Abstract
Introduction: Attachment orientations are associated with the severity of posttraumatic stress disorder (PTSD). However, the mediator role of trauma type in the association between attachment orientation and PTSD remains unknown. Method: The relationship between trauma type, attachment, and PTSD was investigated in a large multiple trauma sample (n=3735). All participants were assessed for PTSD using the Harvard Trauma Questionnaire (HTQ) and for attachment orientations utilizing the Revised Adult Attachment Scale (RAAS). Results: Overall, a secure attachment style was related to lower PTSD severity, while insecure attachment styles were related to higher PTSD severity. Although both attachment dimensions were related to PTSD severity, attachment anxiety had greater contribution in predicting PTSD. PTSD symptom clusters were not found to depend on attachment dimensions. Finally, type of traumatic event moderated the association between attachment dimensions and PTSD severity. While among trauma survivors of family illness, the securely attached group showed the lowest PTSD severity, among trauma survivors of disease and physical health, the dismissively attached individuals showed the lowest level of PTSD severity, compared to other attachment groups. Conclusion: The results underscore the importance of taking into account the nature of the traumatic event while assessing the effects of attachment in posttraumatic reactions. Moreover, dismissing attachment style might be adaptive when facing the trauma of disease.
Highlights
Attachment orientations are associated with the severity of posttraumatic stress disorder (PTSD)
Before investigating the study's hypotheses, we assessed the associations between trauma types and attachment style, PTSD diagnosis and PTSD severity, by conducting Pearson’s chi-square tests and One Way Analysis of Variance (ANOVA)
Simple main effects tests revealed that while among trauma survivors of family illness the securely attached group showed the lowest PTSD severity compared to other attachment groups, among trauma survivors of disease and physical health, the dismissively attached individuals showed the lowest level of PTSD severity compared to other attachment groups
Summary
Attachment orientations are associated with the severity of posttraumatic stress disorder (PTSD). Since the introduction of the posttraumatic stress disorder (PTSD) diagnosis in 1980 in the DSM-III [1], a large number of empirical studies have investigated the prevalence of PTSD after different types of traumatic experiences. These studies have concluded that not everyone exposed to a traumatic event develops PTSD, and that some traumatic experiences are associated with a higher risk for developing PTSD than others [2]. Difficulties in processing the emotional experience of a traumatic event are believed to be associated with PTSD. Trauma may affect attachment leading to attachment insecurities [6,7,8]
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