Research has described and many clinicians have reported the anorectic patient as socially disconnected, having a disembodied sense of self, perfectionist expectations, and inadequate and shameful feelings. The more intense the internal war, the more food-focused and self-defeating behavior ensues, thwarting one's ability to receive value, self-acceptance, and love. Addressing the anorexia phenomenon, this study considered, from a sociological perspective, the dynamics of attachment and shame. On the basis of 4 propositions and using a multi-method, case-replication design, attachment and shame patterns for 5 restrictive and 5 normal eaters were compared, as determined by scores from the Parental Bonding Instrument, Inventory of Parental and Peer Attachment, Internalized Shame Scale, and personal interviews. Analysis was progressive, as propositions were tested by pattern-matching steps of rating, comparing, and interpreting recurring responses to self-report and interview questions. All anorectics reported a dominant mother, with whom 4 were over attached and struggled ambivalently for autonomy, and a quiet, inexpressive father, whom 4 considered frequently absent or unavailable. As compared to normal eaters, anorectics' trust and communication scores were lower for both parents and peers. Generally, anorectics showed markedly higher internalized shame. Findings indicated that nonoptimal parental bonding patterns were related to shame. The maternal bonding pattern of affectionless control (high protection, low care) showed the highest shame score, although affectionate constraint (high protection, high care), the most frequently found pattern, also showed a high shame level. There were polarized differences between restrictive and normal eaters, especially in regards to self-hatred, low self-esteem, and suicide ideation. Anorectics also reported more inferiority and peer alienation. Other emergent findings were noted. A modification of a self-definition/relatedness illustration was suggested, as well as a model for the development of anorexia. Social implications, treatment suggestions, and future research recommendations were also presented.

The relationship between adult attachment style and romantic relationship quality in marriage relationships was explored. Romantic relationship quality was measured at the working model (or perceptual) and the behavioral levels. No previous research had investigated romantic relationship quality as reflecting specific attachment related perceptions of self and spouse or as attachment related behaviors. Two hundred and six married subjects were recruited from university campuses, churches, and on an individual basis. Most of the subjects were white, middle class, and had children. Subjects completed self-report questionnaires measuring adult attachment style, working model of self and romantic partner, and reports of relationship behaviors of self and romantic partner. The first hypothesis proposed that attachment style differences would be seen in specific attachment related working models of self and romantic partner. The second hypothesis proposed that attachment style differences would be seen in reports of attachment related behaviors for self and romantic partner. Hypotheses were tested using multivariate analysis of variance.

Recently, researchers have begun to examine the impact of attachment on coping with a medical illness. It is hypothesised that a patient's responses to unusual or distressing physical symptoms and participation in the patient-clinician relationship can be understood by examining the nature of their attachments. Theoretical links between attachment style and affect regulation suggest that ‘internal working models’ developed in childhood may have implications, not only for the quality of close relationships, such as romantic love, but also for other significant interactions. In the domain of physical illness, patient-clinician interactions represent such a significant relationship. It is proposed that the attachment behaviour of the patient to the clinician in the context of chronic medical illness may impact on medical illness behaviour and illness outcome. This clinical portfolio reviews the literature on attachment theory, health behaviour and the implications of the patient-clinician relationship in the context of a chronic medical illness. Four case studies of different types of chronic medical illness were examined in relation to attachment theory. The cases included: Jenny, a 10 year-old girl with polycystic kidney disease; Angela, a 13 year-old girl with recurrent urinary tract infections; Aarron, a 36 year-old man with Human Immunodeficiency Virus; and Andrew, a 49 year-old man with multiple medical illnesses. It was concluded that attachment theory is a useful conceptual framework for informing clinical formulation and explaining the patient-clinician interaction among individuals with a chronic medical illness.

Thesis (M.A.)--Denver Seminary, 2008. / Includes bibliographical references (leaves 62-68).

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves [114]-129). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2003. / Typescript. Vita. Includes bibliographical references (leaves 57-61). Also available on the Internet.

Thesis (M.A.)--Denver Seminary, 2008. / Includes bibliographical references (leaves 54-64).

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 157-164). Available also in a digital version from Dissertation Abstracts.

Thesis (Ph. D.)--York University, 1999. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 329-371). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ43415.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 152-160). Available also in a digital version from Dissertation Abstracts.