The mediating role of psychological resilience between adult attachment and prenatal depression among women in early pregnancy

Background Adult attachment is a stable and long-lasting emotional bond formed during childhood, and in the face of a series of psychophysiological changes brought about by pregnancy, different attachment types may develop different coping strategies through their internal working models, and insecure attachment types may favor negative coping styles and induce psychological problems such as depression. Thus, prenatal depression, adult attachment, and psychological resilience are interrelated, but the specific links have not been empirically tested. The purpose of this study was to investigate the differences between psychological resilience and the degree of prenatal depression across attachment types, and the effects of psychological resilience and adult attachment on prenatal depression; Methods Pregnant women in early pregnancy who were enrolled in an outpatient clinic of a tertiary hospital in Chongqing, China, from June 2023 to January 2024 were selected using a simple sampling method, and basic information about the participants was collected. Adult attachment, psychological resilience, and prenatal depression were assessed and measured using the AAS, CD-RISC, and PHQ-9 scales, respectively. Comparison of differences between groups included ANOVA and t-test. Spearman correlation was performed, mediation effect test was performed using PROCESS and Bootstrap method in SPSS26.0; Results A total of 857 cases of valid data were obtained. Among them, the detection rate of prenatal depression was 9.92%, the spearman correlation results were significant and insecure adult attachment was a positive predictor of prenatal depression while psychological resilience was a negative predictor of prenatal depression (both p < 0.01). Psychological elasticity had a significant mediating effect of adult attachment on prenatal depression (p < 0.001), and the mediating effect accounted for 41.64% of the total effect; Conclusions The type of adult attachment not only directly affects women's depression in early pregnancy, but also indirectly affects prenatal depression through psychological resilience. Clinicians can screen women's adult attachment type in early pregnancy and individualize the intervention to improve psychological resilience in order to reduce the risk of depressive mood.