Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem

Wickham, S, Sitko, K and Bentall, RP (2015) Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem PSYCHOLOGICAL MEDICINE, 45 (7). pp. 1495-1507. ISSN 0033-2917, 1469-8978

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Abstract

Background A growing body of research has investigated associations between insecure attachment styles and psychosis. However, despite good theoretical and epidemiological reasons for hypothesising that insecure attachment may be specifically implicated in paranoid delusions, few studies have considered the role it plays in specific symptoms. Method We examined the relationship between attachment style, paranoid beliefs and hallucinatory experiences in a sample of 176 people with a diagnosis of schizophrenia spectrum disorders and 113 healthy controls. We also investigated the possible role of negative self-esteem in mediating this association. Results Insecure attachment predicted paranoia but not hallucinations after co-morbidity between the symptoms was controlled for. Negative self-esteem partially mediated the association between attachment anxiety and clinical paranoia, and fully mediated the relationship between attachment avoidance and clinical paranoia. Conclusions It may be fruitful to explore attachment representations in psychological treatments for paranoid patients. If future research confirms the importance of disrupted attachment as a risk factor for persecutory delusions, consideration might be given to how to protect vulnerable young people, for example those raised in children's homes.

Item Type:	Article
Uncontrolled Keywords:	Attachment, hallucinations, mediation, paranoia, self-esteem
Depositing User:	Symplectic Admin
Date Deposited:	11 Jun 2015 14:51
Last Modified:	16 Jun 2026 08:22
DOI:	10.1017/S0033291714002633
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/2013520
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