Objective: Schizophrenia is a chronic psychiatric disorder that arises
from the interaction of biopsychosocial factors. Both the disorder itself
and psychosocial variables, such as attachment styles and childhood
trauma have been associated with impairments in mentalization
processes observed in schizophrenia. This study aimed to assess
attachment styles in individuals with schizophrenia and explore the
associations between insecure attachment, theory of mind, childhood
trauma and psychosocial functioning.
Method: The study included 45 patients with schizophrenia and 45
healthy controls. Assessments included the Psychosis Attachment
Measure (PAM), Dokuz Eylül Theory of Mind Index (DEZİKÖ),
Childhood Trauma Questionnaire (CTQ) and Personal and Social
Performance Scale (PSP). Positive and Negative Syndrome Scale
(PANSS) and Calgary Depression Scale (CDS) were also administered
to patients.
Results: Patients with schizophrenia exhibited significantly higher levels
of childhood trauma and insecure attachment alongside impaired theory
of mind and poorer psychosocial functioning compared to controls. In
the schizophrenia group, insecure attachment correlated with greater
symptom severity, higher trauma burden and lower functioning. A
moderate negative correlation was found between insecure attachment
and theory of mind. However, childhood trauma did not significantly
mediate the relationship between insecure attachment and theory of
mind performance.
Conclusion: In individuals with schizophrenia, insecure attachment
styles are prevalent and are associated with greater symptom severity
and poorer psychosocial functioning. Anxious attachment was found
to be associated with reduced theory of mind performance; however,
no evidence supporting a mediating role of childhood trauma in this
relationship was obtained.
Keywords: Attachment, psychosocial functioning, schizophrenia,
trauma, theory of mind