Sermin Kesebir, Semine Özdoğan Kavzoğlu, Mehmet Fatih Üstündağ

Bağlanma ve Psikopatoloji

Yaşamın erken dönemlerinde belirlenen ve süreklilik gösterdiği düşünülen bağlanma biçimi, kişinin diğer insanlarla ilişki kurma örüntüsünü şekillendiren bir fenomendir. Her bir bağlanma biçiminin klinik görünümleri farklıdır, ileriye ve geriye dönük fenomenolojik yansımaları vardır. Kişinin başka bir kişi ile yakın bir ilişki kurup kurmadığı ve bu ilişkinin destekleyici ve koruyucu özellikler taşıyıp taşımadığı, hayatının her döneminde ve yakın ilişkilerde gözlemlenebilir. Bağlanma kuramcılarına göre süt çocukluğu döneminde güvenli ya da güvensiz olarak bir kez belirlendikten sonra çok az değişkenlik gösterir. Bowlby\'nin çalışmalarından başlamak üzere güvensiz bağlanma biçimi daha sonraki yaşam dönemlerinde psikopatolojinin belirleyicisi olarak düşünülmüşken güvenli bağlanma sağlıklı süreçlerle ilişkilendirilmiştir. Doğanın özgün modeli güvenli bağlanmadır. Güvensiz bağlanma biçimleri olan kaygılı/ikircikli bağlanma anksiyete bozuklukları ve depresif bozukluklarla ilişkilendirilirken, kaçıngan bağlanma davranış bozukluğu ve diğer dışa vuruk patolojilerle ilişkilendirilmiştir. Dağınık bağlanmanın (dezorganize/ dezoryante) ise dissosiyatif bozukluklarla birlikteliğinden sözedilmiştir. Bu yazının amacı, bağlanmayı ve bağlanma ile psikopatoloji arasındaki ilişkiyi gözden geçirmektir.

Anahtar Kelimeler:

bağlanma, bağlanma biçimi, psikopatoloji

Attachment and Psychopathology

The type of attachment defined in the early stages of life and thought to be continuous, is a phenomenon that shapes the pattern of how a person makes contact with others. The clinical appearance of every type of attachment is different and each one has prospective and retrospective phenomenological reflections. In all stages of life and in close relationships, it can be observed if a person gets in close contact with someone else and if this relation bears supportive and protective qualities. According to attachment theorists, once it is defined as safe or unsafe during nursing period, it shows little change. Starting from Bowlby's work, unsafe attachment type is considered as the determining factor of psychopathology in the later periods of life, while safe attachment is considered as in relation with healthy processes. The nature's original model is safe attachment. Anxious/indecisive attachment, an unsafe attachment type, is associated with anxiety disorders and depressive disorder, while avoidant attachment is associated with behavior disorder and other extroverted pathologies. Disorganized/disoriented attachment is considered to be together with dissociative disorder. The aim of this paper is to review attachment theory and the relation between attachment and psychopathology.

Keywords:

attachment, attachment style, psychopathology,

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Thompson RA. Attachment theory and research. In Child and Adolescent Psychiatry, 3rd Ed. (Ed M Lewis):164-172. Philadelphia, Lippincott Williams Wilkins, 2002.
Collins NL, Laurson W. Adolescents’ relationships with parents. J Lang Soc Psychol 2003; 22: 58-65.
Nakash-Eisikovits O, Dutra L, Westen D. Relationship between attachment patterns and personality pathology in adolescents. J Am Acad Child Adolesc Psychiatry 2000; 41:1111-1123.
Hamilton CE. Continuity and discontinuity of attachment from infancy through adolescence. Child Dev 2000; 71:690-694.
George C, Kaplan N, Main M. The adult attachment interview. Berkeley, University of California, 1985.
Hazan C, Shaver PR. Romantic love conceptualized as an attachment process. J Pers Soc Psychol 1987; 52:511-524.
Ainsworth MDS, Blehar MC, Waters E, Walls S. Patterns of Attachment: A Psychological Study of the Strange Situation. Hillsdale, Lawrence Erlbaum, 1978.
Shaver PR, Hazan C, Bradshaw D. Love as attachment: The integration of three behavioral systems. In The Psychology of Love (Eds JR Sternberg, ML Barns):68-99. New Haven, Yale University Press, 1988.
Collins NL, Read SJ. Adult attachment, working models and relationship quality in dating couples. J Pers Soc Psychol 1990; 58:644-663.
Mikulincer M, Florian F, Weller A. Attachment styles, coping strategies, and posttraumatic psychological distress: The impact of the Gulf War in Israel. J Pers Soc Psychol 1993; 64:817-826.
Simpson JA. Influence of attachment styles on romantic relationships. J Pers Soc Psychol 1990; 59:971-980.
Bartholomew K, Horowitz LM. Attachment styles among young adults: A test of a four-category model. J Pers Soc Psychol 1991; 61:226-244.
Brennan KA, Clark CL, Shaver PR. Self report of measurement of adult attachment: an integrative overview. In Attachment Theory and Close Relationships (Eds JA Simpson, WS Rholes):46-76. New York, Guilford Press, 1998.
Sümer N, Güngör D. Yetişkin bağlanma stilleri ölçeklerinin Türk örneklemi üzerinde psikometrik değerlendirmesi ve kültürler arası bir karşılaştırma. Türk Psikoloji Dergisi 1999; 14:71- 76.
Sümer N. Yetişkin bağlanma ölçeklerinin kategoriler ve boyutlar düzeyinde karşılaştı- rılması. Türk Psikoloji Dergisi 2006; 21:1-22.
Parker G, Tupling H, Brown LB. A parental bonding instrument. Br J Med Psychol 1979; 52:1-10.
Bowlby J. Attachment and Loss, 1st Ed. London, Hogarth Press, 1969.
Bowlby J. Attachment and Loss: Separation, Anxiety and Anger. New York, Basic Books, 1973.
Kapçı E, Küçüker S. Anne babaya bağlanma ölçeği: Türk üniversite öğrencilerinde psikometrik özelliklerinin değerlendirilmesi. Turk Psikiyatri Derg 2006; 17:286-295.
Nelson JK. Clinical assessment of crying and crying inhibition based on attachment theory. Bull Menninger Clin 2000; 64:509-529.
Çalışır M. Yetișkin bağlanma kuramı ve duygulanım düzenleme stratejilerinin depres- yonla ilișkisi. Psikiyatride Güncel Yaklaşımlar 2009; 1:240-255.
Stevenson-Hinde J. Attachment theory and John Bowlby: Some reflections. Attach Hum Dev 2007; 9:337-342.
Bowlby J. The Making and Breaking of Affectional Bonds. London, Tavistock Publications, 1979.
Bowlby J. The nature of the child’s tie to his mother. Int J Psychoanal 1958; 39:350- 373.
Lamb ME, Teti DM, Bornstein M. Developmental phases: infancy. In Child and Adolescent Psychiatry, 3ed Ed. (Ed M Lewis):293-323. Philadelphia, Lippincott Williams Wilkins, 2002.
Barnett D, Vondra JI. Atypical attachment in infancy and early childhood among children at developmental risk. I. Atypical patterns of early attachment: theory, research and current directions. Monogr Soc Res Child Dev 1999; 64:1-24.
Bloom KC. The development of attachment behaviors in pregnant adolecents. Nurs
Zeanah CH, Boris NW, Larriey JA. Infant development and developmantal risk: a review of the past 10 years. J Am Acad Child Adolescent Psychiatry 1997; 36:165- 178.
Soysal AŞ, Ergenekon E, Eroğlu D. Bebekleri tanı açısından yüksek-standart risk altında olan annelerin duygudurumlarının kısa süreli yardım grupları ile değerlendi- rilmesi. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi 2000; 8:106-111.
Van de Rijt-Plooij HC, Plooij PX. Distinct periods of mother infant conflict in nor- mal development: sources of progress and germs of pathology. J Child Psychol Psychiatry 1993; 34:229-245.
Goodfriend MS. Treatment of attachment disorder of infancy in a neonatal intensive care unit. Pediatrics 1993; 1:139-142.
Boccio M, Laudenslager MN, Reite ML. Intrinsic and extrinsic factors affect infant responses to maternal separation. Psychiatry 1994; 57:43-50.
Biller HB. Fathers and Families Paternal Factors in Child Development. London, Auburn House, 1993.
Bretherton I, Munholland KA. Internal working models in attachment relationships. A construct revisited. In Handbook of Attachment. Theory, Research and Clinical Applications, 1st Ed. (Eds J Cassidy, PR Shaver):89-114. New York, Guilford Press, 1999.
Lee EJ. The attachment system throughout the life course: Review and criticisms of attachment theory. http://www.personalityresearch.org/papers/lee.html (Accessed at 1.2.2011).
Willemsen E, Marcel K. Attachment 101 for attorneys: Implications for infant placement decisions. http:// www.scu.edu/ ethics/publications/ other/ lawreview/ attachment101.html (Accessed at 1.2.2011).
Horowitz LM, Rosenberg SE, Bartholomew K. Interpersonal problems, attachment styles, and outcome in brief dynamic psychotherapy. J Consult Clin Psychol 1993; 61:549-560.
West ML, Sheldon-Keller AE. Patterns of Relating: An Adult Attachment Perspective. New York, Guilford Press, 1994.
Weger Jr. H, Polcar LE. Attachment style and the cognitive representation of communication situations. Communication Studies 2000; 2:149-161.
Bowlby J. Attachment and Loss: Sadness and Depression, New York, Basic Books, 1980.
Bowlby J. Attachment, 2nd Ed. New York, Basic Books, 1982.
Erözkan A. Lise öğrencilerinin bağlanma stilleri ve yalnızlık düzeylerinin bazı değiş- kenlere göre incelenmesi. Atatürk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi 2004; 4:155-175.
Jones SM. Attachment style differences and similarities in evaluations of affective communication skills and person-centered comforting messages. Western Journal of Communication 2005; 69:233-249.
Weger Jr. H, Polcar LE. Attachment style and person-centered comforting. Western Journal of Communication 2002; 66:84-103.
Belsky J. Developmental origins of attachment styles. Attach Hum Dev 2002; 4:166- 170.
Pearson JL, Cowan PA, Cowan CP. Adult attachment and adult child-order parent relationships. Am J Orthopsychiatry 1993; 4:606-613.
LeCroy CW. Parent adolescent intimacy: Impact on adolescent functioning. Adolescence 1988; 89:137-147.
Atasoy Z, Ertürk D, Şener Ş. Altı ve on iki aylık bebeklerde bağlanma. Turk Psikiyatri Derg 1997; 8:266-279.
Sabuncuoğlu O, Berkem M. Bağlanma biçemi ve doğum sonrası depresyon belirtileri arasındaki ilişki: Türkiye'den bulgular. Turk Psikiyatri Derg 2006; 17:252-258.
Bifulco A, Figueiredo B, Guedeney N. Maternal attachment style and depression associated with childbirth: Preliminary results from a European and US crosscultural study. Br J Psychiatry Suppl 2004; 46:31-37.
McMahon C, Barnett B, Kowalenko N, Tennant C. Psychological factors associated with persistent postnatal depression: past and current relationships, defence styles and the mediating role of insecure attachment style. J Affect Disord 2005; 84:15-24.
Danacı AE, Dinç G, Deveci A. Manisa il merkezinde doğum sonrası depresyon yay- gınlığı ve etkileyen etmenler. Turk Psikiyatri Derg 2000; 11:204-211.
Kökçü F, Kesebir S. İki uçlu olgular ve çocuklarında bağlanma biçiminin mizaç, kişilik ve klinik özellikler ile ilişkisi: kontrollü bir çalışma. Turk Psikiyatri Derg 2010; 21:309-318.
Soysal AŞ, Özçelik A, Arhan E, İşeri E, Gücüyener K. Bir olgu sunumu eşliğinde tepkisel bağlanma bozukluğunun gözden geçirilmesi. Türkiye Klinikleri Pediatri Der- gisi 2009; 18:248-252.
Mangelsdorf SC, Frosch CA. Temperament and attachment: one construct or two? Adv Child Dev Behav 1999; 27:181-220.
Matsuoka N, Uji M, Hiramura H, Chen Z, Shikai N, Kishida Y et al. Adolescents attachment style and early experiences: A gender difference. Arch Womens Ment Health 2006; 9:23-29.
Miller L, Kramer R, Wamer V, Wickramaratne P, Weissmann M. Intergenerational transmission of parental bonding among women. J Am Acad Child Adolesc Psychiatry 1997; 36:1134-1139.
Scinto A, Marinangeli MG, Ka1yvoka A, Daneluzzo E, Rossi A. The use of the Italian version of the Parental Bonding Instrument (PBI) in a elinical sample and in a student group: an exploratory and confirmatory factor analysis study. Epidemiol Psichiatr Soc 1999; 8:276-283.
Martin G, Waite S. Parental bonding and vulnerability to adolescent suicide Acta Psychiatr Scand 1994; 89 :246-254.
Warren SL, Huston L, Egeland B, Sroufe LA. Child and adolescent anxiety disorders and early attachment. J Am Acad Child Adolesc Psychitary 1997; 36:637-644.
Collins NL, Cooper LM, Albino A, Allard L. Psychosocial vulnerability from adoleseence to adulthood: a prospective study of attachment style differences in relationship functioning and partner choice. J Pers 2002: 70:965-1008.
Von IJ, Zendoom MH. Adult attachment representations, parental responsiveness and infant attachment: a meta analysis on the predictive validity of the Adult Attachment Interview. Psychol Bull 1995; 117:387-403.
Çetin FÇ. Gelişimsel psikopatolojinin temel kavramları. In Çocuk ve Ergen Psikiyat- risi Temel Kitabı (Eds FÇ Çetin, A Coşkun, E İşeri, R Uslu):141-142. Ankara, He- kimler Yayın Birliği, 2008.
Eng W, Heimberg RG, Hart TA, Schneier FR, Liebowitz MR. Attachment in individuals with social anxiety disorder: the relationship among adult attachment styles, social anxiety, and depression. Emotion 2001; 1:365-380.
Bifulco A, Kwon J, Jacobs C, Moran PM, Bunn A, Beer N. Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety. Soc Psychiatry Psychiatr Epidemiol 2006; 41:796-805.
Smith M, Calam R, Bolton C. Psychological factors linked to self-reported depression symptoms in late adolescence. Behav Cogn Psychother 2009; 37:73-85.
Marazzati D, Dell'osso B, Catena Del'Osso M, Consoli G, Del Debbio A, Munqai F et al. Romantic attachment in patients with mood and anxiety disorders. CNS Spectr 2007; 12:751-756.
Simpson JA, Rholes WS, Campbell L. Adult attachment, the transition to parenthood, and depressive symptoms. J Pers Soc Psychol 2003; 84:1172-1187.
Twaite JA, Rodriquez-Srednicki O. Childhood sexual and physical abuse and adult vulnerability to PTSD: the mediating effects of attachment and dissociation. J Child Sex Abus 2004; 13:17-38.
Ciechanowski PS, Sullivan M, Jensen M. The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain. Pain 2003; 104:627- 637.
Myhr G, Sookman D, Pinard G. Attachment security and parental bonding in adults with obsessive-compulsive disorder: a comparison with depressed out-patients and healthy controls. Acta Psychiatr Scand 2004; 109:447-456.
Fonagy P, Leigh T, Steele M, Steele H, Kennedy R, Mattoon G. The relation of attachment status, psychiatric classification, and response to psychotherapy. J Consult Clin Psychol 1996; 64:22-31.
Fonagy P, Target M, Gergely G. Attachment and borderline personality disorder: A theory and some evidence. Psychiatr Clin North Am 2000; 23:103-122.
Ciechanowski PS, Walker EA, Katon WJ, Russo JE. Attachment theory: A model for health care utilization and somatization. Psychosom Med 2002; 64:660-667.
Ponizovsly AM, Nechamkin Y, Rosca P. Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients. Am J Orthopsychiatry 2007; 77:324.-331.
Joyce PR. Parental bonding in bipolar affective disorder. J Affect Disord 1984; 7:319-324.
Miklowitz DJ, Wisniewski SR, Miyahara S, Otto MW, Sachs GS. Perceived criticism from family members as a predictor of one-year course of bipolar disorders. Psychiatry
Gilbert P, McEwan K, Hay J. Social rank and attachment in people with a bipolar disorder. Clin Psychol Psychother 2007; 14:48-53.
Morriss RK, van der Guht E, Lancaster G, Bentan RP. Adult attachment in bipolar 1 disorder. Psychol Psychother 2009; 82:267-277.
Vahip I, Kocadere M. Psikososyal-psikoterapötik yaklaşım ve girişimler. In İki Uçlu Duygudurum Bozuklukları Sağaltım Kılavuzu (Eds S Vahip, O Yazıcı):107-130. Türkiye Psikiyatri Derneği, Ankara, 2003.
Çakır S, Bensusan R, Akça YZ, Yazıcı O. Does a psychoeducatioanal approach reach targeted patients with bipolar disorder? J Affect Disord 2009; 12:75-83.