Anxiety and depression among adult amputees: the role of attachment insecurity, coping strategies and social support

A number of studies have investigated the role of coping and social support as protective factors for psychosocial adjustment after amputation. In contrast, few have focused on the role of attachment styles. Therefore, the purpose of this study was to examine the relationship between attachment insecurity, social support, coping strategies and negative emotions, such as anxiety and depression, in adult amputees. Sixty-two amputated adults (71% males, 29% females), recruited from the Prosthetic Centre of the Italian Workers' Compensation Authority, completed the Attachment Style Questionnaire, the Coping Inventory for Stressful Situations, the Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory II and the State-Trait Anxiety Inventory Y. Based on Pearson's correlations results, we conducted a mediation analysis to examine whether the association between attachment insecurity (i.e., attachment anxiety and attachment avoidance) and negative emotion (i.e. depression, state anxiety and trait anxiety) variables was mediated by emotion-oriented coping. Analyses revealed the role of insecure attachment styles in influencing the use of an emotion-oriented coping strategy in particular. The latter mediated the relationship between attachment insecurity, depression and anxiety in adult amputees.