Hochschule Fresenius, University of Applied Sciences, Munich, Germany; Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.
Hochschule Fresenius, University of Applied Sciences, Munich, Germany.
J Affect Disord. 2022 Sep 1;312:61-68. doi: 10.1016/j.jad.2022.06.021. Epub 2022 Jun 18.
A central concept of attachment theory is that early experiences with close attachment figures shape the way we interact with and relate to other social partners throughout life. As such, early experiences of childhood maltreatment (CM) have been suggested as a key precursor of adult insecure attachment representations. As CM has been linked to feelings of loneliness in adulthood, this study examines whether insecure attachment could explain the relationship between CM and loneliness. Also, the moderating role of a diagnosis of persistent depressive disorder (PDD) is investigated, a disorder characterized by high levels of CM and loneliness.
60 patients with PDD (DSM-5) and 60 gender- and age-matched non-clinical control participants (NC) completed self-report questionnaires measuring attachment, loneliness, and CM. Mediation analyses (PDD as a moderator) were performed.
PDD patients reported higher levels of CM, attachment anxiety, attachment avoidance, and loneliness than NC. CM was positively associated with loneliness in both groups. Mediation analyses demonstrated that the relationship between CM and loneliness was mediated by avoidant, but not anxious attachment, regardless of a diagnosis of PDD.
Caution when interpreting these results is crucial as the study lacked a clinical control group, relied on self-report measures, and the cross-sectional design limits the ability to draw causal inferences.
All constructs studied were present to a greater degree in PDD. Above, findings provide initial evidence that avoidant attachment may explain the relationship between CM and loneliness. Potentially, adult avoidant attachment may lead to and maintain feelings of loneliness, regardless of PDD.
依恋理论的一个核心概念是，早期与亲密依恋对象的经历塑造了我们与其他社会伙伴交往和建立关系的方式。因此，儿童期虐待（CM）的早期经历被认为是成人不安全依恋表现的关键前兆。由于 CM 与成年后的孤独感有关，本研究探讨了不安全依恋是否可以解释 CM 与孤独感之间的关系。此外，还研究了持续性抑郁障碍（PDD）诊断的调节作用，这种障碍的特点是 CM 和孤独感水平高。
60 名 PDD（DSM-5）患者和 60 名性别和年龄匹配的非临床对照组（NC）参与者完成了测量依恋、孤独感和 CM 的自我报告问卷。进行了中介分析（PDD 作为调节变量）。
PDD 患者报告的 CM、依恋焦虑、依恋回避和孤独感水平均高于 NC。CM 与两组的孤独感呈正相关。中介分析表明，无论是否诊断为 PDD，CM 与孤独感的关系均由回避型依恋介导，而不是焦虑型依恋介导。
由于研究缺乏临床对照组、依赖自我报告测量以及横断面设计限制了得出因果推论的能力，因此在解释这些结果时应谨慎。
所有研究的结构在 PDD 中表现更为明显。研究结果初步表明，回避型依恋可能解释了 CM 和孤独感之间的关系。可能，成人回避型依恋会导致和维持孤独感，而与 PDD 无关。
