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New research published in the journal Chronobiology International suggests that flight attendants with a preference for evening activity and those who report insecure attachment styles may be more likely to experience symptoms of depression. The study introduces a new “Chrono-Attachment Health Model” to better understand mental health risks in populations with disrupted circadian rhythms, such as shift workers and airline staff.
Flight attendants work in one of the most circadian-disrupted occupations, with irregular schedules, night shifts, and frequent travel across time zones. These patterns desynchronize the body’s internal clock from the external environment, making flight attendants particularly vulnerable to what researchers call “social jetlag” and chronic sleep-wake misalignment. While previous research has linked circadian disruption to negative health outcomes, few studies have examined how chronotype—an individual’s preferred timing for sleep and activity—and attachment styles jointly contribute to mental health outcomes in this setting.
“I became interested in this topic after noticing ongoing environmental stressors and time disruptions affecting under-researched shift worker groups such as flight attendants,” said study author Karim Noureldin, a psychologist and psychotherapist. “This observation fueled my curiosity to explore the connections between individual differences within this population and their mental health outcomes, aiming to guide future interventions tailored for shift workers and frequent travelers.”
Noureldin and his co-author, University of Strathclyde psychology professor Aliyah Rehman, surveyed 288 international flight attendants between the ages of 21 and 55. The majority of participants were female (about 71%) and white (76%), with most based in the United States, Canada, or the United Kingdom. All participants completed a series of online questionnaires measuring their chronotype (whether they preferred morning or evening activity), attachment style, and levels of depression and anxiety. The survey also collected demographic data, job tenure, and information about medication use that could influence mental health.
The most common chronotypes among the flight attendants were intermediate (42%) and evening (41%) types. Only a small minority were classified as morning types. These results align with findings from other studies on shift workers, where eveningness is especially common. Regarding attachment, insecure styles were more prevalent than secure ones, with dismissive-avoidant attachment being the most frequent among the insecure subtypes.
The researchers found that individuals with an evening chronotype reported significantly more symptoms of depression than those with morning or intermediate chronotypes, even after accounting for age, sex, and medication use. However, chronotype was not associated with anxiety levels. In contrast, both attachment anxiety and attachment avoidance were significantly related to higher levels of both depression and anxiety—and these associations were stronger than those observed for chronotype.
To better understand how these factors interact, the researchers conducted a mediation analysis. They found that attachment avoidance partially explained the link between anxiety and depression. In other words, flight attendants who reported higher anxiety and also tended to avoid emotional closeness were more likely to experience depressive symptoms. This suggests that how individuals manage emotional stress—especially through emotional distancing—may exacerbate mental health difficulties over time, particularly when anxiety is already present.
This mediation effect was statistically significant, indicating a small but meaningful indirect pathway from anxiety to depression via attachment avoidance. Attachment anxiety, on the other hand, did not demonstrate a significant mediation effect. These findings echo earlier research indicating that different types of insecure attachment may influence mental health in distinct ways.
The study also found that female flight attendants reported higher levels of depression and anxiety than male flight attendants. This is consistent with broader trends showing women are more likely to experience mood disorders, which may be compounded in high-stress professions like aviation. Younger flight attendants were also more likely to report depressive symptoms, consistent with prior research indicating that younger adults may be more vulnerable to mood disturbances.
“It is important to be aware of a person’s natural circadian rhythm—whether they’re a morning, evening, or intermediate type—and their attachment style, which reflects how they form emotional bonds,” Noureldin told PsyPost. “These factors can interact and relate to symptoms of depression and anxiety.”
“Our findings showed that flight attendants leaned toward being more evening-oriented. Individuals with this chronotype were more likely to experience depression. We also saw that those who worry about relationships (high attachment anxiety) or who tend to avoid emotional closeness (high attachment avoidance) were more likely to report symptoms of depression or anxiety.”
“Interestingly, avoidance in relationships appears to partially explain the connection between anxiety and depression. This suggests that the way someone distances themselves emotionally may influence how anxiety turns into depression—especially in flight attendants, who face disrupted sleep and social stressors. This highlights the importance of considering both circadian and emotional-relational factors when supporting mental health in shift-working populations.”
“This perspective can help uncover deeper psychological processes in therapy—whether through a biopsychosocial framework, psychotherapeutic interventions, or policy decisions,” Noureldin added. “If you can target and change the mediator—in this case, attachment avoidance—you might reduce its negative impact on mental health.”
Like all research, the study has limitations. Because the data were collected at a single time point, the researchers cannot determine whether chronotype or attachment style causes depression and anxiety or whether these traits develop in response to mental health challenges. Also, while the sample was fairly large and included flight attendants from various countries, it was predominantly female and white, which may limit how broadly the results apply.
Still, the findings offer valuable insights into how circadian and psychological factors may interact in a profession known for mental health vulnerabilities. The study introduces the “Chrono-Attachment Health Model,” a framework that combines chronobiology and attachment theory to understand mental well-being in shift-working populations. This model could inform future interventions tailored to flight attendants and similar professions. For example, chronotherapy or attachment-based counseling could help reduce the emotional toll of disrupted sleep and interpersonal stress.
The authors suggest future research should explore these relationships using longitudinal methods to track changes over time. Studying other shift-working groups—such as nurses, first responders, or offshore workers—could also help determine whether similar patterns exist across different high-stress occupations.
“I plan to expand on the research, utilize the Chrono-Attachment Health Model diagnostic tool in other populations, and conduct research in more clinical settings to explore potential interventions for shift workers,” Noureldin said. “Additionally, I’m interested in investigating other mental health outcomes or relationships.”
The study, “Exploring the relationships between chronotypes, attachment styles, and mental health in flight attendants,” was authored by Karim Noureldin and Aliyah Rehman.
