Attachment, emotion regulation and quality of life in women with a diagnosis of endometriosis: a cross-sectional study

Purpose Endometriosis, a prevalent gynecological condition, significantly impacts physical, psychological, and social well-being. This study explores the relationship between attachment styles, emotion regulation difficulties, and quality of life in women with endometriosis. Drawing on attachment theory, the study hypothesized that secure attachment would correlate with fewer emotion regulation difficulties and higher quality of life, while insecure attachment styles would correlate with greater difficulties and lower quality of life.

The study included 354 Italian women diagnosed with endometriosis. Participants completed the Relationship Questionnaire to assess attachment styles, the Difficulties in Emotion Regulation Scale—Short Form to evaluate emotion regulation, and the WHOQOL–BREF to measure quality of life. Data analysis employed structural equation modeling to examine the direct and indirect effects of attachment styles on quality of life, mediated by emotion regulation difficulties.

Results confirmed the hypotheses: secure attachment was associated with better emotion regulation and higher quality of life, whereas preoccupied and fearful attachment styles were linked to greater emotion regulation difficulties and lower quality of life. The dismissing attachment style did not show significant associations.

The findings underscore the importance of addressing emotion regulation in therapeutic interventions for women with endometriosis. Similar content being viewed by others Funding Open access funding provided by Università degli Studi di Cagliari within the CRUI-CARE Agreement. This research received no external funding. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest The authors declare no competing interest. Ethical approval The study was approved by the Ethics Committee of the University of Cagliari—Prot. n. 0230694 10/10/2023. Consent to participate Informed consent was obtained from all individual participants included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. About this article Cite this article Sechi, C., Ahmad, M., Guerriero, S. et al. Attachment, emotion regulation and quality of life in women with a diagnosis of endometriosis: a cross-sectional study. Arch Gynecol Obstet (2026). https://doi.org/10.1007/s00404-026-08512-1 Received: Accepted: Published: DOI: https://doi.org/10.1007/s00404-026-08512-1