- Title
- Attachment insecurity partially mediates the relationship between childhood trauma and depression severity in bipolar disorder
- Creator
- Wrobel, Anna L.; Russell, Samantha E.; Ehrlich, Tobin J.; Marshall, David F.; Berk, Michael; McInnis, Melvin G.; Jayasinghe, Anuradhi; Lotfaliany, Mojtaba; Turner, Alyna; Dean, Olivia M.; Cotton, Sue M.; Diaz-Byrd, Claudia; Yocum, Anastasia K.; Duval, Elizabeth R.
- Relation
- Acta Psychiatrica Scandinavica Vol. 145, Issue 6, p. 591-603
- Publisher Link
- http://dx.doi.org/10.1111/acps.13419
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: Childhood trauma is associated with greater depression severity among individuals with bipolar disorder. However, the mechanisms that explain the link between childhood trauma and depression severity in bipolar disorder remain poorly understood. The mediational role of attachment insecurity in childhood and adulthood was assessed in the current study. Methods: Participants with bipolar disorder (N = 143) completed measures of childhood trauma (Childhood Trauma Questionnaire), attachment insecurity (Experiences in Close Relationships Scale) and depression severity (Hamilton Depression Rating Scale) as part of the Prechter Longitudinal Study of Bipolar Disorder. A sequential mediation model was tested using path analysis: the direct and indirect effects of childhood trauma on depression severity with attachment insecurity (attachment anxiety and avoidance) in childhood (mother and father) and adulthood (partner) as mediators were estimated. Results: The final path model demonstrated an excellent fit to the data (comparative fit index = 0.996; root mean square error of approximation = 0.021 [90% confidence interval = 0.000–0.073]). Supporting the hypothesised sequential mediation model, maternal attachment anxiety in childhood and romantic attachment avoidance in adulthood partially mediated the relationship between childhood trauma and depression severity; this effect accounted for 12% of the total effect of childhood trauma on depression severity. Conclusion: Attachment insecurity in childhood and adulthood form part of the complex mechanism informing why people with bipolar disorder who have a history of childhood trauma experience greater depression severity. Addressing attachment insecurity represents a valuable psychotherapeutic treatment target for bipolar disorder.
- Subject
- attachment; bipolar disorder; childhood abuse; depression; treatment outcomes; SDG 16; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1493689
- Identifier
- uon:53619
- Identifier
- ISSN:0001-690X
- Rights
- © 2022 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 317 KB | Adobe Acrobat PDF | View Details Download |