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Personality and Individual Differences 54 (2013) 355–360
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Personality and Individual Differences
journal homepage: www.elsevier.com/locate/paid
Recollections of parent–child relationships, attachment insecurity, and
obsessive–compulsive beliefs
Jessica Yarbro a, Brittain Mahaffey b, Jonathan Abramowitz b, Todd B. Kashdan a,⇑
a
b
George Mason University, Fairfax, VA, United States
University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
a r t i c l e
i n f o
Article history:
Received 12 July 2012
Received in revised form 29 September
2012
Accepted 1 October 2012
Available online 30 October 2012
Keywords:
Obsessive compulsive disorder
Obsessive–compulsive beliefs
Attachment insecurity
a b s t r a c t
To adequately understand Obsessive Compulsive Disorder (OCD), it is important to understand the developmental origins of obsessive beliefs and corresponding compulsive acts. Prior work has shown that having cold, neglectful parents in childhood and/or insecure attachment styles are both linked to emotional
disturbances. In this study, we explored the potential contributions of early parent–child relationships to
attachment styles and the severity of obsessive–compulsive beliefs in adulthood. A sample of 397 college
students completed online, self-report measures of retrospective parent–child relationships, adult
attachment styles, and ongoing obsessive–compulsive symptoms. Analyses revealed that attachment
anxiety partially mediated the association between parent–child relationships and obsessive beliefs;
attachment avoidance failed to operate as a mediating mechanism. Our findings provide support for
interpersonal approaches to obsessive–compulsive symptoms and disorder, with implications for the
continuity of relationship dysfunction from childhood into adulthood.
Ó 2012 Elsevier Ltd. All rights reserved.
1. Introduction
1.1. Parenting and OCD
The cognitive model of Obsessive Compulsive Disorder (OCD)
posits that obsessions develop from intrusive thoughts that are appraised as dangerous or threatening and in response, need to be
neutralized (Rachman, 1997, 1998). Several types of dysfunctional
beliefs (a.k.a ‘‘obsessive beliefs’’) are thought to contribute to the
misappraisal and avoidance (Obsessive Compulsive Cognitions
Working Group, 1997, 2003, 2005). First, individuals with OCD often overestimate the likelihood that negative events will occur and
the potential harm that could come from them. Second, individuals
with OCD believe that they need to exercise considerable control
over their thoughts or an unwanted event is even more likely to occur. Finally, individuals with OCD are uncomfortable with personal
imperfection and uncertain or ambiguous situations. Although
obsessive beliefs are a risk factor for the onset of OCD (e.g.,
Abramowitz, Nelson, Rygwall, & Khandker, 2007; Taylor et al.,
2010), little research exists on the antecedents to obsessive beliefs.
In the present study, we examined early parent–child relationships
and parent–child attachment styles as interpersonal risk factors
that contribute to the development of obsessive beliefs.
To fully understand any type of psychopathology, we should address developmental trajectories. One potential area of interest
regarding the development of OCD is parenting behavior. Specific
types of interactions between parents and children may increase
the likelihood of developing obsessive beliefs. Researchers have
proposed several pathways that can lead to obsessive beliefs
including parenting behaviors-such as the implementation of rigid
codes of conduct (authoritarian parenting) and neglectful parenting which can inflate feelings of responsibility (Salkovskis, Shafran,
Rachman, & Freeston, 1999).
One potentially relevant component of both authoritarian and
neglectful parenting is inadequate parental care. Parental care reflects the warmth, affection, and support exhibited toward children.
Several researchers found support for an inverse association between recalled parental care and OCD symptoms and personality
traits (Nordahl & Stiles, 1997; Timpano, Keough, Mahaffey,
Schmidt, & Abramowitz, 2010; Wilcox et al., 2008), although other
studies have failed to find evidence for this association (Turgeon,
O’Connor, Marchand, & Freeston, 2002). Despite initial support
there is an absence of conceptual models for why inadequate parental care might relate to OCD. We propose that parent–child attachment may function as the mechanism. Attachment is fundamental
in the formation of cognitive working models of one’s world, others,
and the self which in turn may influence the development of
⇑ Corresponding author. Address: Department of Psychology, George Mason
University, Mail Stop 3F5, Fairfax, VA 22030, United States. Tel.: +1 703 672 1331;
fax: +1 703 993 1359.
E-mail address: [email protected] (T.B. Kashdan).
0191-8869/$ - see front matter Ó 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.paid.2012.10.003
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J. Yarbro et al. / Personality and Individual Differences 54 (2013) 355–360
obsessive beliefs (Collins & Read, 1990; Doron, Kyrios, & Moulding,
2007a; Doron, Kyrios, Moulding, Nedeljkovic, & Bhar, 2007b).
Depending on the quality of early interactions with attachment figures, individuals can develop beliefs about the world being a benevolent and safe place, other people as trustworthy, and the self as a
loveable and competent being (Catlin & Epstein, 1992; Collins &
Read, 1990). The alternative endpoint of these beliefs, such as viewing the world as threatening and unsafe and viewing the self as
incompetent in important life domains, could form the foundation
for obsessive thoughts (Doron, Kyrios, & Moulding, 2007; Doron,
Kyrios, Moulding, Nedeljkovic, 2007).
One goal of this studywas to clarify the link between inadequate
parental care and obsessive beliefs, with explicit attention to the
contribution of attachment styles. A child develops a particular
style of attachment in response to interactions with their primary
caregiver. If the caregiver fails to respond appropriately when the
child is frightened or threatened and seeks proximity, the child is
at risk for an insecure attachment (Bowlby 1969/1982). Insecure
attachment is a risk factor for several types of psychopathology
including depression and anxiety disorders (Riggs et al., 2007;
see Mikulincer & Shaver, 2007 for review). It is possible that insecure attachment provides a framework for understanding the association between parent–child interactions and the development of
obsessive beliefs, specifically the overemphasis of threat and maladaptive perfectionism.
1.2. Attachment anxiety as a mediator
According to attachment theory, an infant will seek proximity
and closeness with an attachment figure in times of danger or distress (Bowlby 1969/1982). Depending on the parent’s reaction to
the child’s proximity-seeking, the child will learn what to expect
from this relationship and will form a particular type of emotional
bond with the attachment figure (Bowlby 1969/1982). Parental
behavior that demonstrates a lack of care is consistently associated
with the development of insecure attachment (Ainsworth, 1967;
Ainsworth, Blehar, Waters, & Wall, 1978; Gittleman, Klein, Smider,
& Essex, 1998; Izard, Haynes, Chisholm, & Baak, 1991). Beyond
impacting the relationship with an individual’s caregiver, attachment styles shape an individual’s beliefs about themselves, others,
and the world via cognitive structures known as Internal Working
Models (IWMs).
These IWMs that are established in childhood tend to remain
stable throughout the lifespan and impact close relationships in
adulthood as well as responses to distress later in life (Bartholomew
& Horowitz, 1991; see Mikulincer & Shaver, 2007 for review).
Therefore, many current attachment researchers treat adult attachment in romantic relationships as a manifestation of infant attachment styles in later relationships (Hazan & Shaver, 1987). Although
there are several ways to categorize adult attachment styles, one of
the main models of attachment introduced by Hazan and Shaver
(1987) differentiates between secure attachment and two dimensions of attachment insecurity: anxiety and avoidance. We will
primarily focus on attachment anxiety since the associated IWMs
are most relevant to OC symptoms and obsessive beliefs.
Attachment anxiety is characterized by negative feelings about
the self (low self-esteem and worthlessness) along with negative
feelings about others, specifically that others will not provide
adequate acceptance and support (Collins & Read, 1990; Hazan &
Shaver, 1987; Mikulincer, 1995). Attachment anxiety is associated
with inadequate parental care and warmth as well (Collins & Read,
1990; Lopez, Melendez, & Rice, 2000). When parents fail to exhibit
supportive behaviors, the child can interpret this as evidence that
they are unworthy of love and that others will not respond when
needed. These feelings about the self and others can give rise to
maladaptive perfectionism which might manifest itself as a need
for perfect social performance to assure acceptance from peers or
engaging in stringent behaviors to ensure that losses never occur
(Ulu & Tezer, 2010; Wei, Mallinckrodt, Russell, & Abraham, 2004).
Since perfectionism is a core cognitive feature of OCD (Frost &
Steketee, 1997; Rheaume, Freeston, Dugas, Letart, & Ladouceur,
1995), we propose that what begins as interpersonally-focused perfectionism can develop into a broad overemphasis on perfection and
certainty which contributes to obsessive–compulsive symptoms.
The Internal Working Models associated with attachment anxiety may also give rise to hypervigilance for threat. Individuals may
become hyperfocused on potential threat (such as constantly being
on guard against touching anything unclean to avoid getting sick) if
they believe that others are unwilling or unable to provide support
in times of need. Research supports the link between attachment
anxiety and increased threat appraisal in a variety of stressful situations (Birnbaum, Orr, Mikulincer, & Florian, 1997; Mikulincer &
Florian, 1995) and elevated trait overestimation of threat (Doron,
Moulding, Kyrios, Nedeljkovic, & Mikulincer, 2009). We propose
that the IWMs associated with attachment anxiety function as
the link between inadequate parental care and the development
of hypervigilance to threat common in OCD.
1.3. The present study
Although a variety of factors contribute to the development of
obsessive beliefs and OCD, ranging from biological temperament
to stress reactivity, early parent–child relationships is an understudied and promising potential antecedent. To date, findings have
been inconclusive as several studies have documented a relationship between inadequate parental care and OCD symptoms (Heider
et al., 2008; Timpano et al., 2010; Wilcox et al., 2008). To add to
this work, we asked: what is the mechanism that accounts for
these associations? Although attachment anxiety is associated
with both inadequate parental care and the current endorsement
of obsessive beliefs (Ainsworth, 1967; Ainsworth et al., 1978; Doron et al., 2009; Gittleman et al., 1998; Izard et al., 1991; Lopez
et al., 2000), no study has examined these three variables together.
We propose that attachment styles in childhood, which develops in
response to parental behavior, shape the way a child and in turn,
adolescents and adults, view the world with anxious attachment
producing certain distorted cognitive representations that increase
the potentiality of obsessive beliefs that underlie OCD.
We tested several hypotheses. First, we hypothesized that there
would be positive correlations between inadequate parental care
and the endorsement of obsessive beliefs. Second, we hypothesized
that attachment anxiety would mediate the relationships between
parental care and (a) overestimation of threat/inflated responsibility and (b) perfectionism/intolerance of uncertainty (i.e., differential obsessive beliefs). There is less theoretical rationale to
address attachment avoidance but to be comprehensive we examined this facet as a mediator between inadequate parental care and
perfectionism/intolerance of uncertainty on an exploratory basis
since prior research has linked attachment avoidance to maladaptive perfectionism (Wei et al., 2004)
2. Methods
2.1. Participants
The sample consisted of 397 undergraduate students at the University of North Carolina, Chapel Hill. Of these students, 31.2% were
men, 68.5% were women, and .3% did not specify. Participant ages
ranged from 18 to 55 years with 97% under the age of 25. The
majority identified themselves as Caucasian (72%), 11.8% were
African American, 3.8% Latino, 7.8% Asian, 4.3% identified as
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J. Yarbro et al. / Personality and Individual Differences 54 (2013) 355–360
‘‘Other’’ and .3% did not specify. Our initial 397 participants were
reduced to 338 by excluding 59 with missing data. Our final sample reported lower attachment anxiety (t = 2.342, p < .05) and differed in racial composition (Fisher’s Exact Test, p < .05) compared
to the excluded group. Our final sample did not significantly differ
in age, gender, recalled parental care, attachment avoidance, or
endorsement of obsessive beliefs compared to the excluded group.
2.2. Procedure
Before data collection began, the study gained approval by the
University of North Carolina, Chapel Hill (UNC-CH) Institutional
Review Board. Since obsessive beliefs, which we are primarily
interested in, exist along a continuum in both clinical and nonclinical populations, we felt it appropriate to use a nonclinical, college student sample to test our hypotheses (e.g., Gibbs, 1996). After
providing informed consent, participants completed several selfreport questionnaires using the online Qualtrics system.
2.3. Measures
2.3.1. Obsessive beliefs
Obsessive beliefs were measured using the Obsessive Beliefs
Questionnaire (OBQ; OCCWG, 2005) a 44 item scale which assessed various dysfunctional beliefs and attitudes that contribute
to obsessive–compulsive symptoms. Responses ranged from
1 = disagree very much to 7 = agree very much. Participants were
given scores for two subscales:responsibility/threat estimation
(16 items) and perfectionism/uncertainty (16 items). Factor analyses have validated the use of these subscale scores (OCCWG, 2005)
and reliability was acceptable for both (responsibility/threat estimation a = 0.90 and perfectionism/uncertainty a = 0.91).
2.3.2. Attachment anxiety and avoidance
Attachment anxiety (6 items) and avoidance (6 items) were
measured using the Experiences in Close Relationships Scale-Short
Form (ECR-S; Wei, Russell, Mallinckrodt, & Vogel, 2007). This subscale assessed attachment anxiety in current romantic relationships with items such as ‘‘I find that my partner(s) don’t want to
get as close as I would like’’ and ‘‘I worry that romantic partner(s)
won’t care about me as much as I care about them’’ and attachment
avoidance with items such as ‘‘I try to avoid getting too close to my
partner’’. Responses ranged from 1 = strongly disagree to
7 = strongly agree. The ECR-S is a shorter version of The Experiences in Close Relationships Scale (ECR: Brennan, Clark, & Shaver,
1998). Wei et al. (2007) provided evidence for the validity of the
ECR-S by examining associations between the ECR-S and variables
known to correlate highly with the ECR (such as depression and
emotional reactivity). They found no differences in the associations
between these variables and the ECR-S compared to the ECR (Wei
et al., 2007). Reliability was also acceptable for both subscales
(attachment anxiety a = 0.88 and attachment avoidance a = 0.80).
2.3.3. Recalled parental care
Recalled parental care was measured using the care subscale
(12 items) of the Parental Bonding Instrument (PBI; Parker,
Tupling, & Brown, 1979). This subscale assessed the degree to
which participants recalled their primary caregivers as emotionally
warm and supportive with items such as my primary caregiver. . .‘‘spoke to me in a warm and friendly voice’’ and ‘‘did not
help me as much as I needed’’ (reverse-scored). Responses ranged
from 0 = very like to 3 = very unlike, and the subscale was
acceptably reliable (a = 0.85).
3. Results
3.1. Preliminary analyses and correlations
Descriptive statistics for variables of interest and zero-order
correlation coefficients are included in Table 1. Multicollinearity
was not a problem since the tolerance diagnostics among predictor
variables were all within acceptable limits (VIF values ranged from
1.04 to 1.06; tolerance values ranged from .95 to .96). Recalled
parental care was significantly associated with all variables of
interest (correlation coefficients ranged from r = .12, p < .05
(responsibility/threat estimation) to r = .22, p < .01 (attachment
avoidance). Correlations were significant between attachment anxiety and both responsibility/threat estimation (r = .37, p < .01) and
perfectionism/uncertainty (r = .30, p < .01), and attachment avoidance was significantly correlated with perfectionism/uncertainty
(r = .11, p < .05).
3.2. Data analytic approach
We examined whether attachment anxiety and avoidance mediated the relationship between recalled parental care and obsessive
beliefs. To test this, we conducted separate hierarchical regression
models described by Baron and Kenny (1986) with responsibility/
threat estimation and perfectionism/uncertainty as dependent
variables, recalled parental care as the independent variable, and
attachment anxiety and avoidance as the mediators. The first
regression equation established that the independent variable (recalled parental care) had a significant association with the mediator (attachment anxiety or avoidance). The second regression
equation established that the independent variable (recalled
parental care) had a significant relationship with the dependent
variable (responsibility/threat estimation or perfectionism/uncertainty). The third regression, which included both the independent
variable and mediator as predictors of the dependent variable,
established that (a) the relationship between the mediator and
the dependent variable was significant when controlling for the
independent variable and (b) inclusion of the mediator decreased
the relationship between the independent and dependent variables. If all of these conditions were met, we employed both the Sobel test (Sobel, 1982) and the more statistically rigorous bootstrap
method (Preacher & Hayes, 2004) with estimate for 3000 resampling iterations as formal tests of mediation. The primary aim of
bootstrapping is to determine whether the indirect effect accounts
for a meaningful portion of variance (the mediator accounts for the
influence of an independent variable on a dependent variable). Statistically significant results imply that the true indirect effect is
greater than zero, as determined by the absence of zero in the
95% confidence interval (CI).
Table 1
Zero-order correlations, means, and standard deviations for study measures.
Measure
1
2
3
4
5
M
SD
1.
2.
3.
4.
5.
–
.61**
.12*
.37**
.04
–
–
–
–
–
–
–
–
–
.04
–
–
–
–
–
54.09
61.19
36.01
23.71
18.41
16.29
17.55
3.75
6.66
6.92
OBQ_RT
OBQ_PC
PBI_Care
ECR-S_Anx
ECR-S_Avoid
.19**
.30**
.11*
.18**
.22**
Note: M = mean; SD = standard deviation; OBQ_RT = Obsessive Compulsive Questionnaire–Responsibility/Treat Estimation; OBQ_PC = Obsessive Compulsive
Questionnaire–Perfectionism/Uncertainty; PBI_Care = Parental Bonding Instrument-Care; ECR-S_Anx = Experiences in Close Relationships Scale-Short Form–
Anxious Attachment; ECR-S_Avoid = Experiences in Close Relationships Scale-Short
Form–Avoidant Attachment.
*
p < .05.
**
p < .01.
358
J. Yarbro et al. / Personality and Individual Differences 54 (2013) 355–360
Attachment
Anxiety
β =-0.18, p<.001
Attachment
Anxiety
β =0.37, p<.001
Parental Care
β = -0.12, t= -2.31, p<.05
Responsibility/
Threat Estimation
β = -0.18, p<.001
Parental Care
β =-0.19, t = -3.54, p<.01
β = -0.05, p>.05
3.3. Attachment anxiety as a mediator of recalled parental care and
responsibility/threat estimation association
Since there were significant relationships between recalled
parental care, attachment anxiety, and responsibility/threat estimation, we tested a mediation model via the data analytic approach outlined above. Recalled parental care significantly
predicted both attachment anxiety (b = 0.18, p < .001) and
responsibility/threat estimation (b = 0.12, p < .05). Attachment
anxiety also significantly predicted responsibility/threat estimation when controlling for recalled parental care (b = 0.37,
p < .001). When attachment anxiety was included in the regression
analyses, recalled parental care no longer significantly predicted
responsibility/threat estimation (b = 0.05, p = .48). As evidence
of partial mediation, attachment anxiety partially accounted for
the significant effects of recalled parental care, bootstrap
mean = .32 (95% CI = .53, .14). Support for partial mediation
was also evidenced by tradition significant Sobel z
scores
(z = 3.25, p < .001). Results are presented in Fig. 1.
3.4. Attachment anxiety as a mediator of recalled parental care and
perfectionism/uncertainty association
Since there were significant relationships between recalled
parental care, attachment anxiety, and perfectionism/uncertainty,
we tested a mediation model via the data analytic approach outlined above. Recalled parental care significantly predicted both
attachment anxiety (b = 0.18, p < .001) and perfectionism/uncertainty (b = 0.19, p < .01). Attachment anxiety also significantly
predicted perfectionism/uncertainty when controlling for recalled
parental care (b = 0.29, p < .001). When attachment anxiety was included in the regression analyses, recalled parental care became a
less strong predictor of perfectionism/uncertainty(b = 0.13,
p < .05). As evidence of partial mediation attachment anxiety partially accounted for the significant effects of recalled parental care,
bootstrap mean = .26 (95% CI = .43, .11). Support for partial
mediation was also evidenced by tradition significant Sobel z
scores (z = 3.05, p < .01). Results are presented in Fig. 2.
3.5. Attachment avoidance as a mediator of recalled parental care and
perfectionism/uncertainty association
Since there were significant relationships between parental
care, attachment avoidance and perfectionism/uncertainty, we
Perfectionism/
Uncertainty
β = -0.13, p<.05
SOBEL Test: Z= -3.25, p<.001
Fig. 1. Mediational model for the relationship between recalled parental care,
responsibility/threat estimation, and anxious attachment.
β =0.29, p<.001
SOBEL Test: Z = -3.05, p<.01
Fig. 2. Mediational model for the relationship between recalled parental care,
perfectionism/uncertainty, and anxious attachment.
tested a mediation model via the data analytic approach outlined
above. Recalled parental care significantly predicted both attachment avoidance (b = 0.22, p < .001) and perfectionism/uncertainty (b = 0.19, p < .01). Attachment avoidance did not
significantly predict perfectionism/uncertainty when controlling
for recalled parental care (b = 0.08, p = .14). Since all the conditions
for mediation were not met, we did not proceed with future analyses and concluded that attachment avoidance did not function as
a mediator for the relationship between recalled parental care and
perfectionism/uncertainty.
4. Discussion
This study investigated whether recalled parent–child relationships characterized by a lack of care relates to the endorsement of
obsessive beliefs through the development of insecure attachment.
Although several studies have examined the relevance of parental
behavior to the development of obsessive beliefs, ours is the first
to consider this relationship within the context of attachment.
Accordingly, our findings provide further support for the link between perceived cold and neglectful parenting and the endorsement of obsessive beliefs. When considering this association in
the context of attachment theory, we found that attachment anxiety partially mediated the relationship between perceived cold
and neglectful parenting and both responsibility/threat estimation
and perfectionism/uncertainty, two obsessive belief domains. In
contrast, attachment avoidance did not mediate the relationship
between cold and neglectful parenting and perfectionism/uncertainty. Our findings indicate that perceived inadequate parental
care is related to anxious attachment and the associated distorted
cognitions about the self and others which then function as cognitive vulnerabilities for OCD.
Our study represents an important first step in understanding
interpersonal factors that might play a role in the development
and maintenance of obsessive beliefs and OCD symptoms.
Although considerable research supports the relevance of interpersonal factors to OCD treatment outcomes, interpersonal antecedents to the development of OCD are relatively understudied. As
Doron and Moulding (2009) suggest, if obsessions and compulsions
have a basis in anxious attachment, the resulting interpersonal
expectations should be addressed in therapy. For example, a woman may compulsively call her husband at work to assure herself
of his safety because she fears abandonment (a characteristic of
anxious attachment) if something happened to him (Doron &
J. Yarbro et al. / Personality and Individual Differences 54 (2013) 355–360
Moulding, 2009). Addressing the role fear of abandonment plays in
her symptoms could enhance treatment.
4.1. Limitations and future directions
One important consideration in interpreting our findings is that
for most of these relationships, the effect sizes were moderate. Indeed, the development of obsessive beliefs is nuanced, and there
are numerous factors at work (such as biological temperament to
stress reactivity). There could also be meaningful latent classes of
individuals with different profiles of family environment, attachment security, and obsessive thinking which our statistical procedures were not able to capture. Future research should examine
these potential latent classes. We also used a non-clinical sample
which limits the generalizability of our findings to clinical populations. With our methodological approach, we are unable to make
causal inferences, but our findings suggest the need for future research using methodologies capable of demonstrating the relevance of parenting behavior and early attachment to the
development of obsessive beliefs. The present study provides
hypotheses to be tested in future longitudinal work. Finally,
although there is support that adult attachment style is a manifestation of infant attachment in adult relationships (Hazan & Shaver,
1987; Mikulincer & Shaver, 2007), there is also evidence that
attachment can change throughout the lifespan (Bowlby, 1973;
Sroufe, Carlson, Levy, & Egeland, 1999). Therefore, our measure of
attachment might not have completely derived from the individual’s early childhood experiences. Using a more direct measure of
infant attachment, such as an attachment interview, would future
strengthen our findings.
4.2. Conclusions
In conclusion, the results of this study suggest that attachment
anxiety at least partially explains the relationship between perceived in adequate parental care and obsessive beliefs that underlie
OCD. These findings add to existing knowledge regarding the etiology of OCD, especially as it relates to parent–child relationships.
More generally, our findings suggest the relevance of interpersonal
factors to the development and maintenance of OCD. Although a
variety of other interpersonal and personality factors likely influence the development OCD, we chose to focus on this particular
combination as a first step. Future research should continue to address attachment styles and other interpersonal and personality
factors to enhance the understanding and treatment of OCD.
References
Abramowitz, J. S., Nelson, C. A., Rygwall, R., & Khandker, M. (2007). The cognitive
mediation of obsessive–compulsive symptoms: A longitudinal study. Journal of
Anxiety Disorders, 21, 91–104.
Ainsworth, M. D. S. (1967). Infancy in Uganda: Infant care and the growth of love.
Baltimore: Johns Hopkins University Press.
Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of
attachment: Assessed in the strange situation and at home. Hillsdale: Erlbaum.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in
social psychological research: Conceptual, strategic, and statistical
considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults:
A test of a four-category model. Journal of Personality and Social Psychology, 61,
226–244.
Birnbaum, G. E., Orr, I., Mikulincer, M., & Florian, V. (1997). When marriage breaks
up-does attachment style contribute to coping and mental health? Journal of
Social and Personal Relationships, 14, 643–654.
Bowlby, J. (1969). Attachment and loss: Vol 1. Attachment (2nd ed.). New York: Basic
Book. Original work published 1969.
Bowlby, J. (1973). Attachment and loss: Vol 2. Separation: Anxiety and anger. New
York: Basic Books.
Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measurement of adult
attachment: An integrative overview. In Attachment theory and close
relationships. New York: Guilford Press.
359
Catlin, G., & Epstein, S. (1992). Unforgettable experiences: The relation of life events
to basic beliefs about the self and the world. Social Cognition, 10, 189–209.
Collins, N. L., & Read, S. J. (1990). Adult attachment, working models, and
relationship quality in dating couples. Journal of Personality and Social
Psychology, 58, 644–663.
Doron, G., Kyrios, M., & Moulding, R. (2007a). Sensitive domains of self-concept in
obsessive–compulsive disorder (OCD): Further evidence for a multidimensional
model of OCD. Journal of Anxiety Disorders, 21, 433–444.
Doron, G., Kyrios, M., Moulding, R., Nedeljkovic, M., & Bhar, S. (2007b). ‘‘We do not
see things as they are; we see them as we are’’: A multidimensional worldview
model of obsessive–compulsive disorder. Journal of Cognitive Psychotherapy: An
International Quarterly, 21, 217–231.
Doron, G., & Moulding, R. (2009). Cognitive behavioral treatment of obsessive
compulsive disorder: A broader framework. Israel Journal of Psychiatry and
Related Sciences, 46, 257–263.
Doron, G., Moulding, R., Kyrios, M., Nedeljkovic, M., & Mikulincer, M. (2009). Adult
attachment insecurities are related to obsessive compulsive phenomena.
Journal of Social and Clinical Psychology, 28, 1022–1049.
Frost, R. O., & Steketee, G. (1997). Perfectionism in obsessive–compulsive disorder
patients. Behaviour Research and Therapy, 35, 291–296.
Gibbs, N. A. (1996). Non-clinical populations in research on obsessive–compulsive
disorder: A critical review. Clinical Psychology Review, 16, 729–773.
Gittleman, M. G., Klein, M. H., Smider, N. A., & Essex, M. J. (1998). Recollections of
parent behavior, adult attachment and mental health: Mediating and
moderating effects. Psychological Medicine, 28, 1443–1455.
Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment
process. Journal of Social and Personal Relationships, 52, 511–524.
Heider, D., Matschinger, H., Bernert, S., Alonso, J., Brugha, T. S., Bruffaerts, R., et al.
(2008). Adverse parenting as a risk factor in the occurrence of anxiety disorders:
A study in six European countries. Social Psychiatry and Psychiatric Epidemiology,
43, 266–272.
Izard, C. E., Haynes, C. M., Chisholm, G., & Baak, K. (1991). Emotional determinants
of infant-mother attachment. Child Development, 62, 906–917.
Lopez, F. G., Melendez, M. C., & Rice, K. G. (2000). Parental divorce, parent–child
bonds, and adult attachment orientations among college students: A comparison
of three racial/ethnic groups. Journal of Counseling Psychology, 47, 177–186.
Mikulincer, M. (1995). Attachment style and mental representation. Journal of
Personality and Social Psychology, 69, 1203–1215.
Mikulincer, M., & Florian, V. (1995). Appraisal of and coping with a real-life stressful
situation: The contribution of attachment styles. Personality and Social
Psychology Bulletin, 21, 406–414.
Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics,
and change. New York: Guilford Press.
Nordahl, H. M., & Stiles, T. C. (1997). Perceptions of parental bonding in patients
with various personality disorders, lifetime depressive disorders, and health
controls. Journal of Personality Disorder, 11, 391–402.
Obsessive Compulsive Cognitions Working Group (1997). Cognitive assessment of
obsessive–compulsive disorder. Behaviour Research and Therapy, 35, 667–681.
Obsessive Compulsive Cognitions Working Group (2003). Psychometric validation
of the obsessive beliefs questionnaire and the interpretation of intrusions
inventory: Part I. Behaviour Research and Therapy, 41, 863–878.
Obsessive Compulsive Cognitions Working Group (2005). Psychometric validation
of the obsessive belief questionnaire and the interpretation of intrusions
inventory: Part 2, factor analyses and testing of a brief version. Behaviour
Research and Therapy, 43, 1527–1542.
Parker, G., Tupling, H., & Brown, L. (1979). A parental bonding instrument. British
Journal of Medical Psychology, 52, 1–10.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect
effects in simple mediation models. Behavior Research Methods, Instruments, &
Computers, 36, 717–731.
Rachman, S. (1997). A cognitive theory of obsessions. Behavior Research and Therapy,
35, 793–802.
Rachman, S. (1998). A cognitive theory of obsessions: Elaborations. Behavior
Research and Therapy, 36, 385–401.
Rheaume, J., Freeston, M. H., Dugas, M. J., Letart, H., & Ladouceur, R. (1995).
Perfectionism, responsibility, and obsessive–compulsive symptoms. Behaviour
Research and Therapy, 33, 785–794.
Riggs, S., Paulson, A., Tunnell, E., Sahl, G., Atkison, H., & Ross, C. (2007). Attachment,
personality, and psychopathology among adult inpatients: Self-reported
romantic attachment style versus adult attachment interview states of mind.
Development and Psychopathology, 19, 263–291.
Salkovskis, P., Shafran, R., Rachman, S., & Freeston, M. (1999). Multiple pathways to inflated
responsibility beliefs in obsessional problems: Possible origins and implications for
therapy and research. Behaviour Research and Therapy, 37, 1055–1072.
Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural
equation models. In S. Leinhart (Ed.), Sociological Methodology (pp. 290–312).
San Francisco: Jossey-Bass.
Sroufe, L., Carlson, E. A., Levy, A. K., & Egeland, B. (1999). Implications of attachment
theory for developmental psychopathology. Development and Psychopathology,
11, 1–13.
Taylor, S., Coles, M., Abramowitz, J., Wu, K., Olatunji, B., Timpano, K., et al. (2010).
How are dysfunctional beliefs related to obsessive-compulsive symptoms?
Journal of Cognitive Psychotherapy, 24, 165–176.
Timpano, K., Keough, M., Mahaffey, B., Schmidt, N., & Abramowitz, J. (2010).
Parenting and obsessive compulsive symptoms: Implications of authoritarian
parenting. Journal of Cognitive Psychotherapy, 24, 151–164.
360
J. Yarbro et al. / Personality and Individual Differences 54 (2013) 355–360
Turgeon, L., O’Connor, K. P., Marchand, A. A., & Freeston, M. H. (2002). Recollections of
parent–child relationships in patients with obsessive–compulsive disorder and
panic disorder with agoraphobia. Acta Psychiatrica Scandinavica, 105, 310–316.
Ulu, I. P., & Tezer, E. (2010). Adaptive and maladaptive perfectionism, adult
attachment, and big five personality traits. The Journal of Psychology:
Interdisciplinary and Applied, 144, 327–340.
Wei, M., Mallinckrodt, B., Russell, D. W., & Abraham, W. T. (2004). Maladaptive
perfectionism as a mediator and moderator between adult attachment and
depressive mood. Journal of Counseling Psychology, 51, 201–212.
Wei, M., Russell, D., Mallinckrodt, B., & Vogel, D. (2007). The Experiences in Close
Relationship Scale (ECR)-short form: Reliability, validity, and factor structure.
Journal of Personality Assessment, 88, 187–204.
Wilcox, H. C., Grados, M., Samuels, J., Riddle, M. A., Bienvenu, O., Pinto, A., et al.
(2008). The association between parental bonding and obsessive compulsive
disorder in offspring at high familial risk. Journal of Affective Disorders, 111,
31–39.