EARLY ATTACHMENT EXPERIENCE AND RECOVERY FROM PSYCHOSIS

Objectives. Two studies were carried out to investigate the relationsh ip between coping styles and co-morbid depression in people adjusting to the onset of psychosis. Evaluative thinking and early attachment ex periences were also examined. Methods and design. In Study 1, a 39-ite m Recovery Style Questionnaire (RSQ) was developed to measure recovery style in people with psychosis, based on McGlashan, Levy & Carpenter' s (1975) interview measure of recovery style. Fifty-six participants c ompleted both the RSQ and McGlashan's interview-based measure. Study 2 explores the relationship between these styles of recovery, depressio n and early childhood attachment experiences. Thirty-six people partic ipated. Results The RSQ was both reliable and correlated highly with M cGlashan's interview-based measure. We found that the RSQ, in keeping with the interview-based measure, was bimodally distributed, thus supp orting McGlashan's contention that they define two distinct recovery s tyles termed 'integration' and 'sealing over'. As predicted, 88 per ce nt of the 'sealers' were moderately to severely depressed compared to 52 per cent of the 'integrators' who were mildly depressed with no mem bers of the 'integration' group experiencing moderate to severe depres sion (p < .0003). Patients who employed the sealing over recovery styl e also made significantly more negative self-evaluations than did pati ents in the integration group and also perceived their parents to be s ignificantly less caring than those in the integration group. Conclusi ons. These findings are explained in terms of a multi-axial model inco rporating personality structure and development as well as mental diso rder. It is suggested that those individuals with a poorly developed s ense of self defend against the threat of psychosis using denial. Clin ical implications are discussed and more research is suggested to furt her investigate the links between evaluative and inferential thinking in co-morbid depression, and how such thinking relates to early childh ood experience.