Women followed up
It was possible to continue to study 154 of women from the first
programme of study, an average of three years later.
The aim was to see how the women changed over the intervening years
in terms of their vulnerability, adverse experiences and disorder.
Also to examine recovery from disorder and positive experience.
follow-up selected women in three groups representing around half
the original series:Adult
(n=57) consisting of negative interaction with partner or child,Childhood
involving neglect or abuse before age 17,Comparison
a consecutive group of women. Good cooperation (80%) was achieved
for the women approached for re-interview. There were no differences
found between those followed-up and those not in terms of demographic
or risk characteristics which might suggest the follow-up sample
was skewed in some way.Demographic
characteristics, attachment style, support and self-esteem assessments
were undertaken at first interview together with measures of depression,
and these repeated at follow-up interview. Assessments reflected
change between time 1 and time 2. At first interview, around a third
of the women (35%) were working-class, over two thirds (67%) were
in employment, just over half were married or cohabiting (55%) and
most (76%) were mothers, with just under a third of the series (26%)
were single mothers at first interview. These rates were no different
from those in the larger series of 303 women. All women were interviewed
in their own homes at both waves of the study.
- Continuation of the Adult Life Phase Interview for new phases and adversities
- Attachment Style Interview and self-esteem repeated
focused particularly on attachment style. This involved testing
whether insecure attachment at first interview related to new onsets
of depression and anxiety at follow-up. This was confirmed, with
highly Fearful or Angry-dismissive styles in particular acting as
mediating factors with childhood experience of neglect and abuse
and new onset of disorder.Changes
in attachment style were also examined. There was high evidence
of stability of secure attachment style with 73% of women remaining
within broadly secure or insecure categories at both time points.
Such stability was higher in the comparison women (83%) than in
vulnerable women (60%). Although change occurred equally in a more
positive (more secure) or negative (less secure) directions (14%
versus 13%), negative change only occurred in comparison women (17%)
and positive change was twice as common in the vulnerable women
(20% versus 11%, p<.008). Highest stability was shown for Fearful
style (correlation at both times 0.44) and those Clearly Secure
sensitive marker of change in attachment style was also devised
using the same measure. In this scheme 53% of women showed small
degrees of change, again equally in a negative or positive direction.
This showed that positive changes in support predicted such positive
attachment style change, together with vulnerable status at first
contact. Negative attachment style change was associated with an
index of loss of employment status, negative change in non-partner
support or negative change in self-esteem. Changes in depression
had no impact on changes in attachment style.