Little is known regarding attachment styles among residents in long-term care homes and the relationship with depression and loneliness

The study evaluated the distribution of attachment among residents in long-term care (LTC) homes and identified their association with depression and loneliness.

This study involved 132 residents in LTC homes in Thailand. All of them were cognitively intact based on Mini-Cog. The Thai version of the Experiences of Close Relationships-Revised questionnaire (ECR-R-18), the Relationships Questionnaire (RQ) were used to assess attachment. The Thai version of Geriatric Depression Scale (GDS-6) and the 6-item Revised version of The University of California Los Angeles Loneliness Scale (RULS-6) were completed.

Participants included 85 females (64.4%) with mean age 74.89 (SD 7.89) years. The mean number of years of education was 6.81(SD 4.46) years. Most of the attachment styles were insecure (60.7%). The distribution of attachment style was 39.4% for secure, 15.2% for fearful, 16.7% for preoccupied, and 28.8% for dismissing. The mean score of attachment- anxiety was 3.58 and of attachment-avoidance was 3.61. Mean GDS score was 1.17 (SD 1.58), while depression based on the GDS cut-off was found in 31.1% of the residents. Mean RULS score was 2.36 (SD 0.75). Factors associated with Depression includes male (c2= 4.50, p <.05), anxious attachment (t = 3.51, p = 0.001) and loneliness (t = 4.90, p <0.001). Anxious attachment was associated with loneliness (p <0.001) and depression score (p <0.001), while avoidant attachment was not.

The majority attachment style among residents in LTC homes is insecure attachment, with dismissing style the most prevalent. Attachment with high anxiety i.e., preoccupied, and fearful was associated with loneliness and depression.