Attachment security and existential distress among patients with advanced cancer.
J Psychosom Res
; 116: 93-99, 2019 01.
Article
in En
| MEDLINE
| ID: mdl-30655000
ABSTRACT
BACKGROUND:
Felt security in close relationships may affect individual adaptation responses to existential threat in severe illness. We examined the contribution of attachment security to demoralization, a state of existential distress involving perceived pointlessness and meaninglessness in advanced cancer.METHOD:
A mixed cross-sectional sample of 382 patients with advanced cancer (mean age 59, 60% female) was recruited from outpatient oncology clinics. Participants completed self-report measures of attachment security, demoralization, depression, and physical symptom burden. We used multiple linear regression to analyze the association between attachment security and demoralization, controlling for demographic factors and symptom burden and tested whether attachment security moderated the association of symptom burden with demoralization. Separate analyses compared the contribution of the dimensions of attachment anxiety and attachment avoidance.RESULTS:
The prevalence of clinically relevant demoralization was 35%. Demoralization was associated with lower attachment security (ßâ¯=â¯-0.54, 95%CI -0.62 to 0.46). This effect was empirically stronger for attachment anxiety (ßâ¯=â¯0.52, 95%CI 0.44 to 0.60) compared to attachment avoidance (ßâ¯=â¯0.36, 95%CI 0.27 to 0.45). Attachment security also significantly moderated the association of physical symptom burden with demoralization, such that with less attachment security, there was a stronger association between symptom burden and demoralization.CONCLUSION:
Attachment security may protect from demoralization in advanced cancer. Its relative lack, particularly on the dimension of attachment anxiety, may limit adaptive capacities to deal with illness burden and to sustain morale and purpose in life. An understanding of individual differences in attachment needs can inform existential interventions for severely ill individuals.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychotherapy
/
Stress, Psychological
/
Existentialism
/
Object Attachment
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Psychosom Res
Year:
2019
Document type:
Article