Attachment Styles as Protective and Amplifying Factors in Caregiver Psychological Distress: A Multicenter Cross-Sectional Study in Oncology and Chronic Disease Caregiving

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dc.authorid0000-0003-1562-6340
dc.authorid0000-0001-5885-3047
dc.authorid0000-0003-4341-6826
dc.authorid0000-0003-3245-1570
dc.contributor.authorOzonder Unal, Ipek
dc.contributor.authorPirincci Aytac, Miray
dc.contributor.authorOzgedik Turhan, Nur
dc.contributor.authorTaylan, Yunus
dc.contributor.authorUnal, Caglar
dc.contributor.authorTopcu, Atakan
dc.contributor.authorBerkol, Tonguc Demir
dc.date.accessioned2026-04-04T18:56:07Z
dc.date.available2026-04-04T18:56:07Z
dc.date.issued2025
dc.departmentİstanbul Bilgi Üniversitesi
dc.description.abstractBackground/Objectives: Caregiving for patients with advanced cancer or chronic illness imposes substantial psychological burden, yet the role of caregiver attachment style in moderating this distress is underexplored. This multicenter, cross-sectional study investigates how attachment styles influence the relationship between psychological distress and caregiver burden in two populations: family caregivers of palliative-stage cancer patients and those supporting patients with chronic diseases. Methods: Across Turkey, 819 caregivers (412 cancer, 407 chronic disease) completed the Zarit Caregiver Burden Scale, DASS-21, and Relationship Scale Questionnaire. Hayes' PROCESS macro was used to test the moderating role of attachment styles. Results: Cancer caregivers reported higher caregiver burden (Cohen's d = 0.35, 95% CI [0.21, 0.49]) and stress than chronic disease caregivers, but lower depression. Secure attachment was negatively associated with burden, while preoccupied attachment was positively associated. For cancer caregivers, secure attachment buffered the impact of depression on burden (interaction B = -0.611, 95% CI [-0.861, -0.361]), whereas preoccupied attachment amplified it in both groups (cancer caregivers: B = 0.292, 95% CI [0.064, 0.520]; chronic disease caregivers B = 0.505, 95% CI [0.174, 0.836]). The final regression models explained 43.1% of variance in burden for the cancer group and 10.9% for the chronic disease group. Conclusions: Attachment styles are significant moderators of the relationship between psychological distress and caregiver burden. Secure attachment is a protective factor, while preoccupied attachment is a vulnerability factor. These findings underscore the need for attachment-informed psychosocial interventions tailored to specific caregiver profiles to mitigate distress.
dc.identifier.doi10.3390/healthcare13202612
dc.identifier.doi10.3390/healthcare13202612
dc.identifier.issn2227-9032
dc.identifier.issue20
dc.identifier.pmid41154290
dc.identifier.scopus2-s2.0-105020182530
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.3390/healthcare13202612
dc.identifier.urihttps://hdl.handle.net/11411/10698
dc.identifier.volume13
dc.identifier.wosWOS:001601575700001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMdpi
dc.relation.ispartofHealthcare
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20260402
dc.snmzKA_Scopus_20260402
dc.subjectAnxiety
dc.subjectAttachment
dc.subjectCaregiver Burden
dc.subjectCancer
dc.subjectDepression
dc.titleAttachment Styles as Protective and Amplifying Factors in Caregiver Psychological Distress: A Multicenter Cross-Sectional Study in Oncology and Chronic Disease Caregiving
dc.typeArticle

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