Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression
Abstract Background Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited. Methods Explicit attachment styles, levels of...
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doaj-ad75b112b9f949259279210a19e7acd12020-11-25T02:03:06ZengBMCBMC Psychiatry1471-244X2020-04-0120111110.1186/s12888-020-02547-7Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depressionJacqueline G. L. A-Tjak0Nexhmedin Morina1Wouter J. Boendermaker2Maurice Topper3Paul M. G. Emmelkamp4SkilsInstitute of Psychology, University of MünsterAddiction, Development, and Psychopathology (ADAPT) Lab, Department of Psychology, University of AmsterdamGGZ-Noord-Holland-NoordDepartment of Clinical Psychology, University of AmsterdamAbstract Background Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited. Methods Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome. Results Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome. Conclusions Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome. Trial registration clinicaltrials.gov ; NCT01517503.http://link.springer.com/article/10.1186/s12888-020-02547-7DepressionTreatmentPredictorsAttachmentImplicitSC-IAT |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jacqueline G. L. A-Tjak Nexhmedin Morina Wouter J. Boendermaker Maurice Topper Paul M. G. Emmelkamp |
spellingShingle |
Jacqueline G. L. A-Tjak Nexhmedin Morina Wouter J. Boendermaker Maurice Topper Paul M. G. Emmelkamp Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression BMC Psychiatry Depression Treatment Predictors Attachment Implicit SC-IAT |
author_facet |
Jacqueline G. L. A-Tjak Nexhmedin Morina Wouter J. Boendermaker Maurice Topper Paul M. G. Emmelkamp |
author_sort |
Jacqueline G. L. A-Tjak |
title |
Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression |
title_short |
Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression |
title_full |
Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression |
title_fullStr |
Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression |
title_full_unstemmed |
Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression |
title_sort |
explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression |
publisher |
BMC |
series |
BMC Psychiatry |
issn |
1471-244X |
publishDate |
2020-04-01 |
description |
Abstract Background Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited. Methods Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome. Results Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome. Conclusions Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome. Trial registration clinicaltrials.gov ; NCT01517503. |
topic |
Depression Treatment Predictors Attachment Implicit SC-IAT |
url |
http://link.springer.com/article/10.1186/s12888-020-02547-7 |
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