Mindfulness Mediation: Insecure Attachment and Psychological Distress among Patients with Coronary Heart Conditions

OBJECTIVE: Heart disease is the leading global cause of mortality, and its management necessitates understanding the interaction between physiological and psychological factors. This study aims to explore the relationship between insecure attachment style, psychological distress, and the mediating impact of mindfulness among patients with coronary heart disease. METHOD: This cross-sectional study was conducted using convenience sampling among 199 patients with coronary heart disease from medical centers in Aran-Bidgol and Kashan during 2022-2023. Data collection involved the use of the Depression, Anxiety, and Stress Scale (DASS-21) for psychological distress assessment, the Collins and Reed attachment style questionnaire (RAAS) to gauge attachment style, and the Brown and Ryan mindfulness scale questionnaire (MAAS) to measure mindfulness. Data analysis was performed using structural equation modeling. RESULTS: The findings indicated a fit for the proposed model. Mindfulness was observed to mediate the relationship between avoidant attachment and psychological distress, while no mediating role was identified for anxious attachment and psychological distress. CONCLUSION: The study highlights the significance of attachment style in influencing both mindfulness and psychological distress levels among patients with coronary heart disease. Moreover, enhancing mindfulness emerges as an avenue for mitigating the impact of insecure attachment styles and subsequently reducing psychological distress in this patient population.