Relationship between attachment and adolescent depression: the role of emotion regulation and cultural context

Abstract

Adolescence marks an increased vulnerability to depression due to the substantial physical, psychological, and social changes during this developmental period. Considerable research has suggested that the development and maintenance of adolescent depression can be shaped by early attachment experiences. However, little is understood about its underlying mechanisms. Given the inextricable link between emotion regulation (ER) and both attachment and depression, the present research examined the role of cognitive reappraisal, suppression, and rumination as potential mediating mechanisms between attachment (anxiety and avoidance) and adolescent depression. As each of these components is deeply embedded in cultural contexts, this research further investigated whether and to what extent the relationship between attachment, ER, and depression varies across cultures using a sample of Vietnamese and British adolescents. This research consisted of three studies that involved two independent samples: one pilot study including young Vietnamese and British people aged 16-25 living in the UK (N= 182), and two empirical studies based on Vietnamese and British adolescents aged 12-18 in secondary schools in Vietnam and Scotland, respectively (N=1136). All studies were cross-sectional and used self-reported measures (either online or in person). Confirmatory factor analysis and structural equation modelling were used to analyse the data. The present research is the first to provide direct empirical evidence supporting the hypothesis that each attachment dimension is linked to depression via predominant ER strategies in adolescents. Analyses showed that while cognitive reappraisal mediated only the link between avoidance and depression, suppression and rumination mediated the link between both avoidance and anxiety and depression. These associations also varied across parental and peer relationships. Together, these results highlight the need to carefully consider the role of specific relationship domains and attachment dimensions as they potentially uniquely contribute to the mechanisms underlying adolescent depression. The cross-cultural comparison identified both similarities and differences in the relationship between attachment, ER, and depression across cultures. There was a consistent predictive power of peer attachment for depression while the contribution of parental attachment was subjected to the cultural contexts. Similarly, while cognitive reappraisal and rumination pathways showed similar patterns, culture-specific associations were found for suppression. The hypothesised model explained a larger proportion of depression variance in the British sample (76%) compared to the Vietnamese sample (53%), indicating that other cultural factors might also be at play. Such findings together directly challenge the tendency to overlook cultural influence in existing attachment and ER conceptualisations. This research presents some exciting avenues for future studies, for example, the adaptive components of peer avoidance, or the cultural factors explaining the cross-cultural variations regarding parent attachment and suppression in relation to depression. Current findings have important clinical implications for the development and cross-cultural adaptions of existing attachment- and ER-based prevention and intervention programs to target depression in adolescents.