McAnena, Caoimhe; (2001) Attachment and early maladaptive schemas in alcohol dependence. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

This study examines the concept of attachment in relation to alcohol use. The process by which insecure attachment increases the likelihood of addictive behaviour is considered, and one possible mechanism, which is via cognitive representations of the self and others, is explored. In addition, the concept of dissociation is discussed, and addictive behaviour as a dissociative process is considered in relation to attachment and cognitive schemas. Participants for the alcohol dependent group were recruited from local alcohol services, including the Community Alcohol Team (CAT) and inpatient detoxification units. Participants in the control group were recruited from local hospital and community services. The Attachment Style Questionnaire was used to measure attachment anxiety and avoidance, and the short form of Young's Schema Questionnaire was used to calculate dimensional scores on each maladaptive schema and schema domain. The Curious Experiences Inventory provided a measure of dissociative experiences when not under the influence of alcohol or other substances. A short interview was used to obtain additional information on demographics, personal history, and alcohol use. The results of this study support the hypothesis that alcohol dependent participants display more insecure attachment than recreational users, and disorganised attachment in particular was highlighted. The alcohol dependent sample were found to have significantly more Early Maladaptive Schemas (EMS) than the non-clinical group, and to score more highly on each schema domain, supporting the proposition that negative beliefs about the self and others are related to alcohol dependence. However, a specific pattern of schema domains was not clearly identified with this population. The clinical group were found to have higher levels of dissociation than the control group, supporting the idea of alcohol dependence as 'chemical dissociation'. However, heavier alcohol use did not predict higher levels of dissociation within either the alcohol dependent or recreational participants. Severity of alcohol dependence was associated with higher levels of depersonalisation and overall dissociation in both groups, and in addition with amnesia in the control group. The relationship between attachment, EMS and dissociation was investigated in an exploratory way, with confusing results. The most reliable finding is that avoidance was surprisingly not associated with any measure of dissociation in either group, while attachment anxiety was related to the depersonalisation sub-scale in both groups. The implications for future research and clinical interventions are discussed.

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