رابطه سبک‌های دلبستگی و اضطراب مرگ در سالمندان: نقش میانجی سبک‌های خاطره‌پردازی

Background: Entering old age brings psychological challenges, such as death anxiety, in addition to physical problems. Therefore, understanding the factors affecting death anxiety is not only a psychological necessity but also an ethical and clinical requirement for designing targeted intervention protocols. Thus, the present study aimed to investigate the relationship between attachment styles and death anxiety through the mediating role of reminiscence styles in older adults.
Method: The current study employed a correlational design using structural equation modeling (SEM). The statistical population included all older adults aged 60 and above in Kermanshah in 2025, from which 285 older adults were selected as the research sample using convenience sampling. Participants completed the Adult Attachment Scale (Collins & Read), the Death Anxiety Scale (Templer), and the Older Adults’ Reminiscence Styles Questionnaire (Amani et al.). The data were analyzed using SPSS version 26 and AMOS version 24.
Results: The results of structural equation modeling indicated that the proposed model had an acceptable fit. The findings showed that secure attachment style had a positive direct relationship with positive reminiscence and a negative direct relationship with death anxiety. In contrast, ambivalent and avoidant attachment styles had negative direct relationships with positive reminiscence and positive direct relationships with death anxiety. In addition, positive reminiscence had a negative direct relationship with death anxiety. Furthermore, the results of indirect paths indicated that secure attachment style had a negative indirect relationship with death anxiety through positive reminiscence, whereas ambivalent and avoidant attachment styles had positive indirect relationships with death anxiety through positive reminiscence.
Conclusion: The findings of this research emphasize the importance of individual psychological factors in better understanding complex phenomena like death anxiety, highlighting the need to consider these factors in supportive interventions.
EXTENDED ABSTRACT
 Introduction
Given the significant increase in the older adult population, attention to their psychological challenges and mental health at this stage of life is of great importance. One of the primary challenges in old age is death anxiety. Previous research has shown that attachment styles and early parent-child relationship experiences play a crucial role in predicting death anxiety in adulthood and middle age. The consequences of attachment styles persist throughout the lifespan and determine how an individual copes with life’s difficulties. Specifically, secure attachment consistently serves as a protective resource throughout life for older adults. Although studies indicate a relationship between attachment styles and death anxiety, almost no research has examined the nature of this relationship and the mechanisms through which attachment affects death anxiety in older adults. While studies highlight the role of various variables in the relationship between attachment styles and death anxiety, reminiscence styles have not yet been investigated as a mediating variable between attachment styles and death anxiety, neither in younger populations nor in older adults. Therefore, considering the existing gaps in the research literature, the present study aimed to investigate the relationship between attachment styles and death anxiety through the mediating role of reminiscence styles.
Method
The present study employed a correlational design utilizing structural equation modeling (SEM). The statistical population included all older adults aged and above in Kermanshah, from which 285 individuals were selected as the research sample using convenience sampling. Inclusion criteria were: (1) aged 60 years or older, and (2) willingness to participate in the study. Exclusion criteria included: (1) experiencing the bereavement of a loved one within the past six months, and (2) the presence of severe mental illnesses or disorders based on the individuals’ medical records. Participants completed the Adult Attachment Scale (Collins & Read), the Death Anxiety Scale (Templer), and the Older Adults’ Reminiscence Styles Questionnaire (Amani et al.). The study questionnaires were administered in physical (paper-and-pencil) format. Then, using a controlled procedure, several elementary schools in Education District two of Kermanshah province were selected to identify eligible older adult grandparents residing in Kermanshah through the students. Comprehensive instructions for completing the questionnaires were provided to the parents and the older adult grandparents. Finally, the data obtained from the questionnaires were analyzed using the Pearson correlation coefficient and structural equation modeling (SEM) in SPSS version 26 and Amos version 24.
Results
To examine the assumption of normality for the research variables, skewness and kurtosis indices were used. Table 1 presents the descriptive indices of the research variables, along with skewness and kurtosis values. As shown in Table 1, the skewness and kurtosis values indicated an approximately normal distribution for all variables. Moreover, the results of the Pearson correlation matrix showed that death anxiety had significant negative relationships with secure attachment style (r = −0.485) and positive reminiscence
(r = −0.552). In contrast, death anxiety had significant positive relationships with ambivalent attachment style (r = 0.441), avoidant attachment style (r = 0.212), and negative reminiscence (r = 0.493). This means that higher levels of secure attachment and positive reminiscence were associated with lower levels of death anxiety. In addition, the findings indicated that positive reminiscence had a significant positive correlation with secure attachment style (r = 0.452). However, positive reminiscence had significant negative relationships with ambivalent attachment style (r = −0.499), avoidant attachment style (r = −0.144), and negative reminiscence (r = −0.487). Furthermore, tolerance coefficients and the variance inflation factor (VIF) indicated that the assumption of no multicollinearity was met. The assumption of independence of errors was examined using the Durbin–Watson test. The Durbin–Watson statistic was calculated as D-W = 2.21, which falls within the acceptable range of 1.5 to 2.5, indicating that this assumption was met. Therefore, the correlational prerequisites for conducting path analysis were satisfied.
The findings demonstrated that attachment styles, through the mediating role of positive reminiscence, played a role in explaining death anxiety. This was supported by the values of the Goodness of Fit Index (GFI = 0.901), Adjusted Goodness of Fit Index (AGFI = 0.911), Incremental Fit Index (IFI = 0.912), and Comparative Fit Index (CFI = 0.952), all of which were greater than 0.90. Moreover, in acceptable models, the ratio of chi-square to degrees of freedom (χ²/df) should fall within the range of 1 to 3; in the present model, the χ²/df ratio was 2.6, which falls within the acceptable range. Additionally, the Root Mean Square Error of Approximation (RMSEA) should be less than 0.09; in this model, it was calculated as 0.04, indicating that the model fit was favorable. Based on the results of bootstrapping, the indirect path from secure attachment to death anxiety through positive reminiscence was confirmed with a path coefficient of β = −0.18. This finding indicates that secure attachment, through increasing positive reminiscence, is associated with a reduction in death anxiety. Moreover, the indirect path from ambivalent attachment to death anxiety through positive reminiscence was confirmed with a path coefficient of β = 0.14. The indirect path from avoidant attachment to death anxiety through positive reminiscence was also confirmed with a path coefficient of β = 0.21. Therefore, insecure attachment styles were associated with higher death anxiety through the mediating role of positive reminiscence.
Conclusion
Secure individuals have a greater ability to coherently express and integrate their life memories, which ultimately leads to their acceptance of both positive and negative memories. Growing up with parents or caregivers who provided a safe environment allows these individuals to form internal working models of the world as a secure place. This, in turn, provides them with the opportunity to pass on their experiences to future generations through transmissive reminiscence. Thus, their high levels of positive reminiscence led them to value their relationships and perceive their lives as fruitful despite both positive and negative events, resulting in an absence of excessive death anxiety. On the other hand, ambivalent and avoidant individuals, who have experienced an environment characterized by contradictions and mixed messages from their caregivers, cannot construct well-formed narratives regarding their memories. They lack the ability to present coherent memories with a clear and distinct message; their narratives during reminiscence are sometimes contradictory and lack proper chronological pacing. This issue can lead to their reluctance to engage in narrative and transmissive reminiscence, which in turn is associated with death anxiety.
Ethical Consideration
Ethical Code
This study was approved by the Ethics Committee of Kermanshah University of Medical Sciences with the ethical code IR.KUMS.REC.1404.266.
Funding
This study received no external funding.
Authors’ Contributions
KH.M.: Project administration, supervision; P. N.: Software, formal analysis, writing - review & editing; P.J.: Writing-Review & editing; F.R.: Data curation; M. M.: Writing - Review & editing; K.J.: Data curation, writing-original draft
Conflict of Interest
The authors declare that there is no conflict of interest regarding the publication of this article.
Acknowledgments
The authors would like to express their appreciation to all older adults who participated in this study.
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