The role of relationship attachment in psychological adjustment to cancer in patients and caregivers: a systematic review of the literature

Abstract

Methods: A systematic search of electronic databases was undertaken, identifying literature published up to June 2013. PsychINFO, Medline, and the Cumulative Index to Nursing & Allied Health Literature (CINAHL) were searched using search strings related to cancer, relationships, attachment, and commonly assessed self-report psychosocial outcome measures. Extracted papers were assessed for their relevance. Key data were extracted to spreadsheets and two raters coded the quality of the research.Results: Following inclusion assessment, data were extracted from 15 quantitative studies. Scores from patients or caregivers on attachment questionnaires did not differ greatly from normative data. A more insecure attachment style has poorer outcomes for patients in terms of their psychological adjustment to cancer, and their ability to perceive and access social support. A secure attachment style is associated with positive growth and better wellbeing. A more insecure attachment style in caregivers was associated with depression, higher caregiving stress, less autonomous motivations for caregiving and difficulties with caregiving.Conclusions: An awareness of attachment theory and the ways in which different forms of insecure attachment impact on patients and caregivers and their wellbeing may substantially improve the ability of those working with cancer patients and their families to better understand and provide for their support needs. The development and evaluation of support interventions tailored to different attachment styles remains a longer-term goal.

The Role of Couples' Attachment Styles in Patients' Adjustment to Cancer

“…In these cases, avoidant and anxious attachment styles impair marital satisfaction. In agreement with the literature [25,26] , we know that avoidant and anxious attachment is associated with poor marital quality, poor perceived quality of life, and also with lower perceived social support. Vice versa, attachment security offers a protective buffer to the stressful situation that can occur during the course of the illness [11] .…”

“…The mood of one of the partners can influence the other, and often these feelings of despair and emotional stress adversely affect the marital relationship. In particular, the results obtained in this research show that anxiety negatively influences the quality of the marital relationship more than depression [25] . Scientific studies [27,28] suggest that the highest levels of anxiety are associated with lower marital quality, higher caregiver strain, and lower life satisfaction.…”

Parental Post-Traumatic Stress Symptoms as Predictors of Psychosocial Problems in Children Treated for Cancer

“…According to the theory of attachment, parents play a role as a secure base when their children face a traumatic event [38]. Parents who suffer from PTSS are thought to have difficulty assuming this role [39]. A previous longitudinal study, which revealed that initially high PTSS in mothers was related to poorer recovery from PTSS in their children, supports this suggestion [40].…”

Coordinación emocional en el afrontamiento del cáncer: alexitimia, apego y estrategias de afrontamiento como predictores de bienestar emocional en mujeres sometidas a radioterapia

“…In fact, attachment is frequently considered a mediator of coping styles (Nicholls, Hulbert-Williams, & Bramwell 2014;Schmidt, Nachtigall, Wuethrich-Martone, & Strauss, 2002). A strong fear of rejection involves expecting critical attachment figures to reject or not understand complaints or requests for help.…”