From preoccupied attachment to depression: Serial mediation model effects on a sample of women

Abstract

Existing studies have confirmed the existence of a relation between depressive symptoms and insecure attachment, an undeveloped ability to mentalize, social anxiety and rumination, as well as their increasingly more frequent presence in the population of women. However, none of the studies have analyzed the mutual relations between the aforementioned phenomena. In this study we tested a multiple serial mediation model in which a preoccupied attachment style has an effect on depressive symptoms among women, mediated by the ability to mentalize one’s own state of mind, social anxiety and a tendency towards rumination, successively, in that order. The research was carried out on a geographical cluster sample and included 1258 working-age adults, respondents from 37 urban and rural locations, 20 administrative districts of Serbia, from which a sample of women was extracted (N= 791). The Relationships Questionnaire – RQ (Bartholomew and Horowitz, 1991), the Mentalization Scale – MentS (Dimitrijević et al., 2015), the Scale of Social Anxiety (Tovilović, 2004) and the Ruminative Thought Style Questionnaire – RTSQ; Brinker and Dozois, 2009) were all used in the study. The results have indicated that there is a significant specific indirect effect of the preoccupied attachment style on depression mediated by all three mediators sequentially (estimated indirect effect = .004, boot-strapped 95% CI = .002-.007), suggesting that the preoccupied attachment style has an effect on depression by leading to a decrease in the ability to mentalize one’s own state of mind, which increases social anxiety, in turn leading to an increase in rumination, which ultimately leads to depression. These findings could be of importance for the treatment of a specific group of female patients with a preoccupied attachment style who suffer from depression.