title: Childhood adversity, attachment and personality styles as predictors of anxiety among elderly caregivers.
abstract: The purpose of this study was to examine the ways in which childhood adversity, attachment and personality styles influenced the likelihood of having an anxiety disorder among aged caregivers for terminally ill spouses. We also sought to determine how childhood adversity and attachment/personality styles jointly influenced the likelihood of developing an anxiety disorder among aged caregivers. Data were derived from semistructured interviews with 50 spouses (aged 60 and above) of terminally ill patients. The Childhood Experience of Care and Abuse (CECA) record provided retrospective, behaviorally based information on childhood adversity. Measures of attachment and personality styles were obtained from self-report questionnaires, and the Structured Clinical Interview for the DSM-III-R (SCID) was used to determine diagnoses for anxiety disorders. Logistic regression models estimated the effects of childhood adversity, attachment/personality disturbances, and the interaction between the two on the likelihood of having an anxiety disorder. Results indicated that childhood adversity and paranoid, histrionic and self-defeating styles all directly increase the odds of having an anxiety disorder as an elderly spousal caregiver. In addition, childhood adversity in conjunction with borderline, antisocial and excessively dependent styles increased the likelihood of having an anxiety disorder. The results indicate the need to investigate further the interaction between childhood experiences and current attachment/personality styles in their effects on the development of anxiety disorders.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pennsylvania, USA.
authors.forename: H G
authors.initials: HG
authors.lastname: Prigerson
authors.forename: M K
authors.initials: MK
authors.lastname: Shear
authors.forename: A J
authors.initials: AJ
authors.lastname: Bierhals
authors.forename: D L
authors.initials: DL
authors.lastname: Zonarich
authors.forename: C F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology; D002650:Child Abuse, Sexual / Q000523:psychology; D017281:Cost of Illness; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D010552:Personality Assessment; D010553:Personality Development; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology; D018454:Spouses / Q000523:psychology; D013727:Terminal Care / Q000523:psychology