Is there an association between insecure attachment & symptom severity in FSDs, & what is the role of mentalized affectivity, 2022, Airey

https://era.ed.ac.uk/handle/1842/39430

Is there an association between insecure attachment and symptom severity in functional somatic disorders, and what is the role of mentalized affectivity?
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Date
13/10/2022
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13/10/2023
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Airey, Stuart
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Conditions such as chronic fatigue syndrome, irritable bowel syndrome, fibromyalgia, functional neurological disorders and many types of chronic pain have no known organic cause.

The increasing consensus that these presentations should be considered as complex interactions between biological, psychological and social factors, is best represented through the term ‘functional somatic disorders’ (FSD).

FSD are common, cause significant disability and distress to sufferers and contribute to a considerable proportion of healthcare consultations.

Developmental theories, and some empirical evidence, suggests a role for attachment, mentalization and emotional regulation in the development of FSD.

Depression/anxiety are also associated with insecure attachment and reduced mentalizing and are commonly comorbid with FSD.

There is limited existing research on this topic, especially regarding FSD in older adults.

Chapter one of this thesis presents a systematic review conducted to explore the question: is there an association between insecure attachment and severity of FSD symptoms in adults?

PsychINFO, Embase and Medline electronic databases were searched for studies conducted with adults, using validated measures of attachment and FSD symptom severity, that reported a statistical relationship between attachment and symptom severity.

Studies were excluded if they were not in the English language or were not peer-reviewed.

A total of 12 studies, comprising 1,601 patients, with a mix of chronic pain, fibromyalgia, irritable bowel syndrome and general somatic disorder were selected for inclusion in the review.

An association between insecure attachment and severity of FSD symptoms could not be established, due to the relatively small number of studies, mixed results and methodological issues.

Future research should focus on clarifying terminology, improving measures, and studies designed to determine causal relationships and identify mechanisms of change.

Chapter two of this thesis presents the findings of a study to explore associations between FSD and attachment in older adults.

A mediation model was tested to explore whether mentalized affectivity and depression/anxiety mediated the relationship between insecure attachment and FSD symptom severity.

Recruitment was undertaken through social media advertising to people aged 45 years and older who identified as having either irritable bowel syndrome, chronic fatigue syndrome or fibromyalgia.

Participants were asked to complete an online questionnaire which used validated measures of attachment security, mentalized affectivity, depression/anxiety and somatic symptoms.

A total of 852 completed responses were received.

Severity of symptoms was found to be associated with measures of attachment, mentalized affectivity and depression/anxiety.

Processing and expressing elements of mentalized affectivity, along with depression/anxiety, were found to mediate the relationship between anxious attachment and symptom severity. Future research should focus on clarifying causal links and the direction of effects.

Clinicians should be aware of the potential for impaired mentalized affectivity, increased depression/anxiety and attachment difficulties in FSD presentations.

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https://hdl.handle.net/1842/39430

http://dx.doi.org/10.7488/era/2680
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• Health in Social Science thesis collection

 

Thread when this was recruiting:

https://www.s4me.info/threads/uni-o...d-45-and-older-–-the-impact-of-emotions.24087

 

Or perhaps an association could not be established because- you know - there isn’t one. I can’t believe they don’t even recognise this as a possibility! Instead they find loads of excuses.

 

Omg I went to Edinburgh University back in the 90s.

Holly molley

@dave30th

Joan

 

How can one possibly employ the term “increasing consensus,” when the IOM report, CDC, NIH, WHO, and recent NICE imbroglio would suggest the opposite?

Will anyone with a shred of influence raise this obvious question? It’s just so disheartening to see this nonsense continually churned out. I know the US is terrible on our illness, but I feel immense sorrow for UK brethren. It’s just a nightmare with these charlatans.

 

In my experience insecure attachment is associated with mirrors falling off the wall.
I salute those who continue to remind us how much pernicious pottiness there is to be dealt with.

 

I also love the notion that we are dealing with a complex model. It’s false illness beliefs leading to people being out of shape. That’s the BPS framework for ME. It couldn’t be more reductive. Yet we are the rubes too unenlightened to see the magisterial work of our betters.

 

I really dont think that clinicians need 'reminding' of the lie that patients are unable to understand their own mental/emotional state! That is the one belief that is ubiquitous among clinicians already! & is at the very heart of the problem!

We understand our state better than they do.

unfortunately patients are all too well aware that their clinicians are unable to understand ANY of the state they're in, body mind, emotions or anything else. Clinicians need treatment for their impaired understanding.

 

Yea I only glaced at the title and I feel too intimidated to commet:
"Is there an association between insecure attachment and symptom severity in functional somatic disorders, and what is the role of mentalized affectivity?"
insecure attachment - objectively measurable?
symptom severity in functional somatic disorders - objective measurements of symptom severity?
symptom severity in functional somatic disorders - objective assessment/classification of "functional disorder"?
what is the role of mentalized affectivity? - indeed - objective measurements of mentalized activity?

So, at a wild guess this is a series of things that can't be measured with any degree of confidence - shouldn't they just give up at that point? Also this relates to people not philosophical thinking --- if it's folks employed at a University shouldn't the University step [EDIT - in] and say - no?

 

So, they looked at some random association, found none, then made-up their own by doing a "study" aimed to do that? That's BPS/FND alright. I am noticing a growing ease with equating FND and BPS as essentially meaning the same thing. This BS about a complex interaction between basically all the possible things in life is truly peak pseudoscience, it means absolutely nothing but applies to everything.

Not that such evidence means anything. Is the complex interaction between this trinity in the room with you? It's hard to believe that this complete hand-waving is affecting healthcare for millions.

 

I love how they also never unravel their complex interactions. Tell us how they interact. If you’ve elucidated the complexity, you should be able to do that. This is the result of an echo chamber so convinced of its own brilliance. Not only should we not question the logic undergirding the research. We should stand in awe, and show our deference to these benevolent clinicians who chose to grace us with their knowledge.

 

This is just getting into some sort of new-age Freud territory, doesn't feel far off stuff like 'the oral stage of development being stunted leads to you having a fascination with your mouth'. Have they tested the treatment for that with some inference yet?

They go full circle eventually and the familiar-feeling language starts tumbling out. Is this researcher one of the mind-body or BPS crew who've now headed this way with this paper, or a psychoanalytic coming onto their turf I wonder.

Anyway given my impression is that even in the general population most people will clam up and try to get out if they find themselves in an conversation that begins lurching to the cliche of 'so tell me about your childhood' I always wonder what quality of information these people think they are working with.

Where are they getting their data from, in what form, how and, if upfront and directly, then surely there is a niche 'who'?

 

Trish, did you ever get the trial documents you asked for a while ago?

 

I'm fascinated by what makes people go down this route, because it seems to be those who managed to get themselves qualified as neurologists too (then double-cert with psychiatry for some reason that I'm also intrigued to know the exact detail of there too).

Part of me wonders whether it is a part of the educational lifecycle somewhere and all are connected by something that plops up in all that. The other part is the chicken and egg issue of 'beliefs first' (hmmm how did you get on with your mother) then finding your tribe and literature that permits them second. Which might be a less formal nurture bit.

I could understand that in Freud's day it was pre tools like MRI, CT and knowing what neural networks were as well as many other disease not being unbundled, but they have been now so it's different for those who've come through since.

When I consider the idea that people just like to sit around navel-gazing on random stuff (which apparently isn't actually what philosophy is as they have to actually think clearly - unless this is a excepting niche) I then harp back to people like Marcel and Holender who were interested in the unconscious, but enough they actually wanted to find ways to understand it and test it: https://en.wikipedia.org/wiki/Anthony_Marcel and note these never get mentioned

It's a pretty weird dive to go into so a few life histories/bios on this question that weren't polished beyond candour would be fascinating.

 

Worth a polite and pithy reply?

Lack of face validity?

Disregard for patients input and biased?

Etc