Evidence map›Paper›PMID 40968777›Full record

ArticlePsychological medicine2025

Unraveling attachment - A network analysis of the cognitive pathways linking attachment and prolonged grief.

Kirsten V Smith, Nora Skjerdingstad, Omid V Ebrahimi, Fiona Maccallum, Anke Ehlers

Abstract read
In one paragraph

Article in Psychological medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kirsten V SmithDepartment of Experimental Psychology, https://ror.org/052gg0110University of Oxford, Oxford, UK.ORCID 0000-0002-6973-2846
Nora SkjerdingstadDepartment of Experimental Psychology, https://ror.org/052gg0110University of Oxford, Oxford, UK.ORCID 0000-0001-8900-059X
Omid V EbrahimiDepartment of Experimental Psychology, https://ror.org/052gg0110University of Oxford, Oxford, UK.ORCID 0000-0002-8335-2217
Fiona MaccallumSchool of Psychology, https://ror.org/052gg0110University of Queensland, Brisbane, Australia.ORCID 0000-0002-3006-0712
Anke EhlersDepartment of Experimental Psychology, https://ror.org/052gg0110University of Oxford, Oxford, UK.ORCID 0000-0002-8742-0192

Funding

Medical Research Council MR/V001841/1Wellcome Trust 200796
6 · The paper itself

Abstract

backgroundAttachment style is widely recognized as influential in shaping responses to bereavement and prolonged grief disorder (PGD). Although theorized extensively, empirical clarity regarding how attachment styles specifically impact PGD symptoms and therapeutic implications remains limited. This study aimed to identify cognitive-behavioral 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-behavioral factors associated with PGD, including appraisals, memory characteristics, maladaptive coping strategies, and a sense of 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 theorized. 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 behaviors and fear of losing connection to the deceased. Cognitive-behavioral 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-behavioral pathways rather than exerting strong direct effects. By bridging the gap between attachment theory and cognitive-behavioral approaches to grief, this study offers a more nuanced understanding of its relationship with PGD and points toward potential new avenues for future interventions aimed at addressing attachment-related challenges in bereaved individuals.

Indexed as

Adaptation, PsychologicalGriefObject AttachmentAdultAgedFemaleHumansMaleMiddle AgedYoung Adultappraisalsattachmentbereavementcognitive-behavioural mechanismscoping strategiesgriefmemory characteristicsnetwork analysisprolonged grief disordersocial disconnection

Identifiers

PMID40968777
PMCPMC13054909

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.