title: The impact of attachment and depression symptoms on multiple risk behaviors in post-war adolescents in northern Uganda.
abstract: BACKGROUND
  We have previously shown that depression symptoms are associated with multiple risk behaviors and that parental attachments are protective against depression symptoms in post-war adolescents. Accumulating literature indicates that low levels of attachment may sensitize individuals to increased multiple risk behaviors when depression symptoms exist. This investigation examined the interactive effects of attachment and depression symptoms on multiple risk behavior.
  
  
  METHODS
  We conducted hierarchical logistic regression analyses to examine the impact of attachment and depression symptoms on multiple risk behavior in our post-war sample of 551 adolescents in Gulu district.
  
  
  RESULTS
  Analyses revealed interactive effects for only maternal attachment-by-depression interaction. Interestingly, high levels of maternal attachment exacerbated the relationship between depression symptoms and multiple risk behaviors while low levels of maternal attachment attenuated this relationship.
  
  
  CONCLUSIONS
  It is possible that this analysis could be biased by a common underlying factor that influences self-reporting and therefore is correlated with each of self-reported attachment security, depressive symptoms, and multiple risk behaviors.
  
  
  CONCLUSIONS
  These findings suggest that maternal attachment serves as a protective factor at low levels while serving as an additional risk factor at high levels. Findings support and expand current knowledge about the roles that attachment and depression symptoms play in the development of multiple risk behaviors and suggest a more complex etiology for post-war adolescents.
authors.affiliation: Makerere University College of Health Sciences, Department of Psychiatry, Uganda; Gulu University, Department of Psychiatry, Gulu, Uganda. Electronic address: drokellojames@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Okello
authors.affiliation: Makerere University College of Health Sciences, Department of Psychiatry, Uganda.
authors.forename: E
authors.initials: E
authors.lastname: Nakimuli-Mpungu
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Centre of Hamburg, Hamburg, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Klasen
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Centre of Hamburg, Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Voss
authors.affiliation: Makerere University College of Health Sciences, Department of Psychiatry, Uganda.
authors.forename: S
authors.initials: S
authors.lastname: Musisi
authors.affiliation: Department of Orthopedagogics, Ghent University, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Broekaert
authors.affiliation: Department of Social Welfare Studies and Centre for Children in Vulnerable Situations, Ghent University, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Derluyn
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009769:Object Attachment; D010290:Parents; D012307:Risk Factors; D012309:Risk-Taking; D057566:Self Report; D014454:Uganda; D014857:Warfare
keywords: Adolescents; Attachment; Depression; Risk behavior; War