Bifulco, Antonia, Moran, P.M., Ball, C. and Bernazzani, O. (2002) Adult attachment style. 1: Its relationship to clinical depression. Social Psychiatry and Psychiatric Epidemiology, 37 (2).
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Although there are an increasing number of studies showing an association of adult attachment style to depressive disorder, such studies have rarely utilised epidemiological approaches with large community-based series and have relied heavily on brief self-report measurement of both attachment style and symptoms. The result is a wide inconsistency in the type of insecure style shown to relate to disorder. The present study examined adult attachment style in a high-risk community sample of women in relation to clinical depression. It utilised an interview measure of adult attachment which allowed for an assessment of both type of attachment style and the degree of insecurity of attachment. A companion paper examines its relationship with other depressive-vulnerability (Bifulco et al. 2002). Method Two hundred and twenty-two highrisk and 80 comparison women were selected from questionnaire screenings of London GP patient lists and intensively interviewed. A global scale of attachment style based on supportive relationships (with partner and very close others) together with attitudes to support- seeking, derived the four styles paralleling those from self-report attachment assessments (Secure, Enmeshed, Fearful, Avoidant). In order to additionally reflect hostility in the scheme, the Avoidant category was subdivided into ‘Angry-dismissive’ and ‘Withdrawn’. The degree to which attitudes and behaviour within such styles were dysfunctional (‘non-standard’) was also assessed.Attachment style was examined in relation to clinical depression in a 12-month period. For a third of the series this was examined prospectively to new onset of disorder. Results The presence of any insecure style was significantly related to 12-month depression. However,when controls were made for depressive symptomatology at interview,only the ‘non-standard’ levels of Enmeshed, Fearful or Angry-dismissive styles related to disorder.Withdrawn-avoidance was not significantly related to disorder. Conclusion The relationship of attachment style to clinical depression is increased by differentiating the degree of insecurity of style and differentiating hostile and non-hostile avoidance.
This is a Published version This version's date is: 02/2002 This item is not peer reviewed
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Deposited by () on 23-Dec-2009 in Royal Holloway Research Online.Last modified on 23-Dec-2009
References 1. Ainsworth M, Blehar M,Waters E,Wall S (1978) Patterns of attachment: a psychological study of the strange situation. Lawrence Erlbaum Associates,Hillsdale, NJ 2. Andrews B, Brown GW (1988) Social support, onset of depression and personality: an exploratory analysis. Soc Psychiat Psychiatr Epidemiol 99â108 3. APA (1987) Diagnostic and statistical manual of mental disorders â DSM-IIIR (3rd edn revised). American Psychiatric Association, Washington DC 4. Bartholomew K, Horowitz LM (1991) Attachment styles among young adults: A test of a four-category model. J Personal Soc Psychol 61: 226â244 5. Beck AT (1967) Depression: clinical, experimental and theoretical perspectives.Hoeber,New York 6. Bifulco A,Bernazzani O,Moran PM,Ball C (2000) Lifetime stressors and recurrent depression: preliminary findings of the Adult Life Phase Interview (ALPHI). Soc Psychiat Psychiatr Epidemiol 35: 264â275 7. Bifulco A, Brown GW, Lillie A, Jarvis J (1997) Memories of childhood neglect and abuse: corroboration in a series of sisters. J Child Psychol Psychiatr 38: 365â374 8. Bifulco A, Brown GW,Moran P, Ball C, Campbell C (1998a) Predicting depression in women: the role of past and present vulnerability. Psychol Medicine 28: 39â50 9. Bifulco A, Lillie A, Ball B,Moran P (1998b) Attachment Style Interview (ASI). Training manual. Royal Holloway, University of London 10. Bifulco A,Moran P,Ball C, Lillie A (2002) Adult attachment style. II: Its relationship to psychosocial depressive-vulnerability. Soc Psychiat Psychiatr Epidemiol 37: 60â67 11. Birtchnell J (1993) How humans relate â a new interpersonal theory. Psychology Press; imprint of Erlbaum (UK) Taylor & Francis, Hove, East Sussex 12. Bowlby J (1973) Attachment and loss: vol 2. Separation: anxiety and anger. Basic Books,New York 13. Brennan KA, Clark CL, Shaver PR (1998) Self-report measurement of adult attachment: an integrative overview. In: Simpson JA, Rholes W (eds) Attachment theory and close relationships. The Guilford Press,New York, pp. 46â76 14. Brown GW, Bifulco AT, Andrews B (1990a) Self-esteem and depression. III. Aetiological issues. Soc Psychiat Psychiatr Epidemiol 25: 235â243 15. Brown GW, Bifulco AT,Veiel HO,Andrews B (1990b) Self-esteem and depression. II. Social correlates of self-esteem. Soc Psychiat Psychiatr Epidemiol 25: 225â234 16. Brown GW, Craig TKJ,Harris TO (1985). Depression: distress or disease? Some epidemiological considerations. B J Psychiat 147: 612â622 17. Crowell JA, Fraley RC, Shaver PR (1999) Measurement of individual differences in adolescent and adult attachment. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical applications. The Guilford Press, New York, pp. 434â465 18. Dozier M, Stovall KC, Albus KE (1999) Attachment and psychopathology in adulthood. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical applications. The Guilford Press,New York, pp. 497â519 19. Finlay-Jones R, Brown GW, Duncan-Jones P, Harris TO,Murphy E, Prudo R (1980) Depression and anxiety in the community. Psychol Medicine 10: 445â454 20. George C,West M (1999) Developmental vs. social personality models of adult attachment and mental ill health. B J Medical Psychol 72: 285â303 21. Gerlsma C, Luteijn F (2000) Attachment style in the context of clinical and health psychology: a proposal for the assessment of valence, incongruence, and accessibility of attachment representations in various working models. B J Medical Psychol 73: 15â34 22. Hammen CL, Burge D, Daley SE, Davila J, et al. (1995) Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress. J Abnorm Psychol 104: 436â443 23. Harris T, Bifulco A (1991) Loss of parent in childhood, attachment style, and depression in adulthood. In: Murray-Parkes C, Stevenson-Hinde J,Marris P (eds) Attachment across the life-cycle. Routledge, London,New York 24. Harris TO, Brown GW, Bifulco AT (1990) Depression and situational helplessness/mastery in a sample selected to study childhood parental loss. Jf Affect Dis 20: 27â41 25. Hazan C, Shaver P (1987) Romantic love conceptualized as an attachment process. J Personality Soc Psychol 52: 511â524 26. McCarthy G (1999) Attachment style and adult love relationships and friendships: a study of a group of women at risk of experiencing relationship difficulties. B J Medical Psychol 72: 305â321 27. Mickelson KD,Kessler RC, Shaver PR (1997) Adult attachment in a nationally representative sample. J Personality Soc Psychol 73: 1092â1106 28. Murphy B, Bates GW (1997) Adult attachment style and vulnerability to depression. Personality Individ Differences 22: 835â844 29. OâConnor P, Brown GW (1984) Supportive relationships: fact or fancy? J Soc Personal Relations 1: 159â175 30. Rholes WS, Simpson JA, Stevens JG (1998) Attachment orientations, social support and conflict resolution in close relationships. In: Simpson JA, Rholes WS (eds) Attachment theory and close relationships.Guilford Press,New York, London 31. Shapiro DL, Levendosky AA (1999) Adolescent survivors of childhood sexual abuse: the mediating role of attachment style and coping in psychological and interpersonal functioning. Child Abuse Neglect 23: 1175â1191 32. Stein H, Jacobs NJ, Ferguson KS, Allen JG, Fonagy P (1998) What do adult attachment scales measure? Bull Menninger Clinic 62: 33â82 33. Stein H, Koontz D, Allen JG, Fultz J, Brethour JR, Allen D, Evans RB, Fonagy P (2000) Adult attachment questionnaires: disagreement rates, construct and criterion validity. The Menninger Clinic Research Dept, Topeka,KS 34. West M, Sheldon A, Reiffer L (1987) An approach to the delineation of adult attachment. J Nervous Mental Disease 175: 738â741 35. Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms: an instruction manual for the Present State Examination and CATEGO programme. Cambridge University Press, Cambridge