Assessment of Attachment in Psychosis: The Validity of the Psychosis Attachment Measure
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Jan 30, 2024
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Abstract
Background. Attachment has become a central construct in explanatory models of psychosis. The Psychosis Attachment Measure is currently the most widely used measure for attachment in a population with a psychotic disorder. However, concerns have been raised about its psychometric properties. In addition, there are two perspectives to operationalize attachment: dimensional and categorical. The categorical method offers added value for the assessment of disorganized attachment which has been mostly linked with vulnerability to psychosis.
Aim. The aims of this study were to re-evaluate the structural and construct validity of the dimensional and categorical approaches of the Psychosis Attachment Measure in a Dutch sample (N=287).
Results. Confirmatory factor analysis indicated poor fit indices for the two-factor model with low loadings of the reversed questions of the Psychosis Attachment Measure on the avoidance factor. Removing these items improved model fit to conventional threshold values. Latent profile analyses suggested a four-class solution: secure, preoccupied, dismissive-avoidant, and disorganized attachment. The construct validity of both approaches was largely in line with expectations.
Conclusion. Both the dimensional and categorical perspective of attachment in psychosis may be used to gain a better understanding of the complexities in the attachment system.
Keywords:
attachment (dimensional and categorical), psychosis, schizophrenia, validation
Article Details
How to Cite
BUSSEL, Evelyn van et al.
Assessment of Attachment in Psychosis: The Validity of the Psychosis Attachment Measure.
Medical Research Archives, [S.l.], v. 12, n. 1, jan. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5005>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v12i1.5005.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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2. Bowlby J. The making and breaking of affectional bonds: I. Aetiology and psychopathology in the light of attachment theory. The British journal of psychiatry. 1977;130(3):201-210.
3. Bucci S, Emsley R, Berry K. Attachment in psychosis: A latent profile analysis of attachment styles and association with symptoms in a large psychosis cohort. Psychiatry Research. 2017;247:243-249.
4. Berry K, Barrowclough C, Wearden A. Attachment theory: a framework for understanding symptoms and interpersonal relationships in psychosis. Behav Res Ther. Dec 2008;46(12):1275-82. doi:10.1016/j.brat.2008.08.009
5. Kotov R, Jonas KG, Carpenter WT, et al. Validity and utility of hierarchical taxonomy of psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry. 2020;19(2):151-172.
6. Read J, & Gumley, A. . Can attachment theory help explain the rlationship between childhood adversity and psychosis. Attachment: New Directions in Psychotherapy and Relational Psychoanalysis. 2008;2:1-35.
7. Barker V, Gumley A, Schwannauer M, Lawrie SM. An integrated biopsychosocial model of childhood maltreatment and psychosis. The British Journal of Psychiatry. 2015;206(3):177-180.
8. Varese F, Smeets F, Drukker M, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. Jun 2012;38(4):661-71. doi:10.1093/schbul/sbs050
9. Van Bussel E, Nguyen N, Wierdsma A, Van Aken B, Willems I, Mulder C. Adult attachment and personal, social, and symptomatic recovery from psychosis: systematic review and meta-analysis. Frontiers in Psychiatry. 2021;12: 641642.
10. Kvrgic S, Beck EM, Cavelti M, Kossowsky J, Stieglitz RD, Vauth R. Focusing on the adult attachment style in schizophrenia in community mental health centres: validation of the Psychosis Attachment Measure (PAM) in a German-speaking sample. Int J Soc Psychiatry. Jul 2012;58(4):362-73. doi:10.1177/0020764011399004
11. Macbeth A, Gumley, A., Schwannauer, M., & Fisher, R. Attachment states of mind, mentalization, and their correlates in a first-episode psychosis sample. Pychology and Psychotherapy, Theory, Research and Practice. 2011;84:42-57.
12. 12. Couture S, Lecomte, T., & Leclerc, C. Personality characteristis and attachment in first episode psychosis. The Journal of Nervous and Mental Disease. 2007;195:631-639.
13. Van Bussel E, Wierdsma A, van Aken B, Willems I, Mulder C. Adult attachment and personal recovery in clients with a psychotic disorder. Schizophrenia Bulletin Open. 2023:sgad010.
14. Bowlby J. Attachment and loss: Volume II: Separation, anxiety and anger. Attachment and Loss: Volume II: Separation, Anxiety and Anger. London: The Hogarth Press and the Institute of Psycho-Analysis; 1973:1-429.
15. Bowlby EJM. Attachment: Volume one of the attachment and loss trilogy. Random House; 2008.
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17. Main M, Solomon J. Discovery of an insecure-disorganized/disoriented attachment pattern ISSN 0893913456. 1986;
18. Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: An integrative overview. 1998;
19. Bartholomew K. Avoidance of intimacy: An attachment perspective. Journal of Social and Personal relationships. 1990;7(2):147-178.
20. Bowlby J. Attachment and loss: retrospect and prospect. American journal of Orthopsychiatry. 1982;52(4):664.
21. Hazan C, Shaver PR. Love and work: An attachment-theoretical perspective. Journal of Personality and social Psychology. 1990;59(2):270.
22. Main M, Solomon J. Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. Attachment in the preschool years: Theory, research, and intervention. 1990;1:121-160.
23. Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. Journal of personality and social psychology. 1991;61(2):226.
24. Korver-Nieberg N, Meijer CJ, Koeter MW, de Haan L. 5Adult attachment in samples of psychotic patients. Attachment and psychosis. 2014:89.
25. Berry K, Wearden A, Barrowclough C, Liversidge T. Attachment styles, interpersonal relationships and psychotic phenomena in a non-clinical student sample. Personality and Individual Differences. 2006;41(4):707-718.
26. Pollard C, Bucci S, MacBeth A, Berry K. The revised psychosis attachment measure: Measuring disorganized attachment. British Journal of Clinical Psychology. 2020;59(3):335-353.
27. Olbert CM, Penn DL, Reise SP, et al. Assessment of attachment in psychosis: A psychometric cause for concern. Psychiatry research. 2016;246:77-83.
28. Asendorpf J, Banse R, Wilpers S, Neyer F. Relationship-specific attachment scales for adults and their validation with network and diary procedures. Diagnostica. 1997;43(4):289-313.
29. Banse R. Adult attachment and marital satisfaction: Evidence for dyadic configuration effects. Journal of Social and personal Relationships. 2004;21(2):273-282.
30. Elizur Y, Mintzer A. Gay males’ intimate relationship quality: The roles of attachment security, gay identity, social support, and income. Personal Relationships. 2003;10(3):411-435.
31. Rokita KI, Dauvermann MR, Donohoe G. Early life experiences and social cognition in major psychiatric disorders: a systematic review. European psychiatry. 2018;53:123-133.
32. Darling Rasmussen P, Storebø OJ, Løkkeholt T, et al. Attachment as a core feature of resilience: A systematic review and meta-analysis. Psychological reports. 2019;122(4):1259-1296.
33. van Aken BC, Bakia A, Wierdsma AI, et al. UP'S: A cohort study on recovery in psychotic disorder patients: Design protocol. Frontiers in psychiatry. 2021;11:1487.
34. Gumley AI, Taylor HE, Schwannauer M, MacBeth A. A systematic review of attachment and psychosis: measurement, construct validity and outcomes. Acta Psychiatr Scand. Apr 2014;129(4):257-74. doi:10.1111/acps.12172
35. 35Andreasen NC, Carpenter Jr WT, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. American Journal of Psychiatry. 2005;162(3):441-449.
36. De Hert M, van Winkel R, Wampers M, Kane J, van Os J, Peuskens J. Remission criteria for schizophrenia: evaluation in a large naturalistic cohort. Schizophrenia Research. 2007;92(1-3):68-73.
37. Van Os J, Kahn R. Remission criteria in schizophrenia. Tijdschrift voor Psychiatrie. 2007;49(1):21-26.
38. 38. Lin CH, Lin HS, Lin SC, Kuo CC, Wang FC, Huang YH. Early improvement in PANSS‐30, PANSS‐8, and PANSS‐6 scores predicts ultimate response and remission during acute treatment of schizophrenia. Acta Psychiatrica Scandinavica. 2018;137(2):98-108.
39. Kroenke K, Spitzer RL, Williams JB. The PHQ‐9: validity of a brief depression severity measure. Journal of general internal medicine. 2001;16(9):606-613.
40. van Steenbergen-Weijenburg KM, de Vroege L, Ploeger RR, et al. Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics. BMC Health Services Research. 2010;10:1-6.
41. Gilbody S, Richards D, Brealey S, Hewitt C. Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. Journal of general internal medicine. 2007;22:1596-1602.
42. Corcoran R, Mercer G, Frith CD. Schizophrenia, symptomatology and social inference: investigating “theory of mind” in people with schizophrenia. Schizophrenia research. 1995;17(1):5-13.
43. Janssen I, Krabbendam L, Jolles J, Van Os J. Alterations in theory of mind in patients with schizophrenia and non‐psychotic relatives. Acta Psychiatrica Scandinavica. 2003;108(2):110-117.
44. Versmissen D, Janssen I, Myin-Germeys I, et al. Evidence for a relationship between mentalising deficits and paranoia over the psychosis continuum. Schizophrenia research. 2008;99(1-3):103-110.
45. Pinkham AE, Penn DL, Green MF, Buck B, Healey K, Harvey PD. The social cognition psychometric evaluation study: results of the expert survey and RAND panel. Schizophrenia bulletin. 2014;40(4):813-823.
46. Bell M, Fiszdon J, Greig T, Wexler B, Bryson G. Neurocognitive enhancement therapy with work therapy in schizophrenia: 6-month follow-up of neuropsychological performance. Journal of Rehabilitation Research & Development. 2007;44(5)
47. Tait L, Birchwood M, Trower P. A new scale (SES) to measure engagement with community mental health services. Journal of mental health. 2002;11(2):191-198.
48. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. International journal of behavioral medicine. 2008;15:194-200.
49. Soer R, Dijkstra MWS, Bieleman HJ, et al. Measurement properties and implications of the Brief Resilience Scale in healthy workers. Journal of Occupational Health. 2019;61(3):242-250.
50. 5Rosseel Y. lavaan: An R package for structural equation modeling. Journal of statistical software. 2012;48:1-36.
51. Byrne BM. Testing for the factorial validity, replication, and invariance of a measuring instrument: A paradigmatic application based on the Maslach Burnout Inventory. Multivariate Behavioral Research. 1994;29(3):289-311.
52. MacCallum RC, Browne MW, Sugawara HM. Power analysis and determination of sample size for covariance structure modeling. Psychological methods. 1996;1(2):130.
53. Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal. 1999;6(1):1-55.
54. Wardenaar K. Latent Profile Analysis in R: A tutorial and comparison to Mplus. 2021;
55. Collins NL, Feeney BC. Working models of attachment shape perceptions of social support: evidence from experimental and observational studies. Journal of personality and social psychology. 2004;87(3):363.
56. Van Dam D, Korver-Nieberg N, Velthorst E, et al. Childhood maltreatment, adult attachment and psychotic symptomatology: a study in patients, siblings and controls. Social psychiatry and psychiatric epidemiology. 2014;49:1759-1767.
57. Steffanowski A, Oppl M, Meyerberg J, Schmidt J, Wittmann WW, Nübling R. Psychometrische Überprüfung einer deutschsprachigen version des relationship scales questionnaire (RSQ). Störungsspezifische Therapieansätze-Konzepte und Ergebnisse. 2001:320-42.
58. Pos K, Bartels-Velthuis AA, Simons CJ, et al. Theory of Mind and attachment styles in people with psychotic disorders, their siblings, and controls. Australian & New Zealand Journal of Psychiatry. 2015;49(2):171-180.
59. Hesse E. The Adult Attachment Interview: Protocol, method of analysis, and empirical studies. 2008;
60. Thompson RA, Simpson JA, Berlin LJ. Attachment: The fundamental questions. Guilford Publications; 2021.
61. Reisz S, Duschinsky R, Siegel DJ. Disorganized attachment and defense: exploring John Bowlby’s unpublished reflections. Attachment & Human Development. 2018;20(2):107-134.
62. Hesse E, Main M. Second‐generation effects of unresolved trauma in nonmaltreating parents: Dissociated, frightened, and threatening parental behavior. Psychoanalytic inquiry. 1999;19(4):481-540.
63. Lyons-Ruth K, Jacobvitz D. Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies. 1999;
64. Holmes J. Roots and Routes to Resilience: Attachment/Psychodynamic Perspectives. Psychoanalytic Discourse. 2017;3(1):20-33.
65. Huguelet P, Mohr S, Rieben I, Hasler R, Perroud N, Brandt P-Y. Attachment and coping in psychosis in relation to spiritual figures. BMC psychiatry. 2015;15(1):237.
66. Berry K, Bucci S, Danquah AN. Attachment theory and psychosis: Current perspectives and future directions. 2019;
67. van Aken B, Wierdsma A, Voskes Y, Pijnenborg G, van Weeghel J, Mulder C. The association between executive functioning and personal recovery in people with psychotic disorders. Schizophrenia Bulletin Open. 2022;3(1):sgac023.
68. Griffin DW, Bartholomew K. Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of personality and social psychology. 1994;67(3):430.
69. Berry K, Barrowclough C, Wearden A. A review of the role of adult attachment style in psychosis: unexplored issues and questions for further research. Clinical psychology review. 2007;27(4):458-475.
2. Bowlby J. The making and breaking of affectional bonds: I. Aetiology and psychopathology in the light of attachment theory. The British journal of psychiatry. 1977;130(3):201-210.
3. Bucci S, Emsley R, Berry K. Attachment in psychosis: A latent profile analysis of attachment styles and association with symptoms in a large psychosis cohort. Psychiatry Research. 2017;247:243-249.
4. Berry K, Barrowclough C, Wearden A. Attachment theory: a framework for understanding symptoms and interpersonal relationships in psychosis. Behav Res Ther. Dec 2008;46(12):1275-82. doi:10.1016/j.brat.2008.08.009
5. Kotov R, Jonas KG, Carpenter WT, et al. Validity and utility of hierarchical taxonomy of psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry. 2020;19(2):151-172.
6. Read J, & Gumley, A. . Can attachment theory help explain the rlationship between childhood adversity and psychosis. Attachment: New Directions in Psychotherapy and Relational Psychoanalysis. 2008;2:1-35.
7. Barker V, Gumley A, Schwannauer M, Lawrie SM. An integrated biopsychosocial model of childhood maltreatment and psychosis. The British Journal of Psychiatry. 2015;206(3):177-180.
8. Varese F, Smeets F, Drukker M, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. Jun 2012;38(4):661-71. doi:10.1093/schbul/sbs050
9. Van Bussel E, Nguyen N, Wierdsma A, Van Aken B, Willems I, Mulder C. Adult attachment and personal, social, and symptomatic recovery from psychosis: systematic review and meta-analysis. Frontiers in Psychiatry. 2021;12: 641642.
10. Kvrgic S, Beck EM, Cavelti M, Kossowsky J, Stieglitz RD, Vauth R. Focusing on the adult attachment style in schizophrenia in community mental health centres: validation of the Psychosis Attachment Measure (PAM) in a German-speaking sample. Int J Soc Psychiatry. Jul 2012;58(4):362-73. doi:10.1177/0020764011399004
11. Macbeth A, Gumley, A., Schwannauer, M., & Fisher, R. Attachment states of mind, mentalization, and their correlates in a first-episode psychosis sample. Pychology and Psychotherapy, Theory, Research and Practice. 2011;84:42-57.
12. 12. Couture S, Lecomte, T., & Leclerc, C. Personality characteristis and attachment in first episode psychosis. The Journal of Nervous and Mental Disease. 2007;195:631-639.
13. Van Bussel E, Wierdsma A, van Aken B, Willems I, Mulder C. Adult attachment and personal recovery in clients with a psychotic disorder. Schizophrenia Bulletin Open. 2023:sgad010.
14. Bowlby J. Attachment and loss: Volume II: Separation, anxiety and anger. Attachment and Loss: Volume II: Separation, Anxiety and Anger. London: The Hogarth Press and the Institute of Psycho-Analysis; 1973:1-429.
15. Bowlby EJM. Attachment: Volume one of the attachment and loss trilogy. Random House; 2008.
16. Mikulincer M, Shaver, P.R. Attachment in adulthood. Structure, Dynamics, and Change. The Guilford Press; 2007.
17. Main M, Solomon J. Discovery of an insecure-disorganized/disoriented attachment pattern ISSN 0893913456. 1986;
18. Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: An integrative overview. 1998;
19. Bartholomew K. Avoidance of intimacy: An attachment perspective. Journal of Social and Personal relationships. 1990;7(2):147-178.
20. Bowlby J. Attachment and loss: retrospect and prospect. American journal of Orthopsychiatry. 1982;52(4):664.
21. Hazan C, Shaver PR. Love and work: An attachment-theoretical perspective. Journal of Personality and social Psychology. 1990;59(2):270.
22. Main M, Solomon J. Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. Attachment in the preschool years: Theory, research, and intervention. 1990;1:121-160.
23. Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. Journal of personality and social psychology. 1991;61(2):226.
24. Korver-Nieberg N, Meijer CJ, Koeter MW, de Haan L. 5Adult attachment in samples of psychotic patients. Attachment and psychosis. 2014:89.
25. Berry K, Wearden A, Barrowclough C, Liversidge T. Attachment styles, interpersonal relationships and psychotic phenomena in a non-clinical student sample. Personality and Individual Differences. 2006;41(4):707-718.
26. Pollard C, Bucci S, MacBeth A, Berry K. The revised psychosis attachment measure: Measuring disorganized attachment. British Journal of Clinical Psychology. 2020;59(3):335-353.
27. Olbert CM, Penn DL, Reise SP, et al. Assessment of attachment in psychosis: A psychometric cause for concern. Psychiatry research. 2016;246:77-83.
28. Asendorpf J, Banse R, Wilpers S, Neyer F. Relationship-specific attachment scales for adults and their validation with network and diary procedures. Diagnostica. 1997;43(4):289-313.
29. Banse R. Adult attachment and marital satisfaction: Evidence for dyadic configuration effects. Journal of Social and personal Relationships. 2004;21(2):273-282.
30. Elizur Y, Mintzer A. Gay males’ intimate relationship quality: The roles of attachment security, gay identity, social support, and income. Personal Relationships. 2003;10(3):411-435.
31. Rokita KI, Dauvermann MR, Donohoe G. Early life experiences and social cognition in major psychiatric disorders: a systematic review. European psychiatry. 2018;53:123-133.
32. Darling Rasmussen P, Storebø OJ, Løkkeholt T, et al. Attachment as a core feature of resilience: A systematic review and meta-analysis. Psychological reports. 2019;122(4):1259-1296.
33. van Aken BC, Bakia A, Wierdsma AI, et al. UP'S: A cohort study on recovery in psychotic disorder patients: Design protocol. Frontiers in psychiatry. 2021;11:1487.
34. Gumley AI, Taylor HE, Schwannauer M, MacBeth A. A systematic review of attachment and psychosis: measurement, construct validity and outcomes. Acta Psychiatr Scand. Apr 2014;129(4):257-74. doi:10.1111/acps.12172
35. 35Andreasen NC, Carpenter Jr WT, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. American Journal of Psychiatry. 2005;162(3):441-449.
36. De Hert M, van Winkel R, Wampers M, Kane J, van Os J, Peuskens J. Remission criteria for schizophrenia: evaluation in a large naturalistic cohort. Schizophrenia Research. 2007;92(1-3):68-73.
37. Van Os J, Kahn R. Remission criteria in schizophrenia. Tijdschrift voor Psychiatrie. 2007;49(1):21-26.
38. 38. Lin CH, Lin HS, Lin SC, Kuo CC, Wang FC, Huang YH. Early improvement in PANSS‐30, PANSS‐8, and PANSS‐6 scores predicts ultimate response and remission during acute treatment of schizophrenia. Acta Psychiatrica Scandinavica. 2018;137(2):98-108.
39. Kroenke K, Spitzer RL, Williams JB. The PHQ‐9: validity of a brief depression severity measure. Journal of general internal medicine. 2001;16(9):606-613.
40. van Steenbergen-Weijenburg KM, de Vroege L, Ploeger RR, et al. Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics. BMC Health Services Research. 2010;10:1-6.
41. Gilbody S, Richards D, Brealey S, Hewitt C. Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. Journal of general internal medicine. 2007;22:1596-1602.
42. Corcoran R, Mercer G, Frith CD. Schizophrenia, symptomatology and social inference: investigating “theory of mind” in people with schizophrenia. Schizophrenia research. 1995;17(1):5-13.
43. Janssen I, Krabbendam L, Jolles J, Van Os J. Alterations in theory of mind in patients with schizophrenia and non‐psychotic relatives. Acta Psychiatrica Scandinavica. 2003;108(2):110-117.
44. Versmissen D, Janssen I, Myin-Germeys I, et al. Evidence for a relationship between mentalising deficits and paranoia over the psychosis continuum. Schizophrenia research. 2008;99(1-3):103-110.
45. Pinkham AE, Penn DL, Green MF, Buck B, Healey K, Harvey PD. The social cognition psychometric evaluation study: results of the expert survey and RAND panel. Schizophrenia bulletin. 2014;40(4):813-823.
46. Bell M, Fiszdon J, Greig T, Wexler B, Bryson G. Neurocognitive enhancement therapy with work therapy in schizophrenia: 6-month follow-up of neuropsychological performance. Journal of Rehabilitation Research & Development. 2007;44(5)
47. Tait L, Birchwood M, Trower P. A new scale (SES) to measure engagement with community mental health services. Journal of mental health. 2002;11(2):191-198.
48. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. International journal of behavioral medicine. 2008;15:194-200.
49. Soer R, Dijkstra MWS, Bieleman HJ, et al. Measurement properties and implications of the Brief Resilience Scale in healthy workers. Journal of Occupational Health. 2019;61(3):242-250.
50. 5Rosseel Y. lavaan: An R package for structural equation modeling. Journal of statistical software. 2012;48:1-36.
51. Byrne BM. Testing for the factorial validity, replication, and invariance of a measuring instrument: A paradigmatic application based on the Maslach Burnout Inventory. Multivariate Behavioral Research. 1994;29(3):289-311.
52. MacCallum RC, Browne MW, Sugawara HM. Power analysis and determination of sample size for covariance structure modeling. Psychological methods. 1996;1(2):130.
53. Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal. 1999;6(1):1-55.
54. Wardenaar K. Latent Profile Analysis in R: A tutorial and comparison to Mplus. 2021;
55. Collins NL, Feeney BC. Working models of attachment shape perceptions of social support: evidence from experimental and observational studies. Journal of personality and social psychology. 2004;87(3):363.
56. Van Dam D, Korver-Nieberg N, Velthorst E, et al. Childhood maltreatment, adult attachment and psychotic symptomatology: a study in patients, siblings and controls. Social psychiatry and psychiatric epidemiology. 2014;49:1759-1767.
57. Steffanowski A, Oppl M, Meyerberg J, Schmidt J, Wittmann WW, Nübling R. Psychometrische Überprüfung einer deutschsprachigen version des relationship scales questionnaire (RSQ). Störungsspezifische Therapieansätze-Konzepte und Ergebnisse. 2001:320-42.
58. Pos K, Bartels-Velthuis AA, Simons CJ, et al. Theory of Mind and attachment styles in people with psychotic disorders, their siblings, and controls. Australian & New Zealand Journal of Psychiatry. 2015;49(2):171-180.
59. Hesse E. The Adult Attachment Interview: Protocol, method of analysis, and empirical studies. 2008;
60. Thompson RA, Simpson JA, Berlin LJ. Attachment: The fundamental questions. Guilford Publications; 2021.
61. Reisz S, Duschinsky R, Siegel DJ. Disorganized attachment and defense: exploring John Bowlby’s unpublished reflections. Attachment & Human Development. 2018;20(2):107-134.
62. Hesse E, Main M. Second‐generation effects of unresolved trauma in nonmaltreating parents: Dissociated, frightened, and threatening parental behavior. Psychoanalytic inquiry. 1999;19(4):481-540.
63. Lyons-Ruth K, Jacobvitz D. Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies. 1999;
64. Holmes J. Roots and Routes to Resilience: Attachment/Psychodynamic Perspectives. Psychoanalytic Discourse. 2017;3(1):20-33.
65. Huguelet P, Mohr S, Rieben I, Hasler R, Perroud N, Brandt P-Y. Attachment and coping in psychosis in relation to spiritual figures. BMC psychiatry. 2015;15(1):237.
66. Berry K, Bucci S, Danquah AN. Attachment theory and psychosis: Current perspectives and future directions. 2019;
67. van Aken B, Wierdsma A, Voskes Y, Pijnenborg G, van Weeghel J, Mulder C. The association between executive functioning and personal recovery in people with psychotic disorders. Schizophrenia Bulletin Open. 2022;3(1):sgac023.
68. Griffin DW, Bartholomew K. Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of personality and social psychology. 1994;67(3):430.
69. Berry K, Barrowclough C, Wearden A. A review of the role of adult attachment style in psychosis: unexplored issues and questions for further research. Clinical psychology review. 2007;27(4):458-475.