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

Published online by Cambridge University Press:  15 August 2018

George W. Brown ,
Tirril O. Harris  and
Thomas K. J. Craig
George W. Brown*
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, Kings College London, De Crespigny Park, LONDON SE5 8AF, PO Box 36, UK
Tirril O. Harris
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, Kings College London, De Crespigny Park, LONDON SE5 8AF, PO Box 36, UK
Thomas K. J. Craig
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, Kings College London, De Crespigny Park, LONDON SE5 8AF, PO Box 36, UK
*
Author for correspondence: George W. Brown, E-mail: george.brown@kcl.ac.uk
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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 By contrast, depression of the insecure fearful and withdrawn was more closely associated with both current low self-esteem and an inadequately supportive core relationship.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.

Keywords

Adult depressionchaotic life styleinsecure attachment typesparental maltreatmentphysical abuse by mother
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 6 , April 2019 , pp. 1025 - 1032
Copyright
Copyright © Cambridge University Press 2018 

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