Breast cancer screening: the role of attachment

Attachment style is the dispositional way in which a person relates to others, and differences in attachment characteristics may offer insight into why many women do not adhere to breast screening guidelines. While mammograms involve contact with medical professionals, breast self-examination (BSE) does not, and may be preferable for women who dislike interpersonal vulnerability. As such, differences in the attachment characteristics that predict mammography versus BSE utilisation may indicate whether attachment related motivations are relevant to both interpersonal examinations and independent self-care behaviours. The current report examined how attachment dimensions predicted the frequency of mammography and BSE in a sample of 1204 ethnically diverse women from Brooklyn, New York. Participants completed measures of mammography and BSE frequency, and attachment, together with demographic, health care context and emotional predictors of screening. Multiple regressions showed that attachment dimensions predicted both mammography and BSE screening even when controlling for established predictors and emotion relevant variables. As hypothesised, fearful avoidance predicted fewer mammograms and BSEs, while preoccupation predicted more frequent BSEs. Consistent with some prior work in male cancer screening, greater attachment security also predicted fewer mammograms while degree of dismissiveness was not associated with screening frequencies. Understanding the psychosocial predictors of screening may help identify low screeners, and guide the development of targeted interventions that are better suited to the interpersonal preferences of older women.