Adult attachment and health-related quality of life after acquired brain injury

Abstract

The current research explores how adult attachment patterns present after an acquired brain injury (ABI) and possible associations with psychological distress, social isolation and health-related quality of life (HRQOL). It was hypothesised that attachment anxiety and attachment avoidance would explain additional variance in HRQOL and that this possible association would be mediated through psychological distress and social isolation. For this quantitative research a non-experimental, cross sectional cohort design was implemented. Forty individuals with ABI completed the Experiences in Close Relationships—Relationship Structures questionnaire, the Quality of Life in Brain Injury questionnaire, the EuroQol-5 Dimension Scale, the Hospital Depression and Anxiety Scale and the Friendship Scale. The results suggest that levels of attachment anxiety and attachment avoidance after an ABI are similar to those reported in healthy samples. Moreover, higher rates of attachment anxiety and attachment avoidance were associated with lower HRQOL, as well as increased levels of anxiety and social isolation. No association was found with depression. However, depression was shown to be the largest significant predictor of HRQOL after ABI (β = -.41, p < .005). Social isolation was also shown to predict HRQOL after ABI (β = .32, p < .05). Mediation analysis suggests that both attachment anxiety and attachment avoidance have an indirect relationship with HRQOL through social isolation, or through social isolation and psychological distress. It is concluded that adult attachment is an important theory to consider after ABI, due to its possible indirect relationship with HRQOL. These findings suggest that professionals should consider individuals’ attachment patterns for treatment purposes and try to foster secure attachment patterns during rehabilitation.