An exploration of adult attachment insecurity and psychiatric symptoms in individuals with obstructive sleep apnea

Adams, G. Camelia; McWilliams, Lachlan A.; Wrath, Andrew J.; Mondal, Prosanta; Harder, Jane A.; Skomro, Robert; Fenton, Mark

doi:10.1016/j.jpsychores.2019.05.009

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…Furthermore, those with sleep apnea have a twofold increased risk of anxiety and the comorbidity of both conditions compared with those without sleep apnea. This finding supports previous studies including one study conducted in Canada, where the patients with obstructive sleep apnea (OSA) had higher levels of depression and anxiety in a small sample size of 102 participants [ 12 ]. A meta-analysis based on 73 articles showed significant associations between OSA, anxiety, and depression, suggesting that the early diagnosis and effective treatment of OSA can improve mental disorders such as depression or anxiety [ 11 ].…”

Section: Discussionsupporting

confidence: 90%

“…Sleep apnea is commonly found to be comorbid with mental disorders such as anxiety, post-traumatic stress disorder, schizophrenia, depression [ 8 , 9 ], heart failure, and chronic opiate use [ 10 ]. A recent study reported that sleep apnea was associated with mental disorders, including anxiety and depression [ 11 ], while another study found that sleep apnea patients had higher levels of depression and anxiety [ 12 ]. Additionally, one more recent study found that depressive and anxious symptoms were prevalent in sleep apnea; however, sleep apnea severity did not contribute to depression and to anxiety [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Sleep Apnea and Substance Use Disorders Associated with Co-Occurrence of Anxiety Disorder and Depression among U.S. Adults: Findings from the NSDUH 2008–2014

et al. 2023

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Few studies have focused on sleep apnea and substance use disorders with co-occurrence of anxiety disorder and depression. This study included a total of 270,227 adults, 9,268 with co-occurrence of anxiety disorder and depression in the past year, from the combined 2008–2014 National Survey on Drug Use and Health (NSDUH) data, which are the latest datasets with measures of anxiety disorder and sleep apnea. Weighted multinomial logistic regression analyses were used to estimate the associations between anxiety disorder and depression and their co-occurrence. Comorbidity was highly prevalent: 40.4% of those with depression also met the criteria for anxiety disorder, whereas 51.8% of those with anxiety disorder also met the criteria for depression. The prevalences of anxiety only and co-occurrence increased from 2008 to 2014. The prevalences of anxiety disorder only, depression only, and co-occurrence of anxiety disorder and depression in individuals with sleep apnea were 4.4%, 12.9%, and 12.2%, respectively, and the prevalences in substance use disorders were 6.4%, 9.4%, and 10.7%, respectively. The results showed that sleep apnea, substance use disorders, and nicotine dependence were significantly associated with increased odds of anxiety disorder, depression, and co-occurrence (all p values < 0.0001). Furthermore, several chronic diseases (asthma, bronchitis, hypertension, and heart disease) were associated with the co-occurrence of anxiety disorder and depression. These findings suggest clinicians and other healthcare providers consider screening for depression and anxiety with sleep apnea and substance use disorders for improved therapeutic outcomes.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Sleep Apnea and Substance Use Disorders Associated with Co-Occurrence of Anxiety Disorder and Depression among U.S. Adults: Findings from the NSDUH 2008–2014

et al. 2023

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“…Secure attachment may allow the individual to acquire the capacity to feel security and a sense of wellbeing. Furthermore, it allows for the construction of a firm sense of one's own identity, facilitating the acquisition of a relatively wide margin of tolerance and effective functioning of the physiological system as a regulatory entity (Adams, McWilliams, Wrath et al ., 2019).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the mediating effect of mentalization on the relationship between attachment styles and emotion dysregulation

Parada-Fernández

Herrero-Fernández

Oliva-Macías

et al. 2021

Scandinavian J Psychology

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The current study aims to explore the relationship between attachment styles, mentalization and emotion dysregulation. Moreover, the mediation effect of mentalization in the relationship between attachment and emotion dysregulation is analyzed. A sample composed of 607 participants taken from the Spanish general population completed the measures in a cross‐sectional designed study. The results show that secure attachment is negatively related to emotion dysregulation dimensions, whereas insecure attachment styles show a positive correlation. Furthermore, the mentalization variables are in general significantly related to emotion dysregulation. The mediation model shows a large mediational effect size (f2 = 2.64). The results suggest that mentalization significantly mediates the relationship between emotion dysregulation and preoccupation, self‐sufficiency, and childhood trauma. These results have important implications, as they indicate that clinical interventions on mentalization should reduce emotion dysregulation even in those people with a predominant insecure attachment style.

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“…Finally, there is the cognitive-affective polarity, which focuses on aspects related to cognition and emotion. 18 , 19 In essence, mentalization gives individuals the ability to reflect on actions, adopt different perspectives, and respond to the demands of the interpersonal environment without reaching emotional states of dysregulation, thus better dealing with negative thoughts or overwhelming emotional states. 19 Diminished mentalization can lead to a variety of different reactions.…”

Section: Introductionmentioning

confidence: 99%

Stressful life events and hopelessness in adults: the mediating role of mentalization and emotional dysregulation

Parada-Fernández

Herrero-Fernández

Oliva-Macías

et al. 2021

Braz. J. Psychiatry

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Objective: Hopelessness is considered a risk factor for several mental and behavioral disorders. Research has shown that a stressful life event can be a significant predictor of hopelessness. The aim of the current research study was to explore the relationship between stressful life events and hopelessness, as well as to analyses the mediation effect of both mentalization and emotional dysregulation on this relationship. Methods: In a cross-sectional design, 607 participants recruited from the Spanish general population completed a series of measures. Results: Hopelessness was significantly related to stressful life events (r = 0.24, p o 0.001), emotion dysregulation variables (r = 0.18/0.38), and most measures of mentalization (r = 0.02/0.34). A goodfitting structural equation modeling-based mediation model (w 2 /df = 2.04; root mean squared error of approximation = 0.042 [90%CI 0.033-0.050]; comparative fit index = 0.97; non-normed fit index = 0.97) showed that mentalization significantly mediated the relationship between stressful life events and hopelessness, while emotion dysregulation had no significant mediating effect. Conclusions: These results could have important clinical implications, such as the development of mentalization-based interventions for people living under a large number of stressors.

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An exploration of adult attachment insecurity and psychiatric symptoms in individuals with obstructive sleep apnea

Cited by 7 publications

References 36 publications

Sleep Apnea and Substance Use Disorders Associated with Co-Occurrence of Anxiety Disorder and Depression among U.S. Adults: Findings from the NSDUH 2008–2014

Sleep Apnea and Substance Use Disorders Associated with Co-Occurrence of Anxiety Disorder and Depression among U.S. Adults: Findings from the NSDUH 2008–2014

Analysis of the mediating effect of mentalization on the relationship between attachment styles and emotion dysregulation

Stressful life events and hopelessness in adults: the mediating role of mentalization and emotional dysregulation

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