An Attachment Theory Approach to Reframing Romantic Relationship Breakups in University Students: A Narrative Review of Attachment, Neural Circuitry, and Posttraumatic Stress Symptoms

Abstract

Background Non-marital romantic relationship breakups (RRBs) frequently occur among university students. These RRBs constitute stressful events but are conventionally not thought of as traumatic. Current research on RRBs has mainly focused on their association with grief and depression. Aim Using attachment theory, we argue that reframing RRBs as potentially traumatic events that can result in posttraumatic stress symptoms (PTSS) is scientifically justifiable, and that further investigation of the relationship of RRBs to posttraumatic stress disorder (PTSD) phenomenology and pathobiology is warranted. Methods To inform our argument, this narrative review draws on the theoretical approach of attachment theory and its nexus with neuroscience. Results Individuals who experience RRBs report a range of negative psychological consequences including severe distress. RRBs remain one of the primary reasons that university students seek campus counseling services. Among university students, relationship problems also have a strong association with completed suicide. Additionally, functional neuroimaging (fMRI) studies document brain changes in the amygdala and hippocampus in individuals with RRBs (brain changes that are also implicated in PTSD). Lastly, the controversy and debate around what constitutes a traumatic event, especially in terms of Criterion A for a PTSD diagnosis according to the Diagnostic and Statistical Manual 5th edition (DSM-5), remains prevalent. Conclusion Reframing RRBs as possible traumatic events may open the door to treatments that are currently effective for PTSD. Further research on RRBs needs to be holistic within an attachment-neural-behavioral system framework to better understand how RRBs can induce long-lasting negative effects.