Attachment styles, developed through early life interactions, influence how individuals perceive relationships and manage stress. Medical students often exhibit insecure attachment styles, which are linked to increased psychological distress.

The primary aim of this study is to explore the extent to which resilience influences the connection between attachment styles and general psychological well-being among medical students.

This cross-sectional study was conducted at New Giza University in Cairo, Egypt, and involved 437 medical students. Participants completed self-report surveys measuring attachment styles, resilience, and psychological distress. The survey instruments included the Relationship Questionnaire (RQ) for attachment styles, the General Health Questionnaire (GHQ-12) for psychological distress (where a lower GHQ-12 score indicates less psychological distress), and the Connor–Davidson Resilience Scale (CD-RISC-10) for resilience. Participants were grouped into four attachment styles: secure (SA), fearful avoidant (FA), anxious preoccupied (AP), and dismissive avoidant (DA).

The sample’s mean age was 20.32 years (SD = 2.09). Females comprised 69.6% of the cohort, and single students made up 80.1% of the whole cohort. The distribution of attachment styles across females and males differed significantly (p < 0.0001, χ² = 25.7), with DA being more prevalent in males compared to females (28.6% and 13.2%, respectively). GHQ-12 median scores were similar between genders (p = 0.23), while CD-RISC-10 scores differed (p = 0.002), with males having a higher median (28).

Median scores of GHQ-12 and CD-RISC-10 differed significantly across groups of attachment styles (p < 0.0001 and p = 0.0002, respectively). AP and FA had the highest GHQ-12 medians (15), while AP had the lowest CD-RISC-10 median (25).

A negative correlation between CD-RISC-10 and GHQ-12 scores was significant in the whole cohort (p < 0.0001, r = -0.3227), with FA showing the strongest correlation (p < 0.0001, r = -0.3292, CI: -0.4714 to -0.1704) and other groups showing similar reuslts (figures 1, 2 and 3).

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The findings underscore the critical role of resilience in buffering against the psychological impacts of insecure attachment among medical students. Approaches targeting resilience enhancement could serve as a valuable intervention target to mitigate psychological distress and improve well-being in this high-risk attachment styles. Future research is recommended to develop and test resilience-focused interventions tailored to medical students with insecure attachment styles, which may help reduce burnout and promote mental health in medical training environments.

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