Individuals with Major Depressive Disorder Report High Scores of Insecure-Avoidant and Insecure-Anxious Attachment Styles, Dissociative Identity Symptoms, and Adult Traumatic Events.

Sanobar Golshani,Annette Beatrix Brühl,Mohammad Saeed Ghezelbash,Kenneth M Dürsteler,Sara Hookari,Dena Sadeghi-Bahmani,Nasser Goudarzi,Ali Najafpour,Seyed Sepehr Hashemian,Mostafa Alikhani,Serge Brand,Kimia Firoozabadi,Ali Firoozabadi

doi:10.3390/healthcare9091169

Abstract

Objective: Individuals with major depressive disorder (MDD) report more issues in social interaction compared to the general population. Moreover, dimensions of dissociation are considered dysfunctional strategies to cope with adverse life events. In this regard, current symptoms of MDD could be associated with traumatic events that occurred in childhood and in adult life. Given this background, the aim of the present study was to explore the associations between attachment styles as a proxy of quality of social interaction, dimensions of dissociation, and childhood and adult traumatic life events among individuals with MDD. Method: A total of 300 individuals with MDD (mean age: 31.31 years; 58.7% female) took part in this study. They completed a series of questionnaires on sociodemographic information, attachment styles, dimensions of dissociation, and childhood and adult traumatic life events. Results: Prevalence rates for attachment styles were as follows: anxious/ambivalent attachment style—71.7%; avoidant/dependent attachment style—13%; secure/close attachment style—15.3%. Compared to the general population, the participants reported higher prevalence rates of insecure attachment styles. Current symptoms of dissociation were associated with adult but not childhood traumatic life events. An anxious attachment style was associated with higher scores of dissociation. Conclusion: Psychotherapeutic treatment of individuals with MDD should consider the individuals’ challenging attachment styles and their risk of dissociation. While it is important to consider both adult and childhood traumatic events, in this research, more recent trauma occurring in adulthood was associated with current symptoms of dissociation.

Highlights

Major depressive disorder (MDD) is a severe and recurrent disease which affects people’s everyday functioning and quality of life [1]
The ethical committee of the Kermanshah University of Medical Science (KUMS; Kermanshah, Iran; code: 96437) approved the study, which was performed in accordance with the rules established in the seventh and current form [33] of the Declaration of Helsinki
The key findings of the present study demonstrate that compared to the general population, individuals with major depressive disorder (MDD) reported a lower prevalence rate of a secure/close attachment style, and higher prevalence rates of insecureanxious/ambivalent and of insecure dependent/avoidant attachment styles

Summary

Introduction

Major depressive disorder (MDD) is a severe and recurrent disease which affects people’s everyday functioning and quality of life [1]. Visted et al [14] concluded in their systematic review and meta-analysis that people with depressive episodes in their biographies (current or remitted state) reported having more difficulties with emotion regulation than people without such periods. As a result, Visted et al [14] speculated that poor emotion regulation and more limited social competencies might be latent risk factors for relapses. We took these observations into consideration in the following two ways: First, we introduced dimensions of dissociation as a proxy of dysfunctional emotion regulation. We introduced attachment styles as a proxy of social competences

Methods

Results

Discussion

Conclusion