title: The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer.
abstract: The present study examines the association between disease-related factors, perceived social support, attachment security (i.e. attachment anxiety and avoidance), and the occurrence of depressive symptoms in a sample of patients with metastatic gastrointestinal or lung cancer. Results from a sample of 326 cancer outpatients with advanced disease indicate that disease-related factors are significantly associated with the occurrence of depressive symptoms, and the latter are inversely related to the degree of attachment anxiety and avoidance, and perceived social support. Attachment security (on the dimension of anxious attachment) significantly buffered the effect of disease-related factors on depressive symptoms, and perceived social support mediated the relationship between attachment security and depressive symptoms. The buffering effect of attachment security on depressive symptoms and its partial mediation through social support suggest that the interaction of individual, social, and disease-related factors contribute to the emergence of depressive symptoms in patients with metastatic cancer.
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, & Psychosocial Oncology and Palliative Care Research Division, Ontario Cancer Institute, University Health Network, Toronto, Canada. gary.rodin@uhn.on.ca
authors.forename: Gary
authors.initials: G
authors.lastname: Rodin
authors.forename: Andrew
authors.initials: A
authors.lastname: Walsh
authors.forename: Camilla
authors.initials: C
authors.lastname: Zimmermann
authors.forename: Lucia
authors.initials: L
authors.lastname: Gagliese
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jones
authors.forename: Frances A
authors.initials: FA
authors.lastname: Shepherd
authors.forename: Malcolm
authors.initials: M
authors.lastname: Moore
authors.forename: Michal
authors.initials: M
authors.lastname: Braun
authors.forename: Allan
authors.initials: A
authors.lastname: Donner
authors.forename: Mario
authors.initials: M
authors.lastname: Mikulincer
mesh_terms: D000223:Adaptation, Psychological; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000523:psychology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D009769:Object Attachment; D012044:Regression Analysis; D012944:Social Support