Search Results (219)

Depressive disorders are strongly influenced by personality organization, attachment style, and defensive functioning. This study examined the associations between depression severity, defense mechanisms, and adult attachment styles, and explored potential moderating effects of gender. A community sample completed standardized measures assessing depressive symptoms, defense mechanisms (mature, neurotic, immature), and attachment dimensions (anxious, avoidant). Correlational and regression analyses indicated that higher depressive severity was negatively associated with denial and dissociation, while no significant links emerged for projection or mature defenses. Anxious attachment predicted greater use of projection (B = 4.65, p = 0.040), but depression did not moderate this association. Cluster analysis identified two distinct profiles: one with moderate depression and higher denial, and another with severe depression and markedly lower denial. Men reported higher dysfunctional defenses overall, whereas a significant depression × gender interaction suggested that depressive severity was associated with reduced dysfunctional defenses among women (B = −0.58, p = 0.002). These findings challenge prevailing evidence that depressive severity correlates with greater immature defense use, instead suggesting a possible defensive collapse at high symptom levels. The study contributes novel insights into how attachment and gender shape defensive functioning in depression, emphasizing the need for longitudinal and clinical replication. Full article

Background and Objectives: Autologous hematopoietic stem cell transplantation (AHSCT) offers life-saving treatment for hematologic malignancies but can result in persistent sexual dysfunction and relationship challenges. Attachment theory provides a valuable framework for understanding how enduring relational patterns influence sexual well-being. This study aimed to assess sexual function and attachment styles in AHSCT survivors and examine correlations between attachment and sexual health outcomes. Materials and Methods: A multicenter, cross-sectional study was conducted from December 2019 to March 2022 in five public hospitals in Athens, Greece. Participants were 127 adult survivors who had undergone AHSCT between 6 months and 5 years before enrollment. Sexual function was evaluated with the International Index of Erectile Function (IIEF) for men and the Female Sexual Function Index (FSFI) for women. Attachment style was measured using the Experience in Close Relationships Scale–Short Form (ECRSHORT-FORMSCALE). Results: Men demonstrated high erectile function (IIEF total: 54.10 ± 20.1), whereas women reported moderate sexual dysfunction (FSFI total: 22.51 ± 8.95). Both genders showed average attachment levels, with anxiety scoring lowest and discomfort with closeness highest. Between-group comparisons revealed no significant difference in anxiety (p = 0.95), a near-significant difference in avoidance (p = 0.056), and a significant difference in discomfort with closeness (p < 0.0001), with women scoring higher. In men, no significant correlations emerged between attachment and sexual function. In women, higher attachment anxiety correlated negatively with all FSFI domains except pain, avoidance correlated positively with lubrication, and discomfort with closeness correlated negatively with desire and pain. Conclusions: Findings reveal gender-specific patterns in attachment and their influence on sexual function of AHSCT survivors, highlighting the need for attachment-informed interventions to support intimacy, relationship satisfaction, and overall quality of life in survivorship care. Full article

Background/Objectives: Emotional eating can pose a significant threat to one’s health as it can be a predictor of eating disorders. It involves eating in response to emotional distress rather than physical hunger and is widely associated with insecure attachment patterns. However, it remains unclear whether this relationship is consistent across cultures and in the general population. This review aimed to examine the relationship between different conceptualizations of attachment and emotional eating in non-clinical adolescent and adult populations. Methods: Nineteen eligible studies were identified through searches of five databases, including ProQuest, Scopus, Google Scholar, PubMed, and ProQuest Dissertations and Theses Global (PQDT), which covers peer-reviewed literature published between 1990 and 2025. Both quantitative and qualitative studies were included, spanning attachment styles, representations, and states. Results: The findings consistently revealed that general secure attachment styles are associated with lower levels of EE. In comparison, insecure–anxious and disorganized attachment styles are positively associated with higher EE levels. In contrast, avoidant attachment showed a weak or inconsistent association. Mediators such as difficulties with emotion regulation, perceived hunger, and body dissatisfaction were frequently identified, and stress emerged as a relevant moderator. Notably, attachment to specific figures (e.g., romantic partners versus caregivers) and cultural context were poorly addressed, which may influence the strength and consistency of the associations. The review also highlights conceptual gaps in the literature, including a limited focus on early attachment representations, context-specific attachment scripts, and the cultural validity of these concepts. Most studies were cross-sectional and conducted in Western contexts, which limited their causal interpretation and generalizability. Conclusions: These findings underscore the importance of attachment-based frameworks in understanding and preventing EE. They suggest the necessity to conduct further studies that are more nuanced, longitudinal, culturally diverse, and that consider sex and pubertal changes for a better understanding of the relationship between attachment and EE. This review contributes to prevention efforts and global health strategies by addressing the relational and emotional determinants of unhealthy eating behaviors in the general population. Full article

Attachment style and emotion regulation (ER) patterns intertwine. Securely attached individuals employ more adaptive ER strategies, while individuals with avoidant, preoccupied, and disorganized styles rely on less adaptive strategies. Defense mechanisms are part of an experience-near, observable construct that parallels implicit ER. The evaluation of a patient’s defense mechanisms may therefore be a means of identifying and understanding the patient’s attachment classification. This article synthesizes recent empirical research and theory to delineate relationships among attachment styles, ER, and defense mechanisms. It then examines how development and culture shape attachment, discusses assessment strategies, and offers clinicians guidance for assessing attachment through a defense mechanism orientation. This clinical technique may assist clinicians in informed assessment and treatment and underscores the benefits of further integration of attachment research with that of defense mechanisms. Full article

In the modernization of cities and buildings around the world, megastructures represent the integration of the means of material production and advanced technology. However, there has been little discussion of the reasons for the enthusiastic phenomenon, especially the associative style between humans and megastructures. Among the methodologies for discussing the material environment and the human spiritual world, Associative Cultural Landscape methodology, based on the cultural landscape, is selected, and the “verticality” and the vertical discussion depth of the megastructure are used to optimize Associative Cultural Landscape methodology by utilizing the “orientational metaphors”. This forms Orientational Metaphors—Associative Cultural Landscape methodology for interpreting megastructure worship. Utilizing the optimized methodology, megastructure worship is interpreted from three interpretative paths: body worship, political worship, and relationship worship. Nine applied models and the matrix that meet the applied scenarios are formed. Finally, the paper presents the framework and its main theoretical contributions: (1) it generates the 16 processes from topic selection to model interpretation; (2) it differentiates the three interpretative paths of megastructure worship; (3) it evolves and optimizes Associative Cultural Landscape methodology; (4) it establishes nine applied models, based on the three interpretative paths; (5) it provides a research outlook—combining the nine existing applied models, a total of 21 interpretative potential applied models have been constructed. Using Orientational Metaphors—Associative Cultural Landscape methodology, the spiritual relationship between humans and megastructures is established with “spiritual relevance” as the core, and three interpretative paths of megastructure worship are interpreted. A comprehensive analysis of the megastructure phenomenon is proposed, providing a framework and models for human emotions that are attached to environmental psychology. The study provides an optimized methodological framework with Associative Cultural Landscape methodology and applied models for city and building scenarios involving the emotional connection between humans and megastructures. In particular, at the methodological level, it provides a new discussion paradigm for philosophical and applied megastructures that explain non-quantitative problems. Full article

Background and Objective: Physicians experience 10–30% of patient interactions as being interpersonally difficult, but the sources of difficulty are not well understood, despite the frequency of anecdotal studies of the “difficult patient.” This study examined whether patients rated as “difficult” by their physicians have more of an insecure attachment style, and whether patients not rated as “difficult” have more of a secure attachment style. Methods: The participants were 100 primary care patients and 28 physicians from a university-based family medicine residency training program in a suburb of Detroit, Michigan, USA. Results: The results revealed that, while adjusting for the patients’ age, education, and income, fearful attachment and the physician’s rating of the patient’s overall health were significantly associated with the physician’s perception of patient difficulty. Conclusions: This study suggests that residency training should include behavioral science education in the assessment and management of insecure attachment styles to ensure that such patients receive optimal care and support the mission of primary care medicine. Full article

Background/Objectives: Caregiving for patients with advanced cancer or chronic illness imposes substantial psychological burden, yet the role of caregiver attachment style in moderating this distress is underexplored. This multicenter, cross-sectional study investigates how attachment styles influence the relationship between psychological distress and caregiver burden in two populations: family caregivers of palliative-stage cancer patients and those supporting patients with chronic diseases. Methods: Across Turkey, 819 caregivers (412 cancer, 407 chronic disease) completed the Zarit Caregiver Burden Scale, DASS-21, and Relationship Scale Questionnaire. Hayes’ PROCESS macro was used to test the moderating role of attachment styles. Results: Cancer caregivers reported higher caregiver burden (Cohen’s d = 0.35, 95% CI [0.21, 0.49]) and stress than chronic disease caregivers, but lower depression. Secure attachment was negatively associated with burden, while preoccupied attachment was positively associated. For cancer caregivers, secure attachment buffered the impact of depression on burden (interaction B = –0.611, 95% CI [–0.861, –0.361]), whereas preoccupied attachment amplified it in both groups (cancer caregivers: B = 0.292, 95% CI [0.064, 0.520]; chronic disease caregivers B = 0.505, 95% CI [0.174, 0.836]). The final regression models explained 43.1% of variance in burden for the cancer group and 10.9% for the chronic disease group. Conclusions: Attachment styles are significant moderators of the relationship between psychological distress and caregiver burden. Secure attachment is a protective factor, while preoccupied attachment is a vulnerability factor. These findings underscore the need for attachment-informed psychosocial interventions tailored to specific caregiver profiles to mitigate distress. Full article

Background: Life satisfaction during the perinatal period has gained increasing attention as a relevant indicator of mental health, providing a more complete view of women’s adaptation to motherhood. Methods: This study examines the evolution of life satisfaction across four time points: the third trimester of pregnancy (T1), 8 weeks after birth (T2), 5 months after birth (T3) and 5 years postpartum (T4). A total of 231 women participated in this longitudinal study. Participants completed an ad hoc questionnaire for sociodemographic data and standardized self-report measures assessing different personality variables (attachment style, social support, maternal self-efficacy and positive/negative affect) at T1 as well as the Satisfaction with Life Scale (SWLS) (T1–T4). Statistical analyses were performed in order to evaluate the relationships between variables (Student’s test, ANOVA, Pearson’s correlation), and a linear regression analysis was conducted to explore the contribution of psychosocial variables at each time point. Additional subgroup analyses (employment status and parity) were carried out. Results: Results showed that at the first and second time points, life satisfaction was maintained, but five months after birth (T3), it decreased, and then it changed again five years after birth, increasing to its highest level. The psychosocial variables significantly associated with changes in life satisfaction varied across time points. Differential profiles are also observed depending on the subgroup. Conclusions: These findings suggest that monitoring these variables throughout the perinatal period may help identify women at risk and guide interventions in addition to preventive programs aimed at promoting well-being during the perinatal period and into motherhood. Full article

Psychopathy in women remains understudied, particularly regarding the role of early relational experiences such as attachment. This systematic review aims to synthesize the current evidence on the association between attachment-related factors and psychopathic traits in women. A structured search following PRISMA guidelines across multidisciplinary databases (Scopus-Elsevier^®, ESBCO^®, Pubmed^®, Sage Publishing^®, B-On, and Web of Science-Core Collection^®) yielded 147 articles, of which eight met the inclusion criteria. The majority of the studies met three to four out of the five methodological quality criteria. Findings indicate that insecure attachment styles are differentially associated with psychopathy. Avoidant attachment is positively linked to callous-unemotional traits, whereas the role of anxious attachment appears more heterogeneous. Some studies associate it with higher levels of affective traits and secondary psychopathy, while others identify it as a negative predictor of callous-unemotional features in women. Avoidant attachment was also negatively correlated with empathy and positively related to maladaptive emotion regulation strategies, particularly among women with secondary psychopathic traits. Negative maternal parenting was associated with elevated psychopathic traits, whereas positive parental involvement acted as a protective factor. Additional predictors included early maladaptive schemas and childhood risk factors such as parental criminality and poor supervision. These findings highlight the relevance of early intervention and attachment-informed approaches in forensic risk assessment, trauma-informed care, and prevention programs targeting women with psychopathic traits. Full article

The rapid increase in global smartphone usage and the range of capabilities they offer have resulted in an overdependence on them, leading to the term nomophobia. Nomophobia refers to the psychological discomfort or anxiety experienced when an individual is unable to use or does not have access to their mobile phone, and it is a phenomenon that warrants research attention due to its psychological and social implications. The aim of the current study was to examine the relationship between nomophobia and the time spent on mobile usage, attachment in close romantic relationships, and loneliness. Participants included 300 adults from Cyprus who were recruited through convenience and snowball sampling methods. Data were gathered using an internet-based questionnaire that assessed participants’ time spent on mobile usage, their attachment styles in close relationships, and their level and type of loneliness. The results suggest that (a) anxiety dimension and time spent on mobile phone are significant predictors of nomophobia, (b) higher levels of nomophobia are associated with an insecure attachment style, (c) more severe levels of nomophobia are associated with higher levels of loneliness, and (d) increased time spent on mobile usage is linked to higher levels of nomophobia. The findings suggest that the widespread emergence of nomophobia raises important concerns, highlighting the need for the development of educational programs that promote balanced mobile usage and encourage direct social interaction. The significance of targeted interventions that address mobile phone regulation and attachment-related vulnerabilities is emphasized. Full article

Introduction: Secure infant/child–caregiver attachment is crucial for the development of social and emotional functioning and can affect long-term outcomes, such as adult relationships, but it may also be influenced by prenatal and early childhood risk factors. Children with a history of prenatal alcohol exposure (PAE) have a complex spectrum of strengths and difficulties and often have the additional risk of early life adversity. There is some evidence that children with PAE are at increased risk of insecure attachment, but it is unclear whether this is consistent or why it is the case. No published review has focused on the relationship between PAE and attachment. Methods: A systematic search of seven academic databases using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines was undertaken by two reviewers to identify primary studies that have focused on the relationship between PAE and attachment. Quality assessments were undertaken using the Quality of Observational Cohort and Cross-Sectional Studies tool, and the report was written following the PRISMA-ScR checklist. Results: A total of 4199 records were returned from the database searches. A total of 11 studies (eight peer-reviewed papers and three dissertations), published between 1987 and 2021, met the criteria. Five studies showed that PAE was related to insecure or disorganised attachment, two of which showed that infant irritability and caregiver–infant interaction mediated this relationship. The other six studies found no significant relationship between PAE and attachment. Conclusions: This scoping review demonstrates that there is a dearth of published research on this topic, and none that takes advantage of more recent understanding of the relationship between adverse childhood experiences and neurodevelopmental disorders. There is some evidence that PAE may impact the attachment relationship via caregiver–infant interaction and infant irritability, but further studies, including those that assess the additional impact of early life adversity, are needed. Full article

Background and Objectives: Suicide is one of the leading causes of death worldwide. Identifying psychopathological factors and personality traits associated with suicidal ideation is crucial for improving prevention. This study investigates the association between current suicidal ideation—measured by item 4 of the Brief Psychiatric Rating Scale-24 items (BPRS-24)—and personality traits assessed with the Personality Inventory for DSM-5 (PID-5) in a transdiagnostic outpatient psychiatric population. The association of BPRS-24 item 4 with early traumatic experiences, attachment styles, and dissociative phenomena is also explored as a secondary objective. Materials and Methods: We propose a secondary analysis on a sample of 137 individuals receiving care at an academic community mental health center. Personality traits were assessed using the PID-5, while attachment styles were assessed with the Experiences in Close Relationships-Revised (ERC-R), childhood traumas with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), and dissociative experiences with the Dissociative Experience Scale II (DES-II). Suicidal ideation was measured with item 4 of the BPRS-24. Associations were examined using Spearman’s correlation and ordinal logistic regression models, adjusted for age, sex assigned at birth, and global clinical severity (CGI-S). Results: We found statistically significant associations between suicidal ideation and the PID-5 trait of depressivity (OR = 1.80, 95 % CI 1.23–2.63, p = 0.002, p-value adjusted Holm’s method 0.012). However, this association lost significance after adjusting for depressive symptoms (BPRS-24 item 3), suggesting a mediating role of depression. We found no significant associations with childhood trauma, attachment styles, or dissociative experiences. Conclusions: Our findings suggest a potential link between specific personality traits and suicidal ideation, mediated by depressive symptomatology. We explore how future studies may evaluate PID-5 as a clinical tool to support the identification of individuals at long-term risk of suicidality or for targeting specific populations for tailored interventions. Full article

Attachment styles and defense mechanisms are widely recognized as central components in personality development. However, few empirical studies have examined their combined contribution to maladaptive personality traits within the dimensional framework of the DSM-5 Alternative Model for Personality Disorders (AMPD). This study investigated the extent to which adult attachment styles and defense mechanisms predict the five AMPD maladaptive personality domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. Data were collected from a community sample of 400 adults (190 males, 47.5%), aged 18 to 69 years (M = 36.96; SD = 11.59). Hierarchical multiple regression analyses were conducted for each maladaptive personality domain to examine the predictive roles of attachment styles and defense mechanisms. Our findings indicate that each maladaptive personality domain is associated with specific configurations of attachment styles and defense mechanisms. In conclusion, the findings suggest the relevance of assessing adult attachment styles and defensive functioning in clinical contexts in order to deepen the understanding of the individuals’ personality profiles. Full article

Background: Binge eating disorder (BED) frequently arises during the transitional age (18–25 years), a critical developmental period characterized by challenges in autonomy, identity formation, and interpersonal functioning. This study investigated psychopathological predictors of BED risk in this age group, with particular focus on parental bonding, attachment style, body dissatisfaction, alexithymia, and depressive symptoms. Methods: A total of 287 participants aged 18–25 years completed the Binge Eating Scale (BES), Beck Depression Inventory-II (BDI-II), Body Shape Questionnaire (BSQ), Toronto Alexithymia Scale (TAS-20), Attachment Style Questionnaire (ASQ), and Parental Bonding Instrument (PBI). Sociodemographic information and body mass index (BMI) were also collected. Results: Compared with non-BED risk groups, individuals at risk of BED exhibited significantly higher BMI, greater alexithymia, higher body dissatisfaction, more insecure attachment patterns, and lower recalled paternal and maternal care. Hierarchical binary logistic regression revealed that the final model explained 56.1% of the variance (Nagelkerke R²) and correctly classified 92.1% of cases. Significant predictors of BED included body dissatisfaction, elevated BMI, low maternal care, and low maternal protection. Conclusions: This study is the first to examine BED risk factors specifically during the transitional age. Findings indicate that body image dissatisfaction, higher BMI, and inadequate maternal emotional care and protection are salient predictors at this life stage. Preventive interventions should integrate parental psychoeducation, nutritional guidance, and therapeutic strategies addressing both eating disorder symptoms and attachment-related difficulties to reduce BED onset and improve psychosocial outcomes in emerging adults. Full article

Attachment styles, rooted in Bowlby’s Attachment Theory, significantly influence our romantic relationships, workplace behavior, and decision-making processes. Traditional methods like self-report questionnaires often have biases, so we aimed to develop a predictive model using objective physiological data. In our study, participants engaged in the Secretary problem, a sequential decision-making task, while their brain activity was recorded with a 16-electrode EEG device. We transformed this data into coherence graphs and used Node2Vec and PCA to convert these graphs into feature vectors. These vectors were then used to train a machine learning model, XGBoost, to predict attachment styles. Using participant-level nested 5-fold cross-validation, our first model achieved 80% accuracy for Secure and 88% for Fearful-avoidant styles but had difficulty distinguishing between Avoidant and Anxious styles. Analysis of the first three principal components showed these two groups overlapped in coherence space, explaining the confusion. To address this, we created a second model that categorized participants as Secure, Insecure, or Extremely Insecure, improving the overall accuracy to about 92%. Together, the results highlight (i) large-scale EEG connectivity as a viable biomarker of attachment, and (ii) the empirical similarity between Anxious and Avoidant profiles when measured electrophysiologically. This method shows promise in using EEG data and machine learning to understand attachment styles. Our findings suggest that future research should include larger and more diverse samples to refine these models. If validated in multi-site cohorts, such graph-based EEG markers could guide personalised interventions by objectively assessing attachment-related vulnerabilities. This study demonstrates the potential for using EEG data to classify attachment styles, which could have important implications for both research and therapeutic practices. Full article