Mona Wilhelmsson Göstas, School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden, mona.vilhelmsson gostas@orebroll.se Attachment styles are relevant to psychotherapy since they highlight the way a person handles interpersonal and emotional stress. This thesis aimed to examine how psychotherapy patients in the public mental health care system report attachment styles related to interpersonal problems and diagnosis before and after psychotherapy and to examine problems and changes and psychotherapy contract and process from patients’ experiences of cognitive behavioural oriented therapy (CBT) and psychodynamic oriented psychotherapy (PDT). The studies are based on data from patients admitted to psychotherapy within the public psychiatric services in Örebro County Council. Studies I and IV were quantitative and used self-reports to examine attachment styles and interpersonal problems before and after psychotherapy. Studies II and III were qualitative interview studies examining patients experiences of problems, changes and psychotherapy process. The patients were diagnosed with mood disorders, anxiety disorders, adjustment disorders and personality disorders and reported insecure avoidant and anxious attachment styles that correlated positively with interpersonal problems when they started therapy. Psychotherapy with CBT or PDT enabled them to turn attachment styles into more secure ones and decrease interpersonal problems Patients aged between 26 and 39, patients who attended 11-25 sessions and patients diagnosed with a personality disorder reported greater changes in secure related attachment than others. Patients described their problems as emotions that could not be regulated, as cognitive disabilities and as problematic behaviours that implied a self-centredness. During the course of psychotherapy, the patients gained abilities to handle their problems. The perceived self-centeredness changed which increased their participation in their life-context. Similarities across the therapy orientations showed that the creation of a new context was essential to pay full attention to the patient’s problems, and that the working method and cooperation with the psychotherapist made up a whole. To make the therapy effective, it is important to build up confidence in cooperation and secure base functions like offering predictability and shaping interventions according to the needs of the patient and their ability to use them.

Although previous research has identified a relationship between insecure attachment styles and symptoms of depression and anxiety, evidence regarding the mechanisms of action driving this relationship has been lacking. Consequently, the current study examined the mediating role of resilience in the relationship between insecure attachment styles (i.e. anxious-avoidant, anxious-ambivalent, helpless-disorganized and frightened-disorganized) and symptoms of depression and anxiety. The current study included a sample of 182 participants (i.e., 87 men and 95 women) who completed six questionnaires that assessed each participants' relationship with their caregivers during their childhood, present symptoms of depression and anxiety, and their resilience. Correlational analyses indicated significant relationships among the variables being studied. The formation of an insecure attachment during childhood predicted significantly symptoms of depression and anxiety in adulthood in both men and women. More specifically, the relationship between anxious-avoidant and anxious-ambivalent with symptoms of depression was partially mediated by resilience for men. There were no significant mediation for symptoms of anxiety for me. Within the women population, resilience served as a partial mediator in the relationship between anxious-ambivalent attachment and depression as well as in the relationship between frightened-disorganized attachment and anxiety. Such findings suggested that resilience could act as a protective factor against symptoms of depression and anxiety. These results demonstrated the importance for promoting resilience, especially for individuals who formed insecure attachments during childhood. The importance of studying the relationships among these variables is discussed further.

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This study shined light on the gap in literature about the impact of communication and involvement of stepparents has on emerging adult’s romantic attachment styles. A sample of 289 college students between the ages of 18 and 22 at the University of Kentucky was recruited to complete an online survey about their perceived experience with their stepparent and parental figures and the effects on their romantic attachment styles. Parental involvement in children’s lives and having good communication, sets the foundation for individuals to have secure attachment styles. Emerging adults who experience parental figures and stepparents as being uninterested or passive in their relationship experience have higher anxious and avoidant attachment styles. These findings inform therapists about the importance of recognizing attachment injuries when dealing with individuals and supports the need for all parental figures to be involved in their child’s life and have positive communication skills.

This thesis examined attachment styles and disengagement strategies used to end romantic relationships for 213 college students.

The use of religion-based spirituality was examined as a factor in strengthening and increasing emotional intelligence and regulation, facilitating relationship choices and maintenance, and as a key factor in the decision-making process of dating and partner selection among African Americans. The theoretical framework for this study included Gardner's theory of multiple intelligences, on which both theories of spiritual and emotional intelligence stand, and Bowlby's theory of attachment. A multiple regression analysis was conducted to analyze relationships between spiritual and emotional intelligences and attachment styles among African American adults. In a criterion-based purposeful sample of 98 African American participants aged 27 and older, a negative correlation was found between high levels of spiritual and emotional intelligence in African Americans and attachment styles, meaning secure attachment styles were found in African Americans with higher levels of both spiritual and emotional intelligence. The study contributes to the validity and reliability of the SISRI, SSEIT, and the ECR-R among African Americans. Scores on these instruments in the study were within normal range. The information in this study may serve as a foundation for future studies on the importance of religion-based spirituality and the strengthening of emotional intelligence to facilitate successful romantic and marital relationships among African Americans, leading to stronger families and communities.

There is a demonstrated association between children's negative behaviors, placement disruption, and foster parents' attachment style in early childhood; however, there is an absence of research examining this relation among foster children in middle childhood. Researchers have found that in early childhood, children respond more favorably to foster parents with a secure attachment style, while greater placement disruption is associated with foster parents having an insecure attachment style. The purpose of this study was to examine the association between foster children's negative behaviors, placement disruption in foster children during middle childhood, and foster parents' attachment style. Bowlby's and Ainsworth's attachment theory was the theoretical framework of this quantitative study. Thirty-six foster parent-child dyads from 2 foster care organizations in Texas formed the convenience sample. Participants completed the Behavior Assessment System for Children, the Parent Rating Scale (predictor variable), the Revised Adult Attachment Scale (moderator variable), and a postbaseline telephone call (criterion variable). The results of a binary logistic regression analysis indicated that children's negative behavior was not significantly related to placement disruption. A moderated regression analysis was not conducted to test if foster parents' attachment style had a moderating effect between children's negative behavior and placement disruption due to the low number of respondents in the insecure style. These findings provide insight into the influence of foster parents' attachment style to children's behaviors. Social change implications could promote attachment theory in the development of training programs for foster parents which may help increase placement stability.

Separation anxiety disorder (SAD) is rarely considered in adults presenting with anxious symptomatology, but a growing body of evidence suggests that its symptoms are experienced by a significant number of adults. Early parent-child relationships are an especially important area of study for understanding SAD. Moreover, the attachment style that is formed through early parent-child interactions may serve as a mediator to later expression of symptoms of adult separation anxiety (ASA). Studying the early parent-child relationship and perceived parenting styles in conjunction with individual attachment styles will allow for a more systemic approach to understanding potential risk factors for the development of ASA. Young adult college students may be particularly vulnerable to ASA as they transition into college and away from primary caregivers. This study investigates a mediational model with individual attachment style serving as a mediator between perceived early parenting styles and symptoms of ASA in 170 first-year college students between the ages of 18-20. As anticipated a large percent of the sample endorsed clinically significant levels of symptoms of ASA (47%). In addition, results utilizing bootstrapping analyses demonstrated that a perceived indifferent parenting style had an indirect effect on symptoms of ASA, with the effect occurring through an anxious attachment style. Support for the mediation model was obtained when statistically controlling for perceived parenting styles of overcontrol and abuse as well as confounding variables including age, sex, number of different families lived with and emotionality domains of temperament (distress, anger, and fearfulness). Highlighting the role of perceived parenting styles and attachment styles in the development of symptoms of ASA will serve to establish potential family-based interventions and help in the development of prevention programs. Examining symptoms of ASA in young adult college students may result in the development of university-based psycho-educational programs to help these students master a challenging transitional period. This study is one of the first to explore a model that can help to explain the developmental trajectory of symptoms of ASA. Future studies are encouraged to consider symptoms of ASA when investigating anxious symptomatology in adult populations.

This study aims to examine the prevalence of traumatic events among university students and to evaluate the predictive values of socio-demographic variables, trauma characteristics, attachment styles and coping styles in posttraumatic growth. 321 students from the Middle East Technical University and Hacettepe University participated in the study. A trauma checklist, Posttraumatic Growth Inventory, Relationship Scales Questionnaire, Attachment Style Questionnaire and Ways of Coping Inventory were administered. The results showed that living a disaster, death of a family member, living a serious accident or a serious health problem, a suicidal attempt or the suicide of a significant other or a friend and losing a significant other in an accident or in an act of violence are the traumas which were reported by the participants. In the regression analysis, gender, felt horror and helplessness during the traumatic event, optimistic coping style and fatalistic coping style are found to be significant predictors of posttraumatic growth. The results are discussed within the existing literature findings. The clinical implications are offered.

The purpose of the present study is to investigate the relationships of attachment styles and conflict behaviors among male and female university students. Three hundred and twelve university students from various departments and grades of Middle East Technical University in Ankara participated in the study. Turkish version of Experiences in Close Relationships-Revised (ECR-R, Sel&ccedil / uk, G&uuml / naydin, S&uuml / mer and Uysal, 2005), and Conflict Behaviors Questionnaire (Tezer, 1986) was applied to students to collect data. The results of cluster analysis employed on the scores of ECR-R yielded four clusters corresponding to four attachment styles (fearful, dismissing, preoccupied, and secure). A two-way ANOVA (2 gender X 4 Attachment Style) was applied to each of the five conflict behaviors. Results yielded a significant main effect for gender in accommodating behavior and a significant main effect for attachment styles in compromising behavior. In accommodating behavior, independent samples t-test was used to find out any significant difference between males and females and the results showed that the males were more inclined to use accommodating behavior than females. No significant difference was found in any of the other conflict behaviors as a function of attachment styles between males and females.