http://www.biomedcentral.com/1471-244X/15/237
Conclusions
During the last decades, research on the etiology of psychosis has predominantly focused on various biological factors. The high level of childhood trauma and insecure avoidant attachment in patients with chronic psychosis as well as their association with symptoms and coping abilities lend support to the investigation of psychological and environmental variables in future research on this condition. Among other, the relationship, in particular in terms of causality, between symptoms and attachment categories represents a major issue, due to the obvious clinical implications it entails. Indeed, the present cross sectional research, but also other research involving follow-up [8] cannot disentangle this problem of causality. This warrants further research on the pathways leading both to psychosis and adult attachment insecurity. That should foster clinicians to shift from a fixed, fatalist stance, for example when facing negative symptoms in the field of relationships with significant others, to a view more concerned with an attachment related stance. That would allow clinicians to place attachment in the core of their psychosocial intervention, instead of reducing patients experience to fixed, biological impairments. Another issue important for clinicians is that patients with unstable attachment may need increased attention and specific interventions in current rehabilitation settings. Approaches involving this domain (e.g. those fostering mentalizing capacities) may be useful in this perspective.
Other studies showed that patients with chronic psychosis can use spirituality as a positive resource for coping (e.g. [17]). In this research, one of the underlying dimensions of the attachment theory which supports these previous data has been highlighted. In particular, it appears that some processes involved in spiritual coping might induce deep psychological changes. At the same time, spiritual beliefs and practices may constitute a privileged window through which to examine IWMs and their transformations.