Mentalization as a mediator between psychological well-being, attachment styles, and treatment adherence: a structural equations model among Iranians with type 2 diabetes

Abstract

Objectives: This study aims to explore the relationship between attachment styles, psychological well-being, and treatment adherence. Also, it examines the mediating role of mentalization in the connection between attachment, well-being, and adherence to treatment.Methods: This cross-sectional study included 230 diabetic patients aged 20 to 65 who sought treatment at the Isfahan endocrinology and metabolism clinics from July to October 2021. Demographic and clinical data were recorded. All participants completed Ryff’s Psychological Well-Being Questionnaire, Collins and Read Attachment Style Questionnaire, Mentalization Questionnaire (Ments), and Tobert's Self-Care Questionnaire. Data analysis was conducted using correlation and structural equation modeling methods.Results: A secure attachment style and psychological well-being were found to have a positive correlation with treatment adherence (p<0.05, T=4.32, p<0.05, T=2.79). Furthermore, mentalization was identified as a significant mediator in the relationship between psychological well-being, avoidant attachment style, and treatment adherence (p<0.05, T=4.38, p<0.05, T=2.05).Conclusion: The study highlights the significant mediating role of mentalization between treatment adherence, psychological well-being, and avoidant attachment. It emphasizes the potential of mentalization to improve treatment adherence, especially among individuals with an avoidant insecure attachment style.

Keywords

• type 2 diabetes
• psychological well-being
• attachment styles
• mentalization
• structural equations model