title: Emotion regulation as a mediator in the relationship between attachment and depressive symptomatology: A systematic review.
abstract: BACKGROUND
  Attachment theory has been conceptualised as an emotion regulation theory. Research attributes the occurrence of depressive symptoms to a dysfunction of emotion regulation. Anxious attachment and avoidant attachment, which are two dimensions of insecure attachment, are hypothesised to lead to the development of hyperactivating and deactivating emotion regulation strategies.
  
  
  METHODS
  This systematic review examines the literature on the role of emotion regulation and its relationship with attachment and depressive symptomatology. Furthermore, we examined evidence for hyperactivating and deactivating strategies.
  
  
  RESULTS
  Nineteen papers were identified. Adolescent studies demonstrated associations of varying strength and found unreliable and contradictory results for emotion regulation as a mediator. Conversely, adult studies provided strong evidence for emotion regulation as a mediator. The hypothesis that hyperactivating strategies mediate anxious attachment and depressive symptoms was consistently supported. Mixed evidence was provided for deactivating strategies as mediators to avoidant attachment and depressive symptomatology.
  
  
  CONCLUSIONS
  Limitations of methodology and quality of studies are identified with particular attention drawn to problems with conceptual singularity and multicollinearity.
  
  
  CONCLUSIONS
  Despite mixed variable findings, this review indicates that emotion regulation is a mediator between attachment and depression. Hyperactivating strategies, in particular, have been consistently noted as mediators for anxious attachment and depressive symptomatology, whereas evidence for deactivating strategies as mediators between avoidant attachment and depressive symptoms has been mixed. Future research should test the mediators of attachment and symptoms and examine theoretically grounded models of psychopathology, such as metacognitive and cognitive models using clinical samples.
authors.affiliation: University of Manchester, School of Psychological Sciences, Manchester, United Kingdom.
authors.forename: Sonia
authors.initials: S
authors.lastname: Malik
authors.affiliation: University of Manchester, School of Psychological Sciences, Manchester, United Kingdom; Manchester Mental Health and Social Care Trust, Manchester, United Kingdom.
authors.forename: Adrian
authors.initials: A
authors.lastname: Wells
authors.affiliation: University of Manchester, School of Psychological Sciences, Manchester, United Kingdom; Manchester Mental Health and Social Care Trust, Manchester, United Kingdom. Electronic address: anja.wittkowski@manchester.ac.uk.
authors.forename: Anja
authors.initials: A
authors.lastname: Wittkowski
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001362:Avoidance Learning; D003863:Depression / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology; D004644:Emotions; D006801:Humans; D008297:Male; D009769:Object Attachment
keywords: Attachment; Depression; Emotion regulation; Mediator