Attachment theory: A framework for understanding symptoms and interpersonal relationships in psychosis

Katherine Berry, Christine Barrowclough, Alison Wearden

    Research output: Contribution to journalArticlepeer-review


    We investigated associations between adult attachment, symptoms and interpersonal functioning, including therapeutic relationships in 96 patients with psychosis. Using a prospective design, we also assessed changes in attachment in both psychiatrically unstable and stable groups. We measured attachment using the Psychosis Attachment Measure (PAM) and interpersonal problems and therapeutic relationships were assessed from both psychiatric staff and patient perspectives. Avoidant attachment was associated with positive symptoms, negative symptoms and paranoia. Attachment ratings were relatively stable over time, although changes in attachment anxiety were positively correlated with changes in symptoms. Predicted associations between high levels of attachment anxiety and avoidance and interpersonal problems were supported, and attachment avoidance was associated with difficulties in therapeutic relationships. Findings suggest that adult attachment style is a meaningful individual difference variable in people with psychosis and may be an important predictor of symptoms, interpersonal problems and difficulties in therapeutic relationships over and above severity of illness. © 2008 Elsevier Ltd. All rights reserved.
    Original languageEnglish
    Pages (from-to)1275-1282
    Number of pages7
    JournalBehaviour research and therapy
    Issue number12
    Publication statusPublished - Dec 2008


    • Attachment
    • Interpersonal
    • Psychosis
    • Schizophrenia
    • Symptoms


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