Reflecting around the functions behind depression : A correlational study of depression, mentalization and attachment

Abstract: Major Depression is a common and complex disorder that is often difficult to treat. Mentalization, facilitated by secure attachment, has been found to serve as a protective function against Borderline Personality Disorder. The aim of the current study was to investigate whether mentalization has the same protective function against depression and to analyze the connection between mentalization and self-rated attachment. Furthermore, the relation between Anxious/Avoidant attachment patterns and the anaclitic/introjective sub-types of depression were examined. Twenty participants with Major Depressive Disorder were interviewed with the Depression Specific Reflective Function Interview (DSRF) and SCID-I. They also completed the self-report questionnaires Experiences in Close Relationships (ECR), Depressive Experiences Questionnaire (DEQ) and Montgomery Åsberg Depression Rating Scale (MADRS). The results revealed a relation between high mentalization ability as measured by DSRF and low levels of depression and between an anxious attachment pattern and introjective depression. Moreover, low scores on DSRF combined with high levels of anaclitic and introjective symptoms accounted for 65% of observer rated depression severity. The results suggest that depression treatment might benefit from focusing on increasing the mentalizing ability and reducing anxious attachment patterns and from an awareness of the symptoms characterized by both the introjective and anaclitic sub-types of depression.