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Exploration of the influence of insecure attachment and parental maltreatment on the incidence and course of adult clinical depression

  • George W. Brown (a1), Tirril O. Harris (a1) and Thomas K. J. Craig (a1)

Abstract

Background

Both childhood maltreatment and insecure attachment are known to be associated with depression in adulthood. The extent insecure attachment increases the risk of adult clinical depression over that of parental maltreatment among women in the general population is explored, using those at high risk because of their selection for parental maltreatment together with an unselected sample.

Methods

Semi-structured interviews and investigator-based measures are employed.

Results

Insecure attachment is highly associated with parental maltreatment with both contributing to the risk of depression, with attachment making a substantial independent contribution. Risk of depression did not vary by type of insecure attachment, but the core pathways of the dismissive and enmeshed involved the whole life course in terms of greater experience of a mother's physical abuse and their own anger as an adult, with both related to adult depression being more often provoked by a severely threatening event involving humiliation rather than loss. By contrast, depression of the insecure fearful and withdrawn was more closely associated with both current low self-esteem and an inadequately supportive core relationship. In terms of depression taking a chronic course, insecure attachment was again a key risk factor, but with this now closely linked with the early experience of a chaotic life style but with this involving only a modest number of women.

Conclusions

Both insecure attachment and parental maltreatment contribute to an increased risk of depression with complex effects involving types of insecure attachment.

Copyright

Corresponding author

Author for correspondence: George W. Brown, E-mail: george.brown@kcl.ac.uk

References

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Arrindell, WA, Hafkenscheid, AJPM and Emmelkamp, PMG (1984) The Hostility and Direction of Hostility Questionnaire (HDHQ): a psychometric evaluation in psychiatric outpatients. Personality and Individual Differences 5, 221231.
Baron, RM and Kenny, DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51, 11731182.
Bifulco, A, Bernazzani, O, Moran, PM and Ball, C (2000) Lifetime stressors and recurrent depression: preliminary findings of the Adult Life Phase Interview (ALPHI). Social Psychiatry Psychiatric Epidemiology 35, 364–275.
Bifulco, A, Bernazzani, O, Moran, PM and Jacobs, C (2005) Childhood Experience of Care and Abuse Questionnaire (CECA.Q) validation in a community series. British Journal of Clinical Psychology 44, 563581.
Bifulco, A, Brown, GW and Harris, TO (1994) Childhood Experience of Care and Abuse (CECA): a retrospective interview measure. Journal of Child Psychology and Psychiatry 35, 14191435.
Bifulco, A, Brown, GW, Moran, P, Ball, C and Campbell, C (1998) Predicting depression in women: the role of past and present vulnerability. Psychological Medicine 28, 3950.
Bifulco, A, Moran, P, Ball, C and Bernazzani, O (2002) Adult Attachment Style I: its relationship to clinical depression. Social Psychiatry & Psychiatric Epidemiology 37, 5059.
Bifulco, AT and Thomas, G (2013) Understanding Adult Attachment in Family Relationships: Research, Assessment and Intervention. Abingdon: Routledge.
Birtchnell, J, Deahl, M and Falkowski, J (1991) Further exploration of the relationship between depression and dependence. Journal of Affective Disorders 22, 221233.
Bowlby, J (1980) Attachment and Loss, Volume 1, Loss, Sadness and Depression. London: The Hogarth Press.
Bowlby, J (1982) Attachment and Loss, Volume 1, Attachment. London: The Hogarth Press.
Bowlby, J (1985) Attachment and Loss, Volume 2, Separation, Anxiety and Anger. London: The Hogarth Press.
Brown, GW, Bifulco, AT and Andrews, B (1990) Self-esteem and depression: 3. Aetiological issues. Social Psychiatry & Psychiatric Epidemiology 25, 235243.
Brown, GW, Craig, TKJ and Harris, TO (2008 a) Parental maltreatment and adult cohabiting partnerships: a life-course study of adult chronic depression – 4. Journal of Affective Disorders 110, 115125.
Brown, GW, Craig, TKJ and Harris, TO (2008 b) Parental maltreatment and proximal risk factors using the Childhood Experience of Care & Abuse (CECA) instrument: a life-course perspective on chronic depression – 5. Journal of Affective Disorders 110, 222233.
Brown, GW, Craig, TKJ, Harris, TO, Handley, RV and Harvey, AL (2007 a) Development of a retrospective interview measure of parental maltreatment using the Childhood Experience of Care & Abuse (CECA) instrument – a life-course study of adult chronic depression – 1. Journal of Affective Disorders 103, 205215.
Brown, GW, Craig, TKJ, Harris, TO, Handley, RV and Harvey, AL (2007 b) Validity of retrospective measures of early maltreatment and depressive episodes using CECA (Childhood Experience of Care & Abuse) – a life-course study of adult chronic depression – 2. Journal of Affective Disorders 103, 217224.
Brown, GW, Craig, TKJ, Harris, TO, Handley, RV and Harvey, AL (2007 c) Child-specific and family-wide risk factors using the retrospective Childhood Experience of Care & Abuse (CECA) instrument: a life-course study of adult chronic depression – 3. Journal of Affective Disorders 103, 225236.
Brown, GW and Harris, TO (1978) Social Origins of Depression. London: Tavistock Publications, New York: Free Press.
Brown, GW, Harris, TO and Hepworth, C (1995) Loss, humiliation and entrapment among women developing depression: a patient and non-patient comparison. Psychological Medicine 25, 721.
Brown, GW and Rutter, M (1966) The measurement of family activities and relationships: a methodological study. Human Relations 19, 241263.
Cohen, J (1968) Weighted kappa: nominal scale agreement provision for scaled disagreement or partial credit. Psychological Bulletin 70, 213220.
Feeney, BC (2007) The dependency paradox in close relationships: accepting dependence promotes independence. Journal of Personality and Social Relationships 24, 535555.
George, C, Kaplan, N and Main, M (1984) Attachment Interview for Adults. Berkeley: University of California.
Harris, TO and Bifulco, A. (1991) Loss of parent in childhood, and attachment style and depression in adulthood. In Parkes, CM and Hinde, JS (eds), Attachment Across the Life Cycle. London: Tavistock, New York: Routledge, pp. 234267.
Harris, TO, Brown, GW and Bifulco, A (1990) Loss of parent in childhood and adult psychiatric disorder: a tentative overall model. Development and Psychopathology 2, 311328.
Mickelson, KD, Kessler, RS and Shaver, PR (1997) Adult attachment in a nationally representative sample. Journal of Personality and Social Psychology 73, 1092–1006.
Mikulincer, M and Shaver, PR (2016) Attachment in Adulthood. New York: Guilford Press.
Nanni, V, Uher, R and Danese, A (2012) Childhood maltreatment predicts unfavourable course of illness and treatment outcome in depression: a meta-analysis. American Journal of Psychiatry 169, 141151.
Philip, AE (1973) Assessing punitiveness with the Hostility and Direction of Hostility Questionnaire (HDHQ). British Journal Psychiatry 123, 435439.
Quinton, D, Rutter, M and Rowlands, O (1976) An evaluation of an interview assessment of marriage. Psychological Medicine 6, 577586.
Rutter, M and Brown, GW (1966) The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry 1, 3853.
Simpson, AE and Stevenson-Hinde, J (1985) Temperamental characteristics of three to four-year old boys. Journal of Child Psychology & Psychiatry 26, 3545.
Wing, JK, Barbor, T and Brugha, TS (1990) SCAN: schedule for clinical assessment in neuropsychiatry. Archives of General Psychiatry 47, 587593.

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