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Personality and attachment in the homeless: a systematic review
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Introdução: As pessoas em situação de sem-abrigo apresentam uma elevada prevalência de psicopatologia, incluindo perturbações da personalidade. Dada a associação entre perturbações da personalidade e vinculação, e a potencial importância destes dois temas na compreensão das pessoas sem-abrigo, o objetivo deste estudo foi o de rever todos os artigos que analisaram as perturbações da personalidade e a vinculação nas pessoas sem-abrigo.
Métodos: Nesta revisão usaram-se critérios de inclusão amplos, de modo a incluir todos os estudos sobre vinculação nos sem abrigo e todos os estudos sobre personalidade nos sem-abrigo, que tenham avaliado a distribuição de pelo menos três perturbações da personalidade. Um total de 213 estudos foram analisados por título e resumo, dos quais 63 foram escolhidos para leitura do texto completo. Destes, 14 artigos obedeceram aos critérios de inclusão, tendo sido incluídos nesta revisão sistemática.
Resultados: Dos 14 artigos incluídos, seis estudos avaliaram as perturbações da personalidade e oito estudos avaliaram a vinculação. As perturbações da personalidade revelaram-se muito frequentes nas pessoas sem-abrigo, ocorrendo em 64% a 79% das amostras. As perturbações da personalidade paranoide, borderline, evitante e anti-social foram as mais comummente identificadas, embora as suas frequências tenham variado entre os estudos. Os artigos sobre vinculação diferiram nos métodos usados e nos resultados obtidos. Ainda assim, observou-se uma predominância dos estilos de vinculação insegura nas pessoas sem-abrigo (62% a 100% das amostras).
Conclusões: A elevada prevalência das perturbações da personalidade e dos estilos de vinculação insegura nos sem-abrigo pode ter um impacto negativo nas estratégias de intervenção planeadas para ajudar estas pessoas. Esta revisão sistemática demonstrou que a literatura disponível sobre as perturbações da personalidade e a vinculação nos sem-abrigo é escassa, e que mais estudos são necessários sobre estes dois temas.
Background: Homeless people present high rates of psychopathology, including personality disorders. Given the link between personality disorders and attachment and the potential importance of these two traits for understanding homeless populations, our aim was to review all studies focusing on personality disorders and attachment in the homeless. Methods: We used broad inclusion criteria to include all studies focusing on attachment and on at least three personality disorders in the homeless. Overall, 213 studies were screened through title and abstract. Of these, 63 were chosen for full-text assessment. A total of 14 articles met eligibility criteria and were included. Results: Six studies evaluated personality in the homeless and eight studies focused on attachment in the homeless. In general, reports suggest personality disorders are highly frequent in the homeless, with frequencies ranging between 64% and 79% for any personality disorder. The most common personality diagnoses were paranoid, borderline, avoidant and antisocial personality disorders, but their frequencies varied greatly between studies. Attachment reports differed in the methods used and presented diverse results and correlates. Even so, insecure types of attachment dominated in the homeless in the few studies showing this analysis (accounted for 62% to 100% of the samples). Conclusions: The high prevalence of personality disorders and insecure types of attachment in the homeless may impact intervention strategies for the homeless. The available literature focusing on attachment and the full assessment of personality disorders in the homeless is scarce. The present review supports the need for more research on these two topics.
Background: Homeless people present high rates of psychopathology, including personality disorders. Given the link between personality disorders and attachment and the potential importance of these two traits for understanding homeless populations, our aim was to review all studies focusing on personality disorders and attachment in the homeless. Methods: We used broad inclusion criteria to include all studies focusing on attachment and on at least three personality disorders in the homeless. Overall, 213 studies were screened through title and abstract. Of these, 63 were chosen for full-text assessment. A total of 14 articles met eligibility criteria and were included. Results: Six studies evaluated personality in the homeless and eight studies focused on attachment in the homeless. In general, reports suggest personality disorders are highly frequent in the homeless, with frequencies ranging between 64% and 79% for any personality disorder. The most common personality diagnoses were paranoid, borderline, avoidant and antisocial personality disorders, but their frequencies varied greatly between studies. Attachment reports differed in the methods used and presented diverse results and correlates. Even so, insecure types of attachment dominated in the homeless in the few studies showing this analysis (accounted for 62% to 100% of the samples). Conclusions: The high prevalence of personality disorders and insecure types of attachment in the homeless may impact intervention strategies for the homeless. The available literature focusing on attachment and the full assessment of personality disorders in the homeless is scarce. The present review supports the need for more research on these two topics.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Homeless Personality disorders Attachment Psychiatry