Adult attachment style. II: Its relationship to psychosocial depressive-vulnerability

Abstract

Background A range of studies show adult
attachment style is associated with depressive-vulnerability
factors such as low self-esteem, poor support and
childhood adversity. However, there is wide inconsistency
shown in the type of insecure style most highly associated.
Few studies have examined attachment style in
relation to clinical depression together with a range of
such factors in epidemiological series.The present study
uses an interview measure of adult attachment which
differentiates type of attachment style and degree of insecurity
of attachment, to see: (a) if it adds to other vulnerability
in predicting depression and (b) if there is
specificity of style to type of vulnerability. Method Two
hundred and twenty-two high-risk and 80 comparison
women were selected from questionnaire screenings of
London GP patient lists and intensively interviewed.The
Attachment Style Interview (ASI) differentiated five
styles (Enmeshed, Fearful, Angry-dismissive, Withdrawn
and Standard) as well as the degree to which attitudes
and behaviour within such styles were dysfunctional
(‘non-standard’).Attachment style was examined
in relation to low self-esteem,support and childhood experience
of neglect or abuse, and all of these examined
in relation to clinical depression in a 12-month period.
Results The presence of any ‘non-standard’ style was significantly
related to poor support, low self-esteem and
childhood adversity. Some specificity of type of style
and type of vulnerability was observed. Logistic regression
showed that non-standard Enmeshed, Fearful and
Angry-dismissive styles, poor support and childhood
neglect/abuse provided the best model for clinical depression.
Conclusion Non-standard attachment in the
form of markedly Enmeshed, Fearful or Angry-dismissive
styles was shown to be associated with other depressive-
vulnerability factors involving close relationships,
self-esteem and childhood adversity and added to
these in modelling depression.