Influence of attachment on socio-psychological adaptation and its dynamics in the course of treatment in adolescent patients with schizotypal disorder
https://doi.org/10.31363/2313-7053-2021-56-3-89-100
Abstract
Summary. Purpose. Study of the influence of attachment quality (based on the analysis of its representation) on the results of treatment and socio-psychological adaptation of adolescent patients with schizotypal disorder.
Materials and Methods. 41 adolescents with pseudoneurotic type of schizotypal disorder were surveyed [F 21.3]. All respondents were divided into two groups based on the type of early attachment to mother («reliable attachment» and «unreliable attachment»). A battery of 6 tests was used: a questionnaire for studying of coping-behavior ways (Lazarus R., Folkman С., WCQ, The Waysof Coping Questionnaire, 1988); test LSI, Life style index Plutchik R., Kellerman H., 1979 (in adapt.Wasserman L. I., etc., 1998), the modified questionnaire of attachment ( Yaremchuk M. V., 2005; in modific. Almazova O.V., Burmenskaya G.V., 2015), SCL-90R («Simptom Check List-90-Revised»; Derogatis, Rickels, Rock, 1976), integrative anxiety test (Bizyuk A.P, Wasserman L.I., Iovlev B.V., 2005), scale of assessment of social functioning of patients (Kotsyubinsky A.P., Sheinina N.S., etc. 2013). Studied were the features of protectively-adaptive behavior and the actual psychological symptomatic status, indicators of personal and situational anxiety, as well as features of contact with the doctor, and dynamics of indicators of social adaptation during treatment.
Results. Confirmed the relationship of representation unreliable type of attachment to the mother, in patients with schizotypal disorder, and sustained violation in the sphere of relationships with parents, disorders of emotional regulation, reduce psychological adaption in general. In such patients, during the treatment process, lower compliance indicators, specific features of the protective-coping style of behavior, as well as slower rates of psychological and social recovery were revealed.
Conclusion. According to the results of the study, data indicating the negative impact of unreliable attachment in adolescent patients with schizotypal disorder on psychological recovery during treatment and socio — psychological adaptation of patients in general were obtained. Psychotherapeutic recommendations are presented.
About the Authors
O. V. GusevaRussian Federation
Olga V. Guseva
St.Petersburg
A. P. Kotsubinsky
Russian Federation
Alexander P. Kotsubinsky
St.Petersburg
J. D. Zvenigorodskaya
Russian Federation
Julia D. Zvenigorodskaya
St. Petersburg
References
1. Avdeeva NN. Child-Parent Relationship Therapy: Child-Parent Interaction Therapy of Sheila Eyberg (on foreign sources). Sovremennaya zarubezhnaya psikhologiya. 2017; 6(2):7-14. (In Russ).
2. Almazova O.V. Privyazannost` k materi, kak faktor vzaimootnosheniy vzroslykh siblingov: avtoreferat dissertatsii k.ps.n., M.: MGU. 2015:38. (In Russ).
3. Bowlby J. (1969) Privyazannost' (perevod s angl. N.G. Grigoryevoy, G.V. Burmenskoy):M: Gardariki. 2003:477. (In Russ).
4. Burmenskaya GV. Attachment of the child to the mother as the basis of the typology of development. Vestnik moskovskogo universiteta. 2009; 4:17-32. (In Russ).
5. Буххайм А., Дороднов Д., Кехеле Х. Привязанность и депрессивная психопатология у взрослых. Консультативная психология и психотерапия. 2008; 2:72-99 [psyjournal.ru]. Psyjournal; 2008 [процитировано 20 мая 2020]. Доступно: https://psyjournal.ru/mpj/008/n2/Buhhaym.shtml
6. Grigorova TP. Destructive attachment as a specific category of attachment in adulthood. Vestnik KGU im. N.A. Nekrasova. 2014; 20:148-152. (In Russ).
7. Гусева О.В., Коцюбинский А.П., Звенигородская Ю.Д. Нарушения привязанности как фактор психологической дезадаптации у здоровых и психически больных. Клиническая и медицинская психология: исследования, обучение, практика. 2016; 4(14). [http://medpsy.ru/climp].Medpsy.ru; 2016 [процитировано 14 мая 2020]. Доступно: http://medpsy.ru/climp/2016_4_14/article07.php
8. Zayakin YuYu, Sedinina NS, Tregubov LZ, Shivirev NA. Clinical features of phenomenologically similar conditions in neurotic and schizotypal disorders. Permskiy meditsinskiy zhyrnal. 2011; 28(5):37-41. (In Russ).
9. Калмыкова Е.С., Падун М. А. Качество привязанности как фактор устойчивости к психической травме. Журнал практической психологии и психоанализа. 2002:1. [http:// psyjournal. ru]. psyjournal.ru; 2002 [процитировано 14 мая 2020]. Доступно: https://psyjournal.ru/articles/kachestvo-privyazannosti-kak-faktor-ustoychivostik-psihicheskoy-travme
10. Kobzova M.P. Dynamics of cognitive functions and social adaptation in patients with schizotypal disorder (STD) (mprj.ru)
11. Kozlovskaya GV, Kalinina MA. Early schizotypal diathesis as a predictor of schizophrenia. Psikhiatriya. 2013; 4(60):27-31. (In Russ).
12. Kotsyubinskiy A.P., Scorik A.I., Aksenova I.O., Shejnina N.S., Zajcev V.V. Shizofrenia: uyazvimost’- diatez-stress-zabolevaniye. Sankt-Peterburg: Gippokrat+. 2004:336. (In Russ).
13. Kotsyubinskiy A.P., Cheynina N.S., Burkovskiy G.V. Aristova T.A., Butoma B.G. Funktsional’nyy diagnoz v psikhiatrii.: Sankt-Peterburg: SpetsLit; 2013:231. (In Russ).
14. Криттенден П. Трансформация отношений привязанности в юности (пер. с англ. К.В. Ягнюка). Журнал практической психологии и психоанализа. 2002; 1:12-15. [http:// psyjournal. ru]. psyjournal.ru; 2002 [процитировано 15 декабря 2020] Доступно: https://psyjournal.ru/articles/transformaciya-otnosheniy-privyazannostiv-yunosti
15. Lutova NB, Makarevich OV. Intercorrelation of therapeutic alliance parameters and type of schizophrenic famili relation to treatment. Obozreniye psikhiatrii i meditsinskoy psikhologii im. V.M. Bekhtereva. 2012; 4:55-59. (In Russ).
16. Malkova EE. Features of psychological defence types and their relationship with anxiety in adolescents with schizotypal disorder. Uchenyye zapiski SPb GMU im. akadem. I.P. Pavlova. 2011; 18(4):48-49. (In Russ).
17. Makarov IV. On the question of schizotypal disorder in children. Voprosy psikhicheskogo zdorov’ya detey i podrostkov. 2003; 3(2):62-63. (In Russ).
18. Pavlova ON. Attachment theory. Styles of attachment and features of its violation. Psikhologicheskaya nauka i obrazovaniye. 2002; 5:59-64. (In Russ).
19. Pushkareva TN. The basics and clinical significance of maternal affection. Zhurnal prakticheskoy psikhologii i psikhoanaliza. 2002; 4:4-8. (In Russ).
20. Смирнова Е.О. Теория привязанности: концепция и эксперимент. Вопросы психологии. 1995; 3:139-151. [http:// www.psychlib.ru]. psychlib. ru; 1995 [процитировано 20 декабря 2020]. Доступно: http://psychlib.ru/mgppu/periodica/VP031995/Stp-139_150.htm#$p139
21. Tyson Ph., Tyson R.L. Psihoanaliticheskie teorii razvitiya. Yekaterinburg: Delovaya kniga; 1998:528. (In Russ).
22. Fedotov I.A. Klinicheskiye i autoagressivnyye kharakteristiki alkogol’noy zavisimosti u patsiyentov s razlichnymi vidami privyazannosti k roditelyam: dissertatsiya kandidata meditsinskikh nauk. M. 2015:150. (In Russ).
23. Fonagi P. Point of contact and discrepancy between psychoanalysis and attachment theory. Zhurnal prakticheskoy psikhologii i psikhoanaliza. 2002; 1:46-58. (In Russ).
24. Cheynina N.S., Kotsyubinskiy A.P., Scorik A.I., Chumachenko A.A. Psikhopatologicheskiy diatez (predvestniki psikhicheskikh zabolevaniy). SPb:Cippokrat. 2008:128. (In Russ).
25. Yuricina N.V. Znacheniye psikhicheskogo diateza v sotsial’no -psikhologicheskoy adaptatsii bol’nykh schizotipicheskim rasstroystvom. Diplomnaya rabota SpbGU. SPb: 2016:94. (In Russ).
26. Yaremchuk MV. The attachment’s perculiarities in child’-and-parents and in love relations of senior teenagers. Psikhologicheskaya nauka i obrazovaniye. 2005; 3:86-94. (In Russ).
27. Ainsworth MDS. Attachments beyond infancy. American Psychologist. 1989; 44(4):709-716.
28. Ainsworth MDS. Infant-mother attachment. American Psychologist. 1979; 34:932-937.
29. Bartholomew K, Horovitz LM. Attachment styles among young adults: a test of a four-category model. Journal of Personality and Social Psychology. 1991; 61(2):226-244.
30. Berman WH, Sperling MB. The structure and function of adult attachment. Attachment in New York-London: Guilford Press. 1994:3-26.
31. Davila J, Burge D, Hammen C. Why does attachment style change? Journal of Personality and Social Psychology. 1997; 73(4):826-838.
32. Frеud A. Thе еgо аnd thе mесhаnisms оf dеfеnsе. Thе writings оf Annа Frеud: 8 Volumes. New York: Indiana University of Pennsylvania (These volumes include most of Freud»s papers). 1966 [1936]; 3:1-191.
33. Illing V, Tasca CA, Balfour L. et. al. Attachment insecurity predicts eating disorder symptoms and treatment outcomes in a clinical sample of women. J. Nerv. Ment. Dis. 2010; 198:653 — 659.
34. Kachele H, Buchheim A, Schmucher G. Development, Attachment and Relationship: New Psychoanalytic Concepts. In: Henn FA, Sartorius N, Helmchen H. Lauter H. (Eds) Contemporary Psychiatry Springer, Berlin. 2001:358-370.
35. Main M, Goldwyn R. Adult attachment classification system.Berkeley: Unpublished manuscript Universiti of California, Department of Psychology. 1985.
36. Mikulinсеr M, Shaver PR. An аttасhmеnt реrsресtivе оn рsyсhораtоlоgy. Wоrld рsyсhiаtry.2012;11(1):11–15.
Review
For citations:
Guseva O.V., Kotsubinsky A.P., Zvenigorodskaya J.D. Influence of attachment on socio-psychological adaptation and its dynamics in the course of treatment in adolescent patients with schizotypal disorder. V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY. 2021;55(3):89-100. (In Russ.) https://doi.org/10.31363/2313-7053-2021-56-3-89-100