Attachment security denotes the internal representations of self and others and corresponding beliefs about the availability and benefit of support from significant others.
Attachment avoidance means the tendency to be inflexibly self-reliant and uncomfortable with closeness and dependency.
Attachment anxiety refers to the tendency to fear the unavailability of significant others.

A recent study shows that:
• Attachment avoidance and attachment anxiety are both associated with less death preparation and less involvement in health care in patients with advanced disease.
• There is a small but consistent mediating effect of couple communication on the relationship of attachment security to death preparation.
• Women reported poorer couple communication with greater attachment anxiety, as well as better preparation for end of life with better communication.
• Younger and middle-aged men show increased preparation for end of life with better couple communication.
• Most mediating effects are conditionally specific to women.
• People with greater attachment avoidance or anxiety may be more reluctant to disclose or assert their needs.
• Younger patients report the least preparation for end of life, especially with poor couple communication at baseline.
• Older patients report the most preparation.
• Preparation for the end of life in younger patients, especially younger men, and women in general improved with better couple communication,

The study (cited in the reference) supports the importance of attachment security and couple communication in facilitating death preparation in advanced cancer. Attachment-informed couple-based interventions for patients with advanced cancer can facilitate constructive conversations about fears and concerns, and can support collaborative planning near the end of life, which may be especially beneficial to younger patients and to women with high attachment anxiety.

See reference for more information.

Adapted from Mah K et al. The impact of attachment security on death preparation in advanced cancer: The role of couple communication. Psycho-Oncology 2020: 1-8.