Cognitive Fusion Mediates the Impact of Attachment Imagery on Paranoia and Anxiety
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ORIGINAL ARTICLE
Cognitive Fusion Mediates the Impact of Attachment Imagery on Paranoia and Anxiety Monica Sood1 · Katherine Newman‑Taylor1
© The Author(s) 2020
Abstract Background Paranoia, in both clinical and non-clinical groups, is characterised by unfounded interpersonal threat beliefs. Secure attachment imagery attenuates paranoia, but little is known about the mechanisms of change. Cognitive fusion describes the extent to which we can ‘step back’ from compelling beliefs, to observe these as mental events, and is implicated in psychopathology cross-diagnostically. Aims This study extends previous research demonstrating the impact of attachment imagery on paranoia and anxiety to determine whether cognitive fusion mediates these relationships. Method We utilised a randomized experimental design and recruited an analogue sample with high levels of non-clinical paranoia to test the impact of imagery and the role of cognitive fusion. Results Secure attachment imagery resulted in reduced paranoia and anxiety compared to threat/insecure imagery. Cognitive fusion mediated the relationships between imagery and paranoia, and imagery and anxiety. Conclusions Secure attachment imagery is effective in reducing paranoia and anxiety and operates via cognitive fusion. In clinical practice, these interventions should seek to facilitate the ability to ‘step back’ from compelling threat beliefs, in order to be most beneficial. Keywords Paranoia · Anxiety · Attachment · Imagery · Cognitive fusion Paranoia is characterised by unfounded interpersonal threat beliefs and results in substantial distress and disability (Freeman 2007). Paranoia is both a defining symptom of psychosis and common in the general population (Johns and van Os 2001). Clinical paranoia shares and builds on the cognitive and affective processes maintaining paranoia in the general population, so examination of mechanisms in analogue groups provides a valuable basis for the development of clinical interventions (Freeman et al. 2005). Negative affect, particularly anxiety, plays a key role in the maintenance of paranoia—as threat beliefs, paranoid cognitions are typically associated with anxiety, and heightened anxiety increases the likelihood of threatening interpretations (Freeman 2016). Interventions targeting anxiety as well as paranoia are therefore likely to be beneficial.
* Monica Sood [email protected] 1
School of Psychology, University of Southampton, Southampton, University Road, SO17 1BJ, UK
Insecure attachment styles are associated with increased paranoia (Lavin et al. 2019), and attachment priming interventions have been shown to reduce paranoia and anxiety (Rowe et al. 2020); however, the cognitive mechanisms remain largely untested.
Attachment Attachment theory (Bowlby 1969, 1973, 1980) is a lifespan model, proposing that humans are predisposed to seek proximity to significant others (attachment figures) to regulate distress. Repeated interactions with attachment figures produce working models of the self, others, and relationsh
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