ATTACHMENT AND LEADERSHIP IN THE NURSING ENVIRONMENT APPROVED BY SUPERVISORY COMMITTEE H. M. Evans, Ph.D . Ted P. Asay, Ph.D. Ira H. Bernstein, Ph. D. Blake A. Frank, Ph. D. Richard Robinson, Ph.D. DEDICATION For my parents, Max and Sylvia, and my sister, Colleen, the best “support staff” in the world. For my Aunt Rachael, who fostered my love of literature and learning. For Clinton, who is proof that superheroes do not exist solely in comic books, but in real life too. Excelsior. ATTACHMENT AND LEADERSHIP IN THE NURSING ENVIRONMENT by ALICIA ANN COLEMAN DISSERTATION Presented to the Faculty of the Graduate School of Biomedical Sciences The University of Texas Southwestern Medical Center at Dallas In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF PHILOSOPHY The University of Texas Southwestern Medical Center at Dallas Dallas, Texas December, 2011 Copyright by ALICIA ANN COLEMAN, 2011 All Rights Reserved ATTACHMENT AND LEADERSHIP IN THE NURSING ENVIRONMENT ALICIA ANN COLEMAN, Ph.D. The University of Texas Southwestern Medical Center at Dallas, 2011 H. M. Evans, Ph.D. Attachment style is a characteristic that is directly related to interpersonal relationship functioning, and in recent years has been found to predict organizational behaviors. This study reports the relationship between the attachment styles of nurses and the attachment and leadership styles of nurse supervisors and nurse managers at a hospital in Dallas, Texas, as well as organizational factors such as nurse satisfaction with their supervisor. Some evidence was found in this study to support this relationship in that insecure attachment is positively associated with certain leadership styles and negatively associated with transformational leadership. Specifically, supervisors with anxious attachment tended to show a passive management-by-exception leadership style and score lower on contingent reward, and two of the five transformational scales, idealized influence attributed and individual consideration. Supervisors with avoidant v attachment demonstrated passive and active management-by-exception, and were the least likely to show transformational leadership in that they scored lower on four of the five transformational scales- idealized influence behavioral, inspirational motivation, intellectual stimulation, and individual consideration. Supervisors with higher scores on the active management-by-exception and contingent reward scales were found to have larger discrepancies between their self-ratings of leadership and ratings from their supervisees. vi TABLE OF CONTENTS CHAPTER ONE: INTRODUCTION............................................................................. 1 CHAPTER TWO: REVIEW OF LITERATURE......................................................... 5 Leadership ................................................................................................................... 5 Theories of Leadership .......................................................................................... 5 Behavioral Theories ....................................................................................... 7 Contingency Theories ..................................................................................... 9 Inspirational Leadership Theories................................................................. 13 Leadership in the Nursing Environment.............................................................. 16 Attachment Theory .................................................................................................... 18 Infant Attachment ............................................................................................... 18 Adult Attachment ................................................................................................ 24 Assessment of Attachment ................................................................................. 29 The Strange Situation.................................................................................... 33 Adult Attachment Interview ......................................................................... 35 Self Report Measures ................................................................................................. 41 The Attachment Style Measure .................................................................... 42 Experiences in Close Relationships Scale ................................................... 44 Interview versus Self Report Measures ....................................................... 46 Attachment in the Workplace .................................................................................... 48 Individual Differences in Attachment Patterns ................................................... 48 Group Differences .............................................................................................. 50 Attachment Orientation and Leadership.............................................................. 51 vii Purpose of Present Study ........................................................................................... 53 Hypotheses................................................................................................................. 53 CHAPTER THREE: METHODOLOGY .................................................................... 56 Participants ................................................................................................................ 56 Procedure .................................................................................................................. 56 Instruments ................................................................................................................ 57 CHAPTER FOUR: RESULTS ..................................................................................... 60 Characteristics of Sample........................................................................................... 60 Data Analyses ........................................................................................................... 61 Hypothesis One ......................................................................................................... 62 Hypothesis Two ......................................................................................................... 64 Hypothesis Three ....................................................................................................... 64 Hypothesis Four ......................................................................................................... 65 Secondary Hypothesis................................................................................................ 66 Confirmatory Factor Analysis of WRI....................................................................... 66 CHAPTER FIVE: DISCUSSION ................................................................................ 68 Nurse Attachment and Leadership............................................................................. 69 Self and Supervisee Evaluations of Leadership Style................................................ 72 Limitations ................................................................................................................. 74 General Conclusions .................................................................................................. 75 FIGURES ....................................................................................................................... 77 TABLES ......................................................................................................................... 78 viii REFERENCES .............................................................................................................. 86 ix PRIOR PUBLICATION Gottlieb, M. & Coleman, A. (2011). Ethical Challenges in Forensic Psychology Practice. In: Knapp, S. ed APA Handbook of Ethics and Psychology. Washington, DC: APA Books. x LIST OF FIGURES FIGURE 1: Scree Plot of WRI ......................................................................................... 77 xi LIST OF TABLES TABLE 1: Demographic Characteristics of the Sample .................................................. 78 TABLE 2: Hypothesis 1 Analysis Results- Anxiety ........................................................ 79 TABLE 3: Hypothesis 1 Analysis Results- Avoidance.................................................... 80 TABLE 4: Hypothesis 2 Results ...................................................................................... 81 TABLE 5: Hypothesis 3 Results ...................................................................................... 82 TABLE 6: Hypothesis 4 Results ...................................................................................... 83 TABLE 7: Secondary Hypothesis Results........................................................................ 84 TABLE 8: Factor Analysis Results .................................................................................. 85 xii LIST OF ABBREVIATIONS & DEFINITIONS Abbreviations AAI Adult Attachment Interview ECR Experiences in Close Relationships Scale HLM Hierarchical Linear Modeling LBDQ Leader Behavior Description Questionnaire LPC Least Preferred Coworker LMX Leader Member Exchange MLQ Multifactor Leadership Questionnaire WRI Workplace Relationships Inventory Definitions Active management-by-exception – style of leadership in which the leader takes corrective action on the basis of results of leader–follower transactions by anticipating problems. Achievement oriented