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      Insecure attachment states: their relationship to borderline and narcissistic personality disorders and treatment process in cognitive analytic therapy

      Clinical Psychology & Psychotherapy

      Wiley-Blackwell

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          Most cited references 39

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          Adult attachment representations, parental responsiveness, and infant attachment: a meta-analysis on the predictive validity of the Adult Attachment Interview.

          About a decade ago, the Adult Attachment Interview (AAI; C. George, N. Kaplan, & M. Main, 1985) was developed to explore parents' mental representations of attachment as manifested in language during discourse of childhood experiences. The AAI was intended to predict the quality of the infant-parent attachment relationship, as observed in the Ainsworth Strange Situation, and to predict parents' responsiveness to their infants' attachment signals. The current meta-analysis examined the available evidence with respect to these predictive validity issues. In regard to the 1st issue, the 18 available samples (N = 854) showed a combined effect size of 1.06 in the expected direction for the secure vs. insecure split. For a portion of the studies, the percentage of correspondence between parents' mental representation of attachment and infants' attachment security could be computed (the resulting percentage was 75%; kappa = .49, n = 661). Concerning the 2nd issue, the 10 samples (N = 389) that were retrieved showed a combined effect size of .72 in the expected direction. According to conventional criteria, the effect sizes are large. It was concluded that although the predictive validity of the AAI is a replicated fact, there is only partial knowledge of how attachment representations are transmitted (the transmission gap).
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            Attachment in late adolescence: working models, affect regulation, and representations of self and others.

             R Kobak,  A Sceery (1988)
            The purpose of this study was to examine the coherence of attachment organization during late adolescence. In a sample of 53 first-year college students, 3 kinds of working models of attachment were assessed with the Adult Attachment Interview: Dismissing of Attachment, Secure, and Preoccupied with Attachment. Affect regulation was evaluated with peer Q-sort ratings of Ego-Resiliency, Ego-Undercontrol, Hostility, and Anxiety, and representations of self and others were assessed with self-report measures of distress, perceived competence, and social support. The Secure group was rated as more ego-resilient, less anxious, and less hostile by peers and reported little distress and high levels of social support. The Dismissing group was rated low on ego-resilience and higher on hostility by peers and reported more distant relationships in terms of more loneliness and low levels of social support from family. The Preoccupied group was viewed as less ego-resilient and more anxious by peers and reported high levels of personal distress, while viewing their family as more supportive than the Dismissing group. These findings are interpreted in terms of different styles of affect regulation and representational bias associated with particular working models of attachment.
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              The relation of attachment status, psychiatric classification, and response to psychotherapy.

              The relation of patterns of attachment and psychiatric status was studied in 82 nonpsychotic inpatients and 85 case-matched controls using the Adult Attachment Interview (AAI). AAI transcripts rated (masked to case vs. control status and treatment) were classified using M. Main and R. Goldwyn's (1991) system. Psychiatric patients, diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.) I and II structured interviews, were more likely to be classified as preoccupied and unresolved with respect to loss or abuse. On Axis I, anxiety was associated with unresolved status, and AAI scales were able to discriminate depression and eating disorder. On Axis II, borderline personality disorder (BPD) was linked to experience of severe trauma and lack of resolution with respect to it. BPD patients were also rated significantly lower on a scale measuring awareness of mental states. Preliminary outcome results suggest that individuals rated as dismissing on the AAI are more likely to show improvements in psychotherapy.
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                Author and article information

                Journal
                Clinical Psychology & Psychotherapy
                Clin. Psychol. Psychother.
                Wiley-Blackwell
                1063-3995
                1099-0879
                May 2000
                May 2000
                : 7
                : 2
                : 138-154
                Article
                10.1002/(SICI)1099-0879(200005)7:2<138::AID-CPP231>3.0.CO;2-9
                © 2000

                http://doi.wiley.com/10.1002/tdm_license_1.1

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