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Attachment theory emphasizes differential relatedness of insecure attachment dimensions (i.e., anxiety vs. avoidance) with specific emotion regulation styles (\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      ). We tested whether the associations between attachment anxiety versus avoidance and paranoia were mediated specifically by hyperactivating (i.e., the use of emotion\u2010amplifying strategies: self\u2010blame, rumination, catastrophization) versus blaming others\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      , respectively. In addition, we explored whether self\u2010blame versus blaming others\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      differentially mediated the associations between attachment anxiety versus avoidance and paranoia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      We included 60 patients with psychosis and 40 healthy controls (HCs) with whom we conducted standardized diagnostic interviews. We assessed paranoia, attachment, and\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      via questionnaires. A structural equation\u00a0mediation model including attachment anxiety and avoidance (predictor), the\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      styles (mediators), and paranoia (outcome) was calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with HCs, patients exhibited significantly more attachment anxiety and avoidance, and used more hyperactivating\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      as well as strategies of blaming others. We found a significant indirect effect between attachment anxiety and paranoia via hyperactivating\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      in patients with psychosis. However, no significant indirect effects involving blaming others or self\u2010blame in any of the groups were found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our study provides a starting point for further investigation of how paranoid delusions in psychosis could emerge from insecure attachment via\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      . This might inspire further research into attachment theories of ER in paranoia. In the long term, this could provide a basis to develop interpersonally oriented interventions for this target group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practitioner points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            In individuals with psychosis, there appears to be an attachment\u2010specific emotion regulation (ER) pathway from attachment anxiety via hyperactivating\n                            <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                            to paranoia.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Blaming others did not explain the significant association between attachment avoidance and paranoia.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Attachment\u2010specific therapeutic approaches to paranoia, that focus on hyperactivating ER, could be a valid way to ameliorate paranoid delusions.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papt.12208","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T23:43:25Z","timestamp":1546991005000},"page":"72-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Pathways from insecure attachment dimensions to paranoia: The mediating role of hyperactivating emotion regulation versus blaming others"],"prefix":"10.1111","volume":"93","author":[{"given":"Leonie","family":"Ascone","sequence":"first","affiliation":[{"name":"Clinical Psychology and Psychotherapy Institute of Psychology Faculty of Psychology and Movement Sciences Universit\u00e4t of Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Schlier","sequence":"additional","affiliation":[{"name":"Clinical Psychology and Psychotherapy Institute of Psychology Faculty of Psychology and Movement Sciences Universit\u00e4t of Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Sundag","sequence":"additional","affiliation":[{"name":"Clinical Psychology and Psychotherapy Institute of Psychology Faculty of Psychology and Movement Sciences Universit\u00e4t of Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania M.","family":"Lincoln","sequence":"additional","affiliation":[{"name":"Clinical Psychology and Psychotherapy Institute of Psychology Faculty of Psychology and Movement Sciences Universit\u00e4t of Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2010.01.025"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.61.2.226"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbm121"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(01)00106-4"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(94)90131-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12009"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6811.2012.01399.x"},{"issue":"3","key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.65030\/idr.10013","article-title":"Exploring the cognitive\u2010emotional pathways between adult attachment and ego\u2010resiliency","volume":"10","author":"Caldwell J. 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