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Does insecure attachment mediate the relationship between trauma and voice-hearing in psychosis?
[Thesis]. Manchester, UK: The University of Manchester; 2014.
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Abstract
The current thesis titled ‘does insecure attachment mediate the relationship between trauma and voice-hearing in psychosis?’ has been prepared by Marie Pilton in the year 2014. The thesis has been submitted to The University of Manchester for the degree of Doctor of Clinical Psychology in the Faculty of Medical and Human Sciences (section of Clinical and Health Psychology). The thesis has been prepared in paper based format and comprises three papers. The overall theme of the thesis is the investigation of potential underlying psychological factors within the experience of voice-hearing. The thesis particular focuses upon attachment and dissociation within the voice-hearing experience. Firstly, a systematic literature review and meta-analysis regarding the relationship between dissociation and voices is presented. Paper 1 provides a comprehensive review of 32 studies investigating the association between dissociative experiences and voice-hearing. The review includes a quality assessment tool and meta-analysis with a view to evaluate and synthesise the research that has been carried out and published to date. The results are considered in relation to methodological limitations, clinical implications and recommendations for future research. Secondly, research was carried out to explore insecure attachment as a potential mediating variable within the trauma and voice-hearing relationship. Paper 2 presents an investigation involving 55 voice-hearing participants with a diagnosis of psychosis. The participants completed a range of self-report measures. Mediation analysis indicated that insecure-anxious attachment might be indicated as a potential mediating factor within the trauma and voice-hearing relationship. The results are considered in relation to limitations of the study and possible clinical implications and recommendations for future research. Thirdly, a critical evaluation and reflection of the two papers mentioned above was carried out. Strengths and weaknesses regarding the chosen methodology, directions for theory, clinical practice and future research were considered. Finally, the overall research process was reflected upon.