Predictors of Anxiety and Depression in Emerging Adulthood

This study constructed a multifactorial model predicting depression and anxiety symptoms among emerging adults, incorporating broad constructs representing adult attachment style, perceived trauma, self-esteem, and irrational beliefs. In the final structural equation model, attachment avoidance and perceived trauma demonstrated direct and indirect effects, whereas attachment anxiety predicted depression only indirectly through low self-esteem or irrational beliefs, and chronic anxiety. Chronic anxiety played a crucial role in linking low self-esteem and irrational beliefs to depression. The theoretical and clinical implications of the findings are discussed.     

Perceived Ability to Cope With Trauma Among U.S. Combat Veterans

The Perceived Ability to Cope With Trauma (PACT) scale measures perceived forward-focused and trauma-focused coping. This measure may also have significant utility measuring positive adaption to life-threatening trauma, such as combat. Our objective was to examine perceived ability to cope with trauma, as measured by the PACT, and the relationships between this perceived ability and clinically pertinent information (anxiety, depression, posttraumatic stress disorder [PTSD]) among U.S. military veterans. Data were provided from 71 combat veterans, consisting of 47 veterans with PTSD and 24 veterans without PTSD who had subthreshold symptoms of the disorder. All veterans completed standardized clinical interviews as well as a battery of well-validated self-report symptom measures. We found that veterans with PTSD had significantly lower PACT scores than veterans without PTSD; those without PTSD self-reported more ability to engage in forward-focused and trauma-focused coping than those with PTSD. Importantly, we also showed relationships between the PACT scores and indices of psychological difficulties as both Forward Focus and Trauma Focus coping scores negatively correlated with PTSD, depression, anxiety, and alexithymia. Finally, the Forward Focus PACT scale improved prediction of PTSD severity over combat exposure alone. The PACT, especially the Forward Focus scale, appears to be a useful measure of perceived positive coping ability with trauma in combat-exposed veterans who report symptoms of traumatic stress, extending the utility of the measure from normative to clinical populations. The importance of adopting forward-focused coping is discussed.     

Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

Adult attachment styles and psychological disease: examining the mediating role of personality traits

The aim of the present study was to examine differences in anxiety and depression related to differences in attachment models of the self and of others and whether personality traits mediate this relationship. The authors assessed attachment styles, anxiety, depression, and personality traits among 274 adult volunteers. Participants were classified into 4 attachment groups (secure, preoccupied, fearful, and dismissing-avoidant) according to K. Bartholomew's (1990) model. The present authors found significant differences among attachment groups on anxiety and depressive symptoms with attachment styles involving a negative self-model showing higher scores than attachment styles characterized by a positive self-model. The authors also found that differences between attachment styles in anxiety and depression remained significant when personality factors related to attachment prototypes were entered as covariates. Results indicate that secure attachment in adults was associated with better mental health, while insecure attachment styles characterized by negative thinking about the self were associated with higher depression and anxiety scores. Our findings seem to evidence that attachment and personality are only partly overlapping and that attachment cannot be considered as redundant with personality in the explanation of psychological disease.     

The Role of Attachment Style and Depression in Patients with Hepatitis C

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population. Over 18 months, 99 consecutively referred HCV infected patients were assessed with the Hamilton Depression Rating Scale (HDRS), Fatigue Severity Scale, Patient Health Questionnaire-15 for physical symptoms and the Relationship Questionnaire for attachment style. An ANOVA was used to identify differences between attachment styles and Pearson correlations were used to evaluate the association between depression, fatigue and physical symptoms. Approximately 15 % of patients in the sample had a fearful attachment style. Patients with fearful attachment style had significantly higher depressive symptoms compared to a secure attachment style (p = .025). No differences in physical and fatigue symptoms were observed between attachment styles. Further, HDRS scores were significantly associated with fatigue scores (p < .001) and physical symptoms (p < .001), reinforcing the relationship between these symptom domains in HCV-infected patients. Although depressive, physical and fatigue symptoms are inter-related in HCV-infected patients, our study results suggest that only depressive symptoms were influenced by the extremes of attachment style. Screening of relationship styles may identify at-risk HCV-infected individuals for depression who may have difficulty engaging in care and managing physical symptoms.     

The association between spouses' self-reports of attachment styles and representations of family dynamics

The current research assesses the association between spouses' self-reports of attachment style and their perceptions of family dynamics. The sample included 93 Israeli married couples with young children. Both husbands and wives completed the adult attachment style scale and the perceived and ideal versions of FACES III. Findings showed that spouses whose self-reports endorsed the secure style perceived relatively high levels of family cohesion and adaptability; persons who endorsed the anxious-ambivalent style reported high levels of family cohesion but low levels of adaptability; and persons who endorsed the avoidant style reported relatively low levels of both family dimensions. In addition, significant associations were found between reports of attachment styles, on the one hand, and ideal representations of family dynamics, the marital partner's representations of family dynamics, and spouses' discrepancies in these representations, on the other. Findings are discussed in terms of attachment theory.     

蒙汉族大学生父母教养方式、成人依恋与心理困扰的关系研究

通过整群抽样方法抽取了576名大学生,对其施测父母养育方式量表、亲密关系体验量表和心理困扰量表,运用结构方程模型技术,分别考察了父母养育方式的蒙汉族差异以及成人依恋模式在父母养育方式和心理困扰间的中介作用。结果表明:(1) 蒙古族父母对孩子的关爱程度和给孩子的自主性要显著高于汉族;(2) 汉族的成人依恋模式在父母过度保护与抑郁-焦虑-压力之间起着部分中介作用,而蒙古族成人依恋的中介作用不明显,但母亲的冷漠拒绝和过度保护会导致个体依恋回避和依恋焦虑,父亲的冷漠拒绝和过度保护会影响个体的抑郁和焦虑,母亲的过度保护和父亲的冷漠拒绝会影响个体的压力。     

Insecure adult attachment style and depressive symptoms: Implications for parental perceptions of infant temperament

The current study tested associations between parental depressive symptoms, adult attachment styles, and perceptions of infant temperament among 319 mother–infant and 173 father–infant dyads. Depressive symptoms and insecure attachment style among the mothers and/or fathers were associated with perceptions of the infant as temperamentally more negatively and/or less positively tuned. Multivariate analyses of depressive symptoms and attachment styles with perceived temperament suggest that depressive symptoms and perceived temperament remain significantly associated, while the associations between attachment styles and perceived temperament, in most instances, were reduced to nonsignificance. We also tested whether secure attachment among the parents buffered any negatively and/or positively tuned depression‐related perceptions, but found no supporting evidence. Even though the study results await replication in longitudinal designs, they nevertheless underline the significance of parental depressive information processing in the perceiving of infant temperament. ©2004 Michigan Association for Infant Mental Health.     

Leaders as attachment figures: leaders' attachment orientations predict leadership-related mental representations and followers' performance and mental health

In 3 studies, the authors examined the contribution of leaders' attachment styles to their leadership motives and beliefs and to followers' outcomes. In Study 1, participants completed measures of attachment orientation, leadership motives, self-representations, and leadership style. Studies 2 and 3 were conducted within Israeli military units either during a leadership workshop or during intensive combat training. Israeli military officers and their soldiers (followers) reported on their attachment styles, and the soldiers reported on the officers' leadership qualities and on the soldiers' own performance and mental health. Leaders' attachment anxiety was associated with more self-serving leadership motives and with poorer leadership qualities in task-oriented situations. Leaders' attachment anxiety also predicted followers' poorer instrumental functioning. Leaders' attachment-related avoidance was negatively associated with prosocial motives to lead, with the failure to act as a security provider, and with followers' poorer socioemotional functioning and poorer long-range mental health. Results are discussed with respect to the value of attachment theory for the study of leadership.     

POSTPARTUM BONDING DIFFICULTIES AND ADULT ATTACHMENT STYLES: THE MEDIATING ROLE OF POSTPARTUM DEPRESSION AND CHILDBIRTH‐RELATED PTSD

Despite decades of research demonstrating the role of adult attachment styles and early mother–infant bonding in parenting behaviors and maternal mental health, these constructs have seldom been studied together. The present study aimed to investigate the relationship between attachment styles and specific bonding difficulties of mothers. In addition, as postpartum depression and childbirth‐related posttraumatic stress symptoms have been associated with both constructs, we explored their possible mediation effect. One hundred fourteen mothers, 4 to 12 weeks’ postpartum, completed a demographic questionnaire, the Adult Attachment Style Questionnaire (M. Mikulincer, V. Florian, & A. Tolmacz, 1990), the Postpartum Bonding Questionnaire (L.F. Brockington, C. Fraser, & D. Wilson, 2006), the Modified Perinatal Posttraumatic Stress Disorder Questionnaire (J.L. Callahan, S.E. Borja, & M.T. Hynan, 2006), and the Edinburgh Postnatal Depression Scale (J.L. Cox, G. Chapman, D. Murray, & P. Jones, 1996), using an online survey system. As predicted, insecure attachment styles were associated with bonding difficulties wherein anxious/ambivalent attachment was associated with greater infant‐focused anxiety, mediated by postpartum depression but not childbirth‐related PTSD symptoms. In contrast, greater avoidant attachment style was associated with greater rejection and anger, mediated by childbirth‐related posttraumatic stress disorder (PTSD), but not depression symptoms. The current study confirmed the association of different attachment styles with bonding as well as the mediating roles of childbirth‐related PTSD and postpartum depression symptoms. Future psychological interventions may utilize such evidence to target interventions for bonding disorders in accordance with individual differences.     

The Aftermath of Romantic Betrayal: What’s Love Got to Do with It?

Approaches to love were explored to determine links to psychological experiences after romantic betrayal. Results indicated that the mania (obsessive) love style predicted post-betrayal trauma reactions, depression, and psychosomatic symptoms, whereas other styles were unrelated to these post-betrayal reactions. Weaker effects also were observed in which the mania style was related to post-betrayal anxiety and embarrassment, as well as low levels of psychological resolution for the betrayal across time among those who were no longer involved with their betrayers.     

Depression and social anxiety mediate the relationship between parenting styles and risk of eating disorders: A study among Arab adolescents

In multicultural Israel, the prevalence of eating disorders (EDs), a common chronic disorder among Western adolescents (especially females), has risen for Arab adolescents, who belong to an Eastern collectivist society. The study examines family and psychological factors that may increase the risk of EDs among Muslim Arab adolescents. We expected social anxiety and depressive symptoms to mediate the association between parenting styles and risk of EDs, with possible gender differences in the mediation model. Participants were 613 Muslim adolescents (394 females and 219 males); mean age = 15.4 ± 1.6; range = 12–19. The analyses revealed that the severity of depressive symptoms and especially social anxiety mediate the relationship between authoritarian parenting style and risk of EDs. Females reported higher levels of risk of EDs, social anxiety, depression and authoritative parenting style than males; no differences appeared for authoritarian or permissive parenting styles. The research sheds new light on risk factors for EDs and the likelihood of authoritarian parenting style and social anxiety being involved in the aetiology of EDs among Arab adolescents. The outcomes meaningfully add to understanding of specific psychological processes that may be associated with the risk of EDs in this population.     

The Role of Perceived Burden and Social Support in Suicide and Depression

In a sample of 114 military veterans with depression histories, perceived burden was related to depression symptoms and suicide attempt history. After accounting for perceived burden, sense of belonging was negatively related to depression. Among the areas of social support, family support was inversely related to both depression and suicide history. After accounting for family support, personal meaning from relationships and friend support were related to depression. The results of this study suggest that perceived burdensomeness may be a stronger determinant of suicidality than sense of belonging or social support. This study highlights the contribution of perceived burdensomeness to suicide and depression.     

The associations between adult attachment,posttraumatic symptoms,and posttraumatic growth

Background and Objectives: Individual differences after trauma vary considerably and can range from posttraumatic stress disorder (PTSD) to posttraumatic growth (PTG). Current theoretical models cannot fully explain this variability. Therefore, we integrated attachment theory with Ehlers and Clark's model of PTSD to understand whether attachment style is associated with negative appraisals of a traumatic event(s), posttraumatic stress symptoms (PTS), and PTG. Our aim was to test this integrated model PTSD in an analog sample who had experienced at least one traumatic event. Design: We used structural equation modeling to test the association of adult attachment and posttraumatic cognitions (self and world/others) with PTS and PTG using a cross-sectional, correlational design. Methods: The sample comprised 393 university staff and students (Range_Age= 18–49, 85% females) who completed online measures. Results: Attachment anxiety and negative posttraumatic self-cognitions were positively associated. Negative posttraumatic self-cognitions were positively associated with PTS. Attachment anxiety had an indirect effect (via negative posttraumatic self-cognitions) on PTS, whereas attachment avoidance predicted more negative posttraumatic world cognitions and lower perceived PTG. Conclusions: The study highlights the importance of considering how attachment styles influence posttraumatic emotion regulation and cognitive processing of the trauma to determine posttraumatic mental health.     

Perceived Parenting Styles and Cultural Influences in Adolescent’s Anxiety: A Cross-Cultural Comparison

A growing body of literature links particular parenting practices with negative child outcomes including greater anxiety symptoms among western societies. However, the effects of cultural differences on such linkages have not been adequately addressed in the anxiety literature. This study therefore aimed to examine the relationship between perceived parenting style and anxiety among Malay, Chinese, Indian, Arab and European/American (Caucasian) origins adolescents and the possible cultural group influences on this relationship was studied. Using multiple cluster sampling, a total of 227 students (122 boys and 105 girls) aged 13–18 years was selected. They completed questionnaires measuring parental rearing behaviors (EMBU-C) and anxiety symptoms scale (SCAS). Results indicated that in comparison to the European/American; Asian samples reported greater anxiety symptoms on all subscales of anxiety. Parental rejection, anxious rearing and control/over protection were correlated to higher anxiety independent of cultural group but these associations were stronger for Caucasians. Parenting styles as predictor of anxiety were found to be cross culturally different. Although European/American adolescents rated their parents as least over controlling, it was significant predictor of anxiety. This study provides evidence for the notion that relationship between parenting factors and anxiety were different across cultural contexts.     

Gender Differences in Coping Styles of Chinese Military Officers Undergoing Intensive Training

This study investigated gender differences in anxiety and coping styles under the stress of intense military training. We surveyed Chinese female (n = 470) and male (n = 379) military officers who were surveyed during the third month of a 10-month intensive training program. Results indicated that state and trait anxiety were highly correlated in both women and men. In general, female officers had higher levels of anxiety, greater negative coping tendencies, and less perceived self-efficacy than their male counterparts. When compared with the norm, both women and men had significantly more positive coping strategies. A hierarchical multiple regression analysis showed factors that influenced male and female state anxiety. Avoidance, which was chosen by women more often than men, in general was less useful for female officers. The most common positive coping style for female officers was problem solving, whereas for men it was help seeking. We suggested that even female officers with lower mental health levels than their male counterparts made active cognitive changes to their coping styles when undergoing intense military training.     

Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.     

Attachment in individuals with social anxiety disorder: the relationship among adult attachment styles,social anxiety,and depression

Despite their apparent implications for social functioning, adult attachment styles have never been specifically explored among persons with social anxiety disorder. In the current study, a cluster analysis of the Revised Adult Attachment Scale (N. L. Collins, 1996) revealed that 118 patients with social anxiety were best represented by anxious and secure attachment style clusters. Members of the anxious attachment cluster exhibited more severe social anxiety and avoidance, greater depression, greater impairment, and lower life satisfaction than members of the secure attachment cluster. This pattern was replicated in a separate sample of 56 patients and compared with the pattern found in 36 control participants. Social anxiety mediated the association between attachment insecurity and depression. Findings are discussed in the context of their relevance to the etiology, maintenance, and cognitive-behavioral treatment of social anxiety disorder.     

Mediationg Role of Mindfulness as a Trait Between Attachment Styles and Depressive Symptoms

Attachment styles and dysfunctional symptoms have been associated. This relationship could be affected by metacognitive capacity. The aim of this study is to clarify the relationship between depressive symptoms, attachment styles, and metacognitive capacity. In addition, the mediating role of metacognition between attachment and depressive symptoms has been studied. A total of 505 participants recruited from the general population of the province of Bizkaia (Spain) completed questionnaires regarding depression, anxiety, mindfulness, decentering, and attachment. Results showed positive and significant relations between (a) dysfunctional symptoms and insecure attachment styles and (b) metacognitive capacity and secure attachment style. Additionally, the mediating role of metacognition between attachment and depressive symptoms was confirmed. Intervention in metacognitive abilities such as mindfulness could be a useful therapeutic tool for depressive symptoms.     

Attachment Patterns as Mediators of the Link Between Combat Exposure and Posttraumatic Symptoms: A Study Among Portuguese War Veterans

We analyzed the role of both attachment anxiety and attachment avoidance as a mediators of the effects of combat exposure on posttraumatic stress disorder (PTSD) symptoms. Participants were Portuguese veterans (N = 60) divided into 2 groups: 30 suffered from chronic PTSD (nonrecovered) and 30 had remission from PTSD (recovered). Combat exposure, attachment patterns, and PTSD symptoms were assessed through self-report measures. Mediation test was performed by conducting several hierarchical regression analyses. Results showed higher attachment anxiety among nonrecovered participants. We did not find statistically significant differences between groups for both attachment avoidance and combat exposure level scores. In mediation analysis, at first step, attachment avoidance was not a significant predictor of PTSD symptoms, and attachment avoidance did not enter in subsequent analysis. Attachment anxiety was a partial mediator of the effect of combat exposure on PTSD symptoms. Implications of the findings for both attachment theory and clinical intervention on trauma are discussed.