Attachment insecurity in advanced cancer patients: psychometric properties of the German version of the Brief Experiences in Close Relationships Scale (ECR-M16-G)

Philipp, Rebecca, Vehling, Sigrun, Scheffold, Katharina, Grünke, Britta, Härter, Martin, Mehnert, Anja, Schulz-Kindermann, Frank, and Lo, Christopher (2017) Attachment insecurity in advanced cancer patients: psychometric properties of the German version of the Brief Experiences in Close Relationships Scale (ECR-M16-G). Journal of Pain and Symptom Management, 54 (4). pp. 555-562.

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Context: Attachment insecurity refers to difficulty in trusting and relying on others in times of need. Its underlying factors attachment anxiety and attachment avoidance have been empirically associated with impaired coping in advanced cancer and, therefore, should be considered in individually tailored medical and psychosocial treatment.

Objectives: The objective of this study was to evaluate the psychometric properties of the German translation of the Brief Experiences in Close Relationships Scale (ECR-M16-G).

Methods: We recruited 182 advanced cancer patients from outpatient psycho-oncology clinics of the University Medical Center Hamburg-Eppendorf and the University Medical Center Leipzig, local and external cancer care facilities. We performed confirmatory factor analysis to replicate the higher order factor structure reported in previous research. We conducted item and reliability analysis, also correlation analysis, to examine concurrent validity.

Results: One hundred fifty-eight patients completed the ECR-M16-G (women 61%, mean age 57.9, SD = 11.1). We replicated the factor structure with the subscales Attachment Anxiety and Attachment Avoidance as second-order factors and Worrying about relationships, Frustration about unavailability, Discomfort with close others, and Turning away from others as first-order factors. An adjusted model that interchanged factor loadings of items 4 and 10 showed good fit (Comparative Fit Index = 0.94, Non-Normed Fit Index = 0.93, root mean square error of approximation = 0.05). Subscales showed acceptable to good internal consistency (anxiety α = .81 and avoidance α = .78). Attachment insecurity (mean = 3.1, SD = 1.0) was positively associated with depression, anxiety, demoralization (P < 0.001), and symptom burden (P = 0.02) and negatively associated with spiritual well-being (P < 0.001).

Conclusion: The ECR-M16-G is a valid and reliable measure of attachment insecurity in patients with advanced cancer and can be recommended as a tool for clinical care and further research.

Item ID: 69146
Item Type: Article (Research - C1)
ISSN: 1873-6513
Keywords: Cancer; advanced; oncology; attachment insecurity; depression
Copyright Information: © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Funders: Deutsche Krebshilfe GgmbH / German Cancer Aid (GCA)
Projects and Grants: GCA grant number: Hamburg 109967, GCA grant number: Leipzig 110746
Date Deposited: 31 Aug 2021 23:01
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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