Accessibility of the mental representation of attachment figures in patients with anxiety and depressive symptoms

According to attachment theory, different attachment styles relate to individuals' innate behaviors aimed at establishing proximity to or distancing oneself from attachment figures when confronted with threat. Unclear is whether these attachment-related threat responses also pertain to clinically depressed or anxious individuals. We therefore examined attachment-related patterns of accessibility of attachment figure representations under threat in 60 patients with anxiety and depressive symptoms (aged 16-58; primary diagnoses: an anxiety disorder, mood disorder, or personality disorder), applying an experimental Stroop procedure. Participants, randomly assigned to one of three priming conditions (neutral, attachment-unrelated threatening, attachment-related threatening prime), were exposed to a person's name preceded by a subliminal prime. Self-reported attachment styles, trait anxiety, and depressive symptoms were measured. Participants with higher scores on attachment avoidance showed reduced accessibility of persons in a neutral context and in response to attachment-unrelated threat, but not in response to attachment-related threat. These effects were independent of trait anxiety and depressive symptoms. Attachment anxiety was not associated with accessibility of persons. These results indicate that the mechanism of attachment-related responses to threat might not pertain to patients with anxiety and depressive symptoms, possibly due to collapse under their chronic strain.