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Attachment style and anxiety in carers of people with Alzheimer's disease: results from the LASER-AD study

Published online by Cambridge University Press:  06 December 2007

Claudia Cooper ,
Colm Owens ,
Cornelius Katona  and
Gill Livingston
Claudia Cooper*
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
Colm Owens
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
Cornelius Katona
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
Gill Livingston
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
*
Correspondence should be addressed to: Dr Claudia Cooper, Medical Research Council Research Training Fellow in Health Services Research, Dept of Mental Health Sciences, University College London (Hampstead Campus), Rowland Hill Street, London, NW3 2PF, U.K. Phone: +44 20 7561 4218; Fax: +44 20 7561 4236. Email: ccooper@doctors.org.uk.
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Abstract

Background: Preliminary evidence indicates that the quality of the carer-care recipient relationship predicts those carers most at risk from anxiety. Attachment style is related to higher carer burden, psychological morbidity and increased care recipient institutionalization. We tested, for the first time, the hypothesis that carer burden and the coping strategies used mediate a relationship between attachment style and anxiety.

Methods: We interviewed 83 people with Alzheimer's disease and their family carers, originally recruited for a larger community study. Carers filled in a validated measure about their attachment style, the Hospital Anxiety and Depression Scale, the COPE to measure coping strategies, and the Zarit-Burden interview.

Results: More avoidant attachment (β = 0.28) and less secure attachment (β = −0.32) predicted anxiety. After adding coping strategies to the equation, the relationship with avoidant attachment (β = 0.15) was no longer significant, and that with less secure attachment was reduced (β = −0.23). A well-fitting structural equation model supported our finding that dysfunctional coping mediated the relationship between attachment style and anxiety.

Conclusion: Carers who were less secure or more avoidantly attached reported higher anxiety. Interventions that aim to modify coping strategies have shown promise in reducing carer anxiety. Our finding that coping strategies also appear partially to explain the excess of anxiety among less securely attached carers suggests they are likely to benefit from such interventions.

Keywords

dementiacoping strategiescarer burden
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 3 , June 2008 , pp. 494 - 507
Copyright
Copyright © International Psychogeriatric Association 2007

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