The theme of death in the transcripts of adult attachment interviews in cancer patients: a pilot study — ASN Events
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The theme of death in the transcripts of adult attachment interviews in cancer patients: a pilot study (#569)

Cristina Civilotti 1 , Valentina Furno 1 , Giulia Di Fini 1 , Martina Cussino 1 , Fabio Veglia 1
  1. Università degli Studi di Torino, Torino, Italy

The attachment theory recognizes the biologically-based need for protective proximity to a conspecific in the case of perceived vulnerability. The activation of attachment is primed "from the cradle to grave"1 , especially in the presence of events – intensive or prolonged – that involve pain, danger, fatigue or protracted vulnerability. It is hence apparent how cancer may represent a threat to the patient's life or physical integrity, which will activate this system.
Previous research showed how complications in the activation and modulation of the attachment system are associated with a recursive thought of traumatic memories2  and a decreased ability of the working memory to function 3 , 4 , 5 , 6 .

The aim of this pilot project was to study the narrative Theme of Death in a group of oncological women (N=15) compared to a sample of healthy women (N=15), through the analysis of the Adult Attachment Interview (AAI) transcripts.
The AAIs were transcribed verbatim and coded according to the criteria of  George, Kaplan and Main 7 . Transcripts were then analyzed at a lexical and a semantic level within the framework of the Grounded Theory8 . 
The Theme of Death was used “out of context” in 60% of patient transcripts (N=9), compared to only 26.7% (N=4) of the control group. Three types of occurrences were identified: 1. in reference to a loved one; 2. in the context of loss in general; 3. in co-occurrence with one’s own illness. The second and third types are found only in patients’ transcripts, as if the Theme of Death entered within the context of attachment, in a typical and possibly perturbing form. Preliminary results will be discussed with the use of transcript excerpts.
From a clinical perspective therefore, the importance of investigating the potentially disturbing effect of cancer on the thought processes assumes particular importance.

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  2. Hesse E., Van Ijzendoorn M.H. (1999), Propensities toward absorption are related to lapses in the monitoring of reasoning or discourse during the Adult Attachment Interview: A preliminary investigation, Attachment and Human Development, 1:67-91.
  3. Hesse, E., & Main, M. (2006). Frightened, threatening, and dissociative (FR) parental behavior as related to infant D attachment in low-risk samples: Description, discussion, and interpretations. Development and Psychopathology, 18, 309–343.
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  5. Moores, K.A., Clark, C.R., McFarlane, A.C., Brown, G.C., Puce, A., & Taylor, D.J. (2008), Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder. Psychiatry Research:Neur
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  7. George, C., Kaplan, N., & Main, M. (1996). The Attachment Interview for Adults. Unpublished Manuscript, Department of Psychology, University of California, Berkeley (3rd Edition).
  8. Glaser, B.G. & Strauss, A.L. (1967b). Discovery of grounded theory: Strategies for qualitative research. Hawthorne, NY: Aldine de Gruyter.