Caregivers' burden and depressive symptoms: the moderational role of attachment orientations

The current study explored whether attachment orientations moderate the associations between caregiver burden and depressive symptoms among women coping with their partners' first time acute coronary syndrome. The association between burden and depression was hypothesized to be stronger among caregivers high on anxious attachment than among caregivers low on this dimension. In addition, the association between burden and depressive symptoms was hypothesized to be weaker among caregivers higher on avoidant attachment than among those lower on this dimension.

The sample consisted of 111 female caregivers of male patients admitted to the cardiac care unit of a hospital in Israel. Caregivers completed a measure of attachment orientations during patients' hospitalization (baseline). Caregiver burden was measured 1 month later. Depressive symptoms were measured at baseline and again at 6-month follow-up. Structural equation modeling was used to test the moderational models.

The association between caregiver burden and depressive symptoms at follow-up was moderated by attachment-related anxiety but not attachment-related avoidance. Congruent with predictions, a stronger association between caregiver burden and depressive symptoms occurred for caregivers with greater (vs. lower) attachment anxiety.

The findings shed light on the possible dynamics among attachment orientations and affect regulation when coping with one's partner's illness. The findings are discussed in light of Pietromonaco, Uchino, and Dunkel Schetter's (2013) model of integrating attachment into health psychology research.