Long-term changes in attachment patterns after psychotherapy in outpatients with Axis I and personality disorders vs. Axis I disorders only

Personal Ment Health. 2021 May;15(2):136-146. doi: 10.1002/pmh.1500. Epub 2020 Dec 9.

Abstract

Background: Adult attachment can be self-reported by rating anxiety of deception and avoidance of emotional closeness. There are few studies of changes in adult attachment patterns after psychotherapy.

Aim: This study investigated how attachment anxiety and avoidance mean scores changed from pre-treatment to follow-up in patients with Axis I disorders only vs. patients with Axis I and comorbid personality disorders (comorbid group) after outpatients psychotherapy.

Method: Of 156 patients with pre-treatment evaluation, 64 (41%) participated in follow-up 6 years later. Axis I and personality disorder interviews were performed at pre-treatment and follow-up, and the participants self-reported attachment patterns at both time points.

Results: At both pre-treatment and follow-up, the Axis I group had significantly lower attachment avoidance scores than the comorbid group, while no significant between-group differences were observed for attachment anxiety. After adjustment, neither the Axis I nor the comorbid group showed any significant reductions in attachment anxiety or avoidance over time. The pre-treatment attachment scores were the only significant predictors of the follow-up scores.

Conclusion: Neither attachment anxiety nor avoidance were amenable to change over time. These findings may be associated with the psychotherapy given. Pre-treatment attachment scores were the only significant predictors of these scores at follow-up. © 2020 John Wiley & Sons, Ltd.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety
  • Anxiety Disorders / therapy
  • Humans
  • Outpatients*
  • Personality Disorders* / therapy
  • Psychotherapy