Toward a causal link between attachment styles and mental health during the COVID-19 pandemic.

BACKGROUND: Recent research has shown that insecure attachment, especially attachment anxiety, is associated with poor mental health outcomes, especially during the COVID-19 pandemic. Other research suggests that insecure attachment may be linked to nonadherence to social distancing behaviours during the pandemic. AIMS: The present study aims to examine the causal links between attachment styles (secure, anxious, avoidant), mental health outcomes (depression, anxiety, loneliness) and adherence to social distancing behaviours during the first several months of the UK lockdown (between April and August 2020). MATERIALS & METHODS: We used a nationally representative UK sample (cross-sectional n = 1325; longitudinal n = 950). The data were analysed using state-of-the-art causal discovery and targeted learning algorithms to identify causal processes. RESULTS: The results showed that insecure attachment styles were causally linked to poorer mental health outcomes, mediated by loneliness. Only attachment avoidance was causally linked to nonadherence to social distancing guidelines. DISCUSSION: Future interventions to improve mental health outcomes should focus on mitigating feelings of loneliness. Limitations include no access to pre-pandemic data and the use of categorical attachment measure. CONCLUSION: Insecure attachment is a risk factor for poorer mental health outcomes.