Women’s Health Bulletin

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Authorship Rules and Regulations

Indexing and Abstracting

Peer Review Process

Metrics

Forms

Investigating the Level of Emotional Distress Based on Attachment Styles and Emotional Schemas in Female Students with Depression Symptoms

Document Type : Research Article

Authors

1 Clinical Psychology, Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Fars, Iran

2 Department of Psychology, Firoozabad Branch, Islamic Azad University, Firoozabad, Fars, Iran

Abstract

Background: People with depression often experience intense emotions and struggle to regulate them. This condition can lead to confusing emotional experiences and unsuccessful attempts to manage and understand emotions. Therefore, the study aimed to investigate the level of emotional distress based on attachment styles and emotional schemas in female students with depression symptoms.
Methods: This was a cross-sectional study; the target population were female undergraduate students at Shiraz Islamic Azad University, Shiraz, Iran who exhibited symptoms of depression in the year 2023. 120 participants were selected using convenience sampling method. The Beck Depression Inventory Second Edition (BDI-II), the Kessler Emotional Distress Scale (K10), the Collins and Read Revised Adult Attachment Scale (RAAS), and the Leahy’s Emotional Schema Scale were given to the participants. The data were analyzed by multiple linear regression using SPSS version 28.
Results: The results indicated a significant correlation between all attachment styles and emotional distress (P<0.05). Among the attachment styles, anxious attachment showed the strongest correlation with emotional distress (r=0.52, P<0.001), followed by secure attachment (r=-0.44, P<0.001) and avoidant attachment (r=0.37, P<0.001). Analysis of the Regression indicated that noncompromising schemas had the strongest association with emotional distress (β=0.43, P<0.001), followed by anxious attachment (β=0.28, P=0.001) and secure attachment (β=-0.28, P<0.001).
Conclusion: Various attachment styles, such as secure, avoidant, and anxious, along with emotional schemas, are linked to emotional distress. The strength of these correlations shows that maladaptive schemas are most strongly associated with emotional distress. Interventions should be provided to address negative core schemas and interpersonal sensitivity in students with attachment/ anxiety issues. Individuals need to recognize maladaptive attachment styles and early schemas for healthy relationships.

Highlights

Ali Naseri: (Google Scholar)

Keywords

References
  1. Zhang J, Lu H, Zeng H, Zhang S, Du Q, Jiang T, et al. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain Behav Immun. 2020;87:49-50. doi: 10.1016/j.bbi.2020.04.031. PubMed PMID: 32304883; PubMed Central PMCID: PMC7156946. ##
  2. Ghasemkhanloo A, Atadokht A, Sabri V. The effectiveness of emotional schema therapy on the severity of depression, emotional dysregulation and emotional schemas in patients with major depressive disorder. Shenakht Journal of Psychology and Psychiatry. 2021;8(3):76-88. doi: 10.32598/shenakht.8.3.76. Persian. ##
  3. Leahy RL. Introduction: Emotional schemas and emotional schema therapy. International Journal of Cognitive Therapy. 2019;12(1):1-4. doi: 10.1007/s41811-018-0038-5. ##
  4. Faustino B, Vasco AB. Emotional schemas mediate the relationship between emotion regulation and symptomatology. Current Psychology. 2023;42(4):2733-2739. doi: 10.1007/s12144-021-01560-7. ##
  5. Kragel PA, Reddan MC, LaBar KS, Wager TD. Emotion schemas are embedded in the human visual system. Sci Adv. 2019;5(7):eaaw4358. doi: 10.1126/sciadv.aaw4358. PubMed PMID: 31355334; PubMed Central PMCID: PMC6656543. ##
  6. Mahdavi Rad H, Zahedi Tajrishi K, Ramezanifarani A, Asgharnejad Farid A. The Mediating Role of Shame and Self-criticism in the Relationship Between Attachment Styles and Severity of Depressive Symptoms. Iranian Journal of Psychiatry and Clinical Psychology. 2023;28(4):492-507. doi: 10.32598/ijpcp.28.4.4429.1. ##
  7. Fraley RC, Shaver PR. Attachment theory and its place in contemporary personality theory and research. In John O, Robins RW, editors. Handbook of personality: Theory and research. 3rd ed. New York: Guilford Press; 2008. p. 518-41. ##
  8. Nascimento BS, Little AC, Monteiro RP, Hanel PH, Vione KC. Attachment styles and mate-retention: Exploring the mediating role of relationship satisfaction. Evolutionary Behavioral Sciences. 2022;16(4):362-370. doi: 10.1037/ebs0000272. ##
  9. Lange J, Goerigk S, Nowak K, Rosner R, Erhardt A. Attachment style change and working alliance in panic disorder patients treated with cognitive behavioral therapy. Psychotherapy. 2021;58(2):206-218. doi: 10.1037/pst0000365. PubMed PMID: 34410790. ##
  10. Remondi C, Casu G, Pozzi C, Greco F, Gremigni P, Brugnera A. A serial mediation model of Insecure attachment and psychological distress: the role of dispositional shame and shame-coping Styles. Int J Environ Res Public Health. 2023;20(4):3193. doi: 10.3390/ijerph20043193. PubMed PMID: 36833888; PubMed Central PMCID: PMC9966328. ##
  11. Kunzler AM, Helmreich I, König J, Chmitorz A, Wessa M, Binder H, et al. Psychological interventions to foster resilience in healthcare students. Cochrane Database Syst Rev. 2020;7(7):CD013684. doi: 10.1002/14651858.CD013684. PubMed PMID: 32691879; PubMed Central PMCID: PMC7388680. ##
  12. Khanjani Z, Mahmoud Alilou M, Ahmadi Z. Structural relationships of attachment styles with depression: the mediating role of theory of mind. Journal of Modern Psychological Researches. 2020;15(58):205-220. Persian. ##
  13. Radmehr F, Karami J. The Effect of Mindfulness based Cognitive Therapy on the Students Attribution Styles of with Major Depressive Disorders. Psychological Studies. 2022;18(1):25-38. doi: 10.22051/psy.2020.25634.1892. Persian. ##
  14. Ceylan A, Zirek E, Akturk SO, Calik BB. An examınatıon of the anxıety states of Turkısh health care workers durıng the COVID-19 pandemıc: a cross-sectıonal study. Rev Assoc Med Bras. 2022;68(3):389-394. doi: 10.1590/1806-9282.20211071. PubMed PMID: 35442369. ##
  15. Colonnello V, Fino E, Russo PM. Attachment anxiety and depressive symptoms in undergraduate medical students: The mediating role of emotion regulation strategies. Perspect Med Educ. 2022;11(4):207-212. doi: 10.1007/s40037-022-00713-z. PubMed PMID: 35587333; PubMed Central PMCID: PMC9391533. ##
  16. Stroian PI. Emotional needs and schematic functioning in depression: A narrative review. Journal of Evidence-Based Psychotherapies. 2021;21(1):21-36. doi: 10.24193/jebp.2021.1.2. ##
  17. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics. Pearson Boston, MA; 2013. ##
  18. Beck AT, Steer RA, Brown GK. Beck Depression Inventory–II (BDI-II); 1996. doi: 10.1037/t00742-000. ##
  19. Rajabi G, Karju Kasmai S. Psychometric properties of a Persian language version of the beck depression inventory-Second Edition. Quarterly of Educational Measurement. 2010;3(10):139-158. Persian. ##
  20. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60(2):184-9. doi: 10.1001/archpsyc.60.2.184. PubMed PMID: 12578436. ##
  21. Lotfalinezhad E, Barati F, Sahaf R, Shati M, Abolfathi Momtaz Y, Forughan M, et al . Psychometric Properties of the Persian Kessler Psychological Distress Scale Among Iranian Older Adults. Iran J Health Sci. 2023;11(1):21-28. doi: 10.32598/ijhs.11.1.909.2. ##
  22. Andrews G, Slade T. Interpreting scores on the Kessler psychological distress scale (K10). Aust N Z J Public Health. 2001;25(6):494-7. doi: 10.1111/j.1467-842x.2001.tb00310.x. PubMed PMID: 11824981. ##
  23. Collins NL, Read SJ. Adult attachment, working models, and relationship quality in dating couples. J Pers Soc Psychol. 1990;58(4):644-63. doi: 10.1037/0022-3514.58.4.644. PubMed PMID: 14570079. ##
  24. Asgarizadeh A, Pakdaman S, Hunjani M, Ghanbari S. Iranian adaptation of the revised adult attachment scale: Validity and reliability in the general population. Appl Psychol. 2023;17(2):167-191. doi: 10.48308/apsy.2023.230293.1443. Persian. ##
  25. Leahy RL. A model of emotional schemas. Cognitive and Behavioral Practice. 2002;9(3):177-190. doi: 10.1016/S1077-7229(02)80048-7. ##
  26. Khanzadeh M, Saidiyan M, Hosseinchary M, Edrissi F. Factor Structure and Psychometric Properties of Difficulties in Emotional Regulation Scale. Journal of Behaviorial Sciences. 2012;6(1):87-96. Persian. ##
  27. Liu Y, Zhou P, Chen J, Peng C, Li Y, He Q. Chain mediating effect of negative core schemas and interpersonal sensitivity on the relationship between adult attachment and depressive symptoms among college students. Current Psychology. 2024;43(8):7526-7534. doi: 10.1007/s12144-023-04896-4. ##
  28. Minihan S, Kwok C, Schweizer S. Social rejection sensitivity and its role in adolescent emotional disorder symptomatology. Child Adolesc Psychiatry Ment Health. 2023;17(1):8. doi: 10.1186/s13034-022-00555-x. PubMed PMID: 36647142; PubMed Central PMCID: PMC9843960. ##
  29. Çelikbaş Z, Yalçınkaya-Alkar Ö. The relationship between attachment styles, ruminative response styles, dysfunctional attitudes and major depression diagnosis. Journal of Rational-Emotive & Cognitive-Behavior Therapy. 2022;40(4):905-927. doi: 10.1007/s10942-022-00446-2. ##
  30. Kozan HİÖ, Arslan C. Social anxiety among college students: Predictive roles of attachment insecurity and emotional schemas. International Journal of Psychology and Educational Studies. 2022;9(1):22-31. doi: 10.52380/ijpes.2022.9.1.387. ##
  31. Rodas JA, Jara‐Rizzo MF, Greene CM, Moreta‐Herrera R, Oleas D. Cognitive emotion regulation strategies and psychological distress during lockdown due to COVID‐19. Int J Psychol. 2022;57(3):315-324. doi: 10.1002/ijop.12818. PubMed PMID: 34747019; PubMed Central PMCID: PMC8652999. ##
  32. Côté J, Aita M, Chouinard MC, Houle J, Lavoie‐Tremblay M, Lessard L, et al. Psychological distress, depression symptoms and fatigue among Quebec nursing staff during the COVID‐19 pandemic: A cross‐sectional study. Nurs Open. 2022;9(3):1744-1756. doi: 10.1002/nop2.1199. PubMed PMID: 35199497; PubMed Central PMCID: PMC8994967. ##
  33. Marshall EM, Karantzas GC, Greenwood CJ, Aarsman SR, Fernando JW, Romano D, et al. Distress, wellbeing, and growth amidst COVID‐19: Considering the dynamic interplay between positive and negative anticipatory emotions. Social and Personality Psychology Compass. 2023;17(10):e12827. doi: 10.1111/spc3.12827. ##
  34. Kaya Y, Aydin A. The mediating role of early maladaptive schemas in the relationship between attachment and mental health symptoms of university students. Journal of Adult Development. 2021;28(1):15-24. doi: 10.1007/s10804-020-09352-2. ##
  35. Ray-Yol E, Altan-Atalay A. Interpersonal emotion regulation and psychological distress: what is the function of negative mood regulation expectancies in this relationship? Psychol Rep. 2022;125(1):280-293. doi: 10.1177/0033294120968086. PubMed PMID: 33100136. ##
  36. Yan L, Gan Y, Ding X, Wu J, Duan H. The relationship between perceived stress and emotional distress during the COVID-19 outbreak: Effects of boredom proneness and coping style. J Anxiety Disord. 2021;77:102328. doi: 10.1016/j.janxdis.2020.102328. PubMed PMID: 33160275; PubMed Central PMCID: PMC7598556. ##
  37. Tutzer F, Frajo-Apor B, Pardeller S, Plattner B, Chernova A, Haring C, et al. Psychological distress, loneliness, and boredom among the general population of Tyrol, Austria during the COVID-19 pandemic. Front Psychiatry. 2021;12:691896. doi: 10.3389/fpsyt.2021.691896. PubMed PMID: 34177672; PubMed Central PMCID: PMC8222609. ##
  38. Chinvararak C, Kirdchok P, Lueboonthavatchai P. The association between attachment pattern and depression severity in Thai depressed patients. PloS One. 2021;16(8):e0255995. doi: 10.1371/journal.pone.0255995. PubMed PMID: 34407094; PubMed Central PMCID: PMC8372919. ##
Women’s Health Bulletin
Volume 12, Issue 1 - Serial Number 44
January 2025
Pages 40-48
Files
Share
How to cite
Statistics