Objective: This study aimed to identify the attachment style of bipolar patients and their children, and to investigate the relationship between attachment style, and temperament, personality characteristics, and clinical features of bipolar disorder.
Method: The study included 44 euthymic bipolar patients, 35 of their healthy children (>16 years old), and 84 healthy controls (matched in terms of age, gender, and sociocultural background with the patients and their children). Diagnostic interviews were conducted using SCID-I, SCID-II, and SCID-NP. Bipolar symptoms were evaluated using SCIP-TURK. Temperament and attachment style were measured using TEMPS-A and AAS.
Results: More of the bipolar patients had an avoidant attachment style and more of their children had an anxious/ambivalent attachment style than did the healthy controls (p < 0.001 and p << 0.001). There was a negative correlation between insecure attachment and hyperthymic temperament (p = 0.008 and r = -0.623, and p = 0.049, r = -0.386). Insecure attachment style in the bipolar patients was predicted by borderline personality disorder, the severity of manic/depressive episodes, and depressive temperament. Insecure attachment in their children was predicted by anxious-avoidant and anxious-ambivalent attachment styles, the number of depressive episodes, irritable temperament (children), low-level social functioning, and a depression-mania-remission pattern.
Conclusion: We observed a reciprocal relationship between insecure attachment style and mood disorders. This study shows that depressive temperament in bipolar patients and irritable temperament in their children predicted insecure attachment in both patients and their children.