Hostility as a Manifestation of Attachment Disorders in Depression

Objectives. To analyze the association between hostility and the features of attachment disorders in endogenous depression. Materials and methods. The study included 49 patients diagnosed with depressive disorders. The study employed the SCL-90R symptoms questionnaire, the diagnostic Bass–Perry Aggression Questionnaire, the Experience in Close Relationships (ECR-R) questionnaire, and the Ammon Ego Structure Test. All patients were assessed on the Hamilton Depression Rating Scale (HDRS-17). Results. Patients with high levels of depression indicators had statistically significantly elevated measures of hostility (p = 0.046), “destructive aggression” (p = 0.04) and “deficit aggression” (p = 0.005). The severity of depression showed significant correlations with the severity of attachment anxiety (close relationships), as well as with pathological narcissism, destructive external self-delimitation, and deficit internal self-delimitation (p < 0.05). For the depression indicator, regression analysis showed that the regression model explained more than 76% of the variance, with significant contributions made by the indicators interpersonal sensitivity, deficit narcissism, and avoidance. For the hostility indicator, the regression model explained about 62% of the variance, while a significant contribution was made, as in the analysis of depression, by the indicators interpersonal sensitivity and avoidance; however, in contrast to depression, non-deficit narcissism rather than destructive narcissism was found to contribute. Conclusions. Severe depressive symptoms were associated with increases in measures of hostility. Hostility in depression is associated with factors generated by impairment to early interpersonal relationships (anxious attachment) (which causes increased sensitivity in relationships with others, building a barrier between the self and the external environment perceived as hostile), narcissistic pathology, and problems in emotional regulation.