Alcohol Dependence and Avoidant Attachment – Implications for Therapy

2.50
Hdl Handle:
http://hdl.handle.net/2436/14641
Title:
Alcohol Dependence and Avoidant Attachment – Implications for Therapy
Authors:
Cornwall, Jane
Abstract:
The literature review revealed co-morbidity between adverse childhood experiences, adult psychopathology and alcohol dependence, although causality was questionable due to multiple variables. The current study used 54 clients at the acute end of the spectrum of severe alcohol dependence from a specialist tertiary substance misuse service (clients) and a control group of 54 non-problematic drinkers from an NHS working population (controls) to examine possible differences in security of attachment and maladaptive schemas and investigated how early relational experiences influenced core beliefs regarding self, others and intimate relationships and therapeutic implications for severely alcohol dependent clients’ engagement in specialist services. The study was divided into two sections: (1) quantitative analysis using Feeney, Noller and Hanrahan’s (1994) Attachment Style Questionnaire to measure attachment style and Young’s Schema Questionnaire (Young & Brown, 2001) to measure maladaptive schemas in the domain of disconnection and rejection and (2) qualitative analysis, using Interpretational Phenomenological Analysis (IPA) to explore eight severely alcohol dependent clients’ subjective experiences of intimate relationships. Clients scored significantly lower in secure attachment style and significantly higher in both avoidant and ambivalent attachment style than controls and suggested overlapping between the two dimensions, known as ‘fearful avoidant’ attachment. Clients scored significantly higher than controls in all five sub-categories of maladaptive schemas in the domain of disconnection and rejection, namely mistrust/abuse, emotional deprivation, abandonment, social isolation/alienation and defectiveness/shame. IPA revealed common themes of negative parent-child interaction: physical and psychological abuse, neglect and explicit maternal rejection and emotional deprivation and hostile and abusive parent-parent interaction. These aetiological factors influenced fearful avoidant attachment and maladaptive core beliefs. Negation of children’s needs implicated an immaturely developed diffuseness of identity and defective self that inhibited formation of intimate adult relationships. A bio-psychosocial explanation suggested alcohol ameliorated hyper-vigilant anxiety and depression from adverse childhood experiences within a threatening family environment that implicated insecure attachment, maladaptive core beliefs and negative self-identity, inhibiting emotional intimacy. It advocated screening procedures and an integrated CBT and schema-based therapeutic approach for those at the more severe end of the spectrum of alcohol dependence deemed at risk of not engaging or disengaging prematurely from services.
Publisher:
University of Wolverhampton
Issue Date:
Oct-2007
URI:
http://hdl.handle.net/2436/14641
Type:
Thesis
Language:
en
Description:
A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the award of Practitioner Doctorate Degree in Counselling Psychology
Appears in Collections:
E-Theses

Full metadata record

DC FieldValue Language
dc.contributor.authorCornwall, Jane-
dc.date.accessioned2007-11-21T10:19:32Z-
dc.date.available2007-11-21T10:19:32Z-
dc.date.issued2007-10-
dc.identifier.urihttp://hdl.handle.net/2436/14641-
dc.descriptionA thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the award of Practitioner Doctorate Degree in Counselling Psychologyen
dc.description.abstractThe literature review revealed co-morbidity between adverse childhood experiences, adult psychopathology and alcohol dependence, although causality was questionable due to multiple variables. The current study used 54 clients at the acute end of the spectrum of severe alcohol dependence from a specialist tertiary substance misuse service (clients) and a control group of 54 non-problematic drinkers from an NHS working population (controls) to examine possible differences in security of attachment and maladaptive schemas and investigated how early relational experiences influenced core beliefs regarding self, others and intimate relationships and therapeutic implications for severely alcohol dependent clients’ engagement in specialist services. The study was divided into two sections: (1) quantitative analysis using Feeney, Noller and Hanrahan’s (1994) Attachment Style Questionnaire to measure attachment style and Young’s Schema Questionnaire (Young & Brown, 2001) to measure maladaptive schemas in the domain of disconnection and rejection and (2) qualitative analysis, using Interpretational Phenomenological Analysis (IPA) to explore eight severely alcohol dependent clients’ subjective experiences of intimate relationships. Clients scored significantly lower in secure attachment style and significantly higher in both avoidant and ambivalent attachment style than controls and suggested overlapping between the two dimensions, known as ‘fearful avoidant’ attachment. Clients scored significantly higher than controls in all five sub-categories of maladaptive schemas in the domain of disconnection and rejection, namely mistrust/abuse, emotional deprivation, abandonment, social isolation/alienation and defectiveness/shame. IPA revealed common themes of negative parent-child interaction: physical and psychological abuse, neglect and explicit maternal rejection and emotional deprivation and hostile and abusive parent-parent interaction. These aetiological factors influenced fearful avoidant attachment and maladaptive core beliefs. Negation of children’s needs implicated an immaturely developed diffuseness of identity and defective self that inhibited formation of intimate adult relationships. A bio-psychosocial explanation suggested alcohol ameliorated hyper-vigilant anxiety and depression from adverse childhood experiences within a threatening family environment that implicated insecure attachment, maladaptive core beliefs and negative self-identity, inhibiting emotional intimacy. It advocated screening procedures and an integrated CBT and schema-based therapeutic approach for those at the more severe end of the spectrum of alcohol dependence deemed at risk of not engaging or disengaging prematurely from services.en
dc.format.extent2875683 bytes-
dc.format.mimetypeapplication/pdf-
dc.language.isoenen
dc.publisherUniversity of Wolverhamptonen
dc.subjectAlcoholen
dc.subjectAvoidanten
dc.subjectAttachmenten
dc.subjectSchemasen
dc.subjectChildhooden
dc.subjectAbuseen
dc.subjectDisconnectionen
dc.subjectRejectionen
dc.subjectMaladaptiveen
dc.subjectBeliefsen
dc.subjectAlcoholism-
dc.subjectHealth Psychology-
dc.subjectsubstance abuse-
dc.subjectPsychotherapy-
dc.titleAlcohol Dependence and Avoidant Attachment – Implications for Therapyen
dc.typeThesisen
dc.type.qualificationlevelDoctoral-
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