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Region Hovedstaden - en del af Københavns Universitetshospital

Desorganiseret tilknytning i klinisk kontekst

Projekt: Typer af projekterProjekt

  • Poulsen, Stig, Institut for Psykologi, Københavns Universitet , Danmark (Projektleder, organisatorisk)
  • Alessandro, Talia, Universitet i Heidelberg, Tyskland (Projektleder, faglig)
  • Weicher Frandsen, Frederik (Projektkoordinator)
  • Simonsen, Sebastian (Projektdeltager)
  • Stougaard Dall Harpøth, Tine, Region Sjælland, Danmark (Projektkoordinator)
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Topic: There is robust evidence that a relatively rare form of adult attachment, Unresolved/disorganized attachment (U/d), is strongly associated with maladaptive parenting and severe mental health issues, particularly personality disorder. However, we know little about how U/d manifests in interpersonal behavior in general, and in the clinical setting in particular. Research has shown that, when speaking in an interview about early losses or traumas, U/d individuals tend to express frightening ideas about death or contradict themselves by denying that any trauma has happened. There is currently no evidence that these forms of incoherence are reflected during psychotherapy as well. While recent work informed by attachment theory discovered discourse markers that characterize the other attachment classifications in psychotherapy, no such work has been conducted with regards to Unresolved/disorganized attachment. For these reasons, it has been difficult to develop preventive and therapeutic interventions tailored to this group of patients. 
Aim: In this project, we wish to explore what types of verbal expression are particularly typical of patients classified as “U/d”. We will conduct a qualitative analysis of the in-session discourse of a relatively small group of patients who have been independently classified as U/d on the Adult Attachment Interview, the gold standard assessment of adult attachment, and compare them with a group of patients without this classification.
Sample: Based on similar previous investigations of the discourse of patients with other attachment classifications in psychotherapy, the present qualitative investigation aims to involve 40 patients who are about to begin treatment or have recently begun treatment. In order to find a sufficient number of patients with a U/d classification, the sample will exclusively consist of patients with any severe personality disorder (U/d is overrepresented among these patients). The project aims to include 20 patients from the outpatient clinic for personality disorders and trauma at Stolpegaard Psychotherapy Centre, Capital Region, as well as 20 patients from to outpatient clinic for personality disorders at Psychiatric Clinic Roskilde, Region Zealand.
Procedure: Before beginning treatment or during the initial stages of treatment, each patient will be interviewed with the AAI by a research assistant; the interviews will be then transcribed verbatim and anonymized, and then coded by reliable coders. For each patient, one or two initial therapy session will be audio-recorded, transcribed verbatim, and anonymized. 
Qualitative analysis: A qualitative investigation of the transcripts will be conducted, where the sessions of the U/d patients will be compared against a control group of equal number of patients extracted from a pool of already collected therapy sessions with patients without a U/d classification but matched for gender and age. 
Results: The results of this investigation will form the basis for introducing and validating a novel observer-based measure of U/d that can be applied to code patients’ discourse in psychotherapy based on in-session discourse markers. The knowledge gained through these studies will lay the ground for more specific interventions for parents and patients with personality disorders and other serious mental health conditions.
StatusIgangværende
Periode01/09/2021 → …

ID: 67399930