A Dynamic-Maturational Framework for the Study of Psychosis and Attachment Theory

Attachment theory has been used to explain the origin of psychotic phenomena. In this article we critically evaluate dominant models and assessment measures of attachment in the study of psychosis. We identify four problems aligning to current theory and assessment: (1) the reliability and/or validity of assessment tools, (2) the failure of current approaches to differentiate between psychotic and non-psychotic cases within attachment classifications, (3) the absence of an integrated conceptual framework and (4) poor clinical utility. We propose the Dynamic-Maturational Model (DMM) of Attachment and Adaptation as an integrative framework with potential explanatory power to address these problems. The DMM is a model of human adaptation, based in attachment theory and integrative of systems theory, psychodynamic psychology, cognitive neuroscience, ethology and behaviourism. We review the present state of knowledge about attachment and psychosis and consider a broader array of empirical information (e.g. cognitive, affective and somatic) to highlight how future investigations and therapeutic intervention might be reconceptualised advantageously within a DMM framework.