The causal model of insecure attachment style and traumatic experiences mediated by mindfulness on the mentalization

Document Type : Research Paper

Authors

1 Ph.D. Students of Psychology, Department of Psychology, Faculty of Literature and Human Sciences, Lorestan University- Khorramabad, Iran

2 Phd in Psychology, Associated Professor, Department of Psychology, Faculty of Literature and Human Sciences, Lorestan University- Khorramabad, Iran.

Abstract

Introduction: Mentalization, which is defined as the capacity to understand the mental states of oneself and others, can be an important factor in social anxiety disorder. This study aimed to investigate the causal model of insecure attachment style and traumatic experiences mediated by mindfulness on the mentalization of people with social anxiety.
Method: The present study is quantitative correlation and structural equations. The statistical population of the study included all students of Payame Noor University in Aleshtar in 1399. 232 students who scored above 40 in the Conover Social Anxiety Questionnaire were selected as the sample. Data collection tools included: Connor Social Anxiety Questionnaire, Dimitrievich mentalization, Hazen Attachment Style, Mohammadkhani Traumatic Experiences, and Freiburg Mindfulness. Data were analyzed using structural equations using AMOS software.
Results: The results showed that the hypothetical model of the research has a good fit with the data. Insecure attachment style and traumatic experiences had a significant negative relationship with mentalization. Mindfulness was able to significantly mediate the relationship between insecure attachment and mentalization, but mindfulness did not play a significant mediating role in the relationship between traumatic experiences and mentalization.
Conclusion: The results of this study indicate that insecure attachment style, directly and indirectly, affects mentalization through mindfulness and traumatic experiences can only directly affect mentalization. Paying attention to these variables can be effective in solving mental problems and improving them.

Keywords


1- Byrow, Y. (2015). The influence of adult attachment style on social anxiety. A dissertation submitted in partial fulfilment of the requirements of the degree of Doctor of Philosophy Department of Psychology, Macquarie University.
2- Nikolić, M. (2020). Social emotions and social cognition in the development of social anxiety disorder. European Journal of Developmental Psychology, 1-17. DOI: 10.1080/17405629 .2020.1722633.
3- Rudaz, M., Ledermann, T., Margraf, J., Becker, E. S., Craske, M.G. (2017). The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia? PLoS ONE, 12(7), 1-14, doi.org/10.1371/journal.pone.0180298.
4- Stein, D., Lim, C. W., Roest, A., Jonge, P., & etal. (2017). the cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Medicine, 15(143), 1-21, DOI 10.1186/s12916-017-0889-
5- Washburn, D., Wilson, G., Roes, M., Rnic, K., & etal. (2014). Theory of mind in social anxiety disorder, depression, and comorbid conditions. Journal of Anxiety Disorders, 37, 71–77, doi.org/10.1016/j.janxdis.2015.11.004.
6- Gabalawy, R. E., Cox, B., Clara, I., Mackenzie, C. (2010). Assessing the validity of social anxiety disorder subtypesusing a nationally representative sample. Journal of Anxiety Disorders, 24, 244–249. doi: 10.1016/j.janxdis.2009.11.003.
7- Ohayon, M. M., Schatzberg, A. F. (2010). Social phobia and depression: Prevalence and comorbidity. Journal of Psychosomatic Research, 68, 235–243. doi: 10.1016/j.jpsychores. 2009.07.018.
8- Ballespí, S., Vives, J., Sharp, C., Tobar, A., Barrantes-Vidal, N. (2019). Hypermentalizing in Social Anxiety: Evidence for a Context-Dependent Relationship. Front. Psychol, 10(15), 1-11. doi: 10.3389/fpsyg.2019.01501.
9- Steinmair, D., Richter, F., Löffler-Stastka, H. (2020). Relationship between Mentalizing and Working Conditions in Health Care. International Journal of Environmental Research and Public Health, 17, 1-14. doi:10.3390/ijerph17072420.
10- Bateman, A., & Fonagy, P. (2016). Mentalization-Based Treatment for Personality Disorders: A Practical Guide. First Edition, Oxford University Press.
11- Sklyarov, O. (2020). The Impact of Adverse Childhood Experiences on Attachment and   Mentalization in Sex Offenders. degree of  Doctor of Psychology in Clinical Psychology. George Fox University.
12- Nazzaro, M. P., Boldrini, T., Tanzilli, A., Muzi, L., & et al. (2017). “Does re fl ective functioning mediate the relationship between attachment and personality?,” Psychiatry Research,  256, 169–175. doi: 10.1016/j.psychres.2017.06.045
13- Samson, A. C., Lackner, H. K., Weiss, E. M., & Papousek, I. (2012). Perception of other people’s mental states affects humor in social anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 43, 625–631.doi.org/10.1016/j. jbtep.2011.08.007
14- Agostini, A., Scaioli, E., Belluzzi, A., Campieri, M. (2019). Attachment and Mentalizing Abilities in Patients with Inflammatory Bowel Disease. Gastroenterology Research and Practice, 16, 1-8. doi.org/10.1155/2019/7847123
15- Kay, S. (2018). The Relationship among Reflective Functioning, History of Childhood Trauma, and Symptoms of Depersonalization and Childhood Trauma, and Symptoms of Depersonalization. degree of Doctor of Philosophy, The City University of New York.
16- Weir, S. (2018). mentalization and mindfulness two related constructs in theory and practice. Degree Doctor of Psychology, Biola University.
17- Redondo, I., & Luyten, P. (2018). The mediating role of mentalizing between Attachment and eating disorders. Summer, 82(3), 202-225. doi: 10.1521/bumc.2018.82.3.202.
18- Bateman, A., & Fonagy, P. (2012). Handbook of mentalizing in mental health practice. Washington, DC: American Psychiatric Publishing.
19- Byrow, Y. (2015). The influence of adult attachment style on social anxiety. A dissertation submitted in partial fulfilment of the requirements of the degree of Doctor of Philosophy Department of Psychology, Macquarie University.
20- Hayden, M., Müllauer, P., Gaugeler, R., Senft, B., & et al. (2019). Mentalization as Mediator between Adult Attachment and Interpersonal Distress. Psychopathology, 30, 65-67. DOI: 10.1159/000496499.
21- Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (2006). Psychotherapy for borderline personality: Focusing on object relations (1st ed.). Arlington: American Psychiatric Publishing.
22- Turner, J., Wittkowski, A., Hare, D. J. (2008). The relationship of maternal mentalization and executive functioning to maternal recognition of infant cues and bonding. British Journal of Psychology, 99, 499–512. DOI:0.1348/000712608X289971.
23- Koenen, K., Roberts, A., Stone, D., Dunn, E. (2010). the Impact of Early Life Trauma on Health and Disease: the Hidden Epidemic. Cambridge University Press.
24- Fowler, S. (2016). The Relationship between Traumatic Events And Psychological Symptomatology And The Moderating Role Of Mentalization. Electronic Theses and Dissertations, Georgia Southern University.
25- Irigaray, T. Q., Pacheco, J. B., Grassi-Oliveira, R., Fonseca, R& etal. (2013). Child maltreatment and later cognitive functioning: A systematic review. Psicologia: ReflexA£o E CrAtica, 26(2), 376-387. doi:10.1590/s010279722013000200018.
26- Stein, H., & Allen, J. G. (2007). Mentalizing as a framework for integrating therapeutic exposure and relationship repair in the treatment of a patient with complex posttraumatic psychopathology. Bulletin of the Menninger Clinic, 71(4), 273–290. doi: http://dx.doi. org/10.1521/bumc.2007.71.4.273
27- Falkenström, F., Solbakken,, O. A., Möller, C., & etal. (2014). Reflective functioning, affect consciousness, and mindfulness: Are these different functions?. Psychoanalytic Psychology, 31(1), 26-40. DOI: 10.1037/a0034049
28- Hayes, S.C., Pistorello, J., Levin, M.E. (2012). Acceptance and commitment therapy as a unified model of behavior change. Couns Psychol, 40(7), 976-1002. DOI:10.1177/0011000012460836.
29- Johansen, M. S., Karterud, S. W., Normann-Eide, E., Rø, F. G., Kvarstein, E. H., & Wilberg, T. (2018). The Relationship between Reflective Functioning and Affect Consciousness in Patients With Avoidant and Borderline Personality Disorders. Psychoanalytic Psychology. 1-14, doi.org/10.1037/pap0000169
30- Woynowskie, K. (2015). Mentalization and Overlapping Constructs: Mindfulness, Empathy, Emotional Intelligence, Psychological Mindedness using exploratory factor analysis. Degree of Doctor of Psychology, Chicago School.
31- Dimitrijevi, A., Hanak, N., Dimitrijevi, A., Marjanovi, Z. (2017). The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity. Journal of Personality Assessment, 1-14. doi.org/10.1080/00223891.2017.1310730
32- Rahmanian, A., Nouri, A, Arizi, H., Rumi, H. (2007). The Relationship between Adult Attachment Style and Nurses' Stress and Job Satisfaction. Iranian Journal of Psychiatry and Clinical Psychology, 13(2), 148-157
33- Ghasemi, R., Mahdi, A., Niko, j. (2014) the validity and reliability of the Persian version of the short form of Freiburg's Awareness Questionnaire. Journal of Rafsanjan University of Medical Sciences. 14(2). 137-150.
34- Mohamadkhani, P., Mohammadi, M., Nazari, M., Salavati, M. (2003) Preparation, validity and reliability of self-report measures of child abuse (CASRS) students in Iran]. International journal of the Islamic Republic of Iran, 17(1), 26-38.
35- Hölzel, B. K., Carmody, J., Vangel, M., Congleton, C., & etal. (2011). Mindfulness practice leads to increases in regional brain gray matter    density. Psychiatry Research: Neuroimaging, 191(1), 36-43. doi:10.1016/j.pscychresns.2010.08.006.
36- Brune, M., Walden, S., Edel, M., & Dimaggio, G. (2016). Mentalization of complex emotions in borderline personality disorder: The impact of parenting and exposure to trauma on the performance in a novel cartoon-based task. Comprehensive Psychiatry, 64, 29-37. doi:10.1016/j.comppsych.2015.08.003
37- Macintosh, H. B. (2019). Development Couple Therapy for Complex Trauma: A Manual for Therapists. Milton Park, Abingdon: Routledge.
38- Leigh, J., Anderson, V. (2013). Secure Attachment and Autonomy Orientation May Foster Mindfulness.  Contemporary Buddhism, 1-29.
39- Shaver, P. R., Lavy, S., Saron, C. D., & Mikulincer, M. (2007). Social foundations of the capacity for mindfulness: an attachment perspective. Psychological Inquiry, 18(4), 264–271. doi.org/10.1080/10478400701598389
40- Stevenson, J., Emerson, L., Millings, A. (2017). The Relationship between Adult Attachment Orientation and Mindfulness: a Systematic Review and Meta-analysis. Mindfulness, 8, 1438–1455. DOI 10.1007/s12671-017-0733-y
41- Read, D.L., Clark, G.I., Rock, A.J., Coventry, W.L. (2018). Adult attachment and social anxiety: The mediating role of emotion regulation strategies. PLoS ONE, 13(12), 1-21. https://doi.org/ 10.1371/journal.pone.0207514
42- Garland, E.L., Roberts-Lewis, A. (2013). Differential roles of thought suppression and dispositional mindfulness in posttraumatic stress symptoms and craving. Addict Behav 38(2), 1555–62. doi:10.1016/j.a ddbeh.2012.02.004
43- Bernstein, A., Tanay, G., Vujanovic, A.A. (2011). Concurrent Relations Between Mindful Attention and Awareness and Psychopathology Among Trauma-Exposed Adults: Preliminary Evidence of Transdiagnostic Resilience. J Cogn Psychother, 25(2), 99–113. DOI:10.1891/0889-8391.25.2.99
44- Elices, M., Pascual, J., Carmona, C., Martín-Blanco, A., & et al. (2015). Exploring the relation between childhood trauma, temperamental traits and mindfulness in borderline personality disorder. BMC Psychiatry, 15, 1-7. DOI 10.1186/s12888-015-0573