Structural Relationships between Attachment Style and Psychological Distress: Mediating Role of Cognitive Emotion Regulation

Document Type : Original Article


Department of clinical psychology, faculty of humanities, Shahed University


Introduction: Given the role of insecure attachment in psychological distress and the effects of emotion regulation on psychological disorders, the aim of current research was to investigate the contribution of cognitive emotion regulation in explaining the relationship between attachment style and psychological distress.
Method: The study sample included 300 B.A and M.D students of Shahed University. Instruments for the study were Depression, Anxiety and Stress Scale (DASS-21), Experiences in Close Relationships Questionnaire (ECR-R) and the short form of Cognitive Emotion Regulation Questionnaire (CERQ-S). The extracted data analyzed by SPSS-23 and AMOS-18 softwares.
Results: The findings were shown significant positive relationships between attachment anxiety and the components of psychological distress, anxiety, depression and stress, and maladaptive emotion regulation. Both Structural Equation Modeling (SEM) and Sobel’s test confirmed the mediating role of maladaptive emotion regulation in the relationship between attachment anxiety and the components of psychological distress.
Conclusion: The findings confirmed the mediating role of maladaptive emotion regulation in the relationship between attachment anxiety and the components of psychological distress. Hence the foregoing variables could be attended in the interpersonal relationships, educational, familial and therapeutic domain.


Main Subjects

1- Ohayashi H, Yamada S. Psychological distress: symptoms, causes, and coping: Nova Science Publishers. 2012.
2- Abeloff M, Armitage J, Lichter A, Niederhuber J. Clinical Oncology. New York, NY: Churchill Livingstone. Inc. 2000.
3- Ridner SH. Psychological distress: concept analysis. Journal of advanced nursing. 2004; 45(5): 536-45.
4- Dohrenwend BS, Dohrenwend BP. Some issues in research on stressful life events.  Handbook of clinical health psychology: Springer. 1982; 91-102.
5- L’Abate L. Programmed writing. Research on Writing Approaches in Mental Health. 2011; 23: 115.
6- Pearlin LI. The family as a context of the stress process. Stress and health: Issues in research methodology. 1987: 143-65.
7- Tasca GA, Kowal J, Balfour L, Ritchie K, Virley B, Bissada H. An attachment insecurity model of negative affect among women seeking treatment for an eating disorder. Eating Behaviors. 2006; 7(3): 252-7.
8- Shahyad S, Besharat MA, Asadi M, Alipour AS, Miri M. The relation of attachment and perceived social support with life satisfaction: structural equation model. Procedia-Social and Behavioral Sciences. 2011; 15: 952-6.
9- Turan N, Erdur-Baker Ö. The contribution of rumination and internal working models of attachment to psychological symptoms. Procedia-Social and Behavioral Sciences. 2010; 5: 1185-9.
10- Turan N, Hoyt WT, Erdur-Baker Ö. Gender, attachment orientations, rumination, and symptomatic distress: Test of a moderated mediation model. Personality and Individual Differences. 2016; 102: 234-9.
11- Ataeifar R, Amiri S, Nadi MA. Investigating the Relationship between Effective Communication of Spouse and Father—Child Relationship (Test Pattern Causes to Education Parents). International Education Studies. 2016; 9(7): 98.
12- Körük S, Öztürk A, Kara A. The Predictive Strength of Perceived Parenting and Parental Attachment Styles on Psychological Symptoms among Turkish University Students. International Journal of Instruction. 2016; 9(2): 215-30.
13- Buller CJ. Dispositional Mindfulness and Emotion Regulation as Mediators of Attachment and Psychological Distress Relationship. Sydney: New Castle. 2015.
14- McDonald HM, Sherman KA, Petocz P, Kangas M, Grant K-A, Kasparian NA. Mindfulness and the experience of psychological distress: the mediating effects of emotion regulation and attachment anxiety. Mindfulness. 2016; 7(4): 799-808.
15- Pickard JA, Caputi P, Grenyer BF. Mindfulness and emotional regulation as sequential mediators in the relationship between attachment security and depression. Personality and Individual Differences. 2016; 99: 179-83.
16- Zhu W, Wang CD, Chong CC. Adult attachment, perceived social support, cultural orientation, and depressive symptoms: A moderated mediation model. Journal of counseling psychology. 2016; 63(6): 645.
17- Cassidy J, Shaver PR. Handbook of Attachment. New York. Guilford Press. 1999.
18- Berk L. Development through the Lifespan. India: Pearson Education. 2017.
19- Bowlby J. Attachment and loss: Retrospect and prospect. American journal of Orthopsychiatry. 1982; 52(4): 664.
20- Brennan KA, Clark CL, Shaver PR. Self-Report Measurement of Adult Attachment: An Integrative Overview. New York: Guilford Press. 1998.
21- Simpson JA, Rholes WS, Oriña MM, Grich J. Working models of attachment, support giving, and support seeking in a stressful situation. Personality and Social Psychology Bulletin. 2002; 28(5): 598-608.
22- Frey LL, Beesley D, Miller MR. Relational health, attachment, and psychological distress in college women and men. Psychology of Women Quarterly. 2006; 30(3): 303-11.
23- Karami J, Yazdanbakhsh K, Karimi P. Mediating Role of Attachment Styles in Relationship between Temperament and Character Dimensions and Alexithymia. Clinical Psychology. 2016; 8: 61-71.
24- De Castella K, Goldin P, Jazaieri H, Ziv M, Dweck CS, Gross JJ. Beliefs about emotion: Links to emotion regulation, well-being, and psychological distress. Basic and Applied Social Psychology. 2013; 35(6): 497-505.
25- van der Meer LB, van Duijn E, Giltay EJ, Tibben A. Do attachment style and emotion regulation strategies indicate distress in predictive testing? Journal of genetic counseling. 2015; 24(5): 862-71.
26- Pascuzzo K, Moss E, Cyr C. Attachment and emotion regulation strategies in predicting adult psychopathology. SAGE Open. 2015; 5(3): 2158244015604695.
27- Garnefski N, Teerds J, Kraaij V, Legerstee J, van Den Kommer T. Cognitive emotion regulation strategies and depressive symptoms: Differences between males and females. Personality and individual differences. 2004; 36(2): 267-76.
28- Gross JJ, Muñoz RF. Emotion regulation and mental health. Clinical psychology: Science and practice. 1995; 2(2): 151-64.
29- Cloitre M, Cohen LR, Koenen KC. Treating survivors of childhood abuse: Psychotherapy for the interrupted life: Guilford Press. 2011.
30- Saeidpoor S, Kazemi-Rezai SA, Karbalaei-Esmaeil E, Kazemi-Rezai SV, Ahmadi F. Diagnostic role of cognitive emotion regulation strategies, cognitive fusion and thought control strategies in Obsessive-Compulsive disorder. Clinical P sychology. 2017; 9: 1-11.
31- Mazloom M, Yaghubi H. Role of Emotion Regulation and Thought Control in Prediction of Post-Traumatic Stress Disorder. Clinical Psychology. 2017; 8: 1-10.
32- Martin RC, Dahlen ER. Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Personality and individual differences. 2005; 39(7): 1249-60.
33- Gratz KL, Gunderson JG. Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior therapy. 2006; 37(1): 25-35.
34- Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review. 2010; 30(2): 217-37.
35- Pepping CA, Duvenage M, Cronin TJ, Lyons A. Adolescent mindfulness and psychopathology: The role of emotion regulation. Personality and Individual Differences. 2016; 99: 302-7.
36- Mesman J, van IJzendoorn M, Sagi-Schwarz A. Cross-cultural patterns of attachment. Handbook of Attachment: Theory, Research, and Clinical Applications. 3th ed. New York: Guilford. 2016.
37- Diamantopoulos A, Siguaw JA. Introducing LISREL: A guide for the uninitiated: Sage; 2013.
38- Arefi M, Navvabi Nejad S, Shafi' Abadi A, Kiamanesh A. Attachment Styles, Gender, and Marietal Satisfaction. Educational Bulletin. 2012 ;31: 117-32.
39- Fraley RC, Waller NG, Brennan KA. An item response theory analysis of self-report measures of adult attachment. Journal of personality and social psychology. 2000; 78(2): 350.
40- Fraley RC. Information on the Experiences in Close Relationships-Revised (ECR-R) adult attachment questionnaire. Self Report Measures of Adult Attachment. 2005.
41- Rotaru T-Ş, Rusu A. Psychometric properties of the Romanian version of Experiences in Close Relationships-Revised questionnaire (ECR-R). Procedia-Social and Behavioral Sciences. 2013; 78: 51-5.
42- Panaghi L, Maleki G, Zabih Zade A, Paosht Mohammadi M, Soltani Nejad Z. Validity, Reliability, and Factorial Structure of Experiences in Close Relationship (ECR). Iran Psychiatry and Clinical Psycology. 2013; 19: 305-13.
43- Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological assessment. 1998; 10(2): 176.
44- Browne MW, Cudeck R. Alternative ways of assessing model fit. Sage focus editions. 1993; 154: 136.
45- Henry JD, Crawford JR. The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample. British journal of clinical psychology. 2005; 44(2): 227-39.
46- Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. Iranian Psychologists. 2005; 4(1): 299-313.
47- Asghari Moghadam M, Sa'ed F, Dibaj Nia P, Zangeneh J. Preliminary investigation of Validity and Reliability of Anxiety and Stress Depression Scales (DASS) in Non-Clinical Samples. Daneshver e Raftar. 2008; 38: 23-31.
48- Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual differences. 2001; 30(8): 1311-27.
49- Garnefski N, Kraaij V. Cognitive emotion regulation questionnaire–development of a short 18-item version (CERQ-short). Personality and individual differences. 2006; 41(6): 1045-53.
50- Hassani J. The Investigation of Validity and Reliability of Short Form of Cognitive Emotion Regulation. Behavioral Sciences Research. 2011; 9: 229-40.
51- Besharat M. Cognitive Emotion Regulation Inventory. Developmental Psychology: Iranian Psychologists. 2016; 13: 221-3.
52- Pedhazur EJ, Schmelkin LP. Measurement, design, and analysis: An integrated approach: Psychology Press. 2013.
53- Abareshi A, Hosseini S. Structural Equation Modeling. Tehran: Jame'eh Shenasan. 2012.
54- Tabachnick BG, Fidell LS. Using multivariate statistics: Allyn & Bacon/Pearson Education. 2007.
55- Mulaik SA, James LR, Van Alstine J, Bennett N, Lind S, Stilwell CD. Evaluation of goodness-of-fit indices for structural equation models. Psychological bulletin. 1989; 105(3): 430.
56- Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal. 1999; 6(1): 1-55.
57- McDermott MJ, Tull MT, Gratz KL, Daughters SB, Lejuez C. The role of anxiety sensitivity and difficulties in emotion regulation in posttraumatic stress disorder among crack/cocaine dependent patients in residential substance abuse treatment. Journal of anxiety disorders. 2009; 23(5): 591-9.
58- Thompson RA. Emotion regulation: A theme in search of definition. Monographs of the society for research in child development. 1994; 59(2‐3): 25-52.