A Comparison of Secure and Insecure Attached Child

Personality Disorders and Romantic Adult Attachment: A Comparison of Secure and Insecure Attached Child Molesters Stefan Bogaerts Stijn Vanheule Mattias Desmet Abstract: This study analyzed personality disorders in a group of 33 securely and 51 insecurely attached child molesters. A total of 51 child molesters were selected from a community-based educational training program, and the other group was selected from a Belgian prison (n = 33). Research shows that adult attachment styles and personality disorders share a common underlying structure. It is remarkable that very little is known about differences between securely and insecurely attached child molesters. In this study, the authors found that the schizoid personality disorder differed between securely and insecurely attached child molesters. These findings have implications for the aetiology and treatment of child molesters. Future research is necessary to determine patterns of attachment in relationship to personality disorders. Keywords: child molesters; attachment styles; personality disorders

A large body of research has shown that childhood and adult attachment differentiate in a significant way among child molesters, normal control participants, and nonsexual delinquents. Empirical evidence was found for the fact that child molesters experienced less secure attachment in childhood and adulthood compared with control groups. The attachment style of child molesters has been characterized as anxious-ambivalent and avoidant (e.g., Bogaerts, Vervaeke, & Goethals, 2004; Bumby & Hansen, 1997; Marshall, Hudson, & Hodkinson, 1993; Marshall, Serran, & Cortoni, 2000; Seidman, Marshall, Hudson, & Robertson, 1994; Smallbone & Dadds, 1998, 2000; Smallbone & McCabe, 2003; Ward, Hudson, Marshall, & Siegert, 1995; Ward, Louden, Hudson, & Marshall, 1995). It has been widely noted though that child molesters are a highly heterogeneous population (Canter, Hughes, & Kirby, 1998; Jamieson & Marshall, 2000; Marshall, Champagne, Brown, & Miller, 1997; Marshall, Laws, & Barbaree, 1990). This heterogeneity could account for some inconsistencies within the research findings concerned with child molesting. Indeed, contrary to expectation, research uncovered child molesters who could not be characterized by insecure adult International Journal of Offender Therapy and Comparative Criminology, XX(X), 2005 1DOI: 10.1177/0306624X05278515 ã 2005 Sage Publications

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attachment. A study by Smallbone and Dadds (1998) found child molesters reporting positive childhood attachment. The research by Smallbone and McCabe (2003) discovered that male sexual offenders more often report secure instead of insecure childhood maternal and paternal attachment. The findings in the field of adolescent male child molesters seem to parallel the ones of adult child molesters. This field appears also to be very heterogeneous and uncovers the same puzzle in the research findings. Here also, a consistent body of research demonstrated that adolescent child molesters fit in the profile of insecure attachment, intimacy deficits, loneliness, and impaired interpersonal functioning (Becker, 1998; Carpenter, Peed, & Eastman, 1995; Deisher, Wenet, Paperny, Clark, & Fehrenbach, 1982; Katz, 1990; Saunders, Awad, & White, 1986). But in the same way, the studies of Ford and Linney (1995) and Worling (1995) did not find significant differences among groups on these variables. An explanation for these inconsistencies could be the relative absence of ingroup research. Most of the time, forensic populations are compared to normal comparison groups and other forensic populations (child molesters compared to rapists, nonsexual offenders, violent sexual offenders, nonsexual violent offenders, etc.). A second explanation could just be that sexual offenders typically have multiple paraphilias (Cortoni & Marshall, 2001). Based on our clinical observations during forensic experiences or therapy with child molesters, we do not think these findings of securely attached child molesters invalidate those revealing attachment disorders and impaired interpersonal functioning. We are rather inclined to think that the aetiology or dynamics of a particular segment of child molesters just might not correspond to the profile of intimacy deficits, loneliness, insecure attachment, and impaired interpersonal functioning. In research, attachment theory was explored as a way of understanding the origins of personality disorders. Brennan and Shaver (1998) suggest that patterns of insecure attachment overlap with patterns of disordered personality. According to the most recent Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association (1994), virtually all personality disorders are characterized by persistent difficulties in interpersonal relations, which are often central features (Birtchnell & Shine, 2000; Brennan & Shaver, 1998). Defining personality disorders from an ontogenetic view as the final result of interpersonal processes, personality disorders were related to insecure childhood attachment (Jones, 1996; Lyons-Ruth, 1996; Wearden, Cook, & Vaughan-Jones, 2003) and specific parent-child interactions during the first years of life (Benjamin, 1993). Research has pointed out that “personality disorders are pervasive, inflexible and stable over time” (American Psychiatric Association, 1994, p. 629). The role of personality disorders in the aetiology and maintenance of sexually deviant behaviour has been explored extensively in research. However, despite the increasing attention paid to personality disorders since the DSM-III-R (American Psychiatric Association, 1987), very little is known about the aetiology of these disorders and the relationship between personality disorders and the aetiol-

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ogy of child molestation. Only weak evidence exists concerning the relationship between specific personality disorders and sexual offenders (Marshall, 1996). In almost all cases, child molesters have been diagnosed as having one or more personality disorders (Buschman & Van Beek, 2003; Hart, 2003; Lussier, Proulx, & McKibben, 2001). There also is a lack of empirical research concerning differences between securely and insecurely attached child molesters. Brennan and Shaver (1998) emphasized the need to focus on elucidating the developmental antecedents of personality disorders to determine which personality disorders are connected with which types of attachment. Furthermore, most research compares child molesters to nonsexual delinquents or normal individuals; in-group research is rather scarce. The purpose of the present study is to investigate whether securely and insecurely attached child molesters differ in the types of personality disorders from which they suffer. Drawing on the results of the ontogenetic research line, we hereby predicted that personality disorders would contribute more to the explanation of insecure rather than secure attached child molesters. Before describing the results, we will present the participants and measured methods.

METHOD A sample of 84 male child molesters was selected between November 1999 and February 2001 from either an educational training program as an alternative sanction (n = 51) or a Belgian prison (n = 33). The prison sentences ranged from 4 to 18 months. In all, 41 were family-related child molesters, and 43 were nonfamily-related child molesters. Child molesters’ age ranged from 21 to 85 years (M = 38, SD = 11.1). Also, 38% were married, 40% were single, and 22% were divorced. Regarding education, 20% finished primary school, 30% finished the first level of secondary school, 32% succeeded in the second level of secondary school, and 16% attended college or university. According to reports of caretakers, 60% of the molesters had 1 victim, 20% had 2 victims, 12% had 3 victims, and 8% had 4 or more victims.

MEASURES The Adult Attachment Scale (Hazan & Shaver, 1987) was used to measure the adult romantic attachment style. This scale contains two parts: a multiple-choice section with three response categories (secure, avoiding, and anxious-ambivalent attachment styles) and a 7-point scale on which the level of secure, avoiding, and anxious-ambivalent attachment can be marked. At 11 weeks apart, the test-retest correlation was .80, indicating that it is a stable measure (Crowell, Fraley, & Shaver, 1999).

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Personality disorders were measured by the Assessment of the DSM-IV Personality Disorders (ADP-IV; Schotte, De Doncker, Vankerckhoven, Vertommen, & Cosyns, 1998). The instrument consists of 94 items and is scored on a 7-point scale. The instrument measures the typicality and the distress or impairment of the DSM-IV criterion (American Psychiatric Association, 1994). The psychometric qualities of the instrument are encouraging. Alpha coefficients for the ADP-IV scales were all higher than .70, except for the obsessive compulsive (a = .68) and the schizoid (a = .60) personality disorders scales. First, nonhierarchical clustering algorithms were used to identify relatively homogeneous groups of securely and insecurely attached child molesters. Because our samples were not very large, we decided to select no more than two clusters (secure and insecure). The independent sample t test was then used as a control instrument to compare the means of secure, avoidant, and anxious-ambivalent attachment styles among both groups. Secondly, a t test was used again to compare whether personality disorders differed between securely and insecurely attached child molesters. Finally, a binary logistic regression analysis was used to estimate the linear relationship between the dependent variable (secure or insecure) and the personality disorders.

FINDINGS In all, 33 child molesters were clustered as secure, and 51 child molesters were clustered as insecure (see Table 1). The means of the three Hazan and Shaver’s (1987) attachment styles differentiated significantly between secure and insecure child molesters (secure attachment styles: t = 5.49, p < .01; avoidant attachment styles: t = 8.16, p < .001; anxious-ambivalent attachment styles: t = 11.64, p < .001). Bivariate analysis was used to examine which personality disorders differed between secure and insecure child molesters. As can be seen in Table 2, securely and insecurely attached child molesters differed significantly with respect to eight personality disorders. Securely attached child molesters reported less paranoid, schizoid, schizotypal, borderline, avoidant, dependant, depressive, and passiveaggressive personality disorders than did insecurely attached child molesters. Next, personality disorders that showed a significant difference on the bivariate level between securely and insecurely attached child molesters were inserted in the logistic regression model to examine which personality disorders contributed independently to the explanation of insecurely attached child molesters. The enter option was used. The model correctly predicted 79% of the 84 respondents in the secure and insecure cluster. A Cox and Snell R2 of .36 showed that the global model explained 36% of the variation in the dependent variable.1 The schizoid personality disorder offered a very strong significant contribution to the prediction of insecure child molesters (b = –.29, Wald = 8.27, df = 1, p < .005, Exp(b) = .74). No other personality disorder contributed to the explanation

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TABLE 1 ATTACHMENT STYLES IN THE SECURE AND INSECURE CHILD MOLESTERS Secure Child Molestersa Attachment Styles Secure attachment style Avoidant attachment style Anxious-ambivalent attachment style

Insecure Child Molestersb

M

SD

M

SD

5.73 1.85 1.42

1.06 1.12 0.79

4.08 4.45 4.51

1.68 1.59 1.61

a. n = 33. b. n = 51.

TABLE 2 PERSONALITY DISORDERS FOR THE SECURE AND INSECURE CHILD MOLESTERS Securea

Insecureb

Independent Samples Test

Personality Disorders

M

SD

M

SD

t

Paranoid Schizoid Schizotypal Antisocial Borderline Histrionic Narcissistic Avoidant Dependant Obsessive-compulsive Depressive Passive-aggressive

16.15 15.30 20.00 14.33 22.87 18.54 18.72 15.60 17.42 21.63 16.09 14.36

5.39 4.40 6.24 5.90 7.37 6.34 5.22 5.68 4.10 7.23 4.85 4.63

19.43 21.52 24.50 16.43 27.43 20.54 19.37 22.50 20.86 24.17 19.41 17.21

6.75 5.57 7.97 6.10 9.69 5.87 5.85 8.12 7.20 8.48 7.09 6.50

2.34 5.41 2.74 1.55 2.29 1.47 0.51 4.25 2.49 1.41 2.35 2.18

p .02* .001*** .007** .12 .02* .14 .60 .001*** .01** .16 .02* .03*

a. n = 33. b. n = 51. *p < .05. **p < .01. ***p < .001.

of the dependant variable. The Exp(b) parameter shows that individuals with a schizoid personality disorder have 74% more chance to develop an insecure attachment style.

DISCUSSION This study focuses on the developmental origins of personality disorders with respect to attachment. Previous research indicated substantial overlap between

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attachment and personality disorder measures and found that personality disorders shared the same similar developmental antecedents as attachment styles do (Brennan & Shaver, 1998). However, a serious problem in previous research is the lack of information about the linkage among the developmental antecedents of personality disorders to determine which personality disorders are shared by patterns of insecure attachment. In our research, a selection of child molesters was clustered into a group of securely attached child molesters and a group of insecurely attached child molesters. The schizoid personality disorder explained 36% of the variation in the dependant variable. No other personality disorders differentiated between the secure and the insecure group. In earlier research using structural equation models, the schizoid personality disorder was also found to be a very strong predictor of child molestation (Bogaerts et al., 2004). Other research confirms this finding (Cosyns, De Doncker, Hamelinck, Koeck, & De Ruyter, 1994; Seto & Barbaree, 1999; Shea, 1996). This result is in line with the fact that the schizoid character appears defensively devoid of any interest in human interaction (Sheldon & West, 1990). The schizoid individual tends to retreat from other persons, thereby isolating himself or herself from relationships with family, friends, and other persons. It is common knowledge that child molesters experienced less intimacy and less friendship during childhood and adulthood than did nonsexual delinquents and normal control groups (Bruinsma, 1996). The description of the schizoid individual can be related to the theory of Finkelhor (1984) and Finkelhor and Araji (1986). They described four components (sexual arousal, emotional congruence, blockage, and disinhibition) that contribute to the development of a child molester’s behavior. In the light of our results, the components emotional congruence and blockage are important. Schizoid individuals are frequently blocked from engaging in adult relationships by bad experiences with age-appropriate adults, sexual dysfunction, or limited and inadequate social and relational skills. Children, on the contrary, appear to them as humble and reliable. They are often emotionally congruent to children, and they feel comfortable in relating to children. Some consequences for the treatment of child molesters can be taken from our findings. Because the attachment style plays a significant role in the development of child molestation, psychotherapists should integrate interpersonal tools in the therapeutic method, especially in the therapeutic work with insecure child molesters. By experiencing an intersubjective relationship with a therapist, a patient can be enabled to develop a deeper understanding of his or her own attachment and abusive history. Sawle and Kear-Colwell (2001) introduced interpersonal focuses in their cognitive-analytic therapy. Through a positive relationship, the client comes to a deeper understanding of his or her own history of development. One limitation of this research is its use of a small clinical sample. It is not always possible to attain large samples of sexual delinquents. The second limitation of our research is its reliance on a self-report measure of personality disorders and adult attachment styles. Although the ADP-IV and the adult attachment scale

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are both reliable, it would be better to use semistructured interviews to test the association between attachment styles and personality disorders. Concerning future research, longitudinal research is very important to get insight into the ontological primacy of attachment styles and personality disorders. There is a fair degree of overlap between attachment styles and personality disorders. Both sets are related to family experiences. Future research among child molesters should focus on elucidating the developmental antecedents of personality disorders to determine which ones are shared by patterns of insecure attachment and which ones are independent. The present study is a first step in connecting personality disorders and insecure adult attachment styles.

NOTE 1. We did not prefer the Nagelkerke R2. The schizoid personality disorder explained 49% of the 2 variation in the dependent variable. It is well known that the Nagelkerke R gives an overestimation of the explained variation.

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Stefan Bogaerts, Ph.D. Department Crime Prevention, Sanctions and Law Enforcement WODC, Ministry of Justice The Hague The Netherlands and University of Tilburg P.O. 20301 2500 EH The Hague The Netherlands Stijn Vanheule, Ph.D. Department of Psychoanalysis and Clinical Consulting Ghent University Belgium H. Dunantlaan, 2 9000 Ghent Belgium Mattias Desmet, M.A. Department of Psychoanalysis and Clinical Consulting Ghent University Belgium H. Dunantlaan, 2 9000 Ghent Belgium