The prevalence and risk factors of complex post-traumatic stress disorder in victims of intimate partner violence.

This study examined how preferences for face-to-face, video, written, AI-chatbot, and AI-avatar consultations in the context of primary care vary between routine and emotionally sensitive contexts, how attachment orientations and trust in the diagnosis contribute to these preferences, and whether distinct user preference profiles can be identified.In an online survey of 934 German adults, participants rated the appropriateness of five formats across routine and emotionally sensitive contexts. Predictors included trust in the diagnosis, attachment anxiety and attachment avoidance, perceived efficiency, gender, and technical resources. Multilevel models and cluster analysis were applied.Face-to-face was preferred for sensitive consultations, while video and written formats were acceptable for routine tasks. AI formats were less accepted overall but judged more appropriate when trust in the diagnosis was high. Trust in the diagnosis strongly supported acceptance of AI formats, while perceived efficiency was positively associated with higher acceptance of video and AI formats . Other predictors had minor effects. Three user preference profiles emerged: face-to-face-oriented, digital without AI-oriented, and broadly digital & AI-oriented.Format-dependent trust in the diagnosis outweighed efficiency in predicting acceptance (especially for AI), and attachment orientations offer an interpersonal perspective on these patterns. Digital formats can support routine care, but sensitive consultations require face-to-face contact. Trust in the diagnosis is important for AI acceptance, while attachment orientation helps to interpret interpersonal differences. Patient needs are heterogeneous; services should provide transparent, efficient, and flexible options without replacing face-to-face care.

Both early childhood trauma and insecure attachment styles are linked to psychopathic personality traits. The main aim of the present study was to investigate whether insecure attachment styles may serve as mediating variables between childhood trauma and psychopathy in adulthood. Therefore, a potential mediating role of attachment anxiety and attachment avoidance within a sample of 355 male inmates was examined by investigating childhood trauma, attachment styles (ECR-R), and psychopathy scores (PCL-R). A significant positive association between childhood trauma and psychopathy was replicated. The mediation analysis did not show a significant mediation effect through the attachment styles; however, a significant contrast between the two attachment styles was found, indicating that attachment avoidance played a more important role than attachment anxiety in explaining the degree of psychopathic traits. The findings of the present study highlight the necessity of thoroughly considering attachment styles in the treatment of individuals with psychopathic personality structures.

Internal Working Models (IWMs) are cognitive structures for simulating and predicting relational outcomes. While self-report attachment scales, such as the Experiences in Close Relationships (ECR), effectively measure the emotional and behavioral dimensions of attachment, they do not directly assess the cognitive function that processes attachment-related information. Transactional Analysis (TA) offers the concept of the Adult ego state, defined as the capacity for reality testing and objective information processing. This study examined whether incorporating a measure of Adult ego state functioning alongside attachment assessment could reveal structural relationships not detected by attachment scales alone. A total of 31healthy Japanese adults (7 males, 24 females; mean age = 51.8 years) completed the Experiences in Close Relationships - Generalized Other (ECR-GO) and Tokyo University Egogram (TEG3) before and after participating in a TA-based collage therapy program. Spearman correlations were calculated between ego state scores and attachment dimensions at both time points. At baseline, a significant negative correlation was observed between Adult (A) and Anxiety, that is, negative self-image (ρ = -0.493, p = 0.005), indicating that low self-image and low Adult ego state functioning are associated. This correlation disappeared after the intervention (ρ = -0.312, n.s.), while a new positive correlation emerged between Adapted Child (AC) and Anxiety, that is, negative self-image (ρ = 0.492, p = 0.005). Both Anxiety and Avoidance decreased significantly (p < 0.0001). The inverse relationship between Adult ego state and attachment anxiety at baseline, and the subsequent change in correlation patterns, may suggest structural reorganization consistent with the TA concept of decontamination. This study is a correlation-based analysis and does not constitute causal inference. The concurrent use of cognitive function measures and attachment scales can reveal structural relationships that attachment measures alone cannot detect. Further research with larger samples is warranted.

Eating disorders among adolescents have emerged as a significant global public health concern, with attachment anxiety identified as a critical risk factor for anorexia nervosa (AN) symptoms. Individuals with attachment anxiety often exhibit heightened sensitivity to others' perceptions and an intense fear of rejection, which may exacerbate their vulnerability to body image concerns. This study investigates the mediating role of appearance-based rejection sensitivity (ARS) and the moderating effect of sex in the relationship between attachment anxiety and AN symptoms among Chinese college students. A total of 826 participants aged 16-25 (M = 18.95, SD = 1.08, 60% females) completed online surveys using three validated scales: the Revised Adult Attachment Scale (RAAS) to assess attachment anxiety, the Appearance-based Rejection Sensitivity Scale (ARSS) to measure sensitivity to rejection related to physical appearance, and the Eating Disorders Inventory (EDI) to evaluate AN symptoms. The results reveal that there was no significant difference in attachment anxiety between males and females, while females experienced significantly higher levels of ARS and severity of AN symptoms than males. Attachment anxiety is positively correlated with AN symptoms, with ARS mediating this association. Sex further moderates the relationship between ARS and AN symptoms, with stronger effects observed in females. Current findings suggest that AN symptoms are closely associated with contemporaneous attachment anxiety, with passive sensitivity to potential rejection acting as a mediating factor. This underscores the importance of addressing attachment styles and communication patterns in interventions targeting adolescent AN symptoms, particularly in females.

Despite research increasingly focusing on romantic relationships with AI companions, little is known about the psychological mechanisms that drive people to engage in such synthetic bonds. Based on attachment theory, this three-wave panel study first examines the reciprocal associations between attachment style and AI companion use. Random intercept cross-lagged panel models demonstrated that, at the within-person level, changes in people’s attachment anxiety over time were positively related to their AI companion use, and that, at the between-person level, people higher in attachment anxiety used AI companions more, whereas those higher in attachment avoidance used less. These findings highlight the need to disentangle within- and between-person dynamics to derive more accurate conclusions when examining underlying drivers in human-AI interactions, as well as offer new insights into the emerging human-AI relationship field by serving as a springboard for understanding how engagement with AI companions may be related to attachment styles longitudinally.

Background The prevalence of problematic social media use among college students has reached levels that constitute a public health concern. This study aimed to investigate the relationship between insecure attachment (attachment anxiety and attachment avoidance) and problematic social media use, while exploring the potential mediating roles of social support and social anxiety. Methods The study utilized the Intimacy Experience Scale, the Interaction Anxiety Scale, the Social Support Scale, and the Problematic Social Media Use Scale to investigate 454 college ( M age = 20.33, SD = 2.15, 74.2% female). Results The results showed that both attachment anxiety and attachment avoidance were positively correlated with problematic social media use. The results of the chain mediation model indicated that both social support and social anxiety independently mediated the relationship between attachment anxiety and problematic social media use. Furthermore, social support and social anxiety acted as chain mediators between attachment anxiety and problematic social media use. A similar chain mediation pathway was identified for attachment avoidance, whereby social support and social anxiety also served as sequential mediators. Conclusion These findings offer new insights for the intervention and treatment of problematic social media use. The implications of the results are discussed.

Capacities for giving compassion to others, being open to others' compassion, and self-compassion are not always balanced for everyone. Identifying unique compassion profiles provides a holistic understanding of how the balance or imbalance among different facets of compassion relates to psychopathology and well-being. Using latent profile analysis (LPA) with U.S. college students (N = 884), the present research revealed four profiles: low compassion, moderate compassion, high compassion, and self-sacrificing compassion. Participants in the moderate and high compassion profiles presented with the lowest psychological distress and highest well-being. Participants in the self-sacrificing compassion profile (i.e., high compassion for others, low compassion from others, and low self-compassion) demonstrated the highest distress and lowest well-being. The study also found that attachment anxiety and attachment avoidance predicted greater odds of being classified as low compassion and self-sacrificing compassion compared with the other two profiles. These findings suggest the need to consider the full picture of how compassion toward self and others manifests for an individual, as this might have important implications in psychotherapy and educational settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The study investigated associations among spiritual well-being, attachment styles, and marital satisfaction in 353 women married before age 18. Findings indicated that avoidant and anxious attachment were strongly and negatively associated with marital satisfaction, whereas spiritual well-being was positively related to marital satisfaction. The findings suggest that attachment patterns and spiritual well-being are meaningfully related to marital satisfaction in this population. These results highlight the potential value of family-therapy approaches that address insecure attachment and support spiritual well-being to enhance relational functioning among women who married at a young age in contemporary clinical practice today.

ABSTRACT Insecure attachment dimensions have been associated with poorer sleep quality and less health-promoting behaviours, but the mechanisms underlying these associations are not fully understood. This study examined whether sleep hygiene mediates the relationship between adult attachment dimensions and sleep quality. Adult participants were recruited via an online opportunity sample and completed measures of attachment anxiety and avoidance, sleep hygiene, and sleep quality, along with demographic and psychological covariates. Multiple regression and mediation analyses were conducted to test whether attachment dimensions predicted sleep hygiene and sleep quality, and whether sleep hygiene partially accounted for these associations while statistically controlling for sex, age, anxious and depressed mood, and fatigue. Higher scores on both attachment anxiety and attachment avoidance were associated with poorer sleep hygiene and poorer sleep quality. Sleep hygiene partially mediated the relationships between both insecure attachment dimensions and sleep quality, suggesting that attachment-related differences may influence everyday sleep-related behaviours, which in turn are linked to sleep outcomes. Future research should evaluate whether incorporating attachment-based strategies into sleep hygiene and sleep interventions can enhance their effectiveness.

This study examined indirect pathways from attachment to post-divorce growth (PDG) through self-efficacy and the moderating role of social support among divorced Korean women. Data from 191 women aged 20–49 were analyzed using PROCESS Models 4 and 14. Attachment anxiety showed a positive direct association with PDG but a negative indirect effect via reduced self-efficacy, indicating suppression. Attachment avoidance was consistently negatively associated with PDG. Informational support strengthened PDG among women high in attachment anxiety. Findings highlight the clinical relevance of growth-oriented, systemic, attachment-informed family therapy interventions conceptualizing divorce as a relational transition within broader familial and sociocultural systems.

Social relationships are shaped by a complex interplay of interests and emotions, making negative interactions inevitable. Research on negative bias and loss aversion demonstrates that people are more sensitive to negative interactions, which often leads to social distancing. However, one study found that individuals with anxious attachment styles may actively seek partners who treat them poorly, suggesting that such relationships can strengthen bonds. But the cognitive mechanisms underlying how negative relationships can signal positive relational outcomes remain unclear. Through five experiments, we examine how shared negative relationships help individuals infer positive relationships and explore the underlying mechanisms. We conducted five pre-registered experiments (N = 1,085; Mage = 20.22, SD = 2.05) using hypothetical scenarios and social network methodologies. In Experiment 1, participants inferred interpersonal relationships from images depicting shared negative relationships. Building on this, Experiment 2 specifically focused on images of bidirectional shared negative relationships. Experiment 3 extended this paradigm to the intergroup level, where participants inferred relationships between groups based on shared negative relationships with a third-party. Experiment 4 refined this focus by examining in-group and out-group dynamics, asking participants to infer relationships from images of shared negative relationships between members of these distinct groups. Finally, Experiment 5 employed a simulated social network paradigm in which participants inferred relationships by learning and remembering social knowledge within an incomplete network, thus modeling real-world social inference under uncertainty. Our results showed that humans can (a) infer positive relationships from shared negative ones and their quantity; (b) adjust these inferences by group size and contextual boundaries-shifting from resource-based inferring in ambiguous settings to identity-based mechanisms in well-defined groups; and (c) shape network representations from incomplete social knowledge, revealing human differences in cognitive mechanisms. While negative relationships can weaken social experiences, shared negative interactions can serve as prosocial tools for inferring positive relationships. Research shows that humans adjust their strategies based on relationship quantity and group structure, enabling them to build networks from incomplete social knowledge.

Family counselors often use relational attachment principles in their work with clients. These attachment principles can also be applied to clients’ faith beliefs, in terms of secure or insecure spiritual attachment styles. More research is needed on the ways in which spiritual attachment intersects with mental health issues, such as problematic dieting behaviors. In the present study, we examined the association between spiritual attachment styles and dieting behaviors among college student participants. We found that an anxious spiritual attachment, which tapped into participant uncertainty and doubt about God or a Higher Power's care, was associated with increased dieting. We discuss the implications of these findings related to how an individual's beliefs about their relationship with God or a Higher Power may be salient to their dieting behaviors. Family counselors can address issues of spiritual attachment in their work with clients.

Self-esteem and attachment are core constructs in adult relational functioning, yet their interrelations across levels of cognitive processing have remained understudied. This study investigated how explicit and implicit attachment styles relate to self-esteem in individuals seeking a romantic partner (N = 399) and in a partnered sample (N = 108). Participants completed explicit attachment and self-esteem scales, along with three single-target Implicit Association Tests (IATs) assessing implicit self-esteem and avoidant and anxious attachment styles. Regression analyses were conducted using explicit and implicit attachment as predictors of explicit and implicit self-esteem while controlling for covariates. In singles, explicit anxious attachment was negatively associated with explicit self-esteem, while implicit anxious attachment and implicit avoidant attachment were negatively associated with implicit self-esteem. No cross-level associations were found, supporting a parallel-level interpretation in which explicit and implicit variables relate primarily within, rather than across, processing levels. The same regression models applied to the partnered sample showed generally similar trends, although the associations observed in singles for explicit anxious and implicit avoidant attachment were not detected in the partnered group. The inclusion of implicit measures provides new insight into non-conscious relational insecurity, with both implicit anxious and avoidant attachment showing negative associations with implicit self-esteem.

Artificial intelligence (AI) has increasingly transitioned from a functional technological tool to a psychologically meaningful presence in the daily lives of college students. Beyond academic assistance, AI systems are now frequently used for emotional expression, companionship, and non-judgmental support, raising important questions regarding emotional bonding and attachment-like relationships with non-human agents. Drawing on attachment theory, the present study aims to examine how attachment styles—specifically attachment anxiety and attachment avoidance—are associated with emotional bonding, trust, and reliance on AI among college students. The study adopts a quantitative research design with a sample of 60 undergraduate students aged 18–23 years from a university in Mohali, India. Data will be collected using an adapted version of the Experiences in Close Relationships (ECR) Scale to assess attachment anxiety and avoidance toward AI, along with selected subscales of the Godspeed Questionnaire Series measuring anthropomorphism, likeability, and trust. Responses will be obtained through online questionnaires, and descriptive and correlational analyses will be conducted to explore relationships between attachment dimensions and emotional engagement with AI. It is anticipated that students with higher attachment anxiety will report stronger emotional bonds, greater trust, and increased reliance on AI for emotional support, whereas attachment avoidance may be associated with more instrumental and emotionally distant patterns of use. The expected findings aim to position AI not merely as a technological tool but as an emerging relational entity in students’ psychological lives. This study contributes to the growing literature on human–AI interaction by applying attachment theory to understand evolving emotional dynamics, while also highlighting implications for mental health practice, ethical AI design, and the prevention of over-reliance on artificial agents.

Abstract Volunteers can help to reduce social isolation in patients with psychosis. However, little is known about the role of patient attachment style in the relationships established between patients and volunteers. This mixed methods study, using a convergent parallel design, aimed to investigate these relationships, and whether patient attachment style affects them. The sample size for both qualitative and quantitative analysis was 34. The Scale to Assess Therapeutic Relationship (Patient and Volunteer versions) and the Revised Adult Attachment Scale were used to investigate the therapeutic relationships and attachment styles. The Spearman’s Rho test revealed a moderate positive correlation between the ratings of the therapeutic relationship of volunteers and patients ( r = 0.538, p = 0.032). No significant influence was found of patient attachment style on the relationship with the volunteers [close attachment ( r = 0.39, p = 0.16), dependent attachment ( r = 0.12, p = 0.66), and anxious attachment ( r = − 0.23, p = 0.4)]. Thematic analysis was conducted on the end of study semi-structured interviews. Seven themes were found: support in the patient-volunteer relationship, trust in the volunteer, impact of the relationship on patients and volunteers, communication between patients and volunteers, attitudes towards the relationship between patients and volunteers, traits of a secure attachment style, and traits of an insecure attachment style. No influence was found between patient attachment style and patient-volunteer relationship. Given the brief intervention, further research is required to investigate these phenomena in greater depth.

This study investigates the interplay between insecure attachment styles, materialism, and phubbing behaviors. Phubbing, the act of ignoring a partner in favor of smartphone use, is influenced by individual differences and societal norms. We hypothesized that attachment anxiety and avoidance would be positively associated with both enacted and perceived phubbing, and that materialism would mediate these relationships. Data were collected from 213 participants using validated scales for attachment, materialism, and phubbing. The results confirmed that attachment anxiety is positively associated with both enacted and perceived phubbing, while attachment avoidance is positively associated with perceived phubbing but not enacted phubbing. Materialism was found to mediate the relationship between attachment insecurity and phubbing behaviors. Specifically, materialism significantly mediated the positive relationships between attachment anxiety and both enacted and perceived phubbing, as well as between attachment avoidance and perceived phubbing. These findings suggest that materialistic values amplify the effects of insecure attachment on phubbing, highlighting the role of materialism as a compensatory mechanism for attachment-related insecurities. Future research should explore interventions targeting materialism and attachment anxiety to mitigate phubbing behaviors and improve relationship quality.

ABSTRACTEmotional eating is critical in the development and maintenance of obesity among children and adolescents. While attachment's influence on emotional eating is increasingly recognised, little is known about how emotion regulation strategies mediate this, particularly in samples with obesity. This study examined how attachment dimensions affect emotional eating through different emotion regulation strategies in youths with obesity. 772 children and adolescents (ages 7–19) with obesity participated. Key variables were measured using validated questionnaires. Mediation effects were analysed through Structural Equation Modelling, with exploratory analyses assessing the role of the emotion regulation strategies diversity index and specific emotion regulation strategies. Higher attachment anxiety and avoidance were associated with greater emotional eating, both directly and indirectly through maladaptive emotion regulation strategies. Adaptive strategies did not show mediating effects. Attachment anxiety and avoidance increased the diversity of emotion regulation strategies, which was associated with higher emotional eating. Interventions may benefit from prioritising the effectiveness of these strategies and addressing maladaptive ones. Excessive diversity of emotion regulation strategies could reflect underlying difficulties and may be associated with higher emotional eating. A deeper understanding of the interplay between attachment and emotion regulation could inform more targeted approaches for preventing and treating obesity in youth.

ABSTRACTChronic stress has well‐documented adverse effects on physical and psychological health. Beyond contributing to the development of fatigue, its impact is intensified by social stressors such as loneliness, making the development of effective interventions crucial. Our randomised controlled trial therefore investigated whether a 14‐day self‐soothing touch (SST) intervention reduces stress, fatigue, and loneliness compared to a minimal‐instruction meditation control in 78 chronically stressed individuals (MAge = 22.2 years; 81% female). We assessed acute (change pre‐to‐post session) and cumulative effects (across days) using Ecological Momentary Assessment (EMA), while also collecting retrospective self‐reports at baseline, post‐intervention, and 4‐week follow‐up. For EMA outcomes, we additionally tested moderation by attachment anxiety and avoidance. Using linear mixed‐effects models, both SST and meditation significantly reduced momentary stress (SST: b = −0.41, SE = 0.08, t = −4.79, p < 0.001; Control: b = −0.56, SE = 0.09, t = −6.43, p < 0.001), as well as fatigue (pSST < 0.001, pControl < 0.001) and loneliness (pSST ≤ 0.011, pcontrol = 0.004) from pre‐to‐post session, with no significant group differences (all ps ≥ 0.212). SST but not meditation yielded a decrease in pre‐session fatigue across the intervention period (b = −0.06, SE = 0.02, p < 0.001), with stronger reductions among individuals higher in attachment avoidance. In contrast, neither intervention had effects on retrospective measures (all ps ≥ 0.117). Overall, SST emerged as a feasible and accessible approach, comparable to brief meditation in reducing stress, fatigue, and loneliness, with additional benefits particularly for those high in attachment avoidance.

First responders are at greater risk of developing posttraumatic stress disorder (PTSD) due to constant exposure to potentially traumatic events. Studies have shown that both insecure attachment and emotion dysregulation contribute to more PTSD symptom severity. However, it is unclear whether emotion dysregulation explains relationships between insecure attachment and PTSD symptoms, especially among Black, Indigenous, and People of Color (BIPOC) first responders. A total of 188 trauma-exposed BIPOC first responders (Mage = 35.40; 71.80% men) residing in Canada completed research questionnaires. The direct and indirect effects of attachment insecurity (i.e., attachment anxiety and attachment avoidance) on PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity) via emotion dysregulation were examined via PROCESS macro Model 4. Results showed that emotion dysregulation mediated the relations between attachment anxiety/avoidance and all four PTSD symptom clusters (Bs = .02 to .16; R² = 19.79% to 38.15%). Trauma-exposed BIPOC first responders with insecure attachment styles are more likely to experience difficulties regulating emotions, which increases the severity of all four PTSD symptom clusters. Culturally congruent, trauma-informed treatments may benefit from targeting emotion regulation among BIPOC first responders to improve posttrauma well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).