how one’s context, specifically minority stress caused by oppression, may uniquely influence IPV in women LGBTQ+ couples. A sample of 64 LGBTQ+ identified women currently in same-gender relationships filled out self-report questionnaires on minority stress, attachment style, and IPV. Contrary to expectations, it was determined that two types of minority stress, internalized homophobia and experiences of discrimination and heterosexism, were not associated with physical or psychological IPV. However, internalized homophobia was significantly associated with attachment avoidance, but not attachment anxiety. Both attachment anxiety and avoidance were significantly associated with psychological, but not physical, IPV. Mediation analysis revealed an inconsistent significant mediation for the effect of internalized homophobia on psychological IPV; this occurs when the mediator acts as a suppressor variable or a variable that masks any direct effect of the independent variable on the dependent variable. In the current study, the overall indirect effect of internalized homophobia on psychological IPV through attachment avoidance and anxiety was significant. The direct effect of internalized homophobia on psychological IPV was significant but the association was negative, such that once attachment (the suppressor variable) was included in the model, lower internalized homophobia was associated with greater psychological IPV. Overall, internalized homophobia uniquely contributed to attachment insecurity, particularly attachment avoidance, which is a significant risk factor for IPV in women’s same-gender relationships The global COVID-19 pandemic onset occurred before data collection commenced, thus questions were added to measure related changes in psychological symptoms, relationship stress, and IPV related to the pandemic. Psychological symptoms including sadness, loneliness, anxiety, and grief increased in the current sample since the pandemic onset. Similarly, self-reported relationship stress due to work, childcare, and health increased since pandemic onset. An increase in relationship stress was significantly positively correlated with an increase in psychological IPV since the pandemic onset. Thus, there was already an impact on participant’s mental health and stress even within the first six months of the pandemic, although most participants did not report an increase in IPV at that time. Overall, the current study highlights the importance of attachment avoidance as a risk factor for IPV in women’s same gender relationships. Additionally, the startlingly high prevalence rates of IPV and discrimination among LGBTQ+ women speaks to the urgent need to continue fighting against oppression and heterosexism to reduce minority stress and to develop IPV resources that better serve the LGBTQ+ population. / Graduate

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Despite evidence for the efficacy of interpersonal psychotherapy (IPT) for depression, there remains little understanding of its specific change-promoting ingredients. This study aimed to establish candidate change mechanisms by identifying whether patients’ interpersonal (theory-specific) and cognitive (theory-nonspecific) characteristics change in an adaptive direction during IPT, and whether such changes differentially relate to depression reduction and improvement in global functioning. The four interpersonal variables and one cognitive variable measured all changed significantly in an adaptive direction, with medium to large effect sizes. Reduced interpersonal problems were marginally associated with self-reported depression reduction (β = 2.846, p = .062), and greater satisfaction with social support was marginally associated with depression reduction (β = -1.423, p = .081). Unexpectedly, reduced romantic relationship adjustment was related to depression reduction (β = 2.028, p = .008 for self-rated depression and β = 1.474, p = .022 for clinician-rated depression), and increased attachment avoidance was marginally related to better clinician-rated global functioning (β = 1.501, p = .09). Thus, theory-relevant interpersonal variables emerged as candidate change mechanisms, and the findings are discussed with respect to their research and practice implications.

This study examined the ability to “fake-good” on the Adult Attachment Interview (AAI). Each of the 21 participants was administered the AAI and MMPI-2 under both “control” (non-faked) and “experimental” (instructed to fake-good) conditions. The scores received on the L and K validity scales of the MMPI-2 under the control versus the experimental conditions were compared to determine if the instructions that were intended to induce faking good in the experimental condition were successful. Significant differences were found between the experimental and control group on the MMPI-2 L and K scales suggesting that the instructions did induce faking good in the experimental condition. Once established, the scores received on the AAI idealization and coherence of mind scales during the control versus experimental condition were compared to determine if the experimental condition instructional set impacted (1) idealization positively, (2) coherence of mind negatively, and (3) overall attachment classification becoming more dismissing, as hypothesized. Significant differences were found between the experimental and control group on the AAI idealization scale and on the AAI coherence of mind scale. These results suggest that the individuals' idealization scores were significantly lower in the control versus experimental conditions while the individuals' overall coherence of mind scores were significantly higher in the control versus experimental conditions. Of the 12 who were found to be dismissing under the experimental condition, 4 had previously not been classified as dismissing when the standard AAI instructions were given. Even though the results were not indicative of a difference in attachment classification under the control versus experimental conditions, a trend was apparent. It appears that one attempting to fake good may appear more dismissing on the AAI than he/she really is. It is even more critical that this study be replicated using a larger sample size to determine if trying to make oneself look positively will impact overall attachment status.