Influence of attachment on experiential acceptance and the mediating role of distress tolerance

Influence of attachment on experiential acceptance and the mediating role of distress tolerance | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Influence of attachment on experiential acceptance and the mediating role of distress tolerance Julie RIBEYRON, Nathalie DURIEZ, Rebecca Shankland This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7601393/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background: Acceptance is an emotion regulation strategy based on openness to internal experiences, without modifying or avoiding them. It is considered adaptive, balanced and associated with better mental health. Attachment security promotes adaptive strategies, whilst insecurity seems to be linked to maladaptive strategies. Similarly, distress tolerance, the ability to cope with difficult internal experiences, appears to be associated with more adaptive strategies. A better understanding of the role of attachment could therefore shed light on its effects on acceptance capacities and allow interventions to be adjusted accordingly. This study assesses the influence of attachment on acceptance and tests the mediating role of distress tolerance. Methods: Measures of attachment (RSQ), acceptance (MPFI), and distress tolerance (DTS) were completed by 330 adults. Simple and hierarchical regressions identified predictive dimensions, and mediations examined indirect links via distress tolerance. Results: The dimensions of anxiety and attachment avoidance were negatively associated with acceptance (adjusted R² = .07 and .13). Hierarchical regression showed that avoidance is the strongest predictor (β = −0.31) compared to anxiety (β = −0.15), with the model explaining 15% of the variance in acceptance (p < .001). Distress tolerance partially mediated these relationships (anxiety: β = −0.13; avoidance: β = −0.16). Conclusion: These results confirm the importance of attachment in acceptance: both dimensions of insecurity (anxiety and avoidance) are associated with decreased acceptance. The ability to open up to internal experiences seems more difficult in cases of attachment insecurity, especially regarding the avoidance dimension. This highlights the value of tailoring acceptance-based interventions (e.g., MBCT, MBSR, ACT) to differing attachment styles, incorporating targeted reinforcement of distress tolerance to support the development of acceptance in individuals with higher levels of insecurity. Attachment acceptance distress tolerance emotion regulation Background Emotional regulation Emotion regulation is recognized as a transdiagnostic process underlying psychopathology ( 1 ) and numerous studies have highlighted the central role of ER in the development and maintenance of psychopathological disorders (for review 2). ER refers to a set of physiological, cognitive, or behavioral processes through which individuals tend to modulate the nature and intensity of their emotions ( 3 ). More specifically, it refers to "the processes by which individuals influence the emotions they feel, the timing of these emotions, and the way they experience and express these emotions" ( 4 ). ER can be implemented through various strategies, which can be adaptive or maladaptive. It has been shown that maladaptive ER strategies, such as distraction, behavioral avoidance, suppression of emotional expression, substance use or rumination, are associated with increased levels of psychopathology. In contrast, adaptive strategies, such as acceptance, cognitive reappraisal, emotional expression, and problem solving, are correlated with better mental health ( 5 ). Nevertheless, this classification in adaptive and maladaptive strategies appears unsatisfactory, insofar as the adaptation of a strategy does not depend solely on its nature, but also on the context in which it is implemented. More recently, an empirical classification of ER strategies has been proposed based on a meta-analysis ( 6 ), according to their underlying structure in relation to the degree of emotional engagement. In this classification, adaptive emotional engagement strategies include approach strategies (e.g., acceptance, reevaluation, mindfulness), and contrast with disengagement strategies, which correspond in attempts to avoid or escape one's own emotions (e.g., avoidance, expressive suppression), and cognitive perseveration strategies, which consist in adopting rumination or worry strategies. People with higher symptoms of emotional disorders frequently use disengagement and perseveration strategies and rarely use engagement strategies ( 5 ). Acceptance Among adaptive and engagement strategies, acceptance is an emotion regulation strategy that involves opening oneself to one's own internal experience without seeking to change or avoid it. Thus, acceptance differs from other emotion regulation strategies (e.g., cognitive reappraisal, rumination, distraction, etc.) that rely on some form of active modification of an emotional state in terms of the quality, intensity, duration, or frequency of the emotion ( 7 ). Nevertheless, it is well regarded as an emotion regulation strategy. Acceptance is an adaptive and balanced strategy ( 5 , 8 , 9 ), linked to better mental health ( 10 ). Furthermore, acceptance of internal experiences is a key mechanism in mindfulness-based cognitive and behavioral therapies (mindfulness and acceptance-based interventions, MABIs). These interventions include the mindfulness-based stress reduction program (MBSR, 11), mindfulness-based cognitive therapy (MBCT, 12), acceptance and commitment therapy (ACT, 9), and dialectical behavioural therapy (DBT, 13). Acceptance is therefore targeted and developed in these approaches and appears to be the main process underlying their effectiveness ( 14 ). Systematic reviews have demonstrated the positive impact of MBI on reducing symptoms in anxiety disorders ( 15 , 16 ), depressive disorders ( 17 ), sleep disorders ( 18 ), stress ( 19 ), post-traumatic stress disorder ( 20 ), eating disorders ( 21 ), substance and behavioral addictions (e.g., 22,23), and psychotic disorders ( 24 , 25 ). Thus, acceptance appears to be a fundamental strategy for emotional regulation and a central process in mental health. Recently, it has been highlighted that the effectiveness of emotional regulation depends not only on the type of strategy used, but also on the interaction between the characteristics of the situation and the individual traits of the person regulating their emotions ( 7 , 26 – 28 ). Similarly, it appears that a dispositional potential differs from one individual to another (e.g., 29–31) particularly due to capacities such as distress tolerance ( 6 ) or attachment style ( 32 ). Thus, it is likely that these dispositions influence the capacity for acceptance as an ER strategy. Attachment Attachment theory ( 33 – 35 ) has long posited that early relationships with attachment figures play a central role in structuring emotional regulation throughout life, through working models. Individuals with secure attachment are more confident in their ability to cope with distressing situations and use more adaptive emotional regulation strategies (e.g., problem solving, cognitive reappraisal). In contrast, individuals with insecure attachment tend to resort to maladaptive, unstable, and inadequate strategies, limiting their ability to effectively regulate emotions in response to stress ( 32 ). Insecure attachment is also considered a risk factor for mental disorders ( 36 – 41 ) and thus plays a role in well-being ( 42 – 44 ). Disturbances in the sense of attachment security lead to the development of secondary attachment strategies ( 45 ), namely anxiety and avoidance. Attachment anxiety is characterized by fear that others will not be available when needed, as well as anxious seeking of support and love, while attachment avoidance reflects distrust of others' intentions and a tendency toward self-reliance ( 32 ). These secondary strategies are initially adaptive during development, in that they allow the child to adjust to their attachment figures' shortcomings. However, they become maladaptive in adulthood when they crystallize into a rigid and systematic relational pattern. This is especially true since these insecure attachment strategies encourage repeated activation and suppression of negative emotions, while maintaining a constant reliance on distorted mental representations of oneself and others, which contributes to poor physical and mental health ( 46 ). In addition, hyperactivation of the attachment system, associated with attachment anxiety, and deactivation of the attachment system, linked to attachment avoidance, are key elements in understanding individual differences in emotional regulation ( 32 , 46 ). Indeed, individuals with avoidant attachment styles regulate their emotions by blocking or inhibiting their emotional states, while those with anxious attachment styles hyperactivate them by intensifying them. Avoidant attachment favors strategies of suppression, cognitive distancing, and emotional disengagement. Conversely, anxious attachment favors strategies such as rumination, characterized by an excessive focus on distress ( 32 ). Attachment in adulthood is generally conceptualized through two complementary theoretical models. First, Bartholomew and Horowitz's ( 47 ) four-dimensional model is based on the image that individuals develop off themselves (positive or negative) and off others. This model distinguishes four attachment styles or prototypes: Secure attachment is based on a positive view of oneself and others, promoting balanced relationships. The preoccupied attachment style incorporates a negative view of oneself and a positive view of others, leading to a fear of abandonment and relational dependence. The detached style is based on a positive view of oneself and a negative view of others, resulting in emotional reserve and a preference for independence. Finally, the fearful style is based on a negative view of oneself and others, leading to emotional instability and ambivalence towards intimacy. Another empirically validated model is the two-dimensional model ( 48 ), which is based on two main dimensions. Anxiety is characterized by a fear of rejection and hyperactivation of the attachment system associated with the preoccupied style, whereas avoidance, reflects emotional reserve in the face of intimacy and deactivation of the attachment system associated with detached and fearful styles. The two-dimensional model offers a more dynamic representation of attachment strategies by integrating the mechanisms of deactivation and hyperactivation of the attachment system described by Mikulincer and Shaver ( 46 ). In this framework, secure attachment is characterized by an absence of anxiety and avoidance, promoting adaptive emotional regulation and balanced interpersonal relationships. Recently, the results of a longitudinal study ( 49 ), exploring data collected over 40 years ( 50 ), confirmed these theoretical assumptions by showing the association between attachment style in childhood and the use of specific emotional regulation strategies in adulthood. Girme et al. ( 49 ) integrated Naragon-Gainey's classification of strategies ( 6 ) with those of attachment to propose a single model, matching emotional regulation strategies with attachment strategies, suggesting that each category of strategy is based on different attachment profiles and therefore on distinct developmental bases ( 49 ). In their study, they refer to the three attachment strategies identified in children( 45 , 51 ), which evolve in adulthood into three distinct profiles, namely security, anxiety, and attachment avoidance. Secure attachment promotes co-regulation strategies and involves seeking closeness with loved ones and engaging in problem solving. Anxious attachment promotes hyperarousal strategies involving amplified negative emotional expressions and dependence on loved ones. Finally, attachment avoidance promotes deactivation strategies that consist of suppressing or minimizing negative emotions to limit the anticipated suffering associated with dependence on loved ones ( 52 , 53 ). Thus, in Girme's model ( 49 ), which incorporates Naragon-Gainey's model ( 6 ), secure attachment is linked to engagement strategies, avoidant attachment to disengagement and emotion dysregulation strategies, and anxious attachment to cognitive perseveration and hyperarousal strategies. Distress tolerance Similarly, distress tolerance, defined as the ability to tolerate unpleasant internal events ( 54 ), is another central dispositional capacity in the ability to regulate emotions and appears to be associated with higher levels of acceptance and less use of maladaptive strategies such as cognitive perseveration ( 6 ). Low distress tolerance is associated with difficulties in regulating emotions ( 55 – 57 ) and leads to the development and maintenance of psychopathology ( 13 , 58 , 59 ). It is also a risk factor for anxiety ( 60 ), problematic behaviors associated with borderline personality disorder ( 13 ) and the development and maintenance of eating disorders ( 61 ). Objectives and hypotheses The main objective of this study was to examine the influence of attachment on acceptance. More specifically, we expected that insecure dimensions (anxiety and avoidance) would be associated with lower acceptance, and that security would be associated with greater acceptance. The secondary objective of this study was to assess the role of distress tolerance in this relationship. We hypothesized that distress tolerance would mediate the relationship between attachment dimensions and acceptance, partially explaining why attachment facilitates (secure) or hinders (insecure) the capacity for acceptance. We attested the moderating role of distress tolerance in the strength of the relationship between attachment dimensions and acceptance. Thus, clarifying the impact of attachment dimensions could enrich our understanding of the process and refine acceptance-based interventions. Similarly, a better understanding of the role of distress tolerance could allow us to target this process upstream or parallel with approaches aimed at developing acceptance, while providing a better understanding of the mechanisms underlying this ER strategy. Methodology Participants and procedure The non-clinical sample consisted of N = 330 adults (283 women (85.76%), 46 men (13.94%) and 1 unspecified (0.3%) from the French-speaking general population. Participants were aged between 20 and 75 (mean age = 42.86 years, median = 43 years, standard deviation = 11.31); 238 lived with a partner, 92 were single. And 54.85% had a high level of education (master's degree or higher), 283 were professionally active adults (See Table 1 ). Using G*Power ( 62 , 63 ), using the F test – Linear Multiple Regression: Fixed model tab, R² increase, and setting a statistical power of 0.80, an alpha risk of 0.01 (corresponding to the Bonferroni correction applied to five tests: 0.05/5), and an average effect size of f²= 0.15, the minimum number of participants required is estimated at 127. The sensitivity analysis, performed using the same tab, indicates that with a power of 0.80, an alpha risk of 0.0125, and a sample of 127 participants, it is possible to detect an effect size of f²= 0.15 (corresponding to d ≈ 0.77), if it exists. The minimum effect size sought (f ²= 0.15) was chosen because an effect size greater than d = 0.50 is considered medium ( 64 ). The study protocol was approved by the local ethics committee of Paris 8 university (protocol #CE-P8-2021-07) on April 21, 2021. All participants gave their free and informed consent in writing prior to data collection. This study complied with ethical standards, in accordance with the 1989 revised Helsinki Declaration and the American Psychology Association, regarding respect for private data, anonymization, free and informed consent, and the right of participants to withdraw from the research at any time. Following a wide call for participants via the co-authors social media accounts (LinkedIn, Facebook, Twitter), and their respective universities in France, the online questionnaires were completed anonymously via Limesurvey ( 65 ). Participants were French-speaking adults (i.e., 18 years of age or older) who participated on a voluntary basis and without compensation. The objective of the study, as communicated to participants, was to better understand relationships and emotions. Table 1 Characteristics of the studied variables DTS MPFI Acceptance ANXIETY model AVOIDANCE model N 330 330 330 330 Alpha Cronbach .83 .92 .80 .68 Mean 2.89 3.92 2.43 2.75 Standard deviation 1.00 1.07 1.00 0.68 Minimum 1.00 1.60 1.00 1.25 Maximum 5.00 6.00 5.00 4.63 Skewness -0.06 0.02 0.43 0.11 SE skewness 0.13 0.13 0.13 0.13 Kurtosis -0.75 -0.79 -0.72 -0.36 SE kurtosis 0.27 0.27 0.27 0.27 Measures Acceptance Acceptance was assessed using the acceptance subscale of the Multidimensional Psychological Flexibility Inventory (MPFI; 66) in its French version ( 67 ). It comprises five self-administered items (e.g., = "I was open to all my emotions, both pleasant and unpleasant," "When I had a disturbing thought or emotion, I tried to welcome it rather than ignore it ") rated on a 6-point Likert scale (from 1 "never true" to 6 "= ly true"). A high score indicates a high level of acceptance. The scale demonstrated excellent internal consistency in our study (Cronbach's α = .92) and in the original validation study (Cronbach's α = .80 to .96) ( 66 ). Attachment Attachment dimensions were assessed using the Relationship Style Questionnaire (RSQ; 68) for the French translation ( 69 ). This is a self-report questionnaire comprising 30 items rated on a 5-point Likert scale (from 1 = not at all like me to 5 = completely like me). The RSQ was designed as a comprehensive tool, combining items from several commonly used measures for assessing attachment in adults, allowing researchers to use different conceptualizations. Thus, the RSQ scoring has been the subject of several proposals, and that of Bartholomew and Horowitz ( 47 ), which yielded scores for four prototypes (detached, secure, preoccupied, and fearful), although these are not intended to be categorical but rather dimensional. However, validity is low, with Griffin and Bartholomew ( 68 ) finding internal consistency coefficients for the subscales ranging from 0.41 to 0.71. A two-dimensional model has also been suggested by the authors based on the dimensions of the prototypes: the self and others model, renamed avoidance and anxiety by Mikulincer & Shaver ( 70 ). Another rating proposal is based on the dimensions of anxiety and avoidance, for which we will use the rating by Simpson et al. ( 71 ) recognized by Kurdek ( 72 ) as having the best validity. It is based on the perspective of Brennan et al. ( 73 ) according to which attachment styles are best represented by the degree to which a person avoids closeness with others (avoidance) and worries about being unloved or abandoned (anxiety). The anxiety dimension is assessed through five items ( 11 , 18 , 21 , 23 , 25 ) and the avoidance dimension through eight items ( 10 , 12 , 13 , 15 , 20 , 24 , 29 , 30 ). In our study, this model showed very good internal consistency for anxiety (Cronbach's α = .80) and acceptable consistency for avoidance (α = .68), as in other studies. Distress tolerance Distress tolerance was assessed using the short version ( 74 ) of the Distress Tolerance Scale in its French version (DTS; 75) was used to assess distress tolerance. The DTS-SF is a self-administered questionnaire consisting of four items (e.g., " Being tormented or upset is always a major ordeal for me "), rated on a 5-point Likert scale (from 1 = strongly agree to 5 = strongly disagree). The DTS-SF is a shortened version of the original Distress Tolerance Scale ( 76 ) containing the item with the highest factor loading from each subscale (tolerance, evaluation, regulation, and absorption), thus forming a single factor of distress tolerance. A high overall score indicates high distress tolerance. This scale showed good internal consistency in our study (Cronbach's α = .83) as well as in a previous study ( 74 ) (Cronbach's α = .81). Results Before conducting the main analyses, assumptions of homogeneity of variances and normality of distributions were examined in accordance with statistical recommendations for parametric analyses ( 77 ). The normality of the distribution residuals was assessed using the Kolmogorov-Smirnov (KS) test, recommended for large samples (N > 300 Razali & Wah, 2011). The results indicate that all variables comply with the normality assumption (ps > .05), suggesting that the distribution residuals do not show any major deviation. The homogeneity of variances was assessed using Levene's and Bartlett's tests for each of the main variables. All variables comply with this assumption (ps > .05). These results confirm that the conditions for applying parametric analyses (linear regressions) are met. Correlations and regressions In order to explore the relationships between attachment and acceptance in greater detail, we conducted correlation and linear regression analyses. Correlations between the two dimensions of attachment and acceptance The correlation analysis indicated a significant negative association between acceptance and attachment anxiety (r = -0.26, p < .001, 95% CI [-0.36, -0.16]) as well as attachment avoidance (r = -0.36, p < .001, 95% CI [-0.27, -0.45]). These findings suggest that acceptance is negatively related to attachment insecurity: individuals with higher levels of attachment anxiety or avoidance appear to have fewer resources to engage in the process of accepting emotions. Linear regression analysis between attachment and acceptance Simple linear regression analyses were conducted to examine the effect of attachment on emotional acceptance. Attachment anxiety and avoidance are significantly associated with lower acceptance (adjusted R² = .07 and .13, respectively), with negative coefficients for anxiety (β= − .26, 95% CI [-.37, − .16], p < .001) and for avoidance (β= − .36, 95% CI [-.46, − .26], p < .001). These results suggest that anxiety or avoidance insecurity leads to greater difficulties in acceptance. Hierarchical multiple linear regression analyses were conducted to examine the effect of attachment on emotional acceptance (See Table 2 ). A hierarchical linear regression was performed to examine the unique contribution of each attachment dimension (anxiety, avoidance) in predicting acceptance. The final model is significant (F(2, 327) = 29.19, p < .001) and explains 15% of the variance in acceptance (R 2 adjusted = .15), indicating a moderate contribution of attachment dimensions. The anxiety dimension was first introduced (model 1) and explains 7% of the variance in acceptance, which is a significant proportion (R 2 adjusted = 0.07, F(1, 328) = 24.41, p < .001). The addition of the avoidance dimension (model 2) increased the explained variance of acceptance (15%) (ΔR² = 0.08, F(1, 327) = 31.70, p < .001) and improved the quality of the model. Multiple regression analysis revealed that both dimensions (anxiety and avoidance) are significantly associated with decreased acceptance, as measured by the MPFI. However, attachment avoidance appears to be a stronger predictor (β = −0.31, 95% CI [− 0.42; −0.20]) than anxiety (β = −0.15, 95% CI [− 0.26; −0.04]). These results suggest that insecure attachment, and particularly avoidance, hinders the ability to accept emotional experiences. Table 2 Multiple hierarchical regressions of attachment dimensions Predictor / model β (standardized) IC 95% t p-value Adjusted R² ∆R² F ∆F p-value Intercept. 5.65 [] 24.07 < .001 Anxiety -0.15 [-0.26, -0.04] 2.74 0.007 Avoidance -0.31 [− 0.42, − 0.20] -5.63 < .001 Model 1 - Anxiety 0.07 – 24.41 – < .001 Model 2 - Avoidance 0.15 0.08 29.19 31.70 < .001 Note . β = standardized beta coefficient; 95% CI = 95% confidence interval; t = t statistic; p = p value; Adjusted R² = adjusted coefficient of determination; ∆R² = change in R²; F = F statistic; ∆F = change in F; p-value = significance level. Finally, we wanted to test the interaction effect of anxiety and attachment avoidance with acceptance. The results of the hierarchical multiple regression indicate that anxiety and attachment avoidance are both independently associated with lower levels of acceptance. However, adding the interaction term between the two dimensions does not significantly improve the model (ΔR² = .01, p = .121), suggesting that their combined effect does not exceed the sum of their individual effects (See Table 3 ). Thus, an attachment profile characterized by both low anxiety and low avoidance is strongly associated with high acceptance, but this effect is additive, with no moderating interaction between the two dimensions. Table 3 Hierarchical multiple regressions with interaction effect of attachment dimensions on acceptance Predictor / model β (standardized) IC 95% t p-value Adjusted R² ∆R² F ∆F p-value Intercept. 6.48 [] 11.01 < .001 Anxiety -0.16 [-0.27, -0.05] -2.17 0.007 Avoidance -0.30 [− 0.41, − 0.20] -3.70 < .001 Anxiety x Avoidance 0.08 [− 0.02, 0.18] 1.55 0.121 Model 1 - Anxiety 0.07 – 24.41 – < .001 Model 2 - Avoidance 0.15 0.08 29.19 31.70 < .001 Model 3 – Interaction Anxiety x Avoidance 0.15 0.01 20.35 2.41 0.121 Note . β = standardized beta coefficient; 95% CI = 95% confidence interval; t = t statistic; p = p value; Adjusted R² = adjusted coefficient of determination; ∆R² = change in R²; F = F statistic; ∆F = change in F; p-value = significance level. Mean comparison analysis Finally, a categorical comparison of acceptance scores between individuals classified as secure and those classified as insecure was performed using an independent samples t-test. The classification was based on a median split of attachment anxiety (median = 2.20) and avoidance (median = 2.75) scores, with participants exhibiting both low anxiety and avoidance (i.e., scores below both medians) being considered secure, and the others as insecure. The results indicate a significant difference between the two groups, t(328) = − 4.94, p < .001, with a higher level of acceptance among secure participants (Mdiff = − 0.64; 95% CI [− 0.87; −0.37]). The effect size is moderate (d = − 0.62), suggesting a significant effect of attachment style on acceptance capacity and that secure individuals have a higher level of acceptance than insecure individuals (anxious and avoidant) (See Table 4 ). These results complement and reinforce the regression analyses by showing that individuals with a secure attachment profile have a significantly higher acceptance capacity than insecure individuals. Table 4 Descriptive statistics for each group Group N Mean Median SD SE Acceptance insecure 245 3.75 3.80 1.05 0.07 secure 85 4.39 4.40 1.00 0.11 Note. SD = standard deviation; SE = standard error; To go further, a one-way analysis of variance (Welch's ANOVA, due to heterogeneity of variances) was conducted to compare acceptance levels between three attachment profiles: secure, anxious, and avoidant, also defined using a median split. More specifically, attachment profiles were defined based on a median split of anxiety scores (median = 2.20) and avoidance scores (median = 2.75). Participants with scores below both medians were classified as secure. Those with high anxiety but low avoidance scores were classified as anxious, and those with high avoidance but low anxiety scores were classified as avoidant. In cases of high scores on both dimensions, participants were classified according to the highest score (anxious or avoidant). The results reveal a significant effect of attachment style on acceptance, F(2, 237) = 12.48, p < .001. The effect size obtained (η² = 0.07) indicates that attachment style explains approximately 7% of the variance in acceptance, which corresponds to a moderate effect size according to Cohen's criteria (1988). Post hoc analyses (Tukey) show that participants with secure attachment have significantly higher levels of acceptance than avoidant participants (Mdiff = 0.69, p < .001, d = 0.67) and anxious participants (Mdiff = 0.59, p < .001, d = 0.57). However, no significant difference was observed between anxious and avoidant profiles (p = .734, d = 0.10). These results suggest that individuals with attachment insecurity (anxious or avoidant) have lower levels of acceptance than secure individuals (See Table 5 ). Table 5 Descriptive statistics, ANOVA, and post hoc comparisons for acceptance (MPFI) by attachment groups (avoidant, secure, anxious) Attachment group N M SD SE Avoidant 121 3.70 1.14 0.10 Secure 85 4.39 1.00 0.11 Anxious 124 3.80 0.95 0.09 Effect SS df MS F p value η² Attachment group 26.74 2 13.37 12.48 < .001 Residuals 26.74 2 13.37 12.48 < .001 0.07 Total 350.25 327 1.07 post hoc comparisons Mean. Diff SE df t p-value (Tukey) Cohen’s d 95% CI Avoidant - Secure -0.69 0.15 327.00 -4.74 < .001 -0.67 [-0.95 ; -0.39] Avoidant - Anxious -0.10 0.13 327.00 -0.75 0.734 -0.10 [-0.35 ; 0.16] Avoidant - Anxious 0.59 0.15 327.00 4.08 < .001 0.57 [0.29 ; 0.86] Note. Comparisons are based on estimated marginal means. M = mean; SD = standard deviation; SE = standard error; SS = sum of squares; df = degrees of freedom; MS = mean square; Mean Diff = mean difference; CI = confidence interval. Relationships between distress tolerance and acceptance Correlations and regressions Correlation and linear regression analyses were conducted to examine the relationships and influence between distress tolerance and acceptance. A Pearson’s correlation showed a moderate and significant positive relationship between distress tolerance (DTS) and acceptance (MPFI) (r = 0.39, 95% CI [0.30; 0.48], p < .001). A linear regression confirmed that distress tolerance significantly predicts acceptance (F(1, 328) = 60.03, p < .001), explaining 15% of the variance (adjusted R² = .15). Distress tolerance is a positive and significant predictor of acceptance (β = 0.39, 95% CI [0.29; 0.49], p < .001), suggesting that greater tolerance of emotional distress facilitates acceptance of internal experiences. Mediation analyses A mediation analysis was conducted to examine whether distress tolerance mediated the relationship between attachment dimensions and acceptance (See Table 6 ). The results showed that the anxiety dimension was negatively associated with acceptance both directly (β = -0.15, p = 0.008) and indirectly via lower distress tolerance (β = -0.13, p < .001), indicating a partial mediation. The avoidance dimension was also negatively associated with acceptance with a direct effect (β = -0.42, p < .001) and an indirect effect via lower distress tolerance (β = -0.16, p < .001), also suggesting partial mediation. The total effect of avoidance on acceptance is stronger (β = -0.57, p < .001) than that of anxiety (β = -0.28, p < .001), indicating that avoidance has a stronger influence on the decrease in acceptance, partly explained by lower distress tolerance. These results indicate that the dimensions of anxiety and avoidance influence acceptance both directly and indirectly via a lower capacity to tolerate distress. Table 6 Mediation estimates of distress tolerance (DTS) between attachment and acceptance (MPFI) Attachment anxiety dimension Effet / Label Est. SE IC 95% Z p % Med. Effect Indirect (a x b) -0.13 0.03 [-0.20 ; -0.08] -4.27 < .001 46.34 Direct (c) -0.15 0.06 [-0.26 ; -0.03] -2.65 0.008 53.66 Total (c + a x b) -0.28 0.05 [-0.39 ; -0.17] -5.18 < .001 100.00 Path Estimates anxiety ◊ Distress tolerance (a) -0.36 0.05 [-0.45 ; -0.26] -7.19 < .001 Distress tolerance ◊ Acceptance (b) 0.37 0.06 [0.25 ; 0.49] 5.98 < .001 Anxiety ◊ Acceptance (c) -0.15 0.06 [-0.26 ; -0.03] -2.65 0.008 Attachment avoidance dimension Effect / Label Est. SE IC 95% Z p % Med. Effect Indirect (a x b) -0.16 0.04 [-0.24 ; -0.09] -3.83 < .001 27.30 Direct (c) -0.42 0.08 [-0.58 ; -0.25] -4.99 < .001 72.70 Total (c + a x b) -0.57 0.08 [-0.72 ; -0.42] -7.57 < .001 100.00 Path estimate Avoidance ◊ Distress tolerance (a) -0.48 0.08 [-0.63 ; -0.31] -6.01 < .001 Avoidance ◊ Acceptance (b) 0.33 0.06 [0.21 ; 0.45] 5.54 < .001 Avoidance ◊ Acceptance (c) -0.42 0.08 [-0.58 ; -0.25] -4.99 < .001 Note . Est. = unstandardized effect estimate; SE = standard error; 95% CI = 95% confidence interval; Z = Wald statistic; % Med. = percentage of mediation. Coefficients a, b, and c refer respectively to the path from predictor to mediator, from mediator to dependent variable, and from predictor to dependent variable (direct path). Moderation analysis A moderation analysis was conducted to test whether distress tolerance (DTS) moderated the relationship between attachment dimensions and acceptance. However, no interaction effects were significant (ps > .05), indicating that distress tolerance did not influence the strength of the relationship between attachment styles or dimensions and acceptance. These results suggest that attachment styles or dimensions and distress tolerance are independently associated with acceptance. Discussion Main objective The main objective of this study was to examine the extent to which attachment dimensions influence the ability to accept internal experiences. Our results confirm the importance of attachment in acceptance, suggesting that secure attachment facilitates it, while insecurity (anxious and avoidant) limits it. More specifically, our results showed that individuals with attachment insecurity (anxiety and avoidance) are associated with lower levels of acceptance. These results are consistent with the literature indicating that insecure attachments lead to the use of less adaptive ER strategies ( 32 , 49 ). Our correlation and regression analyses confirm these trends: attachment anxiety and avoidance predict lower levels of acceptance, revealing that attachment insecurity limits the ability to welcome internal experiences. This is consistent with attachment theory, which suggests that hyperarousal and rumination or deactivation and avoidance associated with attachment insecurity limit the ability to regulate emotions adaptively ( 32 ) and thus to welcome difficult internal experiences. These results suggest that the capacity for acceptance is limited by attachment insecurity. By activating these emotional defense mechanisms, attachment insecurity therefore limits the possibility of adopting an experiential acceptance stance in the face of anxiety or other aversive internal states. Furthermore, attachment avoidance emerged as the strongest predictor, suggesting that the tendency to distance oneself from emotional experiences and the difficulty of accessing emotions ( 46 )—both hallmarks of attachment avoidance—constitute major obstacles to experiential acceptance. These obstacles may even outweigh the emotional overwhelm typically associated with attachment anxiety, thereby supporting the notion that acceptance requires sufficient access to one’s emotions in order to be able to engage with them. Grouping into attachment categories (secure/insecure) confirms that attachment security is associated with significantly higher acceptance. (6,32,e.g., 49), which highlights the association between secure attachment and the use of so-called adaptive emotion regulation strategies, including acceptance. Beyond this empirical confirmation, our results enrich our understanding of the determinants of acceptance. Our data highlight the importance of the ability to be open to one's internal experiences in internal operating models, particularly those related to representations of oneself and one's own internal experiences as sources of security or threat. Thus, attachment styles could influence emotional regulation as predisposing factors for the adoption of so-called engagement strategies, such as acceptance for secure attachments, or the adoption of disengagement or cognitive perseverance strategies for avoidant and anxious attachments, respectively. Secondary objective The secondary objective of this study was to examine the role of distress tolerance in the relationship between attachment and acceptance. First, the results indicate a positive association between distress tolerance and acceptance. This is consistent with previous work showing that low distress tolerance is associated with the use of maladaptive strategies, while higher tolerance is linked to the use of adaptive strategies such as acceptance ( 6 , 56 ). Thus, while attachment has a direct influence on acceptance, the results indicate that it also appears to be indirectly influenced by distress tolerance. The mediation results reveal identical mechanisms for both dimensions of attachment insecurity. The dimensions of anxiety and avoidance negatively influence acceptance both directly and indirectly through lower distress tolerance. This confirms that attachment insecurity directly impedes ER and the use of adaptive strategies, but also that distress tolerance accentuates this trend and also plays a role in the choice of adaptive strategies ( 6 , 56 ). Contrary to expectations, however, distress tolerance does not have a moderating effect on the relationship between attachment and acceptance. The results show that the interaction effect between distress tolerance and attachment is not significant, regardless of attachment styles or dimensions. This means that the relationship between acceptance and attachment does not vary according to the level of distress tolerance. How attachment may affect the ability to accept, a possible explanation Within the developmental framework and trajectory conceptualized by attachment theory, a secure attachment figure enables children to learn to regulate their emotions. On the one hand, they provide a model for appropriate emotion regulation and, on the other hand, they give children the security they need to explore both their external environment and their internal experiences, knowing that they can return to them when needed. They can therefore experience unpleasant emotions in a context where they know they are supported. Little by little, through working models (WM), they will internalize this foundation of security provided by their attachment figure. Based on these explanatory theories, we can draw a parallel with emotion regulation and, more specifically, the ability to accept internal experiences. Indeed, it has been established that early relationships with attachment figures have a lasting influence on the structuring of ER through WM ( 34 , 51 , 53 , 78 , 79 ). Secure attachment promotes the use of so-called adaptive strategies, while insecure attachment (anxious or avoidant) leads to less effective strategies, such as rumination or emotional suppression ( 32 ). These dynamics, based on hyperactivation or deactivation of the attachment system ( 45 ), explain individual differences in emotional regulation ( 46 ). To successfully accept our own emotions, we can hypothesize that it seems necessary to have learned this, either through mindfulness and acceptance-based interventions (MABIs) or through one's own developmental trajectory, having already had an external model that reproduced the main stages of the acceptance process. Let us look at this last hypothesis more closely. We can imagine that an early secure relationship would allow individuals to experience acceptance by externalizing its various sub-processes. Indeed, in a secure relationship, the attachment figure could accompany the subject in accepting their internal experience as it arises. An attachment figure could then serve as an external acceptance process for the subject, offering them a model of openness to emotions, which they can then internalize through repetition of the experience. These learned, reproduced, and integrated processes will then become internalized acceptance processes and an ER strategy to build on. Attachment theory and working models can also help understand individual differences between anxious and avoidant profiles, which can hinder the ability to open up to internal experiences. For individuals with a more strongly avoidant attachment, characterized by emotional distancing and an autonomous and self-sufficient self-representation in terms of regulation, openness to certain internal experiences (e.g., jealousy, anger, envy, sadness) may conflict with this self-concept and cause dissonance, leading to significant discomfort. Furthermore, distancing oneself from threatening experiences does not promote openness to them, which first requires recognition and identification. For people with anxious attachment, characterized by low self-esteem and reduced self-efficacy, exposure to internal experiences, especially if they are related to relationship issues such as rejection, is a challenge on several levels. First, the intensity of emotions linked to a tendency towards hyperactivation of their attachment system ( 80 ) can make openness to these experiences more difficult and frightening. Second, the negative self-image characteristic of attachment anxiety, and in particular self-doubt about self-efficacy, can make the task of acceptance seem more difficult to achieve and threatening. Thus, these differences suggest the difficulty of approaching acceptance in an undifferentiated manner, given that individual variations in attachment address specific issues and challenges that may influence the accessibility and implementation of this strategy. Theoretical and clinical limitations and perspectives Several limitations must be taken into account. First, the cross-sectional nature of the study does not allow causal relationships to be established. The measures used are also based on self-report questionnaires, which are susceptible to biases such as social desirability or conformity effects. In addition, the attachment measurement tool (RSQ) appears to have limitations, including multiple ratings and, i n the inter, sometimes low internal consistency ( 72 ). Future research could explore these mechanisms using experimental or longitudinal approaches and incorporating physiological measures of distress tolerance (stress reactivity, vagal regulation) or assess attachment using other questionnaires, particularly in hetero-assessment. Moreover, the representativeness of the sample may be limited, with a majority of participants being women or highly educated, which could restrict the generalizability of the results. Thus, future studies could benefit from greater diversity in terms of educational level and gender. In addition, the present study is based on a non-clinical sample, whereas further research could be conducted on specific clinical samples to explore the relationship between acceptance and attachment in more detail. Finally, the fact that some participants may have acquired acceptance skills as a result of previous acceptance- and mindfulness-based interventions was not controlled for, which could be a factor influencing their current level of acceptance that could be taken into account in future research. The results of this study highlight the key role of attachment in acceptance capacity, opening up important theoretical and clinical perspectives. From a theoretical perspective, these results reinforce the idea that attachment plays a fundamental role in the development and implementation of emotional regulation strategies, particularly acceptance. The present study suggests that this ability to accept one's emotions is modulated by attachment style, confirming that secure attachment is associated with a greater ability to accept emotions, while insecure attachment (anxiety and avoidance) tends to hinder this ability. It would be interesting to examine, in future research, whether improving attachment is associated with greater acceptance in the long term. Furthermore, if distress tolerance partly explains why attachment influences acceptance, future research could explore other potential underlying mechanisms such as self-compassion. This could also be influenced by attachment. Attachment insecurity may be a barrier to acceptance and therefore make its implementation more complicated. From a clinical perspective, these findings highlight the importance of incorporating attachment assessment into acceptance-based interventions (MABIs). Attachment insecurity may constitute a barrier to the integration and implementation of acceptance strategies, making the process more complex and lengthier for some individuals. It therefore seems appropriate to adapt the content and delivery of these interventions according to patients' attachment profiles. This suggests that access to and learning of acceptance strategies may be longer and more difficult for individuals with insecure attachment. It would therefore be relevant to take this into account in MABIs by adapting the learning processes to attachment-related specificities. More specifically, the results suggest specific avenues for adaptation based on the dimensions of anxiety and avoidance. For individuals with anxious attachment (i.e., with a tendency toward emotional hyperarousal, constant seeking of support, and fear of rejection), interventions could first create a secure therapeutic relationship to strengthen feelings of emotional security and self-efficacy in terms of emotional regulation, but also teach ER strategies to reduce emotional reactivity and intensity (e.g., relaxation, breathing techniques, etc.) before teaching experiential acceptance, then encouraging gradual acceptance of negative emotional states, particularly those created in relational settings that can trigger strong emotional activation, leading them to dissociate their emotional distress from interpersonal rejection. For individuals with avoidant attachment (i.e., a tendency to disengage and be emotionally distant), interventions should therefore encourage emotional reconnection through attention-focusing exercises centered on bodily sensations in the initial stages, work on vulnerability tolerance by gradually exposing the patient to negative emotional experiences in a safe setting, and promote emotional expression and the search for support in interpersonal relationships and within the therapeutic relationship. Future experimental research could test these differentiated approaches in MABIs according to anxious or avoidant attachment. Towards a combined intervention combining attachment and acceptance The results of this study also suggest the possibility of designing a specific acceptance-based intervention that would integrate both attachment work and acceptance training. This combined approach would have a dual objective: to move towards greater attachment security by working on modifying dysfunctional internal schemas (WM), and to strengthen the capacity for acceptance by developing its learning as ER strategies. By simultaneously integrating work on attachment and acceptance, this approach would remove the specific barriers to insecure attachment while promoting better emotional regulation. Improving attachment security could thus facilitate the acceptance of uncomfortable emotional states, creating a synergistic therapeutic dynamic in which relational security and experiential openness reinforce each other. Conclusion This study underscores the central role of attachment security in shaping acceptance capacity. Whereby attachment security facilitates openness to internal experiences, insecurity constrains it, particularly in the form of avoidance. The ability to engage with internal experiences thus appears more limited in the presence of attachment insecurity, with anxiety and avoidance each exerting distinct influences and posing specific obstacles to opening up to painful internal experiences. In addition to the direct impact of attachment on acceptance, distress tolerance was found to play a mediating role. These findings highlight the importance of tailoring acceptance-based interventions (e.g., MBCT, MBSR, ACT) to individuals’ attachment styles. For instance, targeted strategies could be incorporated to strengthen distress tolerance and consequently support the development of acceptance capacity among those with heightened insecurity. Abbreviations ACT Acceptance and Commitment Therapy ER Emotion Regulation MABI Mindfulness and Acceptance Based-Intervention MBCT Mindfulness-based Cognitive Therapy MBSR Mindfulness-Based Stress Reduction WM Working Model Declarations Ethics approval and consent to participate: This study was approved by the local ethics committee of Paris 8 University (protocol #CE-P8-2021-07) on April 21, 2021. All procedures were carried out in accordance with the ethical standards of this research committee and with the 1964 Helsinki Declaration and its later amendments. Written informed consent to participate was obtained from all participants, all of whom were 18 years of age or older. Consent for publication: Not applicable Availability of data and materials: The datasets generated and/or analysed during the current study are available in the OSF repository, https://osf.io/dsv89 Competing interests: The authors declare that they have no competing interests Funding: Not applicable Authors' contributions: JR conceived the study and design, and performed the statistical analyses. RS and ND contributed to the study design and supervised the project. JR collected and managed the data. JR, RS, and ND interpreted the data. JR drafted the manuscript. RS and ND revised the manuscript critically for important intellectual content. All authors read and approved the final manuscript. Acknowledgements: Not applicable Authors' information (optional) References Cludius B, Mennin D, Ehring T. Emotion regulation as a transdiagnostic process. Emotion. 2020;20(1):37. Sloan E, Hall K, Moulding R, Bryce S, Mildred H, Staiger PK. Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical psychology review. 2017;57:141–63. Gross JJ, Thompson RA. Emotion Regulation: Conceptual foundations, Handbook of emotion regulation. Nwe York: Guilford. 2007; Gross JJ. The Emerging Field of Emotion Regulation: An Integrative Review. Review of General Psychology. 1998 Sept;2(3):271–99. Aldao A, Nolen-Hoeksema S. Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behaviour research and therapy. 2010;48(10):974–83. Naragon-Gainey K, McMahon TP, Chacko TP. The structure of common emotion regulation strategies: A meta-analytic examination. Psychological bulletin. 2017;143(4):384. Gross JJ. The Extended Process Model of Emotion Regulation: Elaborations, Applications, and Future Directions. Psychological Inquiry. 2015 Jan 2;26(1):130–7. Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review. 2010;30(2):217–37. Hayes SC, Strosahl, Wilson. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. Guilford Publications; 1999. 324 p. Ribeyron J, Shankland R, Leys C, Duriez N. Acceptance is a better predictor of anxiety, depressive symptoms, and well-being compared to other emotional competences. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement. 2025;57:S86–99. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Dell Publishing; 1990. Segal Z, Williams M, Teasdale J. Mindfulness-based cognitive therapy for depression. Guilford publications; 2002. Linehan MM. Cognitive-behavioral treatment of borderline personality disorder. Guilford Publications; 1993. Lindsay EK, Creswell JD. Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT). Clinical psychology review. 2017;51:48–59. Haller H, Breilmann P, Schröter M, Dobos G, Cramer H. A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders. Sci Rep. 2021 Oct 14;11:20385. Vøllestad J, Nielsen MB, Nielsen GH. Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. Br J Clin Psychol. 2012 Sept;51(3):239–60. Strauss C, Cavanagh K, Oliver A, Pettman D. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLOS one. 2014;9(4):e96110. Rash JA, Kavanagh VA, Garland SN. A meta-analysis of mindfulness-based therapies for insomnia and sleep disturbance: moving towards processes of change. Sleep medicine clinics. 2019;14(2):209–33. Sanada K, Montero-Marin J, Alda Diez M, Salas-Valero M, Pérez-Yus MC, Morillo H, et al. Effects of mindfulness-based interventions on salivary cortisol in healthy adults: a meta-analytical review. Frontiers in physiology. 2016;7:471. Boyd JE, Lanius RA, McKinnon MC. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. Journal of Psychiatry and Neuroscience. 2018;43(1):7–25. Turgon R, Ruffault A, Juneau C, Blatier C, Shankland R. Eating Disorder Treatment: a Systematic Review and Meta-analysis of the Efficacy of Mindfulness-Based Programs. Mindfulness. 2019 Nov;10(11):2225–44. Cavicchioli M, Movalli M, Maffei C. The clinical efficacy of mindfulness-based treatments for alcohol and drugs use disorders: a meta-analytic review of randomized and nonrandomized controlled trials. European addiction research. 2018;24(3):137–62. Sancho M, De Gracia M, Rodriguez RC, Mallorquí-Bagué N, Sánchez-González J, Trujols J, et al. Mindfulness-based interventions for the treatment of substance and behavioral addictions: a systematic review. Frontiers in psychiatry. 2018;9:95. Jansen JE, Gleeson J, Bendall S, Rice S, Alvarez-Jimenez M. Acceptance- and mindfulness-based interventions for persons with psychosis: A systematic review and meta-analysis. Schizophrenia Research. 2020 Jan 1;215:25–37. Louise S, Fitzpatrick M, Strauss C, Rossell SL, Thomas N. Mindfulness-and acceptance-based interventions for psychosis: Our current understanding and a meta-analysis. Schizophrenia research. 2018;192:57–63. Aldao A, Tull MT. Putting emotion regulation in context. Current Opinion in Psychology. 2015;3:100–7. Bonanno GA, Burton CL. Regulatory Flexibility: An Individual Differences Perspective on Coping and Emotion Regulation. Perspect Psychol Sci. 2013 Nov;8(6):591–612. Sheppes G, Scheibe S, Suri G, Gross JJ. Emotion-Regulation Choice. Psychol Sci. 2011 Nov;22(11):1391–6. Berking M, Wupperman P, Reichardt A, Pejic T, Dippel A, Znoj H. Emotion-regulation skills as a treatment target in psychotherapy. Behaviour research and therapy. 2008;46(11):1230–7. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment. 2004;26(1):41–54. Tull MT, Aldao A. Editorial overview: New directions in the science of emotion regulation. Current opinion in psychology. 2015;3:iv–x. Mikulincer M, Shaver PR. Attachment orientations and emotion regulation. Current opinion in psychology. 2019;25:6–10. Bowlby J. Attachment and loss. 2nd edition. Vol. 1. 1969. Bowlby J. Attachment and loss: Volume II: Separation, anxiety and anger. In: Attachment and Loss: Volume II: Separation, Anxiety and Anger. London: The Hogarth press and the institute of psycho-analysis; 1973. p. 1–429. Bowlby J. Loss: Sadness and depression. Vol. 3. Basic books New York; 1980. Calvo V, D’Aquila C, Rocco D, Carraro E. Attachment and well-being: Mediatory roles of mindfulness, psychological inflexibility, and resilience. Curr Psychol. 2022 May;41(5):2966–79. Cortés-García L, Takkouche B, Seoane G, Senra C. Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis. PloS one. 2019;14(3):e0213099. Malik S, Wells A, Wittkowski A. Emotion regulation as a mediator in the relationship between attachment and depressive symptomatology: A systematic review. Journal of affective disorders. 2015;172:428–44. Mallinckrodt B, Wei M. Attachment, social competencies, social support, and psychological distress. Journal of Counseling Psychology. 2005;52(3):358. Messina I, Maniglio R, Spataro P. Attachment Insecurity and Depression: The Mediating Role of Interpersonal Emotion Regulation. Cogn Ther Res. 2023 Aug;47(4):637–47. Mortazavizadeh Z, Forstmeier S. The role of emotion regulation in the association of adult attachment and mental health: A systematic review. Archives of Psychology. 2018;2(9). Kafetsios K. Attachment and emotional intelligence abilities across the life course. Personality and Individual Differences [Internet]. 2004 juillet;37(1):129–45. Available from: http://www.sciencedirect.com/science/article/pii/S0191886903003350 Karreman A, Vingerhoets AJ. Attachment and well-being: The mediating role of emotion regulation and resilience. Personality and Individual differences. 2012;53(7):821–6. Magai C. Attachment in middle and later life. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. 2nd ed. The Guilford press; 2008. p. 532–51. Main M. Cross-cultural studies of attachment organization: Recent studies, changing methodologies, and the concept of conditional strategies. Human development. 1990;33(1):48–61. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. 2nd ed. Guilford Press; 2016. Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. Journal of personality and social psychology. 1991;61(2):226. Hazan C, Shaver PR. Romantic love conceptualized as an attachment process. Journal of personality and social psychology. 1987;52(3):511. Girme YU, Jones RE, Fleck C, Simpson JA, Overall NC. Infants’ attachment insecurity predicts attachment-relevant emotion regulation strategies in adulthood. Emotion. 2021;21(2):260–72. Sroufe LA, Egeland B, Carlson EA, Collins WA. The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. Guilford Press; 2009. Cassidy J. Emotion Regulation : Influences of Attachment Relationships. Monographs Society Res Child. 1994 Feb;59(2–3):228–49. Mikulincer M, Shaver PR, Pereg D. Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion. 2003;27(2):77–102. Shaver PR, Mikulincer M. Attachment-related psychodynamics. Attachment & Human Development. 2002 Sept;4(2):133–61. Smith BM, Villatte JL, Ong CW, Butcher GM, Twohig MP, Levin ME, et al. The influence of a personal values intervention on cold pressor-induced distress tolerance. Behavior Modification. 2019;43(5):688–710. Bardeen JR, Tull MT, Dixon-Gordon KL, Stevens EN, Gratz KL. Attentional Control as a Moderator of the Relationship Between Difficulties Accessing Effective Emotion Regulation Strategies and Distress Tolerance. J Psychopathol Behav Assess. 2015 Mar;37(1):79–84. Jeffries ER, McLeish AC, Kraemer KM, Avallone KM, Fleming JB. The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies. Behav Modif. 2016 May;40(3):439–51. Leyro TM, Zvolensky MJ, Bernstein A. Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychological bulletin. 2010;136(4):576. Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behavior therapy. 2004;35(2):205–30. Orsillo SM, Batten SV. Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behavior modification. 2005;29(1):95–129. Taylor SE. Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. 1999; Corstorphine E, Mountford V, Tomlinson S, Waller G, Meyer C. Distress tolerance in the eating disorders. Eating behaviors. 2007;8(1):91–7. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007 May;39(2):175–91. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009 Nov;41(4):1149–60. Cohen J. Statistical power analysis for the behavioral sciences. Routledge; 1988. Limesurvey GmbH. Hamburg, Germany: LimeSurvey GmbH; 2023. Rolffs JL, Rogge RD, Wilson KG. Disentangling components of flexibility via the hexaflex model: Development and validation of the Multidimensional Psychological Flexibility Inventory (MPFI). Assessment. 2018;25(4):458–82. Ribeyron J, Duriez N, Shankland R. Validation of the French Version of the Multidimensional Psychological Flexibility Inventory (MPFI). in preparation. Griffin DW, Bartholomew K. The metaphysics of measurement: The case of adult attachment. In: Bartholomew K, Perlman D, editors. Attachment processes in adulthood. Jessica Kingsley Publishers; 1994. p. 17–52. Guédeney N, Fermanian J, Bifulco A. La version française du Relationship Scales Questionnaire de Bartholomew (RSQ, Questionnaire des échelles de relation): étude de validation du construit. L’encéphale. 2010;36(1):69–76. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. Guilford Press; 2007. Simpson JA, Rholes WS, Nelligan JS. Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology. 1992;62(3):434. Kurdek LA. On Being Insecure about the Assessment of Attachment Styles. Journal of Social and Personal Relationships. 2002 Dec;19(6):811–34. Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: An integrative overview. Attachment theory and close relationships. 1998;46(1):70–100. Garner LE, Van Kirk N, Tifft ED, Krompinger JW, Mathes BM, Fraire M, et al. Validation of the distress tolerance scale‐short form in obsessive compulsive disorder. Journal of clinical psychology. 2018;74(6):916–25. Wagener A, Blairy S. Version française de la Distress Tolerance Scale et de la Discomfort Intolerance Scale. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement. 2015;47(3):241. Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and emotion. 2005;29(2):83–102. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics (Vol. 6, pp. 497-516). Boston, MA: Pearson; 2019. Bretherton I, Munholland KA. Internal working models in attachment relationships: Elaborating a central construct in attachment theory. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. 2nd ed. The Guilford press; 2008. p. 102–27. Marvin RS, Britner PA. Normative development: The ontogeny of attachment. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. 2nd ed. The Guilford press; 2008. p. 269–94. Wei M, Vogel DL, Ku TY, Zakalik RA. Adult attachment, affect regulation, negative mood, and interpersonal problems: The mediating roles of emotional reactivity and emotional cutoff. Journal of counseling psychology. 2005;52(1):14. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 19 Oct, 2025 Reviewers invited by journal 13 Oct, 2025 Editor assigned by journal 08 Oct, 2025 Editor invited by journal 19 Sep, 2025 Submission checks completed at journal 17 Sep, 2025 First submitted to journal 17 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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15:43:52","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":196097,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7601393/v1/050c695b70e22ed6bffb2032.html"},{"id":94489782,"identity":"9b3c282a-40da-451f-9ed7-d9ed83fce1b3","added_by":"auto","created_at":"2025-10-27 17:05:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1320137,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7601393/v1/05104a1e-4c47-434c-8f7a-52f733526d0a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Influence of attachment on experiential acceptance and the mediating role of distress tolerance","fulltext":[{"header":"Background","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003eEmotional regulation\u003c/h2\u003e\u003cp\u003eEmotion regulation is recognized as a transdiagnostic process underlying psychopathology (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) and numerous studies have highlighted the central role of ER in the development and maintenance of psychopathological disorders (for review 2).\u003c/p\u003e\u003cp\u003eER refers to a set of physiological, cognitive, or behavioral processes through which individuals tend to modulate the nature and intensity of their emotions (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). More specifically, it refers to \"the processes by which individuals influence the emotions they feel, the timing of these emotions, and the way they experience and express these emotions\" (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). ER can be implemented through various strategies, which can be adaptive or maladaptive. It has been shown that maladaptive ER strategies, such as distraction, behavioral avoidance, suppression of emotional expression, substance use or rumination, are associated with increased levels of psychopathology. In contrast, adaptive strategies, such as acceptance, cognitive reappraisal, emotional expression, and problem solving, are correlated with better mental health (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Nevertheless, this classification in adaptive and maladaptive strategies appears unsatisfactory, insofar as the adaptation of a strategy does not depend solely on its nature, but also on the context in which it is implemented. More recently, an empirical classification of ER strategies has been proposed based on a meta-analysis (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), according to their underlying structure in relation to the degree of emotional engagement. In this classification, adaptive emotional engagement strategies include approach strategies (e.g., acceptance, reevaluation, mindfulness), and contrast with disengagement strategies, which correspond in attempts to avoid or escape one's own emotions (e.g., avoidance, expressive suppression), and cognitive perseveration strategies, which consist in adopting rumination or worry strategies. People with higher symptoms of emotional disorders frequently use disengagement and perseveration strategies and rarely use engagement strategies (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eAcceptance\u003c/h2\u003e\u003cp\u003eAmong adaptive and engagement strategies, acceptance is an emotion regulation strategy that involves opening oneself to one's own internal experience without seeking to change or avoid it. Thus, acceptance differs from other emotion regulation strategies (e.g., cognitive reappraisal, rumination, distraction, etc.) that rely on some form of active modification of an emotional state in terms of the quality, intensity, duration, or frequency of the emotion (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Nevertheless, it is well regarded as an emotion regulation strategy.\u003c/p\u003e\u003cp\u003eAcceptance is an adaptive and balanced strategy (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), linked to better mental health (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Furthermore, acceptance of internal experiences is a key mechanism in mindfulness-based cognitive and behavioral therapies (mindfulness and acceptance-based interventions, MABIs). These interventions include the mindfulness-based stress reduction program (MBSR, 11), mindfulness-based cognitive therapy (MBCT, 12), acceptance and commitment therapy (ACT, 9), and dialectical behavioural therapy (DBT, 13). Acceptance is therefore targeted and developed in these approaches and appears to be the main process underlying their effectiveness (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Systematic reviews have demonstrated the positive impact of MBI on reducing symptoms in anxiety disorders (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), depressive disorders (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), sleep disorders (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), stress (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), post-traumatic stress disorder (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), eating disorders (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), substance and behavioral addictions (e.g., 22,23), and psychotic disorders (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThus, acceptance appears to be a fundamental strategy for emotional regulation and a central process in mental health.\u003c/p\u003e\u003cp\u003eRecently, it has been highlighted that the effectiveness of emotional regulation depends not only on the type of strategy used, but also on the interaction between the characteristics of the situation and the individual traits of the person regulating their emotions (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Similarly, it appears that a dispositional potential differs from one individual to another (e.g., 29\u0026ndash;31) particularly due to capacities such as distress tolerance (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) or attachment style (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Thus, it is likely that these dispositions influence the capacity for acceptance as an ER strategy.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eAttachment\u003c/h3\u003e\n\u003cp\u003eAttachment theory (\u003cspan additionalcitationids=\"CR34\" citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e) has long posited that early relationships with attachment figures play a central role in structuring emotional regulation throughout life, through working models.\u003c/p\u003e\u003cp\u003eIndividuals with secure attachment are more confident in their ability to cope with distressing situations and use more adaptive emotional regulation strategies (e.g., problem solving, cognitive reappraisal). In contrast, individuals with insecure attachment tend to resort to maladaptive, unstable, and inadequate strategies, limiting their ability to effectively regulate emotions in response to stress (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Insecure attachment is also considered a risk factor for mental disorders (\u003cspan additionalcitationids=\"CR37 CR38 CR39 CR40\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e) and thus plays a role in well-being (\u003cspan additionalcitationids=\"CR43\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDisturbances in the sense of attachment security lead to the development of secondary attachment strategies (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e), namely anxiety and avoidance. Attachment anxiety is characterized by fear that others will not be available when needed, as well as anxious seeking of support and love, while attachment avoidance reflects distrust of others' intentions and a tendency toward self-reliance (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). These secondary strategies are initially adaptive during development, in that they allow the child to adjust to their attachment figures' shortcomings. However, they become maladaptive in adulthood when they crystallize into a rigid and systematic relational pattern. This is especially true since these insecure attachment strategies encourage repeated activation and suppression of negative emotions, while maintaining a constant reliance on distorted mental representations of oneself and others, which contributes to poor physical and mental health (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). In addition, hyperactivation of the attachment system, associated with attachment anxiety, and deactivation of the attachment system, linked to attachment avoidance, are key elements in understanding individual differences in emotional regulation (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). Indeed, individuals with avoidant attachment styles regulate their emotions by blocking or inhibiting their emotional states, while those with anxious attachment styles hyperactivate them by intensifying them. Avoidant attachment favors strategies of suppression, cognitive distancing, and emotional disengagement. Conversely, anxious attachment favors strategies such as rumination, characterized by an excessive focus on distress (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAttachment in adulthood is generally conceptualized through two complementary theoretical models. First, Bartholomew and Horowitz's (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e) four-dimensional model is based on the image that individuals develop off themselves (positive or negative) and off others. This model distinguishes four attachment styles or prototypes: Secure attachment is based on a positive view of oneself and others, promoting balanced relationships. The preoccupied attachment style incorporates a negative view of oneself and a positive view of others, leading to a fear of abandonment and relational dependence. The detached style is based on a positive view of oneself and a negative view of others, resulting in emotional reserve and a preference for independence. Finally, the fearful style is based on a negative view of oneself and others, leading to emotional instability and ambivalence towards intimacy. Another empirically validated model is the two-dimensional model (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e), which is based on two main dimensions. Anxiety is characterized by a fear of rejection and hyperactivation of the attachment system associated with the preoccupied style, whereas avoidance, reflects emotional reserve in the face of intimacy and deactivation of the attachment system associated with detached and fearful styles. The two-dimensional model offers a more dynamic representation of attachment strategies by integrating the mechanisms of deactivation and hyperactivation of the attachment system described by Mikulincer and Shaver (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). In this framework, secure attachment is characterized by an absence of anxiety and avoidance, promoting adaptive emotional regulation and balanced interpersonal relationships.\u003c/p\u003e\u003cp\u003eRecently, the results of a longitudinal study (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e), exploring data collected over 40 years (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e), confirmed these theoretical assumptions by showing the association between attachment style in childhood and the use of specific emotional regulation strategies in adulthood. Girme et al. (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) integrated Naragon-Gainey's classification of strategies (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) with those of attachment to propose a single model, matching emotional regulation strategies with attachment strategies, suggesting that each category of strategy is based on different attachment profiles and therefore on distinct developmental bases (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). In their study, they refer to the three attachment strategies identified in children(\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e), which evolve in adulthood into three distinct profiles, namely security, anxiety, and attachment avoidance. Secure attachment promotes co-regulation strategies and involves seeking closeness with loved ones and engaging in problem solving. Anxious attachment promotes hyperarousal strategies involving amplified negative emotional expressions and dependence on loved ones. Finally, attachment avoidance promotes deactivation strategies that consist of suppressing or minimizing negative emotions to limit the anticipated suffering associated with dependence on loved ones (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e). Thus, in Girme's model (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e), which incorporates Naragon-Gainey's model (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), secure attachment is linked to engagement strategies, avoidant attachment to disengagement and emotion dysregulation strategies, and anxious attachment to cognitive perseveration and hyperarousal strategies.\u003c/p\u003e\n\u003ch3\u003eDistress tolerance\u003c/h3\u003e\n\u003cp\u003eSimilarly, distress tolerance, defined as the ability to tolerate unpleasant internal events (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e), is another central dispositional capacity in the ability to regulate emotions and appears to be associated with higher levels of acceptance and less use of maladaptive strategies such as cognitive perseveration (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Low distress tolerance is associated with difficulties in regulating emotions (\u003cspan additionalcitationids=\"CR56\" citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e) and leads to the development and maintenance of psychopathology (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e). It is also a risk factor for anxiety (\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e), problematic behaviors associated with borderline personality disorder (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and the development and maintenance of eating disorders (\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eObjectives and hypotheses\u003c/h3\u003e\n\u003cp\u003eThe main objective of this study was to examine the influence of attachment on acceptance. More specifically, we expected that insecure dimensions (anxiety and avoidance) would be associated with lower acceptance, and that security would be associated with greater acceptance.\u003c/p\u003e\u003cp\u003eThe secondary objective of this study was to assess the role of distress tolerance in this relationship. We hypothesized that distress tolerance would mediate the relationship between attachment dimensions and acceptance, partially explaining why attachment facilitates (secure) or hinders (insecure) the capacity for acceptance. We attested the moderating role of distress tolerance in the strength of the relationship between attachment dimensions and acceptance.\u003c/p\u003e\u003cp\u003eThus, clarifying the impact of attachment dimensions could enrich our understanding of the process and refine acceptance-based interventions. Similarly, a better understanding of the role of distress tolerance could allow us to target this process upstream or parallel with approaches aimed at developing acceptance, while providing a better understanding of the mechanisms underlying this ER strategy.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eParticipants and procedure\u003c/h2\u003e\u003cp\u003eThe non-clinical sample consisted of N\u0026thinsp;=\u0026thinsp;330 adults (283 women (85.76%), 46 men (13.94%) and 1 unspecified (0.3%) from the French-speaking general population. Participants were aged between 20 and 75 (mean age\u0026thinsp;=\u0026thinsp;42.86 years, median\u0026thinsp;=\u0026thinsp;43 years, standard deviation\u0026thinsp;=\u0026thinsp;11.31); 238 lived with a partner, 92 were single. And 54.85% had a high level of education (master's degree or higher), 283 were professionally active adults (See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eUsing G*Power (\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e), using the F test \u0026ndash; Linear Multiple Regression: Fixed model tab, R\u0026sup2; increase, and setting a statistical power of 0.80, an alpha risk of 0.01 (corresponding to the Bonferroni correction applied to five tests: 0.05/5), and an average effect size of f\u0026sup2;= 0.15, the minimum number of participants required is estimated at 127. The sensitivity analysis, performed using the same tab, indicates that with a power of 0.80, an alpha risk of 0.0125, and a sample of 127 participants, it is possible to detect an effect size of f\u0026sup2;= 0.15 (corresponding to d\u0026thinsp;\u0026asymp;\u0026thinsp;0.77), if it exists. The minimum effect size sought (f \u0026sup2;= 0.15) was chosen because an effect size greater than d\u0026thinsp;=\u0026thinsp;0.50 is considered medium (\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e The study protocol was approved by the local ethics committee of Paris 8 university (protocol #CE-P8-2021-07) on April 21, 2021. All participants gave their free and informed consent in writing prior to data collection. This study complied with ethical standards, in accordance with the 1989 revised Helsinki Declaration and the American Psychology Association, regarding respect for private data, anonymization, free and informed consent, and the right of participants to withdraw from the research at any time.\u003c/p\u003e\u003cp\u003eFollowing a wide call for participants via the co-authors social media accounts (LinkedIn, Facebook, Twitter), and their respective universities in France, the online questionnaires were completed anonymously via Limesurvey (\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e). Participants were French-speaking adults (i.e., 18 years of age or older) who participated on a voluntary basis and without compensation. The objective of the study, as communicated to participants, was to better understand relationships and emotions.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of the studied variables\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDTS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMPFI Acceptance\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eANXIETY model\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAVOIDANCE model\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e330\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlpha Cronbach\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.68\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.75\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStandard deviation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.68\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMinimum\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMaximum\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkewness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSE skewness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKurtosis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.36\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSE kurtosis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eAcceptance\u003c/h2\u003e\u003cp\u003eAcceptance was assessed using the acceptance subscale of the Multidimensional Psychological Flexibility Inventory (MPFI; 66) in its French version (\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e). It comprises five self-administered items (e.g., =\u003cem\u003e\"I was open to all my emotions, both pleasant and unpleasant,\" \"When I had a disturbing thought or emotion, I tried to welcome it rather than ignore it\u003c/em\u003e\") rated on a 6-point Likert scale (from 1 \"never true\" to 6 \"= ly true\"). A high score indicates a high level of acceptance. The scale demonstrated excellent internal consistency in our study (Cronbach's α\u0026thinsp;=\u0026thinsp;.92) and in the original validation study (Cronbach's α\u0026thinsp;=\u0026thinsp;.80 to .96) (\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eAttachment\u003c/h2\u003e\u003cp\u003eAttachment dimensions were assessed using the Relationship Style Questionnaire (RSQ; 68) for the French translation (\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e). This is a self-report questionnaire comprising 30 items rated on a 5-point Likert scale (from 1\u0026thinsp;=\u0026thinsp;not at all like me to 5\u0026thinsp;=\u0026thinsp;completely like me).\u003c/p\u003e\u003cp\u003eThe RSQ was designed as a comprehensive tool, combining items from several commonly used measures for assessing attachment in adults, allowing researchers to use different conceptualizations. Thus, the RSQ scoring has been the subject of several proposals, and that of Bartholomew and Horowitz (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e), which yielded scores for four prototypes (detached, secure, preoccupied, and fearful), although these are not intended to be categorical but rather dimensional. However, validity is low, with Griffin and Bartholomew (\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e) finding internal consistency coefficients for the subscales ranging from 0.41 to 0.71. A two-dimensional model has also been suggested by the authors based on the dimensions of the prototypes: the self and others model, renamed avoidance and anxiety by Mikulincer \u0026amp; Shaver (\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e). Another rating proposal is based on the dimensions of anxiety and avoidance, for which we will use the rating by Simpson et al. (\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e) recognized by Kurdek (\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e) as having the best validity. It is based on the perspective of Brennan et al. (\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e) according to which attachment styles are best represented by the degree to which a person avoids closeness with others (avoidance) and worries about being unloved or abandoned (anxiety). The anxiety dimension is assessed through five items (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) and the avoidance dimension through eight items (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn our study, this model showed very good internal consistency for anxiety (Cronbach's α\u0026thinsp;=\u0026thinsp;.80) and acceptable consistency for avoidance (α\u0026thinsp;=\u0026thinsp;.68), as in other studies.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eDistress tolerance\u003c/h2\u003e\u003cp\u003eDistress tolerance was assessed using the short version (\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e) of the Distress Tolerance Scale in its French version (DTS; 75) was used to assess distress tolerance. The DTS-SF is a self-administered questionnaire consisting of four items (e.g., \"\u003cem\u003eBeing tormented or upset is always a major ordeal for me\u003c/em\u003e\"), rated on a 5-point Likert scale (from 1\u0026thinsp;=\u0026thinsp;strongly agree to 5\u0026thinsp;=\u0026thinsp;strongly disagree). The DTS-SF is a shortened version of the original Distress Tolerance Scale (\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e) containing the item with the highest factor loading from each subscale (tolerance, evaluation, regulation, and absorption), thus forming a single factor of distress tolerance.\u003c/p\u003e\u003cp\u003eA high overall score indicates high distress tolerance. This scale showed good internal consistency in our study (Cronbach's α\u0026thinsp;=\u0026thinsp;.83) as well as in a previous study (\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e) (Cronbach's α\u0026thinsp;=\u0026thinsp;.81).\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eBefore conducting the main analyses, assumptions of homogeneity of variances and normality of distributions were examined in accordance with statistical recommendations for parametric analyses (\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e). The normality of the distribution residuals was assessed using the Kolmogorov-Smirnov (KS) test, recommended for large samples (N\u0026thinsp;\u0026gt;\u0026thinsp;300 Razali \u0026amp; Wah, 2011). The results indicate that all variables comply with the normality assumption (ps\u0026thinsp;\u0026gt;\u0026thinsp;.05), suggesting that the distribution residuals do not show any major deviation. The homogeneity of variances was assessed using Levene's and Bartlett's tests for each of the main variables. All variables comply with this assumption (ps\u0026thinsp;\u0026gt;\u0026thinsp;.05). These results confirm that the conditions for applying parametric analyses (linear regressions) are met.\u003c/p\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eCorrelations and regressions\u003c/h2\u003e\u003cp\u003eIn order to explore the relationships between attachment and acceptance in greater detail, we conducted correlation and linear regression analyses.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eCorrelations between the two dimensions of attachment and acceptance\u003c/h2\u003e\u003cp\u003eThe correlation analysis indicated a significant negative association between acceptance and attachment anxiety (r = -0.26, p\u0026thinsp;\u0026lt;\u0026thinsp;.001, 95% CI [-0.36, -0.16]) as well as attachment avoidance (r = -0.36, p\u0026thinsp;\u0026lt;\u0026thinsp;.001, 95% CI [-0.27, -0.45]). These findings suggest that acceptance is negatively related to attachment insecurity: individuals with higher levels of attachment anxiety or avoidance appear to have fewer resources to engage in the process of accepting emotions.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eLinear regression analysis between attachment and acceptance\u003c/h2\u003e\u003cp\u003eSimple linear regression analyses were conducted to examine the effect of attachment on emotional acceptance. Attachment anxiety and avoidance are significantly associated with lower acceptance (adjusted\u003csup\u003eR\u0026sup2;\u003c/sup\u003e= .07 and .13, respectively), with negative coefficients for anxiety (β= \u0026minus;\u0026thinsp;.26, 95% CI [-.37, \u0026minus;\u0026thinsp;.16], p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and for avoidance (β= \u0026minus;\u0026thinsp;.36, 95% CI [-.46, \u0026minus;\u0026thinsp;.26], p\u0026thinsp;\u0026lt;\u0026thinsp;.001). These results suggest that anxiety or avoidance insecurity leads to greater difficulties in acceptance.\u003c/p\u003e\u003cp\u003eHierarchical multiple linear regression analyses were conducted to examine the effect of attachment on emotional acceptance (See Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). A hierarchical linear regression was performed to examine the unique contribution of each attachment dimension (anxiety, avoidance) in predicting acceptance. The final model is significant (F(2, 327)\u0026thinsp;=\u0026thinsp;29.19, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and explains 15% of the variance in acceptance (R\u003csup\u003e2\u003c/sup\u003e adjusted\u0026thinsp;=\u0026thinsp;.15), indicating a moderate contribution of attachment dimensions. The anxiety dimension was first introduced (model 1) and explains 7% of the variance in acceptance, which is a significant proportion (R\u003csup\u003e2\u003c/sup\u003e adjusted\u0026thinsp;=\u0026thinsp;0.07, F(1, 328)\u0026thinsp;=\u0026thinsp;24.41, p\u0026thinsp;\u0026lt;\u0026thinsp;.001). The addition of the avoidance dimension (model 2) increased the explained variance of acceptance (15%) (ΔR\u0026sup2; = 0.08, F(1, 327)\u0026thinsp;=\u0026thinsp;31.70, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and improved the quality of the model.\u003c/p\u003e\u003cp\u003eMultiple regression analysis revealed that both dimensions (anxiety and avoidance) are significantly associated with decreased acceptance, as measured by the MPFI. However, attachment avoidance appears to be a stronger predictor (β = \u0026minus;0.31, 95% CI [\u0026minus;\u0026thinsp;0.42; \u0026minus;0.20]) than anxiety (β = \u0026minus;0.15, 95% CI [\u0026minus;\u0026thinsp;0.26; \u0026minus;0.04]). These results suggest that insecure attachment, and particularly avoidance, hinders the ability to accept emotional experiences.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultiple hierarchical regressions of attachment dimensions\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePredictor / model\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eβ (standardized)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIC 95%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAdjusted R\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e∆R\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e∆F\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntercept.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[-0.26, -0.04]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e[\u0026minus;\u0026thinsp;0.42, \u0026minus;\u0026thinsp;0.20]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-5.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModel 1 - Anxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026ndash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e24.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026ndash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModel 2 - Avoidance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e29.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e31.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e. β\u0026thinsp;=\u0026thinsp;standardized beta coefficient; 95% CI\u0026thinsp;=\u0026thinsp;95% confidence interval; t\u0026thinsp;=\u0026thinsp;t statistic; p\u0026thinsp;=\u0026thinsp;p value; Adjusted R\u0026sup2; = adjusted coefficient of determination; ∆R\u0026sup2; = change in R\u0026sup2;; F\u0026thinsp;=\u0026thinsp;F statistic; ∆F\u0026thinsp;=\u0026thinsp;change in F; p-value\u0026thinsp;=\u0026thinsp;significance level.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFinally, we wanted to test the interaction effect of anxiety and attachment avoidance with acceptance. The results of the hierarchical multiple regression indicate that anxiety and attachment avoidance are both independently associated with lower levels of acceptance. However, adding the interaction term between the two dimensions does not significantly improve the model (ΔR\u0026sup2; = .01, p\u0026thinsp;=\u0026thinsp;.121), suggesting that their combined effect does not exceed the sum of their individual effects (See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Thus, an attachment profile characterized by both low anxiety and low avoidance is strongly associated with high acceptance, but this effect is additive, with no moderating interaction between the two dimensions.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eHierarchical multiple regressions with interaction effect of attachment dimensions on acceptance\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"15\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePredictor / model\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eβ (standardized)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eIC 95%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eAdjusted R\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003e∆R\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003e∆F\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eIntercept.\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003e[]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e11.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003e[-0.27, -0.05]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e-2.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003e[\u0026minus;\u0026thinsp;0.41, \u0026minus;\u0026thinsp;0.20]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e-3.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety x Avoidance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[\u0026minus;\u0026thinsp;0.02, 0.18]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModel 1 - \u003cem\u003eAnxiety\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u0026ndash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e24.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e\u0026ndash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModel 2 - \u003cem\u003eAvoidance\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e29.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e31.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModel 3 \u0026ndash; \u003cem\u003eInteraction Anxiety x Avoidance\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e20.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e2.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"15\" nameend=\"c15\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e. β\u0026thinsp;=\u0026thinsp;standardized beta coefficient; 95% CI\u0026thinsp;=\u0026thinsp;95% confidence interval; t\u0026thinsp;=\u0026thinsp;t statistic; p\u0026thinsp;=\u0026thinsp;p value; Adjusted R\u0026sup2; = adjusted coefficient of determination; ∆R\u0026sup2; = change in R\u0026sup2;; F\u0026thinsp;=\u0026thinsp;F statistic; ∆F\u0026thinsp;=\u0026thinsp;change in F; p-value\u0026thinsp;=\u0026thinsp;significance level.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec17\" class=\"Section3\"\u003e\u003ch2\u003eMean comparison analysis\u003c/h2\u003e\u003cp\u003eFinally, a categorical comparison of acceptance scores between individuals classified as secure and those classified as insecure was performed using an independent samples t-test. The classification was based on a median split of attachment anxiety (median\u0026thinsp;=\u0026thinsp;2.20) and avoidance (median\u0026thinsp;=\u0026thinsp;2.75) scores, with participants exhibiting both low anxiety and avoidance (i.e., scores below both medians) being considered secure, and the others as insecure. The results indicate a significant difference between the two groups, t(328)\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;4.94, p\u0026thinsp;\u0026lt;\u0026thinsp;.001, with a higher level of acceptance among secure participants (Mdiff\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.64; 95% CI [\u0026minus;\u0026thinsp;0.87; \u0026minus;0.37]). The effect size is moderate (d\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.62), suggesting a significant effect of attachment style on acceptance capacity and that secure individuals have a higher level of acceptance than insecure individuals (anxious and avoidant) (See Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThese results complement and reinforce the regression analyses by showing that individuals with a secure attachment profile have a significantly higher acceptance capacity than insecure individuals.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003eDescriptive statistics for each group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eAcceptance\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003einsecure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e245\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003esecure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003eNote.\u003c/em\u003e SD\u0026thinsp;=\u0026thinsp;standard deviation; SE\u0026thinsp;=\u0026thinsp;standard error;\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTo go further, a one-way analysis of variance (Welch's ANOVA, due to heterogeneity of variances) was conducted to compare acceptance levels between three attachment profiles: secure, anxious, and avoidant, also defined using a median split. More specifically, attachment profiles were defined based on a median split of anxiety scores (median\u0026thinsp;=\u0026thinsp;2.20) and avoidance scores (median\u0026thinsp;=\u0026thinsp;2.75). Participants with scores below both medians were classified as secure. Those with high anxiety but low avoidance scores were classified as anxious, and those with high avoidance but low anxiety scores were classified as avoidant. In cases of high scores on both dimensions, participants were classified according to the highest score (anxious or avoidant). The results reveal a significant effect of attachment style on acceptance, F(2, 237)\u0026thinsp;=\u0026thinsp;12.48, p\u0026thinsp;\u0026lt;\u0026thinsp;.001. The effect size obtained (η\u0026sup2; = 0.07) indicates that attachment style explains approximately 7% of the variance in acceptance, which corresponds to a moderate effect size according to Cohen's criteria (1988). Post hoc analyses (Tukey) show that participants with secure attachment have significantly higher levels of acceptance than avoidant participants (Mdiff\u0026thinsp;=\u0026thinsp;0.69, p\u0026thinsp;\u0026lt;\u0026thinsp;.001, d\u0026thinsp;=\u0026thinsp;0.67) and anxious participants (Mdiff\u0026thinsp;=\u0026thinsp;0.59, p\u0026thinsp;\u0026lt;\u0026thinsp;.001, d\u0026thinsp;=\u0026thinsp;0.57). However, no significant difference was observed between anxious and avoidant profiles (p\u0026thinsp;=\u0026thinsp;.734, d\u0026thinsp;=\u0026thinsp;0.10). These results suggest that individuals with attachment insecurity (anxious or avoidant) have lower levels of acceptance than secure individuals (See Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive statistics, ANOVA, and post hoc comparisons for acceptance (MPFI) by attachment groups (avoidant, secure, anxious)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAttachment group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eM\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxious\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEffect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003edf\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eη\u0026sup2;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAttachment group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResiduals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e350.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e327\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epost hoc\u003c/p\u003e\u003cp\u003ecomparisons\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean. Diff\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003edf\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep-value (Tukey)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e95% CI\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidant - Secure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e327.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-4.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e[-0.95\u0026nbsp;; -0.39]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidant - Anxious\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e327.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.734\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e[-0.35\u0026nbsp;; 0.16]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidant - Anxious\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e327.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e[0.29\u0026nbsp;; 0.86]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e Comparisons are based on estimated marginal means. M\u0026thinsp;=\u0026thinsp;mean; SD\u0026thinsp;=\u0026thinsp;standard deviation; SE\u0026thinsp;=\u0026thinsp;standard error; SS\u0026thinsp;=\u0026thinsp;sum of squares; df\u0026thinsp;=\u0026thinsp;degrees of freedom; MS\u0026thinsp;=\u0026thinsp;mean square; Mean Diff\u0026thinsp;=\u0026thinsp;mean difference; CI\u0026thinsp;=\u0026thinsp;confidence interval.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eRelationships between distress tolerance and acceptance\u003c/h2\u003e\u003cdiv id=\"Sec19\" class=\"Section3\"\u003e\u003ch2\u003eCorrelations and regressions\u003c/h2\u003e\u003cp\u003eCorrelation and linear regression analyses were conducted to examine the relationships and influence between distress tolerance and acceptance. A Pearson\u0026rsquo;s correlation showed a moderate and significant positive relationship between distress tolerance (DTS) and acceptance (MPFI) (r\u0026thinsp;=\u0026thinsp;0.39, 95% CI [0.30; 0.48], p\u0026thinsp;\u0026lt;\u0026thinsp;.001). A linear regression confirmed that distress tolerance significantly predicts acceptance (F(1, 328)\u0026thinsp;=\u0026thinsp;60.03, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), explaining 15% of the variance (adjusted R\u0026sup2; = .15). Distress tolerance is a positive and significant predictor of acceptance (β\u0026thinsp;=\u0026thinsp;0.39, 95% CI [0.29; 0.49], p\u0026thinsp;\u0026lt;\u0026thinsp;.001), suggesting that greater tolerance of emotional distress facilitates acceptance of internal experiences.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eMediation analyses\u003c/h2\u003e\u003cp\u003eA mediation analysis was conducted to examine whether distress tolerance mediated the relationship between attachment dimensions and acceptance (See Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). The results showed that the anxiety dimension was negatively associated with acceptance both directly (β = -0.15, p\u0026thinsp;=\u0026thinsp;0.008) and indirectly via lower distress tolerance (β = -0.13, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), indicating a partial mediation. The avoidance dimension was also negatively associated with acceptance with a direct effect (β = -0.42, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and an indirect effect via lower distress tolerance (β = -0.16, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), also suggesting partial mediation. The total effect of avoidance on acceptance is stronger (β = -0.57, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) than that of anxiety (β = -0.28, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), indicating that avoidance has a stronger influence on the decrease in acceptance, partly explained by lower distress tolerance. These results indicate that the dimensions of anxiety and avoidance influence acceptance both directly and indirectly via a lower capacity to tolerate distress.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMediation estimates of distress tolerance (DTS) between attachment and acceptance (MPFI)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003eAttachment anxiety dimension\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEffet / Label\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEst.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003eIC 95%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eZ\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e% Med.\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEffect\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndirect (a x b)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.20\u0026nbsp;; -0.08]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-4.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e46.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDirect (c)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.26\u0026nbsp;; -0.03]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-2.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e53.66\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal (c\u0026thinsp;+\u0026thinsp;a x b)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.39\u0026nbsp;; -0.17]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-5.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e100.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePath Estimates\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eanxiety \u0026loz; Distress tolerance (a)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.45\u0026nbsp;; -0.26]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-7.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDistress tolerance \u0026loz; Acceptance (b)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[0.25\u0026nbsp;; 0.49]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety \u0026loz; Acceptance (c)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.26\u0026nbsp;; -0.03]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-2.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAttachment avoidance dimension\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEffect / Label\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eEst.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eSE\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e\u003cb\u003eIC 95%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003eZ\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e% Med.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEffect\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndirect (a x b)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e[-0.24\u0026nbsp;; -0.09]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003e-3.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e27.30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDirect (c)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e[-0.58\u0026nbsp;; -0.25]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003e-4.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e72.70\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal (c\u0026thinsp;+\u0026thinsp;a x b)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.72\u0026nbsp;; -0.42]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-7.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e100.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePath estimate\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidance \u0026loz; Distress tolerance (a)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.63\u0026nbsp;; -0.31]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-6.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidance \u0026loz; Acceptance (b)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[0.21\u0026nbsp;; 0.45]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvoidance \u0026loz; Acceptance (c)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e[-0.58\u0026nbsp;; -0.25]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-4.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e. Est. = unstandardized effect estimate; SE\u0026thinsp;=\u0026thinsp;standard error; 95% CI\u0026thinsp;=\u0026thinsp;95% confidence interval; Z\u0026thinsp;=\u0026thinsp;Wald statistic; % Med. = percentage of mediation. Coefficients a, b, and c refer respectively to the path from predictor to mediator, from mediator to dependent variable, and from predictor to dependent variable (direct path).\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec21\" class=\"Section4\"\u003e\u003ch2\u003eModeration analysis\u003c/h2\u003e\u003cp\u003eA moderation analysis was conducted to test whether distress tolerance (DTS) moderated the relationship between attachment dimensions and acceptance. However, no interaction effects were significant (ps\u0026thinsp;\u0026gt;\u0026thinsp;.05), indicating that distress tolerance did not influence the strength of the relationship between attachment styles or dimensions and acceptance. These results suggest that attachment styles or dimensions and distress tolerance are independently associated with acceptance.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec23\" class=\"Section2\"\u003e\u003ch2\u003eMain objective\u003c/h2\u003e\u003cp\u003eThe main objective of this study was to examine the extent to which attachment dimensions influence the ability to accept internal experiences. Our results confirm the importance of attachment in acceptance, suggesting that secure attachment facilitates it, while insecurity (anxious and avoidant) limits it.\u003c/p\u003e\u003cp\u003eMore specifically, our results showed that individuals with attachment insecurity (anxiety and avoidance) are associated with lower levels of acceptance. These results are consistent with the literature indicating that insecure attachments lead to the use of less adaptive ER strategies (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). Our correlation and regression analyses confirm these trends: attachment anxiety and avoidance predict lower levels of acceptance, revealing that attachment insecurity limits the ability to welcome internal experiences. This is consistent with attachment theory, which suggests that hyperarousal and rumination or deactivation and avoidance associated with attachment insecurity limit the ability to regulate emotions adaptively (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) and thus to welcome difficult internal experiences. These results suggest that the capacity for acceptance is limited by attachment insecurity. By activating these emotional defense mechanisms, attachment insecurity therefore limits the possibility of adopting an experiential acceptance stance in the face of anxiety or other aversive internal states.\u003c/p\u003e\u003cp\u003eFurthermore, attachment avoidance emerged as the strongest predictor, suggesting that the tendency to distance oneself from emotional experiences and the difficulty of accessing emotions (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e)\u0026mdash;both hallmarks of attachment avoidance\u0026mdash;constitute major obstacles to experiential acceptance. These obstacles may even outweigh the emotional overwhelm typically associated with attachment anxiety, thereby supporting the notion that acceptance requires sufficient access to one\u0026rsquo;s emotions in order to be able to engage with them.\u003c/p\u003e\u003cp\u003eGrouping into attachment categories (secure/insecure) confirms that attachment security is associated with significantly higher acceptance. (6,32,e.g., 49), which highlights the association between secure attachment and the use of so-called adaptive emotion regulation strategies, including acceptance.\u003c/p\u003e\u003cp\u003eBeyond this empirical confirmation, our results enrich our understanding of the determinants of acceptance. Our data highlight the importance of the ability to be open to one's internal experiences in internal operating models, particularly those related to representations of oneself and one's own internal experiences as sources of security or threat. Thus, attachment styles could influence emotional regulation as predisposing factors for the adoption of so-called engagement strategies, such as acceptance for secure attachments, or the adoption of disengagement or cognitive perseverance strategies for avoidant and anxious attachments, respectively.\u003c/p\u003e\u003cdiv id=\"Sec24\" class=\"Section3\"\u003e\u003ch2\u003eSecondary objective\u003c/h2\u003e\u003cp\u003eThe secondary objective of this study was to examine the role of distress tolerance in the relationship between attachment and acceptance.\u003c/p\u003e\u003cp\u003eFirst, the results indicate a positive association between distress tolerance and acceptance. This is consistent with previous work showing that low distress tolerance is associated with the use of maladaptive strategies, while higher tolerance is linked to the use of adaptive strategies such as acceptance (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e). Thus, while attachment has a direct influence on acceptance, the results indicate that it also appears to be indirectly influenced by distress tolerance. The mediation results reveal identical mechanisms for both dimensions of attachment insecurity. The dimensions of anxiety and avoidance negatively influence acceptance both directly and indirectly through lower distress tolerance. This confirms that attachment insecurity directly impedes ER and the use of adaptive strategies, but also that distress tolerance accentuates this trend and also plays a role in the choice of adaptive strategies (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e). Contrary to expectations, however, distress tolerance does not have a moderating effect on the relationship between attachment and acceptance. The results show that the interaction effect between distress tolerance and attachment is not significant, regardless of attachment styles or dimensions. This means that the relationship between acceptance and attachment does not vary according to the level of distress tolerance.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e\u003ch2\u003eHow attachment may affect the ability to accept, a possible explanation\u003c/h2\u003e\u003cp\u003eWithin the developmental framework and trajectory conceptualized by attachment theory, a secure attachment figure enables children to learn to regulate their emotions. On the one hand, they provide a model for appropriate emotion regulation and, on the other hand, they give children the security they need to explore both their external environment and their internal experiences, knowing that they can return to them when needed. They can therefore experience unpleasant emotions in a context where they know they are supported. Little by little, through working models (WM), they will internalize this foundation of security provided by their attachment figure.\u003c/p\u003e\u003cp\u003eBased on these explanatory theories, we can draw a parallel with emotion regulation and, more specifically, the ability to accept internal experiences. Indeed, it has been established that early relationships with attachment figures have a lasting influence on the structuring of ER through WM (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e). Secure attachment promotes the use of so-called adaptive strategies, while insecure attachment (anxious or avoidant) leads to less effective strategies, such as rumination or emotional suppression (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). These dynamics, based on hyperactivation or deactivation of the attachment system (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e), explain individual differences in emotional regulation (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTo successfully accept our own emotions, we can hypothesize that it seems necessary to have learned this, either through mindfulness and acceptance-based interventions (MABIs) or through one's own developmental trajectory, having already had an external model that reproduced the main stages of the acceptance process. Let us look at this last hypothesis more closely. We can imagine that an early secure relationship would allow individuals to experience acceptance by externalizing its various sub-processes. Indeed, in a secure relationship, the attachment figure could accompany the subject in accepting their internal experience as it arises. An attachment figure could then serve as an external acceptance process for the subject, offering them a model of openness to emotions, which they can then internalize through repetition of the experience. These learned, reproduced, and integrated processes will then become internalized acceptance processes and an ER strategy to build on.\u003c/p\u003e\u003cp\u003eAttachment theory and working models can also help understand individual differences between anxious and avoidant profiles, which can hinder the ability to open up to internal experiences. For individuals with a more strongly avoidant attachment, characterized by emotional distancing and an autonomous and self-sufficient self-representation in terms of regulation, openness to certain internal experiences (e.g., jealousy, anger, envy, sadness) may conflict with this self-concept and cause dissonance, leading to significant discomfort. Furthermore, distancing oneself from threatening experiences does not promote openness to them, which first requires recognition and identification. For people with anxious attachment, characterized by low self-esteem and reduced self-efficacy, exposure to internal experiences, especially if they are related to relationship issues such as rejection, is a challenge on several levels. First, the intensity of emotions linked to a tendency towards hyperactivation of their attachment system (\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e) can make openness to these experiences more difficult and frightening. Second, the negative self-image characteristic of attachment anxiety, and in particular self-doubt about self-efficacy, can make the task of acceptance seem more difficult to achieve and threatening. Thus, these differences suggest the difficulty of approaching acceptance in an undifferentiated manner, given that individual variations in attachment address specific issues and challenges that may influence the accessibility and implementation of this strategy.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec26\" class=\"Section2\"\u003e\u003ch2\u003eTheoretical and clinical limitations and perspectives\u003c/h2\u003e\u003cp\u003eSeveral limitations must be taken into account. First, the cross-sectional nature of the study does not allow causal relationships to be established. The measures used are also based on self-report questionnaires, which are susceptible to biases such as social desirability or conformity effects. In addition, the attachment measurement tool (RSQ) appears to have limitations, including multiple ratings and, \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003ei\u003c/span\u003en the inter, sometimes low internal consistency (\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e). Future research could explore these mechanisms using experimental or longitudinal approaches and incorporating physiological measures of distress tolerance (stress reactivity, vagal regulation) or assess attachment using other questionnaires, particularly in hetero-assessment. Moreover, the representativeness of the sample may be limited, with a majority of participants being women or highly educated, which could restrict the generalizability of the results. Thus, future studies could benefit from greater diversity in terms of educational level and gender. In addition, the present study is based on a non-clinical sample, whereas further research could be conducted on specific clinical samples to explore the relationship between acceptance and attachment in more detail. Finally, the fact that some participants may have acquired acceptance skills as a result of previous acceptance- and mindfulness-based interventions was not controlled for, which could be a factor influencing their current level of acceptance that could be taken into account in future research.\u003c/p\u003e\u003cp\u003eThe results of this study highlight the key role of attachment in acceptance capacity, opening up important theoretical and clinical perspectives. From a theoretical perspective, these results reinforce the idea that attachment plays a fundamental role in the development and implementation of emotional regulation strategies, particularly acceptance. The present study suggests that this ability to accept one's emotions is modulated by attachment style, confirming that secure attachment is associated with a greater ability to accept emotions, while insecure attachment (anxiety and avoidance) tends to hinder this ability. It would be interesting to examine, in future research, whether improving attachment is associated with greater acceptance in the long term. Furthermore, if distress tolerance partly explains why attachment influences acceptance, future research could explore other potential underlying mechanisms such as self-compassion. This could also be influenced by attachment.\u003c/p\u003e\u003cp\u003eAttachment insecurity may be a barrier to acceptance and therefore make its implementation more complicated. From a clinical perspective, these findings highlight the importance of incorporating attachment assessment into acceptance-based interventions (MABIs). Attachment insecurity may constitute a barrier to the integration and implementation of acceptance strategies, making the process more complex and lengthier for some individuals. It therefore seems appropriate to adapt the content and delivery of these interventions according to patients' attachment profiles. This suggests that access to and learning of acceptance strategies may be longer and more difficult for individuals with insecure attachment. It would therefore be relevant to take this into account in MABIs by adapting the learning processes to attachment-related specificities. More specifically, the results suggest specific avenues for adaptation based on the dimensions of anxiety and avoidance. For individuals with anxious attachment (i.e., with a tendency toward emotional hyperarousal, constant seeking of support, and fear of rejection), interventions could first create a secure therapeutic relationship to strengthen feelings of emotional security and self-efficacy in terms of emotional regulation, but also teach ER strategies to reduce emotional reactivity and intensity (e.g., relaxation, breathing techniques, etc.) before teaching experiential acceptance, then encouraging gradual acceptance of negative emotional states, particularly those created in relational settings that can trigger strong emotional activation, leading them to dissociate their emotional distress from interpersonal rejection. For individuals with avoidant attachment (i.e., a tendency to disengage and be emotionally distant), interventions should therefore encourage emotional reconnection through attention-focusing exercises centered on bodily sensations in the initial stages, work on vulnerability tolerance by gradually exposing the patient to negative emotional experiences in a safe setting, and promote emotional expression and the search for support in interpersonal relationships and within the therapeutic relationship. Future experimental research could test these differentiated approaches in MABIs according to anxious or avoidant attachment.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eTowards a combined intervention combining attachment and acceptance\u003c/h3\u003e\n\u003cp\u003eThe results of this study also suggest the possibility of designing a specific acceptance-based intervention that would integrate both attachment work and acceptance training. This combined approach would have a dual objective: to move towards greater attachment security by working on modifying dysfunctional internal schemas (WM), and to strengthen the capacity for acceptance by developing its learning as ER strategies. By simultaneously integrating work on attachment and acceptance, this approach would remove the specific barriers to insecure attachment while promoting better emotional regulation. Improving attachment security could thus facilitate the acceptance of uncomfortable emotional states, creating a synergistic therapeutic dynamic in which relational security and experiential openness reinforce each other.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study underscores the central role of attachment security in shaping acceptance capacity. Whereby attachment security facilitates openness to internal experiences, insecurity constrains it, particularly in the form of avoidance. The ability to engage with internal experiences thus appears more limited in the presence of attachment insecurity, with anxiety and avoidance each exerting distinct influences and posing specific obstacles to opening up to painful internal experiences. In addition to the direct impact of attachment on acceptance, distress tolerance was found to play a mediating role. These findings highlight the importance of tailoring acceptance-based interventions (e.g., MBCT, MBSR, ACT) to individuals\u0026rsquo; attachment styles. For instance, targeted strategies could be incorporated to strengthen distress tolerance and consequently support the development of acceptance capacity among those with heightened insecurity.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eACT Acceptance and Commitment Therapy\u003c/p\u003e\u003cp\u003eER Emotion Regulation\u003c/p\u003e\u003cp\u003eMABI Mindfulness and Acceptance Based-Intervention\u003c/p\u003e\u003cp\u003eMBCT Mindfulness-based Cognitive Therapy\u003c/p\u003e\u003cp\u003eMBSR Mindfulness-Based Stress Reduction\u003c/p\u003e\u003cp\u003eWM Working Model\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate: \u003c/strong\u003eThis study was approved by the local ethics committee of Paris 8 University (protocol #CE-P8-2021-07) on April 21, 2021. All procedures were carried out in accordance with the ethical standards of this research committee and with the 1964 Helsinki Declaration and its later amendments. Written informed consent to participate was obtained from all participants, all of whom were 18 years of age or older.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e The datasets generated and/or analysed during the current study are available in the OSF repository, https://osf.io/dsv89\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests: \u003c/strong\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding: \u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions: \u003c/strong\u003eJR conceived the study and design, and performed the statistical analyses. RS and ND contributed to the study design and supervised the project. JR collected and managed the data. JR, RS, and ND interpreted the data. JR drafted the manuscript. RS and ND revised the manuscript critically for important intellectual content. All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e Not applicable\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; information (optional)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCludius B, Mennin D, Ehring T. Emotion regulation as a transdiagnostic process. Emotion. 2020;20(1):37. \u003c/li\u003e\n\u003cli\u003eSloan E, Hall K, Moulding R, Bryce S, Mildred H, Staiger PK. Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical psychology review. 2017;57:141\u0026ndash;63. \u003c/li\u003e\n\u003cli\u003eGross JJ, Thompson RA. Emotion Regulation: Conceptual foundations, Handbook of emotion regulation. Nwe York: Guilford. 2007; \u003c/li\u003e\n\u003cli\u003eGross JJ. The Emerging Field of Emotion Regulation: An Integrative Review. Review of General Psychology. 1998 Sept;2(3):271\u0026ndash;99. \u003c/li\u003e\n\u003cli\u003eAldao A, Nolen-Hoeksema S. Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behaviour research and therapy. 2010;48(10):974\u0026ndash;83. \u003c/li\u003e\n\u003cli\u003eNaragon-Gainey K, McMahon TP, Chacko TP. The structure of common emotion regulation strategies: A meta-analytic examination. Psychological bulletin. 2017;143(4):384. \u003c/li\u003e\n\u003cli\u003eGross JJ. The Extended Process Model of Emotion Regulation: Elaborations, Applications, and Future Directions. Psychological Inquiry. 2015 Jan 2;26(1):130\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eAldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review. 2010;30(2):217\u0026ndash;37. \u003c/li\u003e\n\u003cli\u003eHayes SC, Strosahl, Wilson. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. Guilford Publications; 1999. 324 p. \u003c/li\u003e\n\u003cli\u003eRibeyron J, Shankland R, Leys C, Duriez N. Acceptance is a better predictor of anxiety, depressive symptoms, and well-being compared to other emotional competences. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement. 2025;57:S86\u0026ndash;99. \u003c/li\u003e\n\u003cli\u003eKabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Dell Publishing; 1990. \u003c/li\u003e\n\u003cli\u003eSegal Z, Williams M, Teasdale J. Mindfulness-based cognitive therapy for depression. Guilford publications; 2002. \u003c/li\u003e\n\u003cli\u003eLinehan MM. Cognitive-behavioral treatment of borderline personality disorder. Guilford Publications; 1993. \u003c/li\u003e\n\u003cli\u003eLindsay EK, Creswell JD. Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT). Clinical psychology review. 2017;51:48\u0026ndash;59. \u003c/li\u003e\n\u003cli\u003eHaller H, Breilmann P, Schr\u0026ouml;ter M, Dobos G, Cramer H. A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders. Sci Rep. 2021 Oct 14;11:20385. \u003c/li\u003e\n\u003cli\u003eV\u0026oslash;llestad J, Nielsen MB, Nielsen GH. Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. Br J Clin Psychol. 2012 Sept;51(3):239\u0026ndash;60. \u003c/li\u003e\n\u003cli\u003eStrauss C, Cavanagh K, Oliver A, Pettman D. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLOS one. 2014;9(4):e96110. \u003c/li\u003e\n\u003cli\u003eRash JA, Kavanagh VA, Garland SN. A meta-analysis of mindfulness-based therapies for insomnia and sleep disturbance: moving towards processes of change. Sleep medicine clinics. 2019;14(2):209\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eSanada K, Montero-Marin J, Alda Diez M, Salas-Valero M, P\u0026eacute;rez-Yus MC, Morillo H, et al. Effects of mindfulness-based interventions on salivary cortisol in healthy adults: a meta-analytical review. Frontiers in physiology. 2016;7:471. \u003c/li\u003e\n\u003cli\u003eBoyd JE, Lanius RA, McKinnon MC. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. Journal of Psychiatry and Neuroscience. 2018;43(1):7\u0026ndash;25. \u003c/li\u003e\n\u003cli\u003eTurgon R, Ruffault A, Juneau C, Blatier C, Shankland R. Eating Disorder Treatment: a Systematic Review and Meta-analysis of the Efficacy of Mindfulness-Based Programs. Mindfulness. 2019 Nov;10(11):2225\u0026ndash;44. \u003c/li\u003e\n\u003cli\u003eCavicchioli M, Movalli M, Maffei C. The clinical efficacy of mindfulness-based treatments for alcohol and drugs use disorders: a meta-analytic review of randomized and nonrandomized controlled trials. European addiction research. 2018;24(3):137\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eSancho M, De Gracia M, Rodriguez RC, Mallorqu\u0026iacute;-Bagu\u0026eacute; N, S\u0026aacute;nchez-Gonz\u0026aacute;lez J, Trujols J, et al. Mindfulness-based interventions for the treatment of substance and behavioral addictions: a systematic review. Frontiers in psychiatry. 2018;9:95. \u003c/li\u003e\n\u003cli\u003eJansen JE, Gleeson J, Bendall S, Rice S, Alvarez-Jimenez M. Acceptance- and mindfulness-based interventions for persons with psychosis: A systematic review and meta-analysis. Schizophrenia Research. 2020 Jan 1;215:25\u0026ndash;37. \u003c/li\u003e\n\u003cli\u003eLouise S, Fitzpatrick M, Strauss C, Rossell SL, Thomas N. Mindfulness-and acceptance-based interventions for psychosis: Our current understanding and a meta-analysis. Schizophrenia research. 2018;192:57\u0026ndash;63. \u003c/li\u003e\n\u003cli\u003eAldao A, Tull MT. Putting emotion regulation in context. Current Opinion in Psychology. 2015;3:100\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eBonanno GA, Burton CL. Regulatory Flexibility: An Individual Differences Perspective on Coping and Emotion Regulation. Perspect Psychol Sci. 2013 Nov;8(6):591\u0026ndash;612. \u003c/li\u003e\n\u003cli\u003eSheppes G, Scheibe S, Suri G, Gross JJ. Emotion-Regulation Choice. Psychol Sci. 2011 Nov;22(11):1391\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eBerking M, Wupperman P, Reichardt A, Pejic T, Dippel A, Znoj H. Emotion-regulation skills as a treatment target in psychotherapy. Behaviour research and therapy. 2008;46(11):1230\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eGratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment. 2004;26(1):41\u0026ndash;54. \u003c/li\u003e\n\u003cli\u003eTull MT, Aldao A. Editorial overview: New directions in the science of emotion regulation. Current opinion in psychology. 2015;3:iv\u0026ndash;x. \u003c/li\u003e\n\u003cli\u003eMikulincer M, Shaver PR. Attachment orientations and emotion regulation. Current opinion in psychology. 2019;25:6\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eBowlby J. Attachment and loss. 2nd edition. Vol. 1. 1969. \u003c/li\u003e\n\u003cli\u003eBowlby J. Attachment and loss: Volume II: Separation, anxiety and anger. In: Attachment and Loss: Volume II: Separation, Anxiety and Anger. London: The Hogarth press and the institute of psycho-analysis; 1973. p. 1\u0026ndash;429. \u003c/li\u003e\n\u003cli\u003eBowlby J. Loss: Sadness and depression. Vol. 3. Basic books New York; 1980. \u003c/li\u003e\n\u003cli\u003eCalvo V, D\u0026rsquo;Aquila C, Rocco D, Carraro E. Attachment and well-being: Mediatory roles of mindfulness, psychological inflexibility, and resilience. Curr Psychol. 2022 May;41(5):2966\u0026ndash;79. \u003c/li\u003e\n\u003cli\u003eCort\u0026eacute;s-Garc\u0026iacute;a L, Takkouche B, Seoane G, Senra C. Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis. PloS one. 2019;14(3):e0213099. \u003c/li\u003e\n\u003cli\u003eMalik S, Wells A, Wittkowski A. Emotion regulation as a mediator in the relationship between attachment and depressive symptomatology: A systematic review. Journal of affective disorders. 2015;172:428\u0026ndash;44. \u003c/li\u003e\n\u003cli\u003eMallinckrodt B, Wei M. Attachment, social competencies, social support, and psychological distress. Journal of Counseling Psychology. 2005;52(3):358. \u003c/li\u003e\n\u003cli\u003eMessina I, Maniglio R, Spataro P. Attachment Insecurity and Depression: The Mediating Role of Interpersonal Emotion Regulation. Cogn Ther Res. 2023 Aug;47(4):637\u0026ndash;47. \u003c/li\u003e\n\u003cli\u003eMortazavizadeh Z, Forstmeier S. The role of emotion regulation in the association of adult attachment and mental health: A systematic review. Archives of Psychology. 2018;2(9). \u003c/li\u003e\n\u003cli\u003eKafetsios K. Attachment and emotional intelligence abilities across the life course. Personality and Individual Differences [Internet]. 2004 juillet;37(1):129\u0026ndash;45. Available from: http://www.sciencedirect.com/science/article/pii/S0191886903003350\u003c/li\u003e\n\u003cli\u003eKarreman A, Vingerhoets AJ. Attachment and well-being: The mediating role of emotion regulation and resilience. Personality and Individual differences. 2012;53(7):821\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eMagai C. Attachment in middle and later life. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. 2nd ed. The Guilford press; 2008. p. 532\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eMain M. Cross-cultural studies of attachment organization: Recent studies, changing methodologies, and the concept of conditional strategies. Human development. 1990;33(1):48\u0026ndash;61. \u003c/li\u003e\n\u003cli\u003eMikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. 2nd ed. Guilford Press; 2016. \u003c/li\u003e\n\u003cli\u003eBartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. Journal of personality and social psychology. 1991;61(2):226. \u003c/li\u003e\n\u003cli\u003eHazan C, Shaver PR. Romantic love conceptualized as an attachment process. Journal of personality and social psychology. 1987;52(3):511. \u003c/li\u003e\n\u003cli\u003eGirme YU, Jones RE, Fleck C, Simpson JA, Overall NC. Infants\u0026rsquo; attachment insecurity predicts attachment-relevant emotion regulation strategies in adulthood. Emotion. 2021;21(2):260\u0026ndash;72. \u003c/li\u003e\n\u003cli\u003eSroufe LA, Egeland B, Carlson EA, Collins WA. The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. Guilford Press; 2009. \u003c/li\u003e\n\u003cli\u003eCassidy J. Emotion Regulation : Influences of Attachment Relationships. Monographs Society Res Child. 1994 Feb;59(2\u0026ndash;3):228\u0026ndash;49. \u003c/li\u003e\n\u003cli\u003eMikulincer M, Shaver PR, Pereg D. Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion. 2003;27(2):77\u0026ndash;102. \u003c/li\u003e\n\u003cli\u003eShaver PR, Mikulincer M. Attachment-related psychodynamics. Attachment \u0026amp; Human Development. 2002 Sept;4(2):133\u0026ndash;61. \u003c/li\u003e\n\u003cli\u003eSmith BM, Villatte JL, Ong CW, Butcher GM, Twohig MP, Levin ME, et al. The influence of a personal values intervention on cold pressor-induced distress tolerance. Behavior Modification. 2019;43(5):688\u0026ndash;710. \u003c/li\u003e\n\u003cli\u003eBardeen JR, Tull MT, Dixon-Gordon KL, Stevens EN, Gratz KL. Attentional Control as a Moderator of the Relationship Between Difficulties Accessing Effective Emotion Regulation Strategies and Distress Tolerance. J Psychopathol Behav Assess. 2015 Mar;37(1):79\u0026ndash;84. \u003c/li\u003e\n\u003cli\u003eJeffries ER, McLeish AC, Kraemer KM, Avallone KM, Fleming JB. The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies. Behav Modif. 2016 May;40(3):439\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eLeyro TM, Zvolensky MJ, Bernstein A. Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychological bulletin. 2010;136(4):576. \u003c/li\u003e\n\u003cli\u003eBarlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behavior therapy. 2004;35(2):205\u0026ndash;30. \u003c/li\u003e\n\u003cli\u003eOrsillo SM, Batten SV. Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behavior modification. 2005;29(1):95\u0026ndash;129. \u003c/li\u003e\n\u003cli\u003eTaylor SE. Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. 1999; \u003c/li\u003e\n\u003cli\u003eCorstorphine E, Mountford V, Tomlinson S, Waller G, Meyer C. Distress tolerance in the eating disorders. Eating behaviors. 2007;8(1):91\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eFaul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007 May;39(2):175\u0026ndash;91. \u003c/li\u003e\n\u003cli\u003eFaul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009 Nov;41(4):1149\u0026ndash;60. \u003c/li\u003e\n\u003cli\u003eCohen J. Statistical power analysis for the behavioral sciences. Routledge; 1988. \u003c/li\u003e\n\u003cli\u003eLimesurvey GmbH. Hamburg, Germany: LimeSurvey GmbH; 2023. \u003c/li\u003e\n\u003cli\u003eRolffs JL, Rogge RD, Wilson KG. Disentangling components of flexibility via the hexaflex model: Development and validation of the Multidimensional Psychological Flexibility Inventory (MPFI). Assessment. 2018;25(4):458\u0026ndash;82. \u003c/li\u003e\n\u003cli\u003eRibeyron J, Duriez N, Shankland R. Validation of the French Version of the Multidimensional Psychological Flexibility Inventory (MPFI). in preparation. \u003c/li\u003e\n\u003cli\u003eGriffin DW, Bartholomew K. The metaphysics of measurement: The case of adult attachment. In: Bartholomew K, Perlman D, editors. Attachment processes in adulthood. Jessica Kingsley Publishers; 1994. p. 17\u0026ndash;52. \u003c/li\u003e\n\u003cli\u003eGu\u0026eacute;deney N, Fermanian J, Bifulco A. La version fran\u0026ccedil;aise du Relationship Scales Questionnaire de Bartholomew (RSQ, Questionnaire des \u0026eacute;chelles de relation): \u0026eacute;tude de validation du construit. L\u0026rsquo;enc\u0026eacute;phale. 2010;36(1):69\u0026ndash;76. \u003c/li\u003e\n\u003cli\u003eMikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. Guilford Press; 2007. \u003c/li\u003e\n\u003cli\u003eSimpson JA, Rholes WS, Nelligan JS. Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology. 1992;62(3):434. \u003c/li\u003e\n\u003cli\u003eKurdek LA. On Being Insecure about the Assessment of Attachment Styles. Journal of Social and Personal Relationships. 2002 Dec;19(6):811\u0026ndash;34. \u003c/li\u003e\n\u003cli\u003eBrennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: An integrative overview. Attachment theory and close relationships. 1998;46(1):70\u0026ndash;100. \u003c/li\u003e\n\u003cli\u003eGarner LE, Van Kirk N, Tifft ED, Krompinger JW, Mathes BM, Fraire M, et al. Validation of the distress tolerance scale‐short form in obsessive compulsive disorder. Journal of clinical psychology. 2018;74(6):916\u0026ndash;25. \u003c/li\u003e\n\u003cli\u003eWagener A, Blairy S. Version fran\u0026ccedil;aise de la Distress Tolerance Scale et de la Discomfort Intolerance Scale. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement. 2015;47(3):241. \u003c/li\u003e\n\u003cli\u003eSimons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and emotion. 2005;29(2):83\u0026ndash;102. \u003c/li\u003e\n\u003cli\u003eTabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics (Vol. 6, pp. 497-516). Boston, MA: Pearson; 2019. \u003c/li\u003e\n\u003cli\u003eBretherton I, Munholland KA. Internal working models in attachment relationships: Elaborating a central construct in attachment theory. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. 2nd ed. The Guilford press; 2008. p. 102\u0026ndash;27. \u003c/li\u003e\n\u003cli\u003eMarvin RS, Britner PA. Normative development: The ontogeny of attachment. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. 2nd ed. The Guilford press; 2008. p. 269\u0026ndash;94. \u003c/li\u003e\n\u003cli\u003eWei M, Vogel DL, Ku TY, Zakalik RA. Adult attachment, affect regulation, negative mood, and interpersonal problems: The mediating roles of emotional reactivity and emotional cutoff. Journal of counseling psychology. 2005;52(1):14. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Attachment, acceptance, distress tolerance, emotion regulation","lastPublishedDoi":"10.21203/rs.3.rs-7601393/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7601393/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Acceptance is an emotion regulation strategy based on openness to internal experiences, without modifying or avoiding them. It is considered adaptive, balanced and associated with better mental health. Attachment security promotes adaptive strategies, whilst insecurity seems to be linked to maladaptive strategies. Similarly, distress tolerance, the ability to cope with difficult internal experiences, appears to be associated with more adaptive strategies. A better understanding of the role of attachment could therefore shed light on its effects on acceptance capacities and allow interventions to be adjusted accordingly. This study assesses the influence of attachment on acceptance and tests the mediating role of distress tolerance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Measures \u0026nbsp;of attachment (RSQ), acceptance (MPFI), and distress tolerance (DTS) were \u0026nbsp;completed by 330 adults. Simple and hierarchical regressions identified \u0026nbsp;predictive dimensions, and mediations examined indirect links via distress \u0026nbsp;tolerance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The dimensions of anxiety and attachment avoidance were negatively associated \u0026nbsp;with acceptance (adjusted R² = .07 and .13). Hierarchical regression showed \u0026nbsp;that avoidance is the strongest predictor (β = −0.31) compared to anxiety (β = \u0026nbsp;−0.15), with the model explaining 15% of the variance in acceptance (p \u0026lt; \u0026nbsp;.001). Distress tolerance partially mediated these relationships (anxiety: β = \u0026nbsp;−0.13; avoidance: β = −0.16).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e These results confirm the importance of attachment in acceptance: both dimensions of insecurity (anxiety and avoidance) are associated with decreased acceptance. The ability to open up to internal experiences seems more difficult in cases of attachment insecurity, especially regarding the avoidance dimension. This highlights the value of tailoring acceptance-based interventions (e.g., MBCT, MBSR, ACT) to differing attachment styles, incorporating targeted reinforcement of distress tolerance to support the development of acceptance in individuals with higher levels of insecurity.\u003c/p\u003e","manuscriptTitle":"Influence of attachment on experiential acceptance and the mediating role of distress tolerance","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-27 14:25:02","doi":"10.21203/rs.3.rs-7601393/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"334652847098244477521898141120273525233","date":"2025-10-19T07:23:56+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-13T09:25:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-08T09:28:25+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-19T13:05:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-17T15:04:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-09-17T15:00:34+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"75843164-2632-4d01-96cd-1ded2ca4296e","owner":[],"postedDate":"October 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-27T14:25:02+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-27 14:25:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7601393","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7601393","identity":"rs-7601393","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}