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Secondary attachment and mental health in Pakistani and Scottish adolescents: A moderated mediation model

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Original languageEnglish
JournalPsychology and Psychotherapy: Theory, Research and Practice
Early online date29 Apr 2020
Publication statusE-pub ahead of print - 29 Apr 2020


Objectives Research into adolescent mental health has tended to focus on primary attachment relationships. However, the effect of secondary attachment relationships and the role of culture remain under‐explored. This study examined the associations between primary attachment, secondary attachment, and coping strategies (task‐focused, emotion‐focused, and avoidant coping) with psychological wellbeing and psychological distress in adolescents across two cultural settings.
Design A cross‐sectional study.
Method An identical test battery was used across two geographic sites in Pakistan (N = 510; 12–18 years; 51.5% male; mean age = 14.50) and Scotland (N = 610; 12–18 years; 53.6% male; mean age = 13.97). Associations were tested separately in each sample using moderated mediation modelling for the outcome variables: psychological wellbeing and psychological distress.
Results For psychological wellbeing, all three coping strategies were significant partial mediators and secondary attachment was a significant moderator in both samples. Secondary attachment moderated the association between emotion‐focused coping and psychological wellbeing in the Pakistani sample only. For psychological distress, task‐focused coping was a significant full mediator in the Pakistani sample only. In contrast, for the Scottish sample, task‐focused coping and emotion‐focused coping were significant partial mediators. Secondary attachment’s direct effect on psychological distress was significant in both samples. Secondary attachment also moderated the association between emotion‐focused coping and psychological distress in the Pakistani sample only.
Conclusions The cross‐cultural evidence suggests that alongside primary attachment, it is important to target secondary attachment through coping strategies, in order to enhance psychological wellbeing and lessen psychological distress in adolescents.

    Research areas

  • adolescents, secondary attachment, primary attachment, mental health, wellbeing, coping, culture, moderated mediation.

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