Baqiyatallah University of Medical Sciences International Journal of Behavioral Sciences 2322-1194 19 2 2025 08 18 Investigating the Effect of Attachment Styles on the Level of Perceived Anxiety and Stress in Women with Polycystic Ovary Syndrome with the Moderating Role of Defense Mechanisms 124 131 230158 10.30491/ijbs.2025.511310.2207 EN Fateme Tadayonghotbabadi Department of Psychology, Faculty of Medicine, Shiraz Branch, Islamic Azad University, Shiraz, Fars, Iran Narges Argha Department of Psychology, Mohaghegh Ardebili University, Ardebil, Iran Maryam Ilati Training and Counseling Department, Central Tehran Branch, Islamic Azad University, Tehran, Iran Zahra Khorasani Department of Psychology, Exceptional Children Education, University of Tehran, Tehran, Iran 0000-0002-3929-6158 Seyedeh-Sara Hoseini Department of Psychology, Quchan Branch, Islamic Azad University, Quchan, Iran 0009-0000-9894-9422 Journal Article 2025 05 21 <strong>Introduction: </strong>This study investigates the influence of attachment styles on perceived anxiety and stress levels in women with Polycystic Ovary Syndrome (PCOS), considering the moderating effect of defense mechanisms. PCOS, a hormonal imbalance, can cause physical changes and other complications, potentially affecting the mental health of women. <strong>Method:</strong> This cross-sectional, descriptive-correlational study used structural equation modeling and path analysis to examine female patients with PCOS attending women's treatment clinics in Tehran in 2022. A sample of 152 women was selected using purposive sampling. Research instruments included the Revised Adult Attachment Scale (RAAS), Beck Anxiety Inventory (BAI), Perceived Stress Questionnaire (PSQ), and Defense Style Questionnaire (DSQ-40). Descriptive statistics and moderation analysis were carried out with Jamovi software version 2.4, while SmartPLS software version 4 was used for path analysis. The p-value of 0.05 was established for this study. <strong>Results:</strong> Findings revealed that avoidant attachment style significantly reduced stress (β=0.19, P=0.012) but not anxiety (β=0.18, P=0.057). Immature defensive style significantly reduced stress (β=0.50, P=0.0001) and moderated the relationship between both avoidant (β=0.32, P=0.013) and secure (β=-0.25, P=0.036) attachment styles and anxiety. <strong>Conclusion:</strong> This research suggests that women with PCOS experience higher stress levels when displaying avoidant attachment and immature defense mechanisms. Conversely, secure attachment can mitigate anxiety, even with inadequate defense mechanisms. These findings may inform the development of psychological interventions to reduce stress and anxiety in this population. https://www.behavsci.ir/article_230158_58f4302e291f1faf8332394bd93dc533.pdf