Adult attachment profiles, interpersonal difficulties, and response to interpersonal psychotherapy in women with recurrent major depression

We examined adult attachment profiles, interpersonal difficulties, and treatment response in 162 women receiving interpersonal psychotherapy (IPT) for recurrent major depression. Nearly half (43%) of the women in this clinical sample reported a 'Fearful Avoidant' attachment profile in self-reports obtained upon abatement of acute depressive symptoms. As predicted, Fearful Avoidant women reported lower levels of self-esteem and more negative attitudes toward others, as compared with their Secure counterparts. These women also reported heightened interpersonal difficulties in the areas of sociability and intimacy, which remained salient both during and following the acute depressive episode. Although attachment group categorization did not distinguish between patients who did or did not remit with IPT treatment, a positive association emerged between high Fearful Avoidant attachment ratings and a longer time to clinical stabilization among IPT remitters.