Understanding the effect of attachment styles in paranoid ideation: The mediator role of experiential avoidance

Paula Castilho, Maria João Martins, Ana Margarida Pinto, Ricardo Viegas, Sérgio Carvalho, Nuno Madeira


1) to evaluate different attachment styles depending on the attachment figure; 2) to explore the association between experiential avoidance and paranoid ideation frequency; 3) to test a mediation model in which the impact of adult attachment on frequency of paranoid ideation occurs through experiential avoidance.

We assessed adult-attachment, experiential avoidance and paranoid ideation frequency in a sample of 37 (30 male and 7 female) outpatients and inpatients with a psychosis-spectrum diagnosis.

The anxiety attachment pattern was significantly higher in all attachment figures. We found that attachment anxiety (mother) was associated with both experiential avoidance and paranoid ideation. An association between experiential avoidance and paranoid ideation frequency was also found. Results show that experiential avoidance mediated the relationship between attachment anxiety and paranoid ideation frequency.

Our study highlights the importance of addressing therapeutically the mechanisms people with psychosis use to cope with the internal experience elicited by insecure attachment styles, specifically experiential avoidance, and suggests the adequacy of acceptance and mindfulness-based therapies in promoting recovery for psychotic patients.

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