SynthesisThe British journal of clinical psychology2020
The relationship between insecure attachment and paranoia in psychosis: A systematic literature review.
Synthesis in The British journal of clinical psychology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05042050 (Attachment-focused iMAgery Therapy for PSychosis), which is not on this map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Attachment-focused iMAgery Therapy for PSychosis (A-iMAPS): a Case Series
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- How does insecure attachment lead to paranoia? A systematic critical review of cognitive, affective, and behavioural mechanisms.The British journal of clinical psychology · 2022Pooled it
- Adult Attachment and Personal, Social, and Symptomatic Recovery From Psychosis: Systematic Review and Meta-Analysis.Frontiers in psychiatry · 2021Pooled it
- Relationships between attachment insecurity, beliefs about the self and others, paranoia, and social functioning across the psychosis continuum.The British journal of clinical psychology · 2026Article
- Associations of Childhood Trauma with Paranoia and Conspiracy Thinking Among Young Adults: Exploring the Indirect Role of Attachment Styles.Healthcare (Basel, Switzerland) · 2026Article
- The Association Between Attachment Style and Symptomatic, Social, and Personal Recovery: A Comparison Between Male and Female Patients Remitted From Their First-Episode Psychosis.Early intervention in psychiatry · 2026Article
- Limitation to the capacity to love and hypersexual behavior in their relationship with psychoticism and paranoid ideation.Sexual medicine · 2025Article
- Trauma and social pathways to psychosis: Examining the role of attachment, social rank and dissociation in a clinical sample.The British journal of clinical psychology · 2025Article
- Personality Organization, Childhood Adversity, and Paranoid Thinking: Moderating and Mediating Pathways.Psychopathology · 2025Article
- Attachment and Social Functioning in Patients with a Psychosis Spectrum Disorder: A Mediation Study.Schizophrenia bulletin open · 2025Article
- Painting psychosis: an empirical investigation of the self-portraits of Edvard Munch.Frontiers in psychiatry · 2025Article
- The revised Psychosis Attachment Measure: further psychometric evidence.Social psychiatry and psychiatric epidemiology · 2024Article
- Experiences of trauma among persons living with psychosis in KwaZulu Natal, South Africa.PLOS mental health · 2024Article
- The Psychotherapy of Schizophrenia: A Review of the Evidence for Psychodynamic and Nonpsychodynamic Treatments.Psychiatry and clinical psychopharmacology · 2023Review
- The Interplay of Oxytocin and Attachment in Schizophrenic Patients: An fMRI Study.Brain sciences · 2023Article
- Fluctuations in proximity seeking and paranoia.The British journal of clinical psychology · 2022Article
- The co-occurrence of multidimensional loneliness with depression, social anxiety and paranoia in non-clinical young adults: A latent profile analysis.Frontiers in psychiatry · 2022Article
- Article
- Attachment Dimensions predict Social Functioning in persons with Schizophrenia-Spectrum Disorders, regardless of Symptom Severity.Actas espanolas de psiquiatria · 2021Article
- The Impact of Repeated Attachment Priming on Paranoia, Mood and Help-Seeking Intentions in an Analogue Sample.Brain sciences · 2021Article
- Parenting behaviour and paranoia: a network analysis and results from the National Comorbidity Survey-Adolescents (NCS-A).Social psychiatry and psychiatric epidemiology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesParanoia is a key symptom in psychosis and associated with a range of poor outcomes. Earlier life experiences increase vulnerability to paranoid thinking, and attachment theory has been proposed as a key model in explaining this causal pathway. Previous reviews highlight evidence of associations between insecure attachment styles and overall severity of psychotic symptoms. Studies report on associations between insecure attachment and paranoia, but to date, this literature has not been adequately synthesized. The aim of the current review was to report the strength and consistency of associations between paranoia and insecure attachment across published studies, and provide systematic appraisal of study quality.
methodWe carried out a systematic review of electronic databases using search terms to capture concepts of adult attachment, paranoia, and psychosis. We pre-registered the review protocol and followed PRISMA guidelines.
resultsSignificant associations were reported in 11 out of 12 studies between an insecure attachment and paranoia, with associations remaining significant in studies that controlled for comorbid symptoms. The strongest, most commonly reported relationship was between an anxious attachment style and paranoia.
conclusionsThe findings support the proposed role of attachment insecurity in the development and maintenance of paranoia in psychosis and highlight the need to address insecure attachment representations in the treatment of paranoia. PRACTITIONER POINTS: There is consistent evidence of associations between insecure attachment style and paranoia. Insecure anxious attachment is more consistently associated with paranoia than an insecure avoidant attachment. Associations between attachment and paranoia remain significant when key confounders are controlled for in the analyses. Interventions that address insecure attachment representations and promote a more secure attachment are likely to help reduce paranoia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.