Are attachment avoidance and anxiety associated with depression through specific interpersonal problem types? : a cross sectional study in older adolescents.

Objective The theoretical underpinning of Interpersonal Psychotherapy for adolescents (IPT-A) would suggest a relationship between attachment insecurity and depression through interpersonal problems, which could inform possible mechanisms of change. These constructs have not been empirically investigated in adolescents nor in populations including non-depressed participants. This study aimed to explore whether specific interpersonal problems mediate the relationship between attachment avoidance and anxiety and depression in older adolescence. Method A cross-sectional survey was conducted to explore the relationships between variables with predominant direction of causation assumed on the basis of theory. Questionnaires measuring attachment insecurity, interpersonal problems and depression were administered to 225 adolescents aged between 16 and 18 years old at one South London school. Data of 180 participants (80 girls, 100 boys) was analysed. Results As hypothesised, low affiliative interpersonal problems were found to most strongly mediate the relationship between attachment avoidance and depression. Similarly, high affiliative interpersonal problems were found to most strongly mediate the relationship between attachment anxiety and depression. Conclusions These findings are consistent with the constructs that are theorised to underpin IPT and so inform possible mechanisms of change. This is pertinent given the difficult interpersonal context of adolescence. Findings will help Interpersonal Psychotherapists formulate and utilise the most appropriate strategies to improve effectiveness. However, the cross-sectional design means that conclusions about the direction of causation cannot be made. Further research should therefore focus on methods which collect longitudinal data over the course of IPT to enable temporal order to be examined. Keywords Attachment Avoidance, Attachment Anxiety, Interpersonal, Depression, Adolescent