Adult Attachment, Loneliness, Covid-19 Risk Perception and Perceived Stress During Covid-19 Pandemic

Luca Rollè, Tommaso Trombetta, Carla Calabrese, Laura Vismara, Cristina Sechi


The Covid-19 pandemic has spread throughout the world, affecting the psychological well-being of individuals. Drawing on the attachment theory perspective, the present work sought to understand individual differences in response to the Covid-19 pandemic, analyzing the emotional and cognitive factors involved. A cross-sectional study was conducted to examine the complex relationship between attachment anxiety and avoidance, loneliness, Covid-19 risk perception, and perceived stress during the Covid-19 pandemic. Seven hundred sixty-one participants were involved. Data were analyzed using path analysis. Consistent with attachment theory, results showed a direct relationship between attachment anxiety and perceived stress during the Covid 19 pandemic, mediated in part by loneliness and Covid 19 risk perception. Similarly, attachment avoidance was directly related to perceived stress during the Covid-19 pandemic; this relationship was partially mediated by loneliness but not by Covid-19 risk perception. Our results demonstrate the influence of adult attachment on perceived stress during the Covid-19 pandemic through its effect on emotional and cognitive variables, providing useful information for implementing interventions to promote individual well-being during these times of health emergency.


Covid-19; Covid-19 risk perception; Perceived stress; Loneliness; Attachment.

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Anderson, C. A., & Arnoult, L. H. (1985). Attributional Style and Everyday Problems in Living: Depression, Loneliness, and Shyness. Social Cognition, 3(1), 16–35.

Arambasic, J., Sherman, K.A., Elder, E. (2019). Breast Cancer Network Australia. Attachment styles, self‐compassion, and psychological adjustment in long‐term breast cancer survivors. PsychoOncology. 28(5), 1134– 1141.

Aschwanden, D., Strickhouser, J. E., Sesker, A. A., Lee, J. H., Luchetti, M., Stephan, Y., Sutin, A.R., & Terracciano, A. (2020). Psychological and Behavioural Responses to Coronavirus Disease 2019: The Role of Personality. European Journal of Personality.

Berant, E., Mikulincer, M., & Florian, V. (2001a). The association of mothers’ attachment style and their psychological reactions to the diagnosis of infant’s congenital heart disease. Journal of Social and Clinical Psychology, 20(2), 208–232.

Berant, E., Mikulincer, M., & Florian, V. (2001b). Attachment style and mental health: A 1-year follow-up study of mothers of infants with congenital heart disease. Personality and Social Psychology Bulletin, 27(8), 956–968.

Berlin, L., Cassidy, J., & Belsky, J. (1995). Loneliness in Young Children and Infant-Mother Attachment: A Longitudinal Study. Merrill-Palmer Quarterly, 41(1), 91-103.

Birnbaum, G. E., Orr, I., Mikulincer, M., & Florian, V. (1997). When marriage breaks up: Does attachment style contribute to coping and mental health? Journal of Social and Personal Relationships, 14(5), 643–654.

Bowlby, J. (1969). Attachment and Loss, Vol. 1: Attachment. Attachment and Loss. New York: Basic Books.

Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (p. 46–76). The Guilford Press.

Brailovskaia, J., & Margraf, J. (2021). The relationship between burden caused by coronavirus (Covid-19), addictive social media use, sense of control and anxiety. Computers in Human Behavior, 119.

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395(10227), 912–920.

Brown, E. G., Gallagher, S., & Creaven, A. (2018). Loneliness and acute stress reactivity: A systematic review of psychophysiological studies. Psychophysiology, 55(5), 1–14.

Brugnera, A., Zarbo, C., Farina, B., Picardi, A., Greco, A., Lo Coco, G., Tasca, G.A., Carlucci, S., Auteri, A., Greco, F., & Compare, A. (2019). Psychometric properties of the Italian version of the Experience in Close Relationship Scale 12 (ECR-12): an exploratory structural equation modeling study. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(3).

Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging, 21(1), 140–151.

Caldwell, J.G., & Shaver, P. (2012). Exploring the cognitive-emotional pathways between adult attachment and ego- resiliency. Individual Differences Research, 10(3), 141-152.

Carr, S., Colthurst, K., Coyle, M., & Elliott, D. (2013). Attachment dimensions as predictors of mental health and psychosocial well-being in the transition to university. European Journal of Psychology of Education, 28(2), 157–172.

Cassidy, J., & Berlin, L. J. (1994). The Insecure/Ambivalent Pattern of Attachment: Theory and Research. Child Development, 65(4), 971

Charmandari, E., Kino, T., Souvatzoglou, E., & Chrousos, G. P. (2003). Pediatric stress: Hormonal mediators and human development. Hormone Research, 59, 161-179.

Cheng, C., & Cheung, M. W. L. (2005). Psychological Responses to Outbreak of Severe Acute Respiratory Syndrome: A Prospective, Multiple Time-Point Study. Journal of Personality, 73(1), 261–285.

Cohen, S. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health. (pp. 31–67). Sage Publications, Inc.

Creeden, K. (2004). The neurodevelopmental impact of early trauma and insecure attachment: Re-thinking our understanding and treatment of sexual behavior problems. Sexual Addiction & Compulsivity, 11, 223-247.

de Lima, C., Cândido, E. L., da Silva, J. A., Albuquerque, L. V., Soares, L. M., do Nascimento, M. M., de Oliveira, S. A., & Neto, M. (2020). Effects of quarantine on mental health of populations affected by Covid-19. Journal of affective disorders, 275, 253–254.

Dennis, A., Ogden, J., & Hepper, E. G. (2020). Evaluating the impact of a time orientation intervention on well-being during the covid-19 lockdown: Past, present or future? The Journal of Positive Psychology, 1-11.

Ditzen, B., Schmidt, S., Strauss, B., Nater, U. M., Ehlert, U., & Heinrichs, M. (2008). Adult attachment and social support interact to reduce psychological but not cortisol responses to stress. Journal of Psychosomatic Research, 64(5), 479–486.

Evanoff, B. A., Strickland, J. R., Dale, A. M., Hayibor, L., Page, E., Duncan, J. G., Kannampallil, T., & Gray, D. L. (2020). Work-Related and Personal Factors Associated with Mental Well-Being During the COVID-19 Response: Survey of Health Care and Other Workers. Journal of medical Internet research, 22(8), e21366.

Flesia, L., Monaro, M., Mazza, C., Fietta, V., Colicino, E., Segatto, B., & Roma, P. (2020). Predicting Perceived Stress Related to the Covid-19 Outbreak through Stable Psychological Traits and Machine Learning Models. Journal of Clinical Medicine, 9(10), 1-17.

Florian, V., & Mikulincer, M. (1998). Symbolic immortality and the management of the terror of death: The moderating role of attachment style. Journal of Personality and Social Psychology, 74(3), 725–734.

Folkman, S., & Lazarus, R. S. (1988). Coping as a mediator of emotion. Journal of Personality and Social Psychology, 54(3), 466-475.

Ford, R., M. (2011). The Relationship Between Adult Attachment Style and Stress Coping Skills to College Graduation. Walden Dissertations and Doctoral Studies. 1132.

Frazier, P., Keenan, N., Anders, S., Perera, S., Shallcross, S., & Hintz, S. (2011). Perceived past, present, and future control and adjustment to stressful life events. Journal of Personality and Social Psychology, 100(4), 749–765.

Gallagher, M. W., Bentley, K. H., & Barlow, D. H. (2014). Perceived control and vulnerability to anxiety disorders: A meta-analytic review. Cognitive Therapy and Research, 38(6), 571–584.

Garrido Rojas, L., Guzmán-González, M., & Rivera Ottenberger, D. (2016). Romantic attachment and adjustment to divorce and separation in a Chilean adult sample. Journal of Divorce & Remarriage, 57(8), 573–585.

Goodall, K., Trejnowska, A., & Darling, S. (2012). The relationship between dispositional mindfulness, attachment security and emotion regulation. Personality and Individual Differences, 52(5), 622–626.

Heinrich, L. M., & Gullone, E. (2006). The clinical significance of loneliness: A literature review. Clinical Psychology Review, 26(6), 695–718.

Huremović, D. (2019). Psychiatry of Pandemics: A Mental Health Response to Infection Outbreak. Springer, Cham.

Jin, L., & Wang, C. D. C. (2018). International students’ attachment and psychological well-being: the mediation role of mental toughness. Counselling Psychology Quarterly, 31(1), 59–78.

Kafetsios, K., & Sideridis, G. D. (2006). Attachment, Social Support and Well-being in Young and Older Adults. Journal of Health Psychology, 11(6), 863–875.

Killgore, W., Cloonan, S. A., Taylor, E. C., Miller, M. A., & Dailey, N. S. (2020). Three months of loneliness during the COVID-19 lockdown. Psychiatry research, 293, 113392.

Komasi, S., Soroush, A., Saeidi, M., Brugnera, A., Rabboni, M., Fulcheri, M., Carrozzino, D., Marchettini, P., & Compare, A. (2018). Subjective correlates of stress management in outpatient cardiac rehabilitation: the predictive role of perceived heart risk factors. Journal of cardiovascular and thoracic research, 10(2), 104–108.

Koole, S. L. (2009). The psychology of emotion regulation: An integrative review. Cognition and Emotion, 23(1), 4–41.

Lafontaine, M.-F., Brassard, A., Lussier, Y., Valois, P., Shaver, P. R., & Johnson, S. M. (2016). Selecting the best items for a short-form of the Experiences in Close Relationships questionnaire. European Journal of Psychological Assessment, 32(2), 140–154.

Lai, J., Ma, S., Wang, Y., et al. (2020). Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open, 3(3), e203976.

Lane, J. A., & Fink, R. S. (2015). Attachment, Social Support Satisfaction, and Well-Being During Life Transition in Emerging Adulthood. The Counseling Psychologist, 43(7), 1034–1058.

Lange, L. J., Fleming, R., & Toussaint, L. L. (2004). Risk Perceptions and Stress During the Threat of Explosion from a Railroad Accident. Social Behavior and Personality: An International Journal, 32(2), 117–127.

Larose, S., & Bernier, A. (2001). Social support processes: mediators of attachment state of mind and adjustment in late adolescence. Attachment & Human Development, 3(1), 96–120.

Lazarus, R. & Folkman, S. (1984). Stress appraisal and coping. Springer, New York, NY.

Liu, N., Zhang, F., Wei, C., Jia, Y., Shang, Z., Sun, L., Wu, L., Sun, Z., Zhou, Y., Wang, Y., Liu, W. (2020). Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Research, 287, 112921.

Liu, Q.Q., Yang, X.J., Zhu, X.W, & Zhang, D.J. (2019). Attachment anxiety, loneliness, rumination and mobile phone dependence: A cross-sectional analysis of a moderated mediation model. Current Psychology.

López-Vázquez, E. (2001). Risk perception interactions in stress and coping facing extreme risks Environmental Management and Health, 12(2), 122-133.

López-Vázquez, E. & Marván, M. (2003). Risk perception, stress and coping strategies in two catastrophe risk situations. Social Behavior and Personality: an international journal. 31(1), 61-70.

Lopez, F. G., & Brennan, K. A. (2000). Dynamic processes underlying adult attachment organization: Toward an attachment theoretical perspective on the healthy and effective self. Journal of Counseling Psychology, 47(3), 283–300.

Lozano, E. B., & Fraley, R. C. (2020). Put your mask on first to help others: Attachment and sentinel behavior during the covid-19 pandemic. Personality and Individual Differences, 110487.

Man, K., & Hamid, P. N. (1998). The relationship between attachment prototypes, self-esteem, loneliness and causal attributions in Chinese trainee teachers. Personality and Individual Differences, 24(3), 357–371.

Marsa, F., O’Reilly, G., Carr, A., Murphy, P., O’Sullivan, M., Cotter, A., & Hevey, D. (2004). Attachment Styles and Psychological Profiles of Child Sex Offenders in Ireland. Journal of Interpersonal Violence, 19(2), 228–251.

Maunder, R. G., Lancee, W. J., Hunter, J. J., Greenberg, G. R., & Steinhart, A. H. (2005). Attachment insecurity moderates the relationship between disease activity and depressive symptoms in ulcerative colitis. Inflammatory bowel diseases, 11(10), 919–926.

Maunder, R. G., Lancee, W. J., Nolan, R. P., Hunter, J. J., & Tannenbaum, D. W. (2006). The relationship of attachment insecurity to subjective stress and autonomic function during standardized acute stress in healthy adults. Journal of psychosomatic research, 60(3), 283–290.

McGinty, E. E., Presskreischer, R., Han, H., & Barry, C. L. (2020). Psychological distress and loneliness reported by US adults in 2018 and April 2020. JAMA: Journal of the American Medical Association, 324(1), 93–94.

Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. Guilford Press.

Mikulincer, M., & Shaver, P. R. (2014). An attachment perspective on loneliness. In R. J. Coplan & J. C. Bowker (Eds.), The handbook of solitude: Psychological perspectives on social isolation, social withdrawal, and being alone. (pp. 34–50). Wiley Blackwell.

Mikulincer, M., & Shaver, P.R. (2016). Adult Attachment and Emotion Regulation. In Cassidy, J., Shaver, P.R. (2016). Handbook of Attachment. Theory, Research and Clinical Applications. Third Edition (pp. 507-533). The Guildford Press.

Mikulincer, M., Florian, V., & Tolmacz, R. (1990). Attachment styles and fear of personal death: A case study of affect regulation. Journal of Personality and Social Psychology, 58(2), 273–280.

Mikulincer, M., Shaver, P.R. & Pereg, D. (2003). Attachment Theory and Affect Regulation: The Dynamics, Development, and Cognitive Consequences of Attachment-Related Strategies. Motivation and Emotion 27(2), 77–102.

Moccia, L., Janiri, D., Pepe, M., Dattoli, L., Molinaro, M., De Martin, V., Chieffo, D., Janiri, L., Fiorillo, A., Sani, G., Di Nicola, M. (2020). Affective temperament, attachment style, and the psychological impact of the COVID-19 outbreak: an early report on the Italian general population. Brain, Behavior, and Immunity, 87, 75–79.

Mondo, M., Sechi, C. & Cabras, C. (2019). Psychometric evaluation of three versions of the Italian Perceived Stress Scale. Current Psychology.

Myles, L.A.M. (2021). Using Prediction Error to Account for the Pervasiveness of Mood Congruent Thoughts. Mediterranean journal of Clinical Psychology, 9(2).

Myles, L.A.M., Connolly, J., Stanulewiz, N. (2020). The Mediating Role of Perceived Control and Desire for Control in the Relationship between Personality and Depressive Symptomology. Mediterranean Journal of Clinical Psychology, 8(3).

Myles, L. A. M., Merlo, E. M., & Obele, A. (2021). Desire for Control Moderates the Relationship between Perceived Control and Depressive Symptomology. Journal of Mind and Medical Sciences, 8(2), 299-305. 10.22543/7674.82.P299305

Okruszek Ł., Aniszewska-Stańczuk A., Piejka A., Wiśniewska M., & Żurek K. (2020). Safe but Lonely? Loneliness, Anxiety, and Depression Symptoms and COVID-19. Frontiers in Psychology, 11:579181.

Pallini, S., Chirumbolo, A., Morelli, M., Baiocco, R., Laghi, F., & Eisenberg, N. (2018). The relation of attachment security status to effortful self-regulation: A meta-analysis. Psychological Bulletin, 144(5), 501–531.

Pascuzzo, K., Cyr, C., & Moss, E. (2013). Longitudinal association between adolescent attachment, adult romantic attachment, and emotion regulation strategies. Attachment & human development, 15(1), 83–103.

Patrick, S. W., Henkhaus, L. E., Zickafoose, J. S., Lovell, K., Halvorson, A., Loch, S., Letterie, M., & Davis, M. M. (2020). Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey. Pediatrics, 146(4), e2020016824.

Porcelli, P. (2020). Fear, anxiety and health-related consequences after the COVID-19 epidemic. Clinical Neuropsychiatry, 17(2), 103-111. CN2020021

Powers, S. I., Pietromonaco, P. R., Gunlicks, M., & Sayer, A. (2006). Dating couples' attachment styles and patterns of cortisol reactivity and recovery in response to a relationship conflict. Journal of Personality and Social Psychology, 90(4), 613–628.

Riskind, J. H., Williams, N. L., Gessner, T. L., Chrosniak, L. D., & Cortina, J. M. (2000). The looming maladaptive style: Anxiety, danger, and schematic processing. Journal of Personality and Social Psychology, 79(5), 837–852.

Russell, D. W. (1996). UCLA Loneliness Scale (Version 3): Reliability, Validity, and Factor Structure. Journal of Personality Assessment, 66(1), 20-40.

Schimmenti, A., Billieux, J., Starcevic, V. (2020). The four horsemen of fear: An integrated model of understanding fear experiences during the COVID-19 pandemic. Clinical Neuropsychiatry, 17(2), 41-45.

Shaver, P. R., & Hazan, C. (1993). Adult romantic attachment: Theory and evidence. In D. Perlman & W. Jones (Eds.), Advances in personal relationships (Vol. 4, pp. 29-70). London: Jessica Kingsley.

Sockalingam, S., Wnuk, S., Strimas, R., Hawa, R., & Okrainec, A. (2011). The Association between Attachment Avoidance and Quality of Life in Bariatric Surgery Candidates. Obesity Facts, 4(6), 456–460.

Spence, R., Jacobs, C., & Bifulco, A. (2020). Attachment style, loneliness and depression in older age women. Aging and Mental Health, 24(5), 837-839.

Steptoe, A., Owen, N., Kunz-Ebrecht, S. R., & Brydon, L. (2004). Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Psychoneuroendocrinology, 29(5), 593–611.

Taubman-Ben-Ari, O., & Ben-Yaakov, O. (2020). Distress and apprehension among new parents during the COVID-19 pandemic: The contribution of personal resources. American Journal of Orthopsychiatry, 90(6), 810–816.

VanderWeele, T. J., Hawkley, L. C., & Cacioppo, J. T. (2012). On the Reciprocal Association Between Loneliness and Subjective Well-being. American Journal of Epidemiology, 176(9), 777–784.

Victor, C. R., & Yang, K. (2012). The Prevalence of Loneliness Among Adults: A Case Study of the United Kingdom. The Journal of Psychology, 146(1-2), 85–104.

Vowels, L. M., & Carnelley, K. B. (2020). Attachment styles, negotiation of goal conflict, and perceived partner support during covid-19. Personality and Individual Differences, 110505.

Wagerman, S. A., Bedikian, A., & Ross, B. S. (2020). Psychodynamic and sociopolitical predictors of covid distress and gravity. Personality and Individual Differences, 110506.

Wang, C. D. C., King, M. L., & Debernardi, N. R. (2012). Adult attachment, cognitive appraisal, and university students’ reactions to romantic infidelity. Journal of College Counseling, 15(2), 101–116.

Wei, M., Russell, D. W., & Zakalik, R. A. (2005). Adult Attachment, Social Self-Efficacy, Self-Disclosure, Loneliness, and Subsequent Depression for Freshman College Students: A Longitudinal Study. Journal of Counseling Psychology, 52(4), 602–614.

Williams, N. L., & Riskind, J. H. (2004). Adult Romantic Attachment and Cognitive Vulnerabilities to Anxiety and Depression: Examining the Interpersonal Basis of Vulnerability Models. Journal of Cognitive Psychotherapy, 18(1), 7–24.

Wiseman, H., Mayseless, O., & Sharabany, R. (2006). Why are they lonely? Perceived quality of early relationships with parents, attachment, personality predispositions and loneliness in first-year university students. Personality and Individual Differences, 40(2), 237–248.

WHO coronavirus disease (COVID-19) dashboard. (2020, December 16th). World Health Organization (2020).

Xiang, Y.-T. et al., 2020. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry, 7(3), pp.228–229.

Zhou, X., & Yao, B. (2020). Social support and acute stress symptoms (ASSs) during the COVID-19 outbreak: Deciphering the roles of psychological needs and sense of control. European Journal of Psychotraumatology, 11(1).



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