Abstract

This study investigated the potential impact of attachment styles and external shame on depression symptoms among married couples from low-income apartments in the suburbs of Kuala Lumpur. A door-to-door approach was used to recruit participants and collect data. Three research scales were used in this study: the Experience in Close Relationship-Revised Version questionnaire was used to measure individual differences in adult attachment styles, the Other as Shamer Scale was used to measure external shame, and the Personal Health Questionnaire was used to measure depression symptoms. This study reports that the most common depression symptoms reported are among individuals who experienced depression symptoms for less than one month. Results showed that dual-insecure couples (wives’ anxiety attachment and husbands’ avoidance attachment, wives’ avoidance attachment and husbands’ avoidance attachment) were significantly correlated with depression in a sample of the wives. The findings also revealed that a specific type of dual-insecure couples (wives’ anxiety attachment and husbands’ avoidance attachment) was a predictor of depression symptoms. These results provide evidence for a role of specific dual-insecure couples and external shame on depression symptoms.

Keywords: dual-insecure relationships, mental health, vulnerability, Malaysia

A number of scholars have suggested that the quality of a couple’s relationship is grounded in attachment style, the individual patterns being among the most important factors. Secure attachment has been identified as a major positive influence in explaining variations in the quality of good marital relationships (Molero et al., 2016; Strauss, Morry, & Kito, 2012). What can we expect when one or both parties in the couple have anxiety attachment or avoidance attachment? Givertz and colleagues (2013) found that both anxious and anxiety attachments were associated with lower relationship quality and that one partner’s insecure attachment was associated with the spouse’s report of lower relationship quality. Other studies reported a sense of insecurity in one’s current romantic relationship was significantly related to depression between partners, however, an individual’s secure attachment reduced one’s own depression (Mehta, Cowan, & Cowan, 2009). These results indicated that couples’ relationships clearly influence depression (Beach & Whisman, 2012). While there is a clear association between depression and personal relationship, there is a need to identify the specific pattern of insecure attachment styles that influence this association (Heene, Buysse, & Van Oost, 2005). Insecure attachment may be a significant factor that offers increased understanding the dynamics of coupled relationships, and particularly may influence depression (Jinyao, Xiongzhao, Auerbach, Gardiner, Lin, Yuping et al., 2012) and external shame (Gilbert & Miles, 2000).

Research on the effects of adult anxiety attachment, avoidance attachment, and external shame on depression symptoms is scarce in close relationship studies. Only a few studies were found that investigated the impact of attachment styles and external shame on collaborative problem-solving orientations (Lopez, Gover, Leskela, Sauer, Schirmer, & Wyssmann, 1997), the connection between attachment styles and investment in relatedness (Gross & Hansen, 2000), associations of personality, shame, and social bonds (Shaher, 2001), adult attachment styles in relation to shame, depression, and loneliness (Wei, Shaffer, Young, & Zakalik, 2005), and traumatic memory-related shame in relation to depression (Matos & Pinto-Gouveia, 2014, 2013). For instance, Matos and Pinto-Gouveia (2014) examined the phenomenological characteristics of shame-related childhood memories and their impact on psychopathology among 230 adults in Portugal. The study revealed that shame memories showed a higher correlation between external shame and depression while higher correlations between internal shame and depression were seen in relation to attachment figures.

One study discovered that preoccupied and fearful attachment styles were significantly related to shame, while those with secure attachment style were less vulnerable to the experience of shame (Gross & Hansen, 2000). Relating this to a working model of attachments (Bartholomew & Horowitz, 1991), those with preoccupied attachment style and those with fearful attachment style demonstrated a negative sense of self that would lead to higher levels of experiencing shame. Therefore, those who have a high need to be loved and accepted, and who worry about hurting or offending others in a close relationship may be more sensitive and vulnerable to experience shame. Such concerns may cause some negative feelings, such as fear of rejection, separation, or feeling unwanted, all linked to shame. Thus, individuals with preoccupied and fearful styles increase doubt about their competency and lovability in a close relationship, and would report higher levels of shame that could lead to mental health problems.

Kilmann and colleagues (2012) studied partner attachment and interpersonal characteristics among 113 non-clinical couples in long-term marriages. They discovered that spouses with greater anxiety attachment endorsed dysfunctional relationship beliefs. The study also reported that husbands with higher scores for anxiety attachment were rated less aggressive, less controlling, and more rebellious; wives with a higher score in this dimension were rated more dependent, more self-critical, and less competitive. The study also revealed that greater marital distress more likely existed in marriages consisting of at least one insecure partner.

The present study

Although contributing factors and the negative impact of adult attachment styles on psychosocial functioning are well-established using retrospective and prospective designs in most Western countries, attachment styles among married couples have not yet been investigated in many Eastern countries. Studies concerning attachment styles among married couples have been lacking due to the time and costs involved, as well as the low response from the participants, especially male participants. This study aims to fill this research gap by investigating attachment styles among married couples in the Malaysian context. More precisely, this study examines whether the attachment style of married couples is significantly correlated with depression. It is our hope that this research can help fill a gap that has been present for decades in psychology literature concerning adult attachment styles and depression among married couples. The study’s researchers reviewed close relationship studies from 2007 to 2014 using Google Scholar, ScienceDirect, and Ebscohost, and only found eight relevant studies (e.g., Melore, Shaver, Ferrer, Cuadrado, & Alonso-Arbiol, 2010; Givertz, Woszidle, Sergin, & Knutson, 2013; Monin, Feeney, & Schulz, 2011). These studies were conducted among couples in the United States, Canada, and Spain. Thus, the present study has a threefold objective: First, this study aims to investigate the tabulation of duration for depression symptoms; second, to examine the relationships between anxiety attachment, avoidance attachment, and external shame of depression; and finally, to determine predictors of depression in a sample of married couple pairings in Malaysia.

Method

Results

The first analysis examined the distribution of duration for individual depression symptoms. Next, associations between adult attachment styles and external shame on depression symptoms were examined using Pearson’s Correlation. Finally, multiple regression was applied to determine predictors of depression symptoms.

Discussion and Conclusions

Attachment styles, external shame, and their relation to depression symptoms were the focus of this study. The research team was interested whether specific patterns of insecure attachment pairings were more likely to be associated with depression symptoms in this sample of married couples. Finally, this study also sought to determine whether a specific pattern of insecure attachment in individual members of couples could predict depression symptoms.

In this study, more than half of the husbands and wives reported having more than four depressive symptoms. Our findings were not consistent with the findings of previous research (e.g., Kessler, McGonagle, Swartz, Blazer, & Nelson, 1993; Rohde, Lewinsohn, Klein, Seeley, & Gau, 2013) in terms of gender, where reports suggested males were more than twice as likely to experience depression symptoms as females. Our findings suggested that both men and women reported high rates of depression symptoms. The findings offered an important significant contribution to our understanding of adult depression symptoms, particularly those married couples with insecure attachment styles. We suggested that gender differences in depression symptoms may due to social roles occupied by men and women. Social roles may be increasingly different as the level of family commitment increases, for instance married women with children have an increased risk of depression symptoms due to multiple roles to perform. This can be also explained in terms of traditional roles as homemaker and caregiver may increase stress due to their responsibilities to manage children, elderly parents, and household chores. In similar employed wives with young children are also expected to perform their duties and responsibilities for the sake of family’s well-being particularly when they do not earn sufficient amounts to hire out their caregiver duties. Previous studies reported that having more than four young children at home would increase the risk of depression symptoms (Brown & Harris, 1978).

We found that the wives who reported higher anxiety attachment or greater avoidance attachment reported greater experience for depression, while no correlations were found among the husbands. These findings were consistent with the findings of other research that individuals with anxiety hold significantly more irrational beliefs (Stackert & Bursik, 2003) and a negative evaluation of self (Bifulco & Moran, 1998; Murphy & Bates, 1997), which tends to be linked with mental disorder, particularly depression (Bifulco, Moran, Ball, & Bernazzani, 2002). Thus, we suggested that those with higher scores on anxiety attachment or avoidance attachment or both associated with depression symptoms are more vulnerable and distressing. Relating our findings with attachment theory, we concluded that higher anxiety attachment and avoidance attachment were the most important factors in increased risks of depression.   

Our findings suggested that wives with anxiety attachment and wives with avoidance attachment were significantly correlated with depression symptoms. The findings for wives suggest that additional processes may need to be considered in order to fully understand wives’ depression symptoms. Additionally, this could likely create troubled close relationships with the husbands, increase marital conflicts, and, thus, would lead to depression symptoms. We also conclude that those wives with anxiety attachment were extremely emotionally sensitive with their avoidant husbands, which can lead to depression symptoms. 

Our findings also suggest that external shame was also significantly related with depression symptoms. This finding is consistent with other findings (Balsamo et al., 2015; Gilbert & Miles, 2000; Gilbert, McEwan, Bellew, Mills, & Gale, 2009; Goss et al., 1994). We concluded that external shame emerged as a signal which insecure wives experienced fear of negative evaluation of others, such as unattractive, unworthy or unacceptable. In terms of the internal working models of self and others, it might be that respondent wives with high levels of anxiety attachment tended to have a negative working model of self, including experiencing the self as defective, unlovable, unworthy, undesirable in the mind of the spouse or attachment figures; this model sets others as threatening, harsh, hostile and powerful, and thus may have become part of a negative relational schema. Further, respondent wives with high levels of avoidance attachment were more likely to have a negative model of others and have learned that self-reliance was a preferable model. In addition, such wives tended to believe that others were unavailable to help them in times of stress. Therefore, they were more likely to rely on themselves in order to manage their stress. Another possible explanation is that the wives could find relationships with others particularly difficult due to their concern about being discovered as worthless and others losing interest. Our results were also in line with Lewis’ (1971) suggestion that “shame involves the failure of the central attachment bond” whereas Kaufman (1989) relates shame to the experience of being emotionally and psychologically detached from attachment figures. Shame, whether internal or external, involves extreme inferiority, worthlessness, and unlovability that may be associated with the experiences of fears of being rejected and separated (Lopez et al., 1997).

In relating our findings with traditional gender roles in which the wives were expected to be obedient, passive, and devoted to their husbands; these values and practices would influence attachment styles. Because culture exerts a strong influence on both gender role practices and the way in which those practices are interpreted by the spouses, it is also reasonable to expect a somewhat differential distribution of attachments. This is in line with attachment theory that states the long history of interpersonal development and behaviors within the culture and social values would shape the variability in an attachment activation system. Thus, the frequency and quality of interactions and supportive relationship in times of crisis between spouses may form the basis of different attachments. Another potential reason that culture would shape attachments can be attributed to the nature of collective culture because collective individuals merge their identity with their society and prioritize the collective goals over their personal goals. For instance, Asians emphasize social harmony (Markus et al., 1997), fear of being on one's own, of being separated or disconnected from others (Markus & Kitayama, 1994), and tend to suppress their own emotions (Butler, Lee, & Gross, 2007) which would lead to avoidance attachment, meanwhile unable to maintain social harmony and trust may lead to fears of being rejected and abandoned, which, in turn, would shape anxiety attachment.

Our study is the first study in Malaysia that measured married couples in relation to depression symptoms. Our findings revealed that participant wives with anxiety attachment married to avoidant husbands reported that the most common depression symptoms; this was consistent with the findings of prior research (e.g., Scott & Cordova, 2002). We also concluded that wives with anxiety attachment might be an important factor in increasing depression symptoms. We also suggested that the husband’s avoidance attachment might affect one’s own mental health. Thus, we suggested that the attachment styles of wives might be an important factor in shaping depression symptoms, while the husband’s avoidance attachment can add to the depression symptoms. Future research should identify the risk factors that might help these couples to improve their marital satisfaction and intimacy in close relationships. 

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Acknowledgements

This study was sponsored by the Ministry of Higher Education of Malaysia and Universiti Kebangsaan Malaysia, Grant UKM-SK-05-FRGS0227-2010. We thank the deputy director of the Housing Management & Community Development Department of Kuala Lumpur City Hall who collaborated with this study, as well as the research assistants and social work undergraduate students who undertook the fieldwork and collected the data.