The relationship between attachment style, empathy level and social functioning in depressive patients

Objective: This study was designed to investigate the relationship between attachment style, empathy level, and social functioning in depressive patients. Method: A total of 100 patients (63 women, 37 men) between the ages of 18 and 65 who were diagnosed with major depressive disorder (n=76) or a bipolar disorder depressive episode (n=24) and 54 (39 women, 15 men) healthy controls were enrolled. The Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HAM-A), the Basic Empathy Scale (BES), the Adult Attachment Style Questionnaire (AAQ), and the Functioning Assessment Short Test (FAST) were administered to all of the participants and the results were analyzed. Results: The patients had lower BES total and cognitive empathy subdimension scores than the controls. The cognitive empathy score was negatively correlated with the duration of the most recent depressive episode and the HDRS and FAST interpersonal relationship scores, and positively correlated with the number of depressive episodes. Cognitive empathy was more impaired in patients with chronic depression than those diagnosed with recurrent depression. The attachment style scores were not correlated with the empathy scores. The depressive patients had lower secure attachment scores and higher insecure (avoidant and anxious/ambivalent) attachment scores than the controls. Conclusion: The results of this study indicated that an insecure attachment style and reduced cognitive empathy may be associated with depression. Impaired empathy and attachment leading to impaired social functioning may play a role in the etiopathogenesis of depression. These may be risk factors for the chronicity and recurrence of depression and should be taken into consideration in the treatment process.

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