Monday, November 14, 2022

Attachment Anxiety Following Mild TBI Associated With Poor Outcomes

Adults with attachment anxiety are more likely to have severe and persistent symptoms following a mild traumatic brain injury (mTBI), according to a report in The Journal of Neuropsychiatry and Clinical Neurosciences. The presence of attachment anxiety following mTBI was also associated with increased depression, increased anxiety, and decreased quality of life.

“Interpersonal attachment influences the development and course of disease,” wrote Noah D. Silverberg, Ph.D., of the University of British Columbia and colleagues. “Overall, our findings suggest that attachment strategies in current relationships may buffer or exacerbate stress after mTBI. Greater consideration of the attachment system may improve understanding and management of persistent symptoms after mTBI.”

Silverberg and colleagues recruited 91 adults from two outpatient mTBI clinics in British Columbia who were experiencing persistent mTBI symptoms such as headache, fatigue, memory, and/or sleep problems. The participants completed two sets of questionnaires on TBI symptoms, depression, anxiety, and health-related quality of life at intake (about 18 weeks after their injury) and about three to four months later. They also completed the Relationship Scales Questionnaire (includes questions about attachment) at the follow-up session. Eighty-three adults who completed both assessments were included in the final analysis.

The researchers found significant associations between higher attachment anxiety and persistent symptoms, greater depression and anxiety symptoms, and less improvement in depression and quality of life at follow-up. In contrast, there was no association between higher attachment avoidance (being more emotionally and affectionately distant) and any clinical measures.

Silverberg and colleagues wrote that the mechanisms that connect attachment anxiety with slower mTBI recovery are unclear.

“Future research is needed to disentangle the directionality of the relationship between attachment strategies and clinical outcomes after mTBI,” they concluded. “Longitudinal assessment of attachment strategies and analyses of individual trajectories might reveal unique patterns (attachment strategies contributing to persistent symptoms, persistent symptoms influencing attachment strategies, or both) for different patients.”

To read more on this topic, see the Psychiatric News article “Healing After Moderate to Severe TBI Takes Time.”

(Image: iStock/KatarzynaBialasiewicz)

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