Attachment Dimensions predict Social Functioning in persons with Schizophrenia-Spectrum Disorders, regardless of Symptom Severity

Abstract

Introduction. Attachment patterns and early-life adversities are relevant to understand the role of psychosocial factors in the vulnerability and the development of psychosis. The first aim of the study was to test whether a dimensional attachment instrument, the CAMIR (from French; Cartes: Modèles Individuels de Relation), may differentiate attachment styles by comparing a group of psychotic patients with a non-clinical sample. Also, we hypothesised that attachment dimensions would predict Social Functioning (SF) within the clinical group.

Methods. Seventy-nine persons were assessed by the reduced Spanish version (CAMIR-R). We used Cronbach’ alpha to test reliability. A t-test was performed to assess differences between groups. Multiple linear regressions and Mediation analyses were conducted within the clinical group to explore attachment dimensions as possible predictors of SF.

Results. A more insecure attachment was found in the clinical group (73.8% versus 33.3%). Attachment dimensions differentiated between both samples with large effect sizes. Psychopathology and parental interference predicted general SF (R² = 0.30; p < 0.05) as family concern predicted more social isolation (R² = 0.19; p = 0.02) and worse employment status (R² = 0.45; p < 0.01). Parental permissiveness and child traumatism inversely predicted educational level (R² = 0.31; p < 0.05). Mediation analyses revealed that attachment dimensions were linked to SF regardless of symptoms.

Conclusions. CAMIR-R was reliable to assess attachment in psychosis. Persons with schizophrenia-spectrum disorders show a significant impaired SF and a higher prevalence of insecure attachment. Several attachment dimensions predict specific areas of SF, regardless of symptom severity.