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Mindfulness Mediation: Insecure Attachment and Psychological Distress among Patients with Coronary Heart Conditions

Mohammadreza Tamannaiefar1, Fatimah Eslami Bidgoli1, Ahmad Daghigh2

  • 1Department of Psychology, University of Kashan, Kashan, Iran.

Western Journal of Nursing Research
|December 19, 2025
PubMed

Insights

Insecure attachment styles increase psychological distress in heart disease patients. Mindfulness helps reduce this distress, particularly for those with avoidant attachment, offering a therapeutic target.

Area of Science:

  • Cardiology
  • Psychology
  • Health Psychology

Background:

  • Heart disease is a leading cause of global mortality.
  • Effective management requires understanding physiological and psychological factors.
  • Insecure attachment styles may impact patient outcomes.

Purpose of the Study:

  • To investigate the relationship between insecure attachment style, psychological distress, and mindfulness in coronary heart disease (CHD) patients.
  • To examine the mediating role of mindfulness in the association between attachment styles and psychological distress.
  • To identify potential targets for psychological interventions in CHD management.

Main Methods:

  • Cross-sectional study with 199 CHD patients from Aran-Bidgol and Kashan (2022-2023).
  • Utilized Depression, Anxiety, and Stress Scale (DASS-21), Revised Attachment Style Questionnaire (RAAS), and Mindful Attention Awareness Scale (MAAS).
  • Structural equation modeling was employed for data analysis.

Main Results:

  • The proposed model demonstrated a good fit.
  • Mindfulness significantly mediated the relationship between avoidant attachment and psychological distress.
  • No significant mediating role of mindfulness was found for anxious attachment and psychological distress.

Conclusions:

  • Attachment style significantly influences mindfulness and psychological distress in CHD patients.
  • Enhancing mindfulness may mitigate the negative effects of insecure attachment styles.
  • Mindfulness interventions could be beneficial in reducing psychological distress in coronary heart disease patients.
Abstract

Keywords:
attachment stylecoronary heart diseaseinsecuremindfulnesspsychological distress

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