Adam Danquah

Changes in attachment representations during psychological therapy

Abstract Objectives: This review systematically examines research that investigates changes in adult attachment representations during psychological therapy. Method: Studies from two adult attachment approaches are reviewed (interview and self-report) with the aim of concluding whether psychotherapy can improve attachment representations. To guide the interpretation of findings, the methodological quality of studies is assessed. Results: The results suggest that attachment security increases following therapy, whereas attachment anxiety decreases following therapy. Findings are unclear with regard to attachment avoidance. Improvements are observed across different methodologies, patient groups, therapeutic approaches, and therapy settings. Findings also appear to be consistent across different levels of study quality. Conclusions: Overall, research supports the suggestion that attachment styles may alter during the course of psychotherapy, but further controlled trials are required to confirm this conclusion.

An exploratory study of associations between adult attachment, health service utilisation and health service costs

We investigated associations between attachment, psychopathology, quality of life, service utilisation and costs. Twenty-five people with psychosis completed self-report measures and service use was assessed from case note review. Insecure attachment was associated with greater psychopathology and higher service utilisation and costs. Insecure anxious attachment was related to higher service utilisation independent of symptoms.

Borderline personality disorder in an intermediate psychological therapies service

ABSTRACT The intermediate psychological therapies service is provided for individuals referred with common mental health problems within the primary care psychological therapies service, but whose difficulties are longstanding and/or complex. The prevalence of borderline personality disorder (BPD) in intermediate psychological therapy services has not been researched to-date. The current study aimed to measure the prevalence of BPD amongst patients attending intermediate psychological therapies (n = 63). The prevalence of BPD was established by identifying the number of patients who met DSM-IV criteria. BPD prevalence amongst patients attending an intermediate psychological therapy service was 37%. The high proportion of patients presenting with BPD indicates the potential need for staff training and supervision in how to manage such high levels of need at this service level. This is the first study to report prevalence rates of BPD specifically in an intermediate care psychological therapy service.