title: Contribution of attachment insecurity to health-related quality of life in depressed patients.
abstract: OBJECTIVE
  To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life (HRQoL) in patients diagnosed with adjustment disorder (AJD) with depressed mood.
  
  
  METHODS
  Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance (ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package (SPSS Inc., Chicago, IL, United States).
  
  
  RESULTS
  ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggest that depressive symptoms were more severe (F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer (F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQoL, accounting for 21.4% and 29.7% of the total variance, respectively [R(2) = 0.79; Adjusted R(2) = 0.77; F (5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.
  
  
  CONCLUSIONS
  The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in AJD with depressed mood.
authors.affiliation: Alexander M Ponizovsky, Mental Health Services, Ministry of Health, Jerusalem 9101002, Israel.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Ponizovsky
authors.forename: Angela
authors.initials: A
authors.lastname: Drannikov
keywords: Adjustment disorder; Adult attachment style; Attachment insecurity; Depression; Health-related quality of life