Od Preokupirajućeg Vezivanja Do Depresije: Serijski Medijacijski Model Na Uzorku Žena

Abstract

FROM PREOCCUPIED ATTACHMENT TO DEPRESSION: SERIAL MEDIATION MODEL EFFECTS ON A SAMPLE OF WOMEN 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.

Disorganized attachment, mentalization and dissociation in context of childhood trauma: Implications for depressive symptoms

“…There is no person worth running to, and without capacity to regulate their fear on their own, disorganised children remain helpless. Often the trauma remains within them, untreated, and is carried over into adulthood (Stefanović Stanojević et al, 2018).…”

“…Among individuals with trauma, mentalisation can be weakened through the chronic activation of the attachment system, a high level of vigilance, and fear of the content of others' minds. That leads to insight into the causes of their own and other people's behaviour, and in turn is an important tool for processing unfavourable content and understanding and integrating experience (Ensink et al, 2017; Stefanović Stanojević et al, 2018). While not dealing with mental states in combination with trauma can serve a protective function, it can also disrupt basic social cognitive abilities and make it difficult for the child to process their own experiences and modulate their emotions.…”

“…For example, Hesse and Main (2000) found that over 80 percent of disorganised children had experienced abuse or neglect. Moreover, trauma can be ‘hidden’ and often intergenerational, usually when everyday frightening or frightened mother's reactions to the baby's signals (related to the mother's disorganisation and unresolved trauma) have the same meaning and physiological consequences for the child as more serious traumas have for adults (Stefanović Stanojević et al, 2018).…”

“…Although literature suggests a relationship between depressive symptoms and all styles of insecure attachment (Bolduc et al, 2018; Murphy & Bates, 1997; Patrick et al, 1994; Rosenstein & Horowitz, 1996), the underlying mediating mechanisms are different. For example, in a recently published study it was found that a preoccupied attachment style has an effect on depressive symptoms among women, mediated by the ability to mentalise one's own mental states, social anxiety and a tendency towards rumination (Stefanović Stanojević et al, 2020).…”

“…So, faced with trauma and with the pervasive paradox that, at the same time, their parents are both a source of comfort and a source of fear for them, disorganised children choose not to feel the painful and incomprehensible parts of their experience with their parents and to emotionally separate themselves from what is happening. Children defend themselves by the non‐use of their mind, by non‐thinking, that is, blocking the development of mentalisation (Ensink et al, 2017; Stefanović Stanojević et al, 2018). This is, developmentally, extremely problematic.…”