Need of approval predicts OCD diagnosis

Attachment style should be evaluated among adults with obsessive-compulsive disorder, according to study results published in Journal of Psychiatric Research.

“Several authors have implicated insecure attachment experiences in the development of OCD symptoms and cognitions,” Andrea Pozza, of the department of medical sciences, surgery and neurosciences at the University of Siena in Italy, and colleagues wrote. “These researchers suggest that the adult attachment system acts as an emotional regulation system in adulthood that may escalate or prevent the exacerbation of intrusive thoughts into obsessions.”

Prior studies did not put forth solid evidence that discriminated which form of attachment insecurity correlated with OCD, with both anxiety and avoidance linked to OCD symptomatology. Moreover, no previous research used the Attachment Style Questionnaire (ASQ), which enables examination of differentiated facets of attachment anxiety and avoidance, according to the researchers.

In the current study, Pozza and colleagues analyzed data of 135 patients with OCD and 135 matched controls who completed the Obsessive-Compulsive Inventory-Revised, Obsessive Beliefs Questionnaire-46 and the ASQ.

Results showed lower levels of confidence and higher levels of attachment anxiety among patients with OCD compared with controls. Higher need of approval most strongly predicted OCD diagnosis compared with the other attachment facets, even more so than obsessive beliefs. Multivariate generalized linear models showed the two facets of attachment anxiety; the need for approval and preoccupation with relationships appeared to account for variance over and above OCD-linked beliefs and sociodemographics. Discomfort with closeness played a role in predicting ordering symptoms.

“With regards to future directions for research, it would be interesting to investigate the relationship between attachment styles and OCD severity during treatment,” Pozza and colleagues wrote. “Future studies should examine whether changes in the attachment styles could be associated with changes in OC symptoms.”