Brief Article
Copyright ©2013 Baishideng. All rights reserved.
World J Psychiatr. Jun 22, 2013; 3(2): 41-49
Published online Jun 22, 2013. doi: 10.5498/wjp.v3.i2.41
Contribution of attachment insecurity to health-related quality of life in depressed patients
Alexander M Ponizovsky, Angela Drannikov
Alexander M Ponizovsky, Mental Health Services, Ministry of Health, Jerusalem 9101002, Israel
Angela Drannikov, Talbieh Mental Health Center, Jerusalem 9101002, Israel
Author contributions: Ponizovsky AM designed the study, analyzed data and wrote the manuscript; Drannikov A collected data, was involved in writing and approved a final version of the manuscript.
Supported by (in part) The Ministry of Immigrant Absorption to Dr. Ponizovsky AM
Correspondence to: Alexander M Ponizovsky, MD, PhD, Mental Health Services, Ministry of Health, 39 Yirmiyahu Str 1176, Jerusalem 9101002, Israel. alexander.ponizovsky@moh.health.gov.il
Telephone: +972-3-5080627 Fax: +972-2-5655911
Received: March 25, 2013
Revised: April 17, 2013
Accepted: May 16, 2013
Published online: June 22, 2013
Abstract

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life (HRQoL) in patients diagnosed with adjustment disorder (AJD) with depressed mood.

METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance (ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package (SPSS Inc., Chicago, IL, United States).

RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggest that depressive symptoms were more severe (F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer (F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQoL, accounting for 21.4% and 29.7% of the total variance, respectively [R2 = 0.79; Adjusted R2 = 0.77; F (5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.

CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in AJD with depressed mood.

Keywords: Attachment insecurity, Adult attachment style, Health-related quality of life, Depression, Adjustment disorder

Core tip: Adult attachment insecurity is a factor predisposing to relational stress and, as a result, to depressive reactions. Depression is a well-known factor reducing health-related quality of life (HRQoL). The study hypothesises that both variables will significantly predict poor HRQoL outcome, even after controlling for confounding sociodemographic variables. The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in adjustment disorder (AJD) with depressed mood. The findings also suggest that therapeutic techniques, alleviating emotional distress and promoting well-being, could accelerate recovery and improve HRQoL in the anxious/ambivalently attached patients with protracted AJD.