Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients

Abstract

The authors tested the hypotheses that the insecure attachment styles of adult patients with schizophrenia are associated with (a) diagnosis, (b) psychopathological syndromes, and (c) course of the disorder. Thirty schizophrenic and 30 age-matching control males answered a self-report questionnaire tapping secure, avoidant, and anxious/ambivalent attachment styles. The patients were diagnosed using the Structured Clinical Interview for DSM-IV (M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1995), and their symptoms were quantified using the Positive and Negative Syndrome Scale (PANSS; S. R. Kay, A. Fizhbein, & L. A. Opler, 1987). Patients with schizophrenia did not significantly differ from nonpatient controls in secure style mean scores, but they exceeded the latter in both avoidant and anxious/ambivalent style scores. There were no significant correlations between secure attachment style and any PANSS symptom dimensions, whereas avoidant style correlated positively with both positive and negative syndromes, and anxious/ambivalent style correlated only with positive syndrome. Compared with patients with secure style, those with insecure attachment styles were younger at onset of the illness and had longer psychiatric hospitalizations. The preliminary results suggest that the insecure types of attachment, in particular the avoidant style, are associated with schizophrenic symptomatology and course of the illness in male inpatients. Further studies using a longitudinal design on extended samples are needed to determine the direction of causality in the composite relationships among the distinct attachment styles, psychopathology, and course of schizophrenia.