Adult attachment insecurity and responses to prolonged severe occupational stress in hospital workers during the COVID-19 pandemic

Figures & data

Figure 1. Severity of attachment insecurity conceptualized as the vector addition of attachment anxiety and attachment avoidance.

Table 1. Characteristics of the sample.

	N	%
Job type
Nurse	49	23.4
Other healthcare care professional	66	31.6
Non-professional with patient contact	33	15.8
Non-professional without patient contact	61	29.2
Gender
Female	171	81.8
Male	33	15.8
Other/prefer not to say	5	2.4
Ethno-cultural identity
African/Black	11	5.3
Asian	60	28.7
European/White	107	51.2
Hispanic	4	1.9
South Asian	14	6.7
Other	13	6.2
Education
High school or less	3	1.4
College diploma	24	11.5
Undergraduate degree	63	30.1
Graduate or professional degree	119	56.9
Marital status
Single	83	39.7
Married/Common-law	117	56.0
Divorced/Separated	9	4.3
Age
18–30	69	33.0
31–40	54	25.8
41–50	50	23.9
51 and older	36	17.3

Table 2. Correlations between attachment insecurity and aspects of stress response.

Aspects of stress response (1)	Correlations with attachment insecurity
	Attachment avoidance (2)	Attachment anxiety (3)	Significance of difference between R12 and R13		Severity of insecure attachment (4)
	R12	R13	z	p	R14
A. Appraisal of personal resources
Occupational resilience	−.32***	−.30***	−0.3	.80	−.37***
Pandemic self-efficacy	−.30***	−.48***	2.4	.02	−.48***
B. Coping behaviors
Denial	.07	.19**	−1.4	.15	.18*
Seeking emotional support	−.23***	.16*	−4.6	<.001	−.04
Seeking instrumental support	−.16*	.16*	−3.8	<.001	.03
Self-blame	.12	.35***	−2.8	.005	.34***
Substance use	.00	.05	−0.6	.56	.01
Active coping	−.20**	−.10	−1.2	.23	−.17*
Humor	.03	.11	−0.9	.35	.11
Religion	.03	.00	0.4	.72	.04
C. Interpersonal problems
Domineering	.25***	.33***	−1.0	.32	.36***
Vindictive	.42***	.30***	1.6	.12	.44***
Cold	.51***	.30***	2.8	.005	.48***
Socially inhibited	.42***	.32***	1.3	.19	.43***
Nonassertive	.11	.29***	−2.2	.03	.24***
Exploitable	.08	.34***	−3.2	.002	.28***
Overly-nurturant	.05	.31***	−3.1	.002	.24***
Intrusive	.03	.35***	−3.9	<.001	.28***
Mean interpersonal problems	.39***	.46***	−.95	.34	.53***

*p < 0.05; **p < 0.01; ***p < 0.001.

Table 3. Associations between attachment variables and changes in stress outcomes over time.

	Attachment variable			Time			Time X attachment
	F	p	eta^2	F	p	eta^2	F	p	eta^2
Independent variable: attachment anxiety
Emotional exhaustion	12.1	<.001	.13	8.0	<.001	.05	1.4	.22	.02
Depersonalization	8.0	<.001	.12	7.6	<.001	.06	3.4	.001	.06
Personal accomplishment	6.4	.002	.10	0.8	.55	.01	1.6	.12	.03
Psychological distress	19.5	<.001	.19	11.3	<.001	.06	1.7	.09	.02
Posttraumatic symptoms	13.7	<.001	.14	3.9	.02	.02	1.1	.34	.01
Independent variable: attachment avoidance
Emotional exhaustion	7.0	.001	.08	7.7	<.001	.04	0.6	.74	.01
Depersonalization	9.7	<.001	.15	6.6	<.001	.06	0.8	.58	.01
Personal accomplishment	7.9	<.001	.12	1.1	.36	.01	0.6	.74	.01
Psychological distress	7.7	<.001	.09	10.8	<.001	.06	1.4	.21	.02
Posttraumatic symptoms	4.9	.009	.05	3.5	.03	.02	1.0	.38	.01
Independent variable: severity of attachment insecurity
Emotional exhaustion	19.7	<.001	.19	7.8	<.001	.05	1.0	.44	.01
Depersonalization	14.0	<.001	.20	7.5	<.001	.06	2.6	.01	.04
Personal accomplishment	12.1	<.001	.18	0.9	.46	.01	2.7	.008	.05
Psychological distress	28.3	<.001	.26	11.4	<.001	.07	2.0	.04	.02
Posttraumatic symptoms	26.8	<.001	.24	3.8	.03	.02	0.3	.85	.00

Figure 2. Temporal trends in psychological distress and dimensions of occupational burnout by severity of attachment insecurity.