Social support and the consequences of heart failure compared with other cardiac diseases: The contribution of support received within an attachment relationship

SummaryBackgroundInterpersonal support is protective in heart disease, but sources of support and the quality of support may change over time, especially with aging and disease progression.AimsTo determine if support received within an attachment relationship with a spouse is more protective than other types.MethodsSubjects were sex- and age-matched cardiac outpatients with (n=40) or without (n=43) heart failure; they were studied with an observer-rated measure of attachment and self-report measures of other variables.ResultsHaving heart failure was associated with more depressive symptoms and illness intrusiveness. Although perceived social support did not differ in people with or without heart failure, those with heart failure had a spouse as the primary source of attachment functions less frequently than those without heart failure (50% vs 79%; P=0.006). Not having a spouse as the main provider of attachment functions was a partial mediator of the relationship between disease type (heart failure or no heart failure) and depressive symptoms (β=–0.24, t=–2.2; P=0.03) and deficits in non-attachment support made a further independent contribution (β=–0.24, t=–2.4; P=0.02). Neither perceived social support nor having a spouse serving attachment needs made a significant contribution to illness intrusiveness.ConclusionHaving someone other than a spouse to provide attachment support is more common in cardiac patients who have heart failure and is associated with an increased risk of depressive symptoms