A Mixed-Methods Exploration of Attachment and Cultural Orientation in Co-dependency

Co-dependency is associated with poor mental health, yet research remains conceptually inconsistent. The systematic literature review conducted revealed that emerging frameworks increasingly acknowledge developmental disruptions, though most research continues to focus on individual pathology. Co-dependency remains linked to reduced wellbeing, identity and relational difficulties. Building on this, this study explored the roles of attachment and cultural orientation in predicting co-dependency, and whether cultural orientation moderates the relationship between co-dependency and mental well-being. It also explored the attachment narratives of individuals engaged with a UK Support Group for Co-dependency (SGFC). A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 328 participants with co-dependency traits, recruited via opportunity sampling. Participants completed measures of co-dependency, attachment style, cultural orientation, and mental well-being. Qualitative data came from semi-structured interviews with six SGFC members, guided by an adapted Dynamic Maturational Model (DMM)-Adult Attachment Interview. Quantitative results indicated that insecure attachment and horizontal individualism predicted co-dependency. Co-dependency negatively predicted mental well-being, and horizontal collectivism partially mediated this relationship. Qualitatively, all participants displayed insecure attachment strategies, as identified through DMM coding. Attachment-informed thematic analysis revealed a developmental trajectory across six themes: insecure and unsafe beginnings, living through adversity, the co-dependency backstage, navigating connection and self-protection, co-dependency in action, and empowering vs performative self-growth. Clinical implications include the need to increase awareness of co-dependency, while acknowledging the current lack of validated screening tools in clinical settings. The development of such measures represents a logical next step. Further recommendations include offering targeted interventions addressing attachment, trauma and defences. Policy implications encompass public awareness campaigns, preventative education, and increased funding for intervention development.