Gestational diabetes perception profiles based on attachment style: a cross-sectional study

Abstract

Aims: Gestational diabetes (GDM) is a prevalent complication in pregnancy that requires effective self-management, which can be influenced by illness perceptions. Moreover, behavioral regulation can be affected by attachment styles. Thus, our study aimed to identify common GDM perception profiles and test their association with attachment styles.

Methods: In this cross-sectional study, 446 women completed the Relationship Questionnaire (RQ), the Brief Illness Perception Questionnaire (BIPQ), and additional items about GDM diagnosis, information, competence, adherence, behavioral change. Latent profile analysis (LPA) was conducted to determine GDM perception profiles. Multinomial logistic regression followed to calculate the association between GDM perception profiles and attachment styles.

Results: Three distinct profiles emerged: coping (n = 172, 38.6%)-characterized by the most positive GDM perception, burdened (n = 222, 49.8%)-indicating the emotional burden of the disease, and resourceless (n = 52, 11.7%)-reporting lack of resources (i.e. information, competence). Women with insecure attachment styles were more likely to develop a burdened GDM perception profile. Specifically, the expression of a fearful (OR = 1.184 [95%CI: 1.03; 1.36], p = 0.016) and a preoccupied (OR = 1.154 [95%CI: 1.01; 1.32], p = 0.037) attachment style increased the likelihood for a burdened perception profile, while a secure attachment style (OR = 10.791 [95%CI: 0.65; 0.96], p = 0.017) decreased likelihood for developing resourceless GDM perception profile.

Conclusions: Three GDM perception profiles were identified and the role of attachment styles in shaping these perceptions was confirmed. Further studies are needed to investigate whether a tailored treatment approach based on the predominant attachment style could lead to more positive GDM perceptions, improved glycemic control, and better perinatal outcomes.

Keywords: Attachment styles; Disease burden; Gestational diabetes; Illness perception; Latent profile analysis.

Fig. 1

The GDM perceptions profiles characterized by their patterns (mean z-score) of the 14 illness perceptions, where a higher score represents more negative illness perception. Note. CON-Consequences (BIPQ1), TIME-Timeline (BIPQ2), PC-Personal Control (BIPQ3), TC-Treatment Control (BIPQ4), IDE-Identity (BIPQ5), CONC-Concern (BIPQ6), UND-Understanding (BIPQ7), ER-Emotional response (BIPQ8), INT-The intensity of emotions at diagnosis, HID-Hiding the diagnosis, INF-Information, COM-Competence, ADH-Adherence to recommendations, CE-Change effort