Unravelling attachment – A network analysis of the cognitive pathways linking attachment and prolonged grief

BackgroundAttachment style is widely recognised as influential in shaping responses to bereavement and prolonged grief disorder (PGD). Although theorised extensively, empirical clarity regarding how attachment styles specifically impact PGD symptoms and therapeutic implications remains limited. This study aimed to identify cognitive-behavioural mechanisms linking attachment styles to PGD symptoms.MethodsData were collected from a community sample of 695 bereaved adults. Network analysis explored interactions between attachment styles (anxious and avoidant) and various cognitive-behavioural factors associated with PGD, including appraisals, memory characteristics, maladaptive coping strategies, and social disconnection.ResultsThe findings reveal attachment styles as peripheral within the network, suggesting that their direct influence on PGD symptoms may be less central than previously theorised. However, anxious attachment correlated positively with injustice rumination and altered social self, while avoidant attachment was positively associated with perceived loss of future and relationships and preferences for solitude, and negatively associated with proximity-seeking behaviours and fear of losing connection to the deceased. Cognitive-behavioural factors, particularly memory characteristics and social disconnection, held central positions within the network, mediating relationships between attachment styles and PGD.ConclusionsAttachment styles indirectly influence PGD through cognitive-behavioural pathways rather than exerting strong direct effects. By bridging the gap between attachment theory and cognitive-behavioural approaches to grief, this study offers a more nuanced understanding of its relationship with PGD, and points towards potential new avenues for future interventions aimed at addressing attachment-related challenges in bereaved individuals.