Attachment Style and Mental Health: A 1-Year Follow-Up Study of Mothers of Infants with Congenital Heart Disease
Abstract
The longitudinal contribution of attachment style to mental health was examined among mothers of infants with Congenital Heart Disease (CHD). Eighty-five mothers of newborns with CHD completed self-report scales tapping attachment style, appraisal of motherhood, ways of coping with motherhood tasks, and mental health 2 weeks after the infant’s CHD diagnosis and 1 year later. Mothers’ attachment anxiety and avoidance at Time 1 were related to poor mental health at the same point of time. In addition, attachment avoidance at Time 1 predicted further deterioration of mental health from Time 1 to Time 2. Attachment style at Time 1 also predicted the ways mothers appraised and coped with motherhood tasks, which, in turn, were related to mental health changes. The theoretical implications of the data were discussed.
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1.
1. In our study, we did not focus on the fearful subgroup because these persons do not possess a unique coping strategy. In fact, fearful persons seem to indiscriminately move between avoidant strategies and anxious strategies. Moreover, findings indicated that all the interactions between attachment avoidance and attachment anxiety were not significant, implying that persons scoring high on avoidance and anxiety did not significantly differ from those scoring high only in either anxiety or avoidance.
2.
2. With the exception of 12 infants whose health status was improved due to a surgery intervention, no notable change in CHD severity (as rated by cardiologists) was found in infants between Time 1 and Time 2. Again, no significant association was found between these ratings and mothers’ attachment style, mental health, cognitive appraisal, and coping scores at Time 2. The statistical control of these ratings at Time 2 did not affect the associations reported in the Results section.
3.
3. Participants also answered Hazan and Shaver’s (1987) categorical measure of attachment style, in which they were asked to endorse the attachment style that fit their feelings in close relationships. Statistical analyses using this categorical scale replicated the findings obtained with the continuous attachment scores and were not reported in the Results section.
4.
4. We conducted a detailed analysis to examine overlap in content between items of the various scales. With the exception of eight items in the Ways of Coping Scale that tapped emotion-focused coping and somewhat overlapped in content with distress items from the Mental Health Inventory (MHI), no notable overlap was found between other items. We dropped the overlapping items from the Ways of Coping Scale so that the scores used in the statistical analyses were derived from nonoverlapping items.
5.
5. Beyond the strong association between the various appraisal factors, statistical tests revealed no notable problem of multicollinearity in all the reported regressions.
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Article first published: August 2001
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