Insecure attachment as a risk factor for later-life mental health issues


An instinctive drive for attachment is our fundamental survival mechanism in early childhood. According to Bowlby’s attachment theory (1969), an insecure, or unreliable and inconsistent attachment relationship with a caregiver in infancy decreases resilience in managing traumatic and stressful situations and makes children liable to mental breakdowns in critical circumstances, whereas a secure, or consistent and sensitive attachment style is a basis for a more constructive and optimistic trajectory of a child’s development. Insecure attachment, influenced by environmental and genetic factors, can be considered as a predisposition, or susceptibility to mental illness; however, the formation or reinstatement of a feeling of a secure attachment may improve resilience and enhance psychological wellbeing.

In general terms, the attachment can be defined as a specific mode of relating to other people, and attachment dynamics can be distinguished into secure and insecure. Insecure attachment patterns in childhood have been found to confer risks to the development of psychopathology in adulthood. Insecure attachment style is represented by insecure-avoidant, insecure-resistant and disorganised attachment types. Attachment behaviour is any type of action intended for getting a response from a preferred person, someone who is typically wiser or stronger. Bowlby (1977) observes that many psychiatric patients are insecure and immature people, who in stressful situations develop mental disorders. Research confirms that most of these individuals have experienced neglectful parenting, which is at the core of insecure attachment in infancy.
Strange situation, developed by Ainsworth in 1978, is a method which evaluates the attachment quality in children. Bowlby claimed that depending on caregivers’ attachment style, children form the internal working models which are conceived as the background for directing one’s views, emotions, and actions in the context of later-life interactions.

A substantial body of research, including longitudinal studies of the long-term consequences of insecure attachment relationships in early years on mental illness in later life, supported Bowlby’s ideas. Findings of Harris, Brown, and Bifulco (2012) demonstrate that the loss of a parent or long separation from parents in early life confers risk to adult depression. Coffino (2009) pointed out that the strongest predictor of depression in adulthood was the history of parental death between 5 and 10 years old.
Carlson, Egeland, and Sroufe (2009) investigated in a longitudinal study the developmental pathway of borderline personality disorder (BPD), from childhood to adulthood. They confirmed that repetitive contradictory cues representative of disorganised attachment in childhood, are strongly linked to a failure in regulatory tactics to manage stressful situations. The study reports that disorganised attachment, characterised by severe conditions of maltreatment in childhood, is linked to dissociative processes in later life, a marker in the development of BPD.

However, insecure attachment relationships do not result in psychopathology linearly, but other factors such as social and family life, intelligence, substance abuse are likely to augment the effects of insecure attachment on the way to a mental disorder.

While insecure attachment styles are conceived as risk factors for mental illness, the formation and regeneration of a feeling of security may improve mental health and resilience to stress. Mikulincer and Shaver (2012) report that the effects of an improved sense of security on different psychological indicators have been observed in the “security priming” trials that employed triggering mental associations with caring attachment figures. The researchers stated that security providers’ name priming alleviated symptoms of eating disorders, including distortion of body perception, in women diagnosed with eating disorders. There is also evidence of an improved patient’s psychological condition resulted from the feeling of security that was generated in a psychotherapeutic relationship.

Attachment in the context of psychology generally refers to the permanent emotional proximity between children and parents, or caregivers, which is necessary to prepare children for challenges of adulthood. Secure attachment in childhood facilitates the development of mental wellbeing and generates emotional resources for the management of difficulties, whereas insecure attachment style usually results in psychopathology. Formation or reinstatement of a feeling of secure attachment has been shown to enhance resilience to hardships and alleviate symptoms of mental illness.




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Emotion regulation: which strategies to employ?


Emotion regulation processes manage manifestation, expression, strength, and duration of emotions, which critically influence our daily life and mental health. Adaptive strategies of emotion regulation tend to produce constructive outcomes such as reduced negative reactions and stress, while maladaptive strategies can substantially contribute to psychological disorders.

Attention control, acceptance, reappraisal, problem solving as well as rumination, avoidance, and suppression are among key strategies of emotion regulation. Research points out that maladaptive emotion control strategies, such as rumination, avoidance, and suppression are linked to psychopathology to a great extent as opposed to the adaptive emotion regulation methods – attention control, reappraisal, acceptance, and problem solving.

Attention control plays a significant role in decreasing adverse emotional effects of stressful events on people’s life. The strategy consists of two major components – the ability to focus on the task and the ability to shift attention, or multitask.

Problem solving refers to a deliberate attempt, a specific action such as brainstorming, which aims at modifying a stressful incident, adjusting to stressors or eliminating them. Studies demonstrate that a lack of problem-solving abilities may lead to anxiety, depression, eating disorders, and substance abuse. Problem-solving skill training is a component of cognitive-behavioural therapies (CBT) designed to treat these disorders.

Reappraisal involves benign and encouraging interpretations or appraisals of negative situations to transform their meaning and reduce their negative impact on emotions. Several models (e.g. Beck’s, 1976) showed that maladaptive appraisals are at the core of anxiety and depression; thus, CBT for anxiety and depression emphasise reappraisal skill learning.

The concept of mindfulness has been gaining an increasing interest. Although the mechanisms of mindfulness are yet to be understood and defined, researchers agree on its non-judgmental nature. Acceptance strategy is aimed at realising emotions without judging or altering them.

Imagery re-scripting has been suggested as one more adaptive strategy to regulate elicited emotions. Re-scripting aims at updating and correcting recollections of negative or traumatic experiences, as memories do not represent events in a static way. Beck, one of the fathers of cognitive therapy, adopted this method from P. Janet, who first presented it in 1919.

All these adaptive strategies have a similar effect of reducing daily distress by altering aversive components of emotions.

By contrast, suppression (suppressing negative thoughts and/or feelings) and avoidance (avoiding circumstances that may be unpleasant) are known as maladaptive strategies, which may result in anxiety, depression or substance abuse. Although suppression in the short-term perspective may decrease the external expression of emotion and, perhaps, the subjective experience of emotion, in the long run it will be ineffective for reducing emotional and physiological distress. As an alternative to suppression and avoidance, some people engage in rumination, or perseverative and repetitive negative thinking about their concerns; however, rumination has an inverse relationship with problem solving, and it is a key feature of a clinical problem.

To sum up, adaptive strategies such as attention control, acceptance, reappraisal, problem solving and re-scripting are linked to wellbeing, whereas maladaptive rumination, avoidance, and suppression are inefficient ways of coping with stress and are strongly associated with psychopathology.





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