Correlates of self‐rated attachment in patients with cancer and their caregivers: a systematic review and meta‐analysis

Nissen, Kathrine G.

doi:10.1002/pon.4057

Cited by 30 publications

(44 citation statements)

References 69 publications

(125 reference statements)

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“…This finding is in accordance with previous research that suggests that attachment avoidance may have corrosive effects on health in general (e.g., Maunder & Hunter, 2008;McWilliams & Bailey, 2010) and specifically for the process of adaptation to cancer (e.g., Nicholls et al, 2014 ;Nissen, 2016 & Białecka-Pikul, 2015) and supports the idea that more avoidantly attached individuals may suppress the expression of their emotions. Results from this study indicate that, as hypothesised, higher levels of attachment avoidance were significantly associated with poorer quality of life.…”

Section: Discussionsupporting

confidence: 92%

“…The link between attachment insecurity and difficulties in adaptation to breast cancer is now well recognised (Nicholls et al, 2014;Nissen, 2016). It also aimed to explore the mediating role of avoidant emotion processes in this association.…”

Section: Discussionmentioning

confidence: 99%

“…It also aimed to explore the mediating role of avoidant emotion processes in this association. The link between attachment insecurity and difficulties in adaptation to breast cancer is now well recognised (Nicholls et al, 2014;Nissen, 2016). Little is known, however, about the underlying pathway involved in the association between attachment and quality of life after breast cancer diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…In the specific context of breast cancer, attachment insecurity has been related to poorer psychological outcomes, particularly moodrelated disruptions such as anxiety, depressive symptoms and greater psychological distress (see Nicholls, Hulbert-Williams, &Bramwell, 2014 andNissen, 2016; for a review). The specific reasons why attachment might facilitate or hinder adaptation to cancer, however, are less explored.…”

Section: Introductionmentioning

confidence: 99%

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Attachment and adaptation to breast cancer: The mediating role of avoidant emotion processes

2018

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Attachment insecurity is associated with difficulties in adapting to cancer. Accumulating evidence points to the influence of avoidant emotion processes in this association. This study explored this pathway by examining the association between attachment insecurity and quality of life in women with breast cancer, and by exploring the mediating role of two avoidant emotion processes in this association. Women with breast cancer (N = 155) completed measures of attachment, emotional suppression, emotional awareness and quality of life. Avoidance of attachment was positively associated with emotional suppression (β = .29, p < .01) and lack of emotional awareness (β = .27, p < .01), and negatively associated with quality of life (β = -.22, p < .05). Lack of emotional awareness partially mediated the relationship between attachment avoidance and quality of life (indirect effect β = -.12, p = .008). Attachment anxiety was not associated with any variable. Attachment avoidance may hinder the process of adaptation to breast cancer and difficulties in identifying and describing emotions may be partly responsible for this influence. Access to and ability to benefit from social and medical supports is likely to depend on being able to engage with others and recognise and process emotions effectively. Research and clinical implications are discussed.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Attachment and adaptation to breast cancer: The mediating role of avoidant emotion processes

2018

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“…The Hand in Hand (HiH) randomised controlled trial (RCT) for couples coping with BC evaluates the effects of a psychological couple intervention in the early treatment phase addressing some of the methodological limitations seen in previous couple intervention studies. The theoretical framework is attachment theory, providing an explanation of how attachment behaviour and attachment style may influence the exchange of support within couples and their adjustment to BC …”

Section: Introductionmentioning

confidence: 99%

The effect of an attachment‐oriented couple intervention for breast cancer patients and partners in the early treatment phase: A randomised controlled trial

et al. 2018

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ObjectivePatients and partners both cope individually and as a dyad with challenges related to a breast cancer diagnosis. The objective of this study was to evaluate the effect of a psychological attachment‐oriented couple intervention for breast cancer patients and partners in the early treatment phase.MethodsA randomised controlled trial including 198 recently diagnosed breast cancer patients and their partners. Couples were randomised to the Hand in Hand (HiH) intervention in addition to usual care or to usual care only. Self‐report assessments were conducted for both patients and partners at baseline, postintervention (5 months), and follow‐up (10 months), assessing cancer‐related distress, symptoms of anxiety and depression, and dyadic adjustment. Patients' cancer‐related distress was the primary outcome.ResultsCancer‐related distress decreased over time in both patients and partners, but the intervention did not significantly affect this decrease at postintervention (P = .08) or follow‐up (P = .71). A significant positive effect was found on dyadic adjustment at follow‐up for both patients (P = .04) and partners (P = .02).ConclusionsThere was no significant effect of the HiH intervention cancer‐related distress. The results suggest that most couples can cope with cancer‐related distress in the context of usual care. However, the positive effect on dyadic adjustment implies that the HiH intervention benefitted both patients and partners. Future studies should investigate how to integrate a couple focus in usual cancer care to improve dyadic coping in the early treatment phase.

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Attachment styles, self‐compassion, and psychological adjustment in long‐term breast cancer survivors

2019

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Objective: The increasing numbers of breast cancer survivors highlight the importance of delineating factors that identify women who are at risk of poor psychological adjustment in the long term. In breast cancer survivors, higher attachment anxiety and attachment avoidance have been associated with poorer psychological adjustment. Moreover, there is evidence that self-compassion, a kind manner of treating oneself during difficulties, is associated with psychological adjustment in this population. This study aimed to extend the association between attachment styles and psychological adjustment to the context of long-term breast cancer survivors and to determine whether lower self-compassion underlies this association.Methods: Participants (N = 82) were recruited through emailed invitations to members of the Review and Survey Group of Breast Cancer Network Australia. Following online consent, participants completed measures assessing attachment styles, selfcompassion, psychological stress, and the perceived negative impact of cancer.Bootstrapping analyses using the PROCESS macro were used to test the significance of indirect effects.Results: As hypothesised, correlational analyses revealed that higher attachment anxiety and attachment avoidance were significantly and positively associated with stress and perceived negative impact of cancer. Bootstrapping analyses revealed significant indirect effects of attachment anxiety and attachment avoidance (on both stress and perceived negative impact of cancer) through lower self-compassion.Conclusions: These findings suggest that self-compassion training may be useful for enhancing the psychological adjustment of long-term breast cancer survivors.Future longitudinal and experimental studies in more diverse samples are needed to confirm causal directionality of these relationships and to expand upon these findings. KEYWORDS attachment style, breast cancer, cancer, negative impact of cancer, oncology, psychological stress, self-compassion, survivorship

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Correlates of self‐rated attachment in patients with cancer and their caregivers: a systematic review and meta‐analysis

Cited by 30 publications

References 69 publications

Attachment and adaptation to breast cancer: The mediating role of avoidant emotion processes

Attachment and adaptation to breast cancer: The mediating role of avoidant emotion processes

The effect of an attachment‐oriented couple intervention for breast cancer patients and partners in the early treatment phase: A randomised controlled trial

Attachment styles, self‐compassion, and psychological adjustment in long‐term breast cancer survivors

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