The contribution of attachment to psychological adjustment in women facing breast cancer

TitleThe contribution of attachment to psychological adjustment in women facing breast cancer
Publication TypeJournal Article
Year of Publication2013
AuthorsCairo Notari, S, Favez, N, Charvoz, L, Notari, L, Panes-Ruedin, B, Delaloye, J-F
NumberSuppl. 3

BACKGROUND: Attachment theory provides a general model for understanding the way individuals emotionally react when stressed. Two main dimensions of attachment have been identified: anxiety (to exacerbate the emotional needs and dependence to others) and avoidance (to downplay threat and distress).This study examines the association between treatment-related physical symptoms of breast cancer, anxious or avoidant attachment, and psychological distress in women.

METHOD: This study is part of a larger project on the role of social support in women facing cancer. Women were recruited during hospitalisation at the Breast Centre of the University Hospital of Lausanne. For this study, we used data from 72 women. Their mean age is 53.73 (SD = 12.17). After surgery, women completed the following self-reported questionnaires: the European Organization for Research and Treatment of Cancer (EORTC-QLQ BR23) for physical symptoms; the Experiences in Close Relationships-revised (ECR-R) for adult attachment; and the Brief Symptoms Inventory (BSI-18) for psychological distress. Several socio-demographic and medical data were used as control variables.

RESULTS: Different multiple regression models have been tested to examine the link between physical symptoms, attachment styles and psychological distress. Contrarily to our hypothesis, anxiety does not moderate but instead directly predicts distress. On the contrary, avoidant attachment has a moderating effect on the link between physical symptoms and distress. Nevertheless, the best-fit model includes physical symptoms, anxious attachment and neoadjuvant treatment (control variable) as predictors; this model accounts for 50.7% of the variance in distress. In this model no direct nor moderating effect for avoidant attachment was found. CONCLUSIONS: Our study shows that attachment plays a role in adjustment to breast cancer. This result demonstrates that women’s response to stress is not only determined by disease-specific variables but also by their general way of regulating emotions which is a trait of their personality. Interventions aiming at helping women to cope with breast cancer should take into account individual variability in emotion regulation to be more efficient.

ACKNOWLEDGEMENT OF FUNDING: This study benefited from the support of the Swiss National Centre of Competence in Research LIVES – Overcoming vulnerability: life course perspectives, which is financed by the Swiss National Science Foundation. The authors are grateful to the Swiss National Science Foundation for its financial assistance.

Refereed DesignationRefereed