
Postgraduate Student at the Department of Pedagogy and Medical Psychology, Institute of Psychological and Social Work, Sechenov First Moscow State Medical University
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Death-Related Fears and Attachment Style in Children with Congenital Heart DiseaseTheoretical and Experimental Psychology 2026. 1. p.135-153read more87
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Background. Death anxiety have a significant impact on an individual's psychological well-being. The specifics of these experiences depend on age, type of attachment, health status, and other factors. At the same time, the relationship between death-related fears and the type of attachment in children with congenital heart disease and children without cardiac pathologies has not been sufficiently studied.
Objectives. To study the role of attachment style as a factor determining the severity of fears associated with death in children with congenital heart disease and without cardiac pathologies.
Study Participants. 83 children aged 7–10 years were interviewed, 32 of them were diagnosed with Congenital heart disease (CHD) and were hospitalized (Mage = 8.63; SD = 1.129), 51 children had no cardiac pathology (Mage = 8.73; SD = 0.94).
Methods. Attachment style was assessed using a questionnaire on attachment to the mother in primary school age (E. Pupyreva). Understanding of death and death-related fears were assessed by means of "Tell a Story" (G. Makhortova) — Story No. 4 ("Death") and "Fears in Houses" (A.I. Zaharov, M.A. Panfilova) methodology. The statistical analysis was performed using the Kolmogorov-Smirnov test, Pearson's chi-square test, Fisher's exact test, Student's t-test, nonparametric Mann — Whitney U test, and Spearman correlation.
Results. The correlations between death-related fears and attachment style in children with and without CHD have been identified. Both groups turned to be similar in terms of attachment styles and understanding of death. For children with heart disease, there were no correlation between attachment styles and death-related fears. In healthy children, anxiety-ambivalent attachment correlated with more pronounced death-related fears, while avoidant attachment — with less intense death-related fears.
Conclusions. The experience of death-related fears in children with CHD is determined by specific factors of the disease, and not by the type of child-parent attachment.
Keywords: death anxiety; attitude towards death; attachment style; primary school age; congenital heart disease
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