Camelia Adams - Academia.edu (original) (raw)

Papers by Camelia Adams

Research paper thumbnail of Childhood trauma as a mediator between attachment and recidivism risk: A study of Canadian offenders with mental disorders

Behavioral Sciences & the Law

Research paper thumbnail of Exploring the Relationship Between Attachment and Pathological Personality Trait Domains in an Outpatient Psychiatric Sample

Journal of Nervous & Mental Disease

Research paper thumbnail of Practical Pedagogical Tips for Using Movies in Medical Education

Research paper thumbnail of An exploration of adult attachment insecurity and psychiatric symptoms in individuals with obstructive sleep apnea

Journal of Psychosomatic Research, 2019

Obstructive sleep apnea (OSA) is a common sleep disorder, often associated with multiple medical ... more Obstructive sleep apnea (OSA) is a common sleep disorder, often associated with multiple medical comorbidities as well as psychological difficulties. Among the latter, relationship difficulties as well as mood and anxiety symptoms have been reported, without a clear understanding of the mechanism. In the current study we wanted to further explore these aspects, while comparing groups of OSA individuals with good vs poor sleep. The primary goal of the study was to examine the relationship between sleep and adult attachment and secondly to explore the relationship between sleep and couple satisfaction as well as symptoms of depression and anxiety. Methods: Following diagnosis of OSA by overnight polysomnography, 102 participants completed several psychological measures (e.g. adult attachment, couple satisfaction, depression and anxiety symptoms) and sleep measures (sleep quality and daytime sleepiness). Variables of interest were compared between the OSA groups with either good/poor sleep quality or no/excessive daytime sleepiness. Results: Adult attachment avoidance was higher in individuals with low sleep quality (mean difference = 0.33, p = .04, d = 0.46) while adult attachment anxiety was higher in individuals with high daytime sleepiness (mean difference = 0.46, p = .04, d = 0.43). Individuals with either poor sleep quality or excessive daytime sleepiness had greater severity of depression and anxiety (both p < .05). Conclusions: OSA patients with poor sleep quality and excessive daytime sleepiness have greater attachment insecurity and higher levels of depression and anxiety. A multidisciplinary approach including psychological interventions, should be considered in OSA cases with high levels of sleep disturbance.

Research paper thumbnail of The Relationship between Adult Attachment and Mental Health Care Utilization: A Systematic Review

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2018

Several studies have shown a relationship between individual attachment and various aspects of tr... more Several studies have shown a relationship between individual attachment and various aspects of treatment utilization in individuals with medical problems as well as mental health disorders. This review systematically evaluates existing literature targeting the relationship between attachment and all aspects of treatment utilization, such as engagement, participation, and completion, in adults with mental health problems. A computerized search of PsycINFO, Medline, Embase, PubMed, and Healthstar and a manual search were employed. Of 5733 titles, 105 abstracts were selected. Of these, 18 studies met full inclusion criteria. The quality of studies was evaluated and scored according to 9 characteristics. Most studies supported an association between attachment and treatment engagement and participation. In general, attachment anxiety was associated with higher engagement and participation in services while attachment avoidance was associated with less. Data regarding attachment dimensio...

Research paper thumbnail of Self-Injurious Behaviors and Adult Attachment: A Review of the Literature

Archives of suicide research : official journal of the International Academy for Suicide Research, Jan 31, 2018

Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and gene... more Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and general population, sometimes with fatal consequences. The development of SIB seems to share developmental pathways and mechanisms similar to attachment insecurity. To date, no reviews have explored their relationship. A search of publication databases PubMed and PsychInfo from 1969 through April 2018 was conducted and 17 papers met inclusion criteria. Of the 17 articles identified, 13 reported a positive relationship and 1 reported a negative relationship between attachment insecurity and SIB. Both attachment anxiety and avoidance seem to play a role in the risk for SIB, possibly through different mechanisms and likely with different impacts on the choice for either self-harm or suicide attempts.

Research paper thumbnail of Depression with or without comorbid social anxiety: Is attachment the culprit?

Psychiatry research, Jan 14, 2018

Major depressive disorder (MDD) frequently co-occurs with social anxiety disorder (SAD), and thei... more Major depressive disorder (MDD) frequently co-occurs with social anxiety disorder (SAD), and their comorbidity (MDD-SAD) increases clinical severity and functional impairment. Still, the specific psychological vulnerabilities of individuals with MDD-SAD are poorly understood. Individual attachment characteristics develop early in life through interactions with primary caregivers, and tend to persist throughout life. Early trauma can worsen attachment insecurity, increasing the risk for future anxiety and depression. The purpose of this study is to examine differences in individual attachment and history of trauma in depressed individuals with or without comorbid SAD and controls. One hundred sixty-two participants were categorized into three groups based on SCID-I interview: healthy controls (HC), individuals with current MDD without SAD (MDD), and individuals with current MDD comorbid with SAD (MDD-SAD). MDD-SAD group had significantly greater attachment anxiety and attachment avoi...

Research paper thumbnail of Relationships between patients' attachment characteristics and views and use of psychiatric treatment

Psychiatry research, Oct 15, 2017

This study explored the influence of attachment on psychiatric treatment by considering attitudes... more This study explored the influence of attachment on psychiatric treatment by considering attitudes towards and the use of psychotropic medication and psychotherapy in patients with depressive and anxiety disorders. Adults referred to a psychiatrist completed self-report measures and participated in a diagnostic interview based on DSM-IV criteria. Those with depressive, anxiety or adjustment disorders were included (n = 124). Patients reported the types and dosage of current psychotropic medication as well as number of different psychiatrists and psychologists/counselors they had seen in the past 10 years. Multiple regression analyses were used to examine relationships between attachment anxiety and avoidance and the variables capturing treatment use and attitudes towards treatments. Attachment anxiety was positively associated with the number of current psychiatric medications and with both the number of psychiatrists and the number of psychologists/counselors seen. Attachment avoida...

Research paper thumbnail of Sleep tight: Exploring the relationship between sleep and attachment style across the life span

Sleep Medicine Reviews, 2014

Based on early life experiences in which developmental, genetic, and environmental components int... more Based on early life experiences in which developmental, genetic, and environmental components interact, humans learn to trust themselves and others and connect emotionally in consistent ways that are broadly defined as "attachment styles." These relatively stable patterns of interpersonal interaction are associated with either vulnerability to various health risks or resilience. Similarly, the mechanisms involved in sleep regulation undergo developmental changes that overlap temporally with attachment formation and remain sensitive to a series of biological, environmental and psychological influences. Interestingly, while sleep has been conceptualized as a fundamental attachment behavior given its dyadic context, few studies have explored its relationship with attachment style in various ages. We present the first systematic review of the published literature examining the relationship between attachment style and sleep in humans across the life span. While levels of evidence and methods of assessment vary significantly, the results suggest a possible lifelong relationship between individual attachment style and sleep. These findings are particularly useful in understanding relatively ingrained psychological mechanisms that can affect and be affected by sleep. Clinical and research implications are discussed.

Research paper thumbnail of Doctors’ Professional and Personal Reflections: A Qualitative Exploration of Physicians’ Views and Coping during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health

Numerous studies have examined the risks for anxiety and depression experienced by physicians dur... more Numerous studies have examined the risks for anxiety and depression experienced by physicians during the COVID-19 pandemic. Still, qualitative studies investigating physicians’ views, and their discovered strengths, are lacking. Our research fills this gap by exploring professional and personal reflections developed by physicians from various specialties during the pandemic. Semi-structured interviews were conducted with physicians practicing in the province of Saskatchewan, Canada, during November 2020–July 2021. Thematic analysis identified core themes and subthemes. Seventeen physicians, including nine males and eight females, from eleven specialties completed the interviews. The pandemic brought to the forefront life’s temporality and a new appreciation for life, work, and each other. Most physicians found strength in values, such as gratitude, solidarity, and faith in human potential, to anchor them professionally and personally. A new need for personal fulfilment and hybrid ca...

Research paper thumbnail of Exploring the Impact of Religion and Spirituality on Mental Health and Coping in a Group of Canadian Psychiatric Outpatients

Journal of Nervous & Mental Disease

Research has shown that religious/spiritual (R/S) beliefs can impact mental health. In addition, ... more Research has shown that religious/spiritual (R/S) beliefs can impact mental health. In addition, individual attachment impacts R/S views and mental health. Still, clinical studies are lacking. This study explores the presence of R/S beliefs and attachment insecurity in psychiatric outpatients and the implication for mental health. Ninety psychiatric outpatients reported their R/S beliefs and were categorized into two groups: religious/spiritual (+R/S) or nonreligious/spiritual (-R/S). The groups were compared on attachment, psychiatric symptoms, religious coping, and life satisfaction. Multivariate linear regression was also performed. The +R/S group had significantly higher religious coping and lower attachment insecurity, depression severity, and social anxiety. Attachment insecurity was associated with negative religious coping. Higher attachment avoidance was associated with lower life satisfaction and higher social anxiety. Many patients in psychiatric care hold R/S views and use religious coping. Their R/S beliefs and attachment characteristics might influence each other and impact their mental illness.

Research paper thumbnail of Alexithymia is a Mediating Factor in the Relationship Between Adult Attachment and Severity of Depression and Social Anxiety

Journal of Affective Disorders

Research paper thumbnail of The relationship between attachment, treatment compliance and treatment outcomes in patients with obstructive sleep apnea

Journal of Psychosomatic Research

Research paper thumbnail of Resilience in the Time of Pandemic

The Canadian Journal of Psychiatry

Research paper thumbnail of Attachment impacts cortisol awakening response in chronically depressed individuals

Research paper thumbnail of The Relationship Between Attachment and Self-Injurious Behaviors in the Child and Adolescent Population: A Systematic Review of the Literature

Archives of Suicide Research

Research paper thumbnail of The roles of attachment and resilience in perceived stress in medical students

Canadian Medical Education Journal

Background: Medical students are susceptible to high levels of psychological stress, while being ... more Background: Medical students are susceptible to high levels of psychological stress, while being equipped with lower levels of resilience, especially females. Adult attachment is a known risk factor for a broad range of mental health difficulties and poor coping. The purpose of this study is to examine relationship attachment style, perceived stress, and resilience in medical students.Methods: Data was collected via an online survey using self-report measures from University of Saskatchewan undergraduate medical students (n = 188). Attachment was assessed with the Relationship Questionnaire and Experiences in Close Relationships Scale. Resilience and stress were assessed with the Connor-Davidson Resilience Scale and Perceived Stress Scale, respectively.Results: Approximately half of our sample endorsed secure attachment style (49.4%). Females reported significantly more attachment insecurity, higher attachment anxiety, higher perceived stress, and lower resilience compared to males,...

Research paper thumbnail of A longitudinal exploration of the impact of social anxiety and individual attachment on depression severity

Journal of Affective Disorders

Research paper thumbnail of The roles of attachment and resilience in perceived stress in medical students

Canadian Medical Education Journal, Nov 13, 2018

Background: Medical students are susceptible to high levels of psychological stress, while being ... more Background: Medical students are susceptible to high levels of psychological stress, while being equipped with lower levels of resilience, especially females. Adult attachment is a known risk factor for a broad range of mental health difficulties and poor coping. The purpose of this study is to examine relationship attachment style, perceived stress, and resilience in medical students. Methods: Data was collected via an online survey using self-report measures from University of Saskatchewan undergraduate medical students (n = 188). Attachment was assessed with the Relationship Questionnaire and Experiences in Close Relationships Scale. Resilience and stress were assessed with the Connor-Davidson Resilience Scale and Perceived Stress Scale, respectively. Results: Approximately half of our sample endorsed secure attachment style (49.4%). Females reported significantly more attachment insecurity, higher attachment anxiety, higher perceived stress, and lower resilience compared to males, as expected. As predicted, attachment anxiety and avoidance were predictors of perceived stress. Mediation analyses supported the hypothesis that resilience acted as a partial mediator between attachment insecurity and perceived stress. Conclusion: These findings suggest attachment plays a role in perceived stress in medical students. In addition, the role of resiliency in protecting against this effect highlights potential areas for intervention to improve medical student well-being and provides a foundation for longitudinal follow-up.

Research paper thumbnail of When social anxiety and depression go together: A population study of comorbidity and associated consequences

Journal of Affective Disorders, 2016

Despite several studies suggesting higher depression severity and dysfunction occurring in indivi... more Despite several studies suggesting higher depression severity and dysfunction occurring in individuals with major depressive disorder (MDD) comorbid with social anxiety disorder (SAD), a clear understanding of the specific risks associated with this comorbidity is lacking. In this study we compared the disease characteristics and level of disability of individuals with MDD-SAD with other comorbidities between depression and anxiety. Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) (N=20,013) were used. Individuals were divided in four groups comparing MDD-SAD with MDD alone, as well as other comorbidities between MDD and one anxiety (MDD-1ANX) or more than two anxiety disorders (MDD≥2ANX), with respect to several clinical, demographic, and functional characteristics. MDD-SAD comorbidity in the general population occurred in younger people, particularly men, and seemed to have an earlier onset of MDD. Occupational and social dysfunction was similar between individuals with MDD-SAD and those with MDD-1ANX. However, individuals with MDD≥2ANX had significantly higher severity as measured by suicidality as well as substance abuse and social and occupational dysfunction. SAD was the most prevalent comorbid anxiety in this group. The findings of this study were derived from the cross-sectional data. Our results suggest that the particular risks associated with MDD-SAD are the early onset and likelihood of additional anxiety, leading to higher severity and disability levels. Clinicians should increase the screening and treatment of SAD and other anxiety disorders in individuals with MDD given the higher associated health risk and functional impairment.

Research paper thumbnail of Childhood trauma as a mediator between attachment and recidivism risk: A study of Canadian offenders with mental disorders

Behavioral Sciences & the Law

Research paper thumbnail of Exploring the Relationship Between Attachment and Pathological Personality Trait Domains in an Outpatient Psychiatric Sample

Journal of Nervous & Mental Disease

Research paper thumbnail of Practical Pedagogical Tips for Using Movies in Medical Education

Research paper thumbnail of An exploration of adult attachment insecurity and psychiatric symptoms in individuals with obstructive sleep apnea

Journal of Psychosomatic Research, 2019

Obstructive sleep apnea (OSA) is a common sleep disorder, often associated with multiple medical ... more Obstructive sleep apnea (OSA) is a common sleep disorder, often associated with multiple medical comorbidities as well as psychological difficulties. Among the latter, relationship difficulties as well as mood and anxiety symptoms have been reported, without a clear understanding of the mechanism. In the current study we wanted to further explore these aspects, while comparing groups of OSA individuals with good vs poor sleep. The primary goal of the study was to examine the relationship between sleep and adult attachment and secondly to explore the relationship between sleep and couple satisfaction as well as symptoms of depression and anxiety. Methods: Following diagnosis of OSA by overnight polysomnography, 102 participants completed several psychological measures (e.g. adult attachment, couple satisfaction, depression and anxiety symptoms) and sleep measures (sleep quality and daytime sleepiness). Variables of interest were compared between the OSA groups with either good/poor sleep quality or no/excessive daytime sleepiness. Results: Adult attachment avoidance was higher in individuals with low sleep quality (mean difference = 0.33, p = .04, d = 0.46) while adult attachment anxiety was higher in individuals with high daytime sleepiness (mean difference = 0.46, p = .04, d = 0.43). Individuals with either poor sleep quality or excessive daytime sleepiness had greater severity of depression and anxiety (both p < .05). Conclusions: OSA patients with poor sleep quality and excessive daytime sleepiness have greater attachment insecurity and higher levels of depression and anxiety. A multidisciplinary approach including psychological interventions, should be considered in OSA cases with high levels of sleep disturbance.

Research paper thumbnail of The Relationship between Adult Attachment and Mental Health Care Utilization: A Systematic Review

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2018

Several studies have shown a relationship between individual attachment and various aspects of tr... more Several studies have shown a relationship between individual attachment and various aspects of treatment utilization in individuals with medical problems as well as mental health disorders. This review systematically evaluates existing literature targeting the relationship between attachment and all aspects of treatment utilization, such as engagement, participation, and completion, in adults with mental health problems. A computerized search of PsycINFO, Medline, Embase, PubMed, and Healthstar and a manual search were employed. Of 5733 titles, 105 abstracts were selected. Of these, 18 studies met full inclusion criteria. The quality of studies was evaluated and scored according to 9 characteristics. Most studies supported an association between attachment and treatment engagement and participation. In general, attachment anxiety was associated with higher engagement and participation in services while attachment avoidance was associated with less. Data regarding attachment dimensio...

Research paper thumbnail of Self-Injurious Behaviors and Adult Attachment: A Review of the Literature

Archives of suicide research : official journal of the International Academy for Suicide Research, Jan 31, 2018

Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and gene... more Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and general population, sometimes with fatal consequences. The development of SIB seems to share developmental pathways and mechanisms similar to attachment insecurity. To date, no reviews have explored their relationship. A search of publication databases PubMed and PsychInfo from 1969 through April 2018 was conducted and 17 papers met inclusion criteria. Of the 17 articles identified, 13 reported a positive relationship and 1 reported a negative relationship between attachment insecurity and SIB. Both attachment anxiety and avoidance seem to play a role in the risk for SIB, possibly through different mechanisms and likely with different impacts on the choice for either self-harm or suicide attempts.

Research paper thumbnail of Depression with or without comorbid social anxiety: Is attachment the culprit?

Psychiatry research, Jan 14, 2018

Major depressive disorder (MDD) frequently co-occurs with social anxiety disorder (SAD), and thei... more Major depressive disorder (MDD) frequently co-occurs with social anxiety disorder (SAD), and their comorbidity (MDD-SAD) increases clinical severity and functional impairment. Still, the specific psychological vulnerabilities of individuals with MDD-SAD are poorly understood. Individual attachment characteristics develop early in life through interactions with primary caregivers, and tend to persist throughout life. Early trauma can worsen attachment insecurity, increasing the risk for future anxiety and depression. The purpose of this study is to examine differences in individual attachment and history of trauma in depressed individuals with or without comorbid SAD and controls. One hundred sixty-two participants were categorized into three groups based on SCID-I interview: healthy controls (HC), individuals with current MDD without SAD (MDD), and individuals with current MDD comorbid with SAD (MDD-SAD). MDD-SAD group had significantly greater attachment anxiety and attachment avoi...

Research paper thumbnail of Relationships between patients' attachment characteristics and views and use of psychiatric treatment

Psychiatry research, Oct 15, 2017

This study explored the influence of attachment on psychiatric treatment by considering attitudes... more This study explored the influence of attachment on psychiatric treatment by considering attitudes towards and the use of psychotropic medication and psychotherapy in patients with depressive and anxiety disorders. Adults referred to a psychiatrist completed self-report measures and participated in a diagnostic interview based on DSM-IV criteria. Those with depressive, anxiety or adjustment disorders were included (n = 124). Patients reported the types and dosage of current psychotropic medication as well as number of different psychiatrists and psychologists/counselors they had seen in the past 10 years. Multiple regression analyses were used to examine relationships between attachment anxiety and avoidance and the variables capturing treatment use and attitudes towards treatments. Attachment anxiety was positively associated with the number of current psychiatric medications and with both the number of psychiatrists and the number of psychologists/counselors seen. Attachment avoida...

Research paper thumbnail of Sleep tight: Exploring the relationship between sleep and attachment style across the life span

Sleep Medicine Reviews, 2014

Based on early life experiences in which developmental, genetic, and environmental components int... more Based on early life experiences in which developmental, genetic, and environmental components interact, humans learn to trust themselves and others and connect emotionally in consistent ways that are broadly defined as "attachment styles." These relatively stable patterns of interpersonal interaction are associated with either vulnerability to various health risks or resilience. Similarly, the mechanisms involved in sleep regulation undergo developmental changes that overlap temporally with attachment formation and remain sensitive to a series of biological, environmental and psychological influences. Interestingly, while sleep has been conceptualized as a fundamental attachment behavior given its dyadic context, few studies have explored its relationship with attachment style in various ages. We present the first systematic review of the published literature examining the relationship between attachment style and sleep in humans across the life span. While levels of evidence and methods of assessment vary significantly, the results suggest a possible lifelong relationship between individual attachment style and sleep. These findings are particularly useful in understanding relatively ingrained psychological mechanisms that can affect and be affected by sleep. Clinical and research implications are discussed.

Research paper thumbnail of Doctors’ Professional and Personal Reflections: A Qualitative Exploration of Physicians’ Views and Coping during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health

Numerous studies have examined the risks for anxiety and depression experienced by physicians dur... more Numerous studies have examined the risks for anxiety and depression experienced by physicians during the COVID-19 pandemic. Still, qualitative studies investigating physicians’ views, and their discovered strengths, are lacking. Our research fills this gap by exploring professional and personal reflections developed by physicians from various specialties during the pandemic. Semi-structured interviews were conducted with physicians practicing in the province of Saskatchewan, Canada, during November 2020–July 2021. Thematic analysis identified core themes and subthemes. Seventeen physicians, including nine males and eight females, from eleven specialties completed the interviews. The pandemic brought to the forefront life’s temporality and a new appreciation for life, work, and each other. Most physicians found strength in values, such as gratitude, solidarity, and faith in human potential, to anchor them professionally and personally. A new need for personal fulfilment and hybrid ca...

Research paper thumbnail of Exploring the Impact of Religion and Spirituality on Mental Health and Coping in a Group of Canadian Psychiatric Outpatients

Journal of Nervous & Mental Disease

Research has shown that religious/spiritual (R/S) beliefs can impact mental health. In addition, ... more Research has shown that religious/spiritual (R/S) beliefs can impact mental health. In addition, individual attachment impacts R/S views and mental health. Still, clinical studies are lacking. This study explores the presence of R/S beliefs and attachment insecurity in psychiatric outpatients and the implication for mental health. Ninety psychiatric outpatients reported their R/S beliefs and were categorized into two groups: religious/spiritual (+R/S) or nonreligious/spiritual (-R/S). The groups were compared on attachment, psychiatric symptoms, religious coping, and life satisfaction. Multivariate linear regression was also performed. The +R/S group had significantly higher religious coping and lower attachment insecurity, depression severity, and social anxiety. Attachment insecurity was associated with negative religious coping. Higher attachment avoidance was associated with lower life satisfaction and higher social anxiety. Many patients in psychiatric care hold R/S views and use religious coping. Their R/S beliefs and attachment characteristics might influence each other and impact their mental illness.

Research paper thumbnail of Alexithymia is a Mediating Factor in the Relationship Between Adult Attachment and Severity of Depression and Social Anxiety

Journal of Affective Disorders

Research paper thumbnail of The relationship between attachment, treatment compliance and treatment outcomes in patients with obstructive sleep apnea

Journal of Psychosomatic Research

Research paper thumbnail of Resilience in the Time of Pandemic

The Canadian Journal of Psychiatry

Research paper thumbnail of Attachment impacts cortisol awakening response in chronically depressed individuals

Research paper thumbnail of The Relationship Between Attachment and Self-Injurious Behaviors in the Child and Adolescent Population: A Systematic Review of the Literature

Archives of Suicide Research

Research paper thumbnail of The roles of attachment and resilience in perceived stress in medical students

Canadian Medical Education Journal

Background: Medical students are susceptible to high levels of psychological stress, while being ... more Background: Medical students are susceptible to high levels of psychological stress, while being equipped with lower levels of resilience, especially females. Adult attachment is a known risk factor for a broad range of mental health difficulties and poor coping. The purpose of this study is to examine relationship attachment style, perceived stress, and resilience in medical students.Methods: Data was collected via an online survey using self-report measures from University of Saskatchewan undergraduate medical students (n = 188). Attachment was assessed with the Relationship Questionnaire and Experiences in Close Relationships Scale. Resilience and stress were assessed with the Connor-Davidson Resilience Scale and Perceived Stress Scale, respectively.Results: Approximately half of our sample endorsed secure attachment style (49.4%). Females reported significantly more attachment insecurity, higher attachment anxiety, higher perceived stress, and lower resilience compared to males,...

Research paper thumbnail of A longitudinal exploration of the impact of social anxiety and individual attachment on depression severity

Journal of Affective Disorders

Research paper thumbnail of The roles of attachment and resilience in perceived stress in medical students

Canadian Medical Education Journal, Nov 13, 2018

Background: Medical students are susceptible to high levels of psychological stress, while being ... more Background: Medical students are susceptible to high levels of psychological stress, while being equipped with lower levels of resilience, especially females. Adult attachment is a known risk factor for a broad range of mental health difficulties and poor coping. The purpose of this study is to examine relationship attachment style, perceived stress, and resilience in medical students. Methods: Data was collected via an online survey using self-report measures from University of Saskatchewan undergraduate medical students (n = 188). Attachment was assessed with the Relationship Questionnaire and Experiences in Close Relationships Scale. Resilience and stress were assessed with the Connor-Davidson Resilience Scale and Perceived Stress Scale, respectively. Results: Approximately half of our sample endorsed secure attachment style (49.4%). Females reported significantly more attachment insecurity, higher attachment anxiety, higher perceived stress, and lower resilience compared to males, as expected. As predicted, attachment anxiety and avoidance were predictors of perceived stress. Mediation analyses supported the hypothesis that resilience acted as a partial mediator between attachment insecurity and perceived stress. Conclusion: These findings suggest attachment plays a role in perceived stress in medical students. In addition, the role of resiliency in protecting against this effect highlights potential areas for intervention to improve medical student well-being and provides a foundation for longitudinal follow-up.

Research paper thumbnail of When social anxiety and depression go together: A population study of comorbidity and associated consequences

Journal of Affective Disorders, 2016

Despite several studies suggesting higher depression severity and dysfunction occurring in indivi... more Despite several studies suggesting higher depression severity and dysfunction occurring in individuals with major depressive disorder (MDD) comorbid with social anxiety disorder (SAD), a clear understanding of the specific risks associated with this comorbidity is lacking. In this study we compared the disease characteristics and level of disability of individuals with MDD-SAD with other comorbidities between depression and anxiety. Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) (N=20,013) were used. Individuals were divided in four groups comparing MDD-SAD with MDD alone, as well as other comorbidities between MDD and one anxiety (MDD-1ANX) or more than two anxiety disorders (MDD≥2ANX), with respect to several clinical, demographic, and functional characteristics. MDD-SAD comorbidity in the general population occurred in younger people, particularly men, and seemed to have an earlier onset of MDD. Occupational and social dysfunction was similar between individuals with MDD-SAD and those with MDD-1ANX. However, individuals with MDD≥2ANX had significantly higher severity as measured by suicidality as well as substance abuse and social and occupational dysfunction. SAD was the most prevalent comorbid anxiety in this group. The findings of this study were derived from the cross-sectional data. Our results suggest that the particular risks associated with MDD-SAD are the early onset and likelihood of additional anxiety, leading to higher severity and disability levels. Clinicians should increase the screening and treatment of SAD and other anxiety disorders in individuals with MDD given the higher associated health risk and functional impairment.