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01-11-2019 | Mood Disorders | Original Article

Spiritual well-being mediates the association between attachment insecurity and psychological distress in advanced cancer patients

Authors: Katharina Scheffold, Rebecca Philipp, Sigrun Vehling, Susan Koranyi, Dorit Engelmann, Frank Schulz-Kindermann, Martin Härter, Anja Mehnert-Theuerkauf

Published in: Supportive Care in Cancer | Issue 11/2019

Abstract

Purpose

The diagnosis of a terminal disease bears existential challenges, which activate the attachment system. Attachment insecurity, as well as existential resources, such as spiritual well-being, influences patients’ extent of psychological distress. Knowledge about the interrelation of these constructs is limited. Based on current research, we assume spiritual well-being to mediate the association of attachment insecurity and psychological distress.

Methods

We obtained data from the baseline measurement of a randomized controlled trial in advanced cancer patients. Patients were sampled from the University Medical Centers of Hamburg and Leipzig, Germany. Main outcome measures included the Patient Health Questionnaire (PHQ-9), the Death and Dying Distress Scale (DADDS), the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT-Sp), and the Experience in Close Relationships Scale (ECR-M16) for assessing attachment insecurity. We tested the mediation hypothesis with two regression analyses using bootstrapping procedure.

Results

A total of 190 patients were included. Spiritual well-being mediated the association of attachment insecurity and depression (R² = 11%), as well as death anxiety (R² = 15%), in fearful-avoidant attached patients. Neither dismissingly nor preoccupied attached patients differ in terms of spiritual well-being and psychological distress in comparison with secure attached patients.

Conclusion

Spiritual well-being plays a relevant role in advanced cancer patient’s mental health through mediating the association of attachment and psychological distress. Developing a better understanding of the interdependency of the constructs of spiritual well-being and attachment can help to develop individually tailored advanced cancer care programs and psychotherapeutic interventions.

Trial registration

NCT02051660

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Title: Spiritual well-being mediates the association between attachment insecurity and psychological distress in advanced cancer patients
Authors: Katharina Scheffold
Rebecca Philipp
Sigrun Vehling
Susan Koranyi
Dorit Engelmann
Frank Schulz-Kindermann
Martin Härter
Anja Mehnert-Theuerkauf
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Mood Disorders
Affective Disorder
Anxiety
Published in: Supportive Care in Cancer / Issue 11/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-04744-x

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Abstract

Purpose

Methods

Results

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