Jennifer Strand

Attachment styles and symptoms in individuals with psychosis

Abstract Background: The capacity to manage affects is rooted in early interactions with caregivers, which in adulthood are internalized as different attachment styles. Few studies have explored associations between all four attachment styles and symptoms. Aim: Our aim was to investigate the relations between the four attachment styles and psychological distress in a group of people with psychosis. Method: In a cross-sectional study, associations between self-reported attachment style and symptoms in a psychosis group were explored. Attachment styles were measured with the Relationship Questionnaire (RQ) and symptoms were assessed with the revised version of the Symptom Checklist (SCL-90R) Results: The analyses showed a significant positive association between preoccupied attachment and the severity of symptoms. Furthermore, the analyses indicated significant positive associations between preoccupied attachment and the subscales measuring depression, anxiety, interpersonal sensitivity, paranoia and psychoticism. We also found significant positive associations between fearful attachment and both interpersonal sensitivity and psychoticism. Conclusion: The associations between attachment styles and symptoms found here are consistent with those of previous studies. It could be important for clinicians to identify patients’ attachment styles. Such knowledge would help mental health professionals to understand better the patients’ capacity to handle distress and help professionals to address interventions aiming to target each patients specific needs.

“If you’re not safe anywhere, you turn it inside yourself”: Narratives about childhood experiences told by 12 individuals diagnosed with psychosis

The aim was to study what patients diagnosed with psychosis related about early relationships with caregivers and about themselves as children. Data consisted of transcripts of 12 interviews, which were analyzed according to a thematic analysis. Through the narratives, a picture emerged of parents who had been unable to put aside their own difficulties and negative emotions. Parents were portrayed as sexually, physically, and/or emotionally abusive, often in tandem with a non-abusive parent described as passive. A family atmosphere marked by silence became visible. Further, a picture appeared of an introverted and “conformable” child, who had handled sadness, as well as fear, alone. Childhood strategies such as daydreaming and ”trying to become invisible” emerged. These strategies resemble what in other frames of reference are often regarded as childhood symptoms of schizophrenia spectrum disorders. Consequently, it could be questioned whether what are commonly viewed as early symptoms of schizophrenia might instead be the child’s attempts to adapt, in order to survive in a disorganized family.

Individual experiences following a 6-month exercise intervention: A qualitative study

Purpose Dropout is a common problem in various exercise interventions. The individuals experience is believed to greatly impact dropout, yet little is known about the individual experiences of taking part in exercise interventions. The aim of this study was to examine individuals’ experiences following a self-determination theory–based exercise intervention in order to gain understanding of how standardized interventions can be adjusted to fit individuals’ specific needs, capacities, and circumstances. Methods A qualitative approach with semi-structured interviews was conducted with eight informants (three male and five female) aged between 26 and 47 years, whom all had participated in a 6-month exercise intervention with individual coaching based on self-determination theory and motivational interviewing. The interviews were analyzed thematically with an inductive approach. Results Aspects that influenced the informants’ motivation and participation in the exercise intervention were linked to three themes: the frames of the intervention, measurable changes, and the individuals context. The themes present information about the process and to what extent the informants felt that the intervention was adapted to fit their lives and needs. Conclusions This study emphasizes the importance of individualizing exercise interventions to support individuals’ diverse capacities and psychological needs.

Perceptions and Experiences of an Attachment-Based Intervention for Parents Troubled by Intimate Partner Violence

It is known that intimate partner violence (IPV) negatively affects both parental capacity and children’s well-being, but few studies have focused on the experiences of those taking part in family interventions focused on IPV. In this study, 26 parents (16 mothers and 10 fathers) with a history of IPV participated in focus groups concerning their attachment-based group intervention experience in the program Parenting and Violence. The transcripts, subjected to thematic analysis, showed that participants experienced the intervention as supportive and confirming of their role as parents. Parents described feeling more in control, more self-confident, more skilled in communicating, and more able to provide security for their children. However, they also expressed a need for continuing support to maintain their improved parenting strategies.

Parenting Difficulties and Needs Described by Victims and Perpetrators of Intimate Partner Violence

Intimate partner violence (IPV) can negatively affect childrens well-being and development, but few studies have looked specifically at parenting as experienced by IPV victims and abusers. Such knowledge could contribute to IPV interventions focused on parenting. The aim of this study was to gain understanding of parenting difficulties and needs of victims and perpetrators of IPV. Focus groups conducted with 16 mothers and 10 fathers showed after analysis that these parents had difficulty controlling aggression toward their children and wished to be better able to provide security for them. Insecurity about their childrens reactions to the IPV also emerged. Parents seemed to seek a “roadmap” to help them interpret whether their childrens behaviors were “normal.” They also wanted to share their concerns in a group of parents in the same situation, but feared being shown to be “worse” than the others or having to confront sensitive issues between group sessions.

Effects of the Two-Way Communication Checklist (2-COM): A one-year cluster randomized study in a group of severely mentally ill persons

Background: In a health-care service with the emphasis on improvement related to functioning and well-being, the communication process between patient and professionals is essential. There is a lack of research on this matter. Aim: The aim was to investigate, in a group of severely mentally ill persons, whether the use of a simple communication tool could influence the sense of empowerment, satisfaction with care, therapeutic alliance and unmet needs. Method: The study had a cluster randomized design. The intervention was a communication tool (2-COM) applied in two teams during one year. In a comparison group of two other teams, the treatment was as usual. At baseline, after six months, and after one year, assessments were made. Results: After one year the 2-COM groups seemed to have a larger reduction in unmet needs compared to the treatment-as-usual group. However, there were large problems with attrition in the study, and it was not possible to draw relevant conclusions. Conclusions: The methodological problems were substantial, and the study may be considered as a pilot study. In a main study the researchers ought to take control over the selection of patients on the basis of the experiences from this study.

A qualitative evaluation of professionals’ experiences of conducting Beardslee’s family intervention in families with parental psychosis

Abstract After Sweden passed new health care legislation in 2010, Beardslee’s preventive family intervention (FI) was implemented to meet children’s rights to information and support. No studies have yet evaluated perceived effectiveness of FI in families with parental psychosis or its reception by families or professionals. This study focused on professionals’ experiences of offering FI to parents with psychosis, their partners, and their children. We conducted 11 semi-structured interviews with FI-educated professionals at open care psychosis service units. Both authors applied thematic analysis to the interview data. The main reported benefit of FI was more open communication in the family; discussing the parent’s illness was thought to be helpful for all family members. Psychoeducation was described as particularly useful because family members generally seemed to lack sufficient information about psychosis. The FI manual also made professionals more confident about asking about patients’ parenting capacity and their children’s wellbeing. Despite positive descriptions, participants had conducted few FI interventions because of heavy workloads, organizational problems, and patients’ resistance to talking about their children. These barriers need to be addressed because children of parents with psychosis are a vulnerable group in great need of information and support.