A National Study of the Association of Attachment Styles With Depression, Social Anxiety, and Suicidal Ideation Among Lebanese Adolescents

Chadia Haddad, PhD^b,c,d; Pascale Salameh, PharmD, MPH, PhD^d,e,f,g; Souheil Hallit, PharmD, MSc, MPH, PhD^a,b,j; Hala Sacre, PharmD^d; Sahar Obeid, PhD^k; Nour Fattouh, MD^a; Rabih Hallit, MD^a,h,i; Michel Soufia, MD^a

Prim Care Companion CNS Disord 2022;24(3):21m03027

ABSTRACT

Objective: In Lebanon, depression and social phobia are prevalent, as is suicidal ideation. Consistent violence in Lebanon may cause distress and even mental illness among some children and adolescents. The objective of this study was to generate the first general population-based survey estimates on the association between insecure attachment styles (fearful, preoccupied, and dismissing), mental health disorders (depression and social anxiety), and a clinical manifestation of some mental/psychiatric disorders (suicidal ideation) among Lebanese adolescents.

Methods: This cross-sectional study was conducted between January and May 2019. Of 2,250 questionnaires distributed, 1,810 (80.44%) were completed and collected. Participants were enrolled in the study using a proportionate random sample of schools from all Lebanese governates (Beirut, Mount Lebanon, North, South, and Bekaa).

Results: The results showed that a secure attachment style was significantly associated with less fear (β = 5.966), depression (β = −0.319), and suicidal ideation (β = −0.583). Insecure attachment styles (preoccupied, fearful, and dismissing) were significantly associated with more fear and avoidance, depression, and suicidal ideation; more preoccupied attachment style was significantly associated with higher fear (β = 5.639) and avoidance (β = 9.974). Higher fearful attachment style was significantly associated with more avoidance (β = 4.605) and depression (β = 0.980). Finally, more dismissing attachment style was significantly associated with more fear (β = 8.508), avoidance (β = 10.689), and suicidal ideation (β = 0.528).

Conclusions: The study results revealed that insecure attachment styles are associated with higher levels of depression, suicidal ideation, and social phobia. Future research is necessary to confirm the findings.

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