Insecure Attachment Orientations Research Articles

The Mediating Role of Posttraumatic Stress Symptoms in the Relationship between Adult Attachment and Quality of Life.

There is evidence that anxiety and avoidance toward close relationships (i.e., insecure attachment orientations), as well as posttraumatic stress symptoms (PTSSs), are linked to a poor quality of life. The current study aimed to investigate the potential mediating effects of PTSSs on the associations between insecure attachment orientations and domains of quality of life. A convenience sample of 497 adults (375 females, 75.5%), ranging in age between 18 and 65 years old (M = 32.48, SD = 13.26), was recruited. Participants were administered self-report instruments assessing attachment anxiety and avoidance, PTSSs, and domains of quality of life, including physical health, psychological status, social relationships, and environment. A series of mediation analyses were performed to test the mediating role of PTSSs in the relationships between attachment orientations and domains of quality of life. Results showed that attachment anxiety was related to decreased levels of quality of life in all domains, and that their associations were mediated by PTSSs. Also, attachment avoidance was related to a worse quality of psychological status and social relationships, and PTSSs were a significant mediating variable in these associations. Prevention programs and clinical interventions focused on promoting effective strategies for managing distress might be critical in reducing the impact of distressing events on the quality of life of individuals with insecure attachment.

The moderating role of parenting stress when it comes to romantic attachment and sexual satisfaction

Sexual satisfaction is at the heart of a thriving romantic relationship and is intertwined with both partners romantic attachment orientations. Prior research has found that insecure romantic attachment orientations (anxiety and avoidance) are associated with lower sexual satisfaction in oneself and one’s partner. Stress is known to exacerbate insecure attachment tendencies, and couples with children are often exposed to parenting stress, which has been associated with lower sexual satisfaction. It is therefore possible that parenting stress moderates the association between the attachment and sexual systems, such that among those who are high in parenting stress, the negative link between attachment insecurity and sexual satisfaction is stronger. The objective of this study was to examine the link between romantic attachment and sexual satisfaction, and the impact of parenting stress on this association. One hundred three mixed-sex couples completed self-report questionnaires and were included in actor and partner analyses. Both parents’ attachment avoidance was associated with their own reduced sexual satisfaction. Fathers’ attachment avoidance was associated with mothers’ reduced sexual satisfaction. Additionally, fathers’ parenting stress moderated the association between their own romantic attachment avoidance and their partner’s sexual satisfaction. Contrary to prediction, as fathers’ parenting stress increased, the association between their higher attachment avoidance and mothers’ lower sexual satisfaction became weaker. Findings are discussed in light of research and theory on the role of attachment and parenting stress for sexual satisfaction in couples with children.

How Does Trauma Make You Sick? The Role of Attachment in Explaining Somatic Symptoms of Survivors of Childhood Trauma.

Exposure to traumatic events during childhood is common, and the consequences for physical and mental health can be severe. Adverse childhood experiences (ACEs) such as physical abuse, sexual abuse, emotional abuse, and neglect appear to contribute to the onset and severity of a variety of somatic inflictions, including obesity, diabetes, cancer, and heart disease. The aim of this scoping review was to try to gain insight into how this might occur. Given the evidence of indirect (i.e., through unhealthy behaviours such as excessive drinking or poor eating habits) and direct (i.e., through its impact on the endocrine, immune, and cardiovascular systems as well as on the brain) effects of attachment on health, we examined the possibility that insecure attachment might contribute to the development of somatic symptoms in adult survivors of childhood trauma. Eleven studies met our inclusion criteria. Findings from this review suggest that insecure and disorganized attachment orientations are related to DNA damage, metabolic syndrome and obesity, physical pain, functional neurological disorder, and somatization in adults exposed to childhood trauma. We discuss the implications of this for the conceptualization and treatment of trauma and stress disorders.

Pre-event attachment anxiety and avoidance predict posttraumatic stress symptom severity – Results from a longitudinal population-based study

Attachment-related anxiety and avoidance have been identified as risk factors for psychopathology following traumatic events. However, the predictive value of pre-event attachment orientations for PTSD symptoms in the general population remains unclear. Attachment anxiety and avoidance, as well as symptoms of anxiety and depression, were assessed in autumn 2010 (T0) in 270 adult members of a Dutch research panel. PTSD symptoms were assessed in April (T1), August (T2), and December (T3) 2012 for events occurring within one year before T1. The predictive value of attachment orientations for severity and remission of PTSD cluster and total scores was estimated by latent growth curve analyses controlling for gender, age, and pre-event psychopathology. Attachment anxiety predicted higher posttraumatic stress severity at T1, while attachment avoidance predicted lower initial posttraumatic stress levels, together adding 7.4 % independently explained variance. Higher attachment anxiety was related to more remission of PTSD total scores (6.0 % independently explained variance) which might be understood as an effect of regression to the mean. In conclusion, insecure attachment orientation predicts PTSD symptoms in the general population. Our results advocate the significance of pre-traumatic factors for the prediction of posttraumatic stress and the consideration of attachment orientations in clinical work with trauma survivors.

‘I just know I am upset, and thats it!’: The role of adolescents’ attachment, emotions, and relationship with caregivers in residential care

AbstractAccording to the attachment theory, the establishment of emotional bonds with significant figures is an important process in human development throughout life. The quality of the relationships between adolescents and their caregivers in residential care (RC) may act as a protective factor for internal reorganisation and the development of emotional regulation skills. The present study aims to analyse the effect of insecure attachment orientation and the quality of relationships developed with caregivers in RC settings and adolescent emotion regulation. It also aims to assess the mediating role of emotion regulation in the association between attachment and the quality of the relationship with caregivers. The sample consisted of 249 adolescents, aged between 12 and 18 years old, living in RC facilities in Porto (Portugal). The results suggest that perceived insecurity of attachment to significant figures has a negative effect on emotional regulation and on the quality of the relationship with caregivers. We also found a negative mediating effect of the differentiating emotions dimension on the association between attachment and the quality of the relationship with caregivers. It is relevant to highlight the importance of close affective relationships in developing adolescents' ability to regulate their emotions and particularly the impact of caregivers and their work in residential care.

Sensitivity and Attachment in an Italian Sample of Hikikomori Adolescents and Young Adults.

Hikikomori is a severe form of social withdrawal increasing among the young Italian population. Hikikomori has been connected to psychological problems and high environmental sensitivity. Nevertheless, only a few studies have been carried out in the Italian context, and they did not analyze several aspects strictly related to the hikikomori phenomenon, such as the role of attachment and sensitivity. We aimed to investigate the relationship between attachment, sensitivity, and psychological problems in a sample of Italian hikikomori. Our sample comprised 72 Italian adolescents and young adults (49 males and 23 females), meanly aged 22.5 years, recruited through online forums and clinical centers for the hikikomori phenomenon. Our participants fulfilled the Highly Sensitive Person Scale (HSPS), the Attachment Style Questionnaire (ASQ), and the Hopkins Symptom Checklist (SCL-90-R). The results showed high psychological issues (i.e., depression and anxiety), environmental sensitivity, and insecure attachment orientations. Moreover, we discovered a significant relationship between attachment dimensions, environmental sensitivity, and psychopathology. Our study sheds light on a novel research path and could help both the researchers and the clinicians who work with people suffering from social withdrawal.

Insecure Attachment Orientation in Adults and Children and Negative Attribution Bias: A Meta-Analysis.

This is the first meta-analysis to synthesize the literature on insecure attachment and negative attribution bias (NAB) from both developmental and social/personality attachment traditions. This meta-analysis is important because extant studies report inconsistent associations, making it difficult to draw conclusions about the nature of these associations. Based on 41 samples (N = 8,727) from 32 articles, we specify and compare the effect sizes of these associations across studies. Results confirmed positive associations between NAB and anxious and avoidant attachment dimensions and an insecure composite, with a medium effect size. Correlations were moderated by age group, type of attachment measurement, and cultural background. Our findings advance knowledge and build on attachment and attribution theories, reconcile mixed findings, and inform the development of NAB interventions. Important gaps in the literature are revealed that will inspire future research.

Attachment in the time of COVID-19: Insecure attachment orientations are associated with defiance of authorities' guidelines during the pandemic.

Previous research has linked people’s relational attachment orientations to emotional reactions and coping during crises, and to social trust and trust in societal institutions. The COVID-19 pandemic is a global crisis for which collective efforts, such as social distancing, are necessary to stop the spread of the virus. During previous pandemics, people high in trust have typically adhered to such efforts. In the present study, we investigated whether attachment orientations were related to people’s adherence to authorities’ guidelines to stop the spread of COVID-19. We also tested whether previous mediational findings—linking attachment-related avoidance to welfare state trust via social trust—would replicate. We used a web-based survey of 620 participants. Our findings showed that attachment-related anxiety was linked to low adherence to social distancing regulations. This finding was especially noteworthy because high attachment-anxious participants also experienced more negative emotions, yet negative emotions were generally linked to high adherence. Thus, people higher in attachment anxiety seem to have more difficulties in avoiding social situations despite heightened risk of catching and spreading the virus. In addition, attachment-related avoidance was negatively related to adherence and to welfare state trust, and its effects on welfare state trust were statistically mediated by low social trust.

Attachment orientation and depression: A moderated mediation model of self-silencing and gender differences.

While the effect of insecure attachment on depression is well established, findings pertaining to the relationship between specific attachment dimensions (anxious and avoidant) and depression are inconsistent. The role of interpersonal factors underlying this effect has been little explored. 'Silencing the Self', a socio-cognitive construct may provide important insights as a mediating pathway from insecure attachment to depression and help resolve the inconsistencies. The present study explored the mediating effect of self-silencing and the role of gender as a moderator in the relation between insecure attachment orientation (i.e. avoidant and anxious) and depressive symptoms. Data was collected via an online survey, from 121 adults who were in a relationship. The participants were asked to complete three self-report questionnaires, assessing attachment orientation, silencing the self and depressive symptoms. Moderated mediation analysis was performed using conditional process analysis. The results indicated that the effect of both insecure attachment dimensions on depressive symptoms was mediated by silencing the self. In addition, gender moderated the association between insecure attachment and self-silencing. This study adds to the literature on mediating pathways between insecure attachment and depression, and provides a new perspective for therapeutic interventions in the context of depression. It indicates that professionals should focus on current social context and relational schemas of individuals with an insecure attachment, especially women, while treating cases of depression in clinical settings.

Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia

Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD. The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality. One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up. (1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index. Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition. Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress. Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties. Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity.

Interparental conflict and relational attitudes within romantic relationships: The mediating role of attachment orientations

Early experiences and childhood perceptions of interparental conflict (IPC) have consistently been shown to have detrimental consequences for future psychological adjustment, in particular for attachment and couple relationships during adolescence and adulthood. We hypothesized that 1. IPC would predict anxious and avoidant attachment styles, and three relational attitudes associated with couple relationships: sense of relational entitlement, pathological concern, and authenticity; and 2. Attachment style would mediate the associations between IPC and these three relational attitudes. Measures of perceived IPC, attachment orientations, relational entitlement, pathological concern, and authenticity in romantic relationships were completed online by 280 young adults aged 19–32. IPC was positively correlated with anxious and avoidant attachment styles, restricted and inflated sense of entitlement, and pathological concern and negatively with authenticity. A structural equations model showed that IPC predicted avoidant and anxious attachment styles, which positively predicted an inflated and restricted sense of relational entitlement and pathological concern and negatively predicted authenticity. Attachment styles fully mediated the relationships between IPC and the relational attitudes. IPC therefore seems to be related to imbalanced attitudes in romantic relationships, due in part to a propensity toward insecure attachment orientations. Children with insecure attachment who are exposed to significant levels of IPC may be at high risk for relationship problems later in life because of difficulties exposing their vulnerability, assessing need fulfillment realistically, and caring for themselves as well as others. They should therefore be helped to communicate their relational needs to significant others, in particular to their partners.

I Need a Doctor, Call Me a Doctor: Attachment and the Evaluation of General Practitioners before and during the COVID-19 Pandemic.

Attachment is a system of threat regulation, and insecure (anxious and avoidant) attachment orientations are important individual difference antecedents to the cognitive and affective attributions of trait inferences. However, little is known about how threat-related contexts, such as the current COVID-19 pandemic, influence attachment-related socio-cognitive schemas. Using an experimental research design across two independent samples of 330 (pre-onset of COVID-19) and 233 (post-onset of COVID-19) participants, we tested whether attachment orientations influenced general practitioner (GP) ratings and selection differently pre- and post-onset of the COVID-19 pandemic. We found that during the COVID-19 pandemic, when presented with only negative information signals, avoidant individuals attributed positive ratings to GPs, with differing ratings as the number of positive signals increased. Differences between pre- and post-onset of the COVID-19 pandemic were less pronounced with regards to positive signals. We discuss these results in line with signal detection theory (SDT) and provide practical implications in response to our findings.

Attachment insecurities and body image self-consciousness among women: The mediating role of pornography use

The present study examined the mediating role of pornography use between attachment insecurities and body image self-consciousness in a large sample of women. We hypothesized that pornography use would mediate the relationship between insecure attachment orientations and body image self-consciousness. We recruited a convenient sample of 1001 Israeli women who completed measures assessing attachment orientation, body self-consciousness, and pornography use frequency. We employed structural equation modeling with maximum likelihood estimation method to examine the direct pathways between attachment and body image self-consciousness, as well as the indirect, or mediational, pathways through pornography use. Results found a direct effect of anxious and avoidant attachment on body image self-consciousness in women regardless of their relationship status. However, we only found a mediating role of pornography use between anxious attachment and body-image self-consciousness in women currently in a romantic relationship. In conclusion, our results suggest women may be more susceptible to the influence of pornography use on their body image self-consciousness when they are anxiously attached to a romantic partner. Implications for clinical practice and future directions are discussed.

Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy

Severe posttraumatic stress symptoms (PTSS) are connected to a variety of health-related and interpersonal problems, among them are the insecure attachment orientations. However, psychotherapy seems to improve not only PTSS but also attachment insecurities. In a large multicenter, randomized clinical trial, the attachment characteristics and PTSS of 85 adolescents and young adults (aged 14–21 years) with clinically relevant abuse-related PTSS were assessed at study entry, at the end of treatment, and 3 months after the end of treatment. Participants were randomized either to a developmentally adapted cognitive processing therapy (D-CPT) or to a wait-list with treatment advice (WL/TA). The purpose of the study was to analyze the association between PTSS and attachment at study entry as well as changes in attachment during the trial. We found that attachment-related avoidance (AR avoidance) was positively associated with PTSS from both self-reports and clinician ratings, whereas attachment-related anxiety (AR anxiety) was only related to self-reported PTSS (Pearson correlation coefficients between 0.37 and 0.46). Changes in AR anxiety occurred in both conditions at some point during the study (baseline to 3-month follow-up effect size was d = 0.60 for D-CPT and d = 0.44 for WL/TA) whereas for AR avoidance, only participants in D-CPT improved significantly (baseline to 3-month follow-up effect size was d = 0.75). The results indicate that PTSS and attachment are connected. Positive changes in attachment insecurities brought about by trauma-focused psychotherapy seem possible.Trial registration: German Clinical Trials Register (DRKS); Germanctr.de; identifier: DRKS00004787; date of registration: 18 March 2013.

Psychological Abuse as a Mediator Between Insecure Attachment Orientations and Relationship Satisfaction

ObjectiveTo test the mediating effect of perpetrating psychological abuse between insecure attachment orientations and relationship satisfaction among couples.MethodThe mediating effect of psychological abuse between attachment orientation and relationship satisfaction was investigated among 128 couples (N = 256 participants) in enduring relationships using the actor–partner interdependence model.ResultsActor effects indicated men and women higher in anxious attachment perpetrate more psychological abuse, which in turn is linked to their low personal relationship satisfaction. Partner effects revealed two significant paths: Women higher in anxious attachment perpetrated more psychological abuse, which in turn was negatively linked to their partners' relationship satisfaction. Second, the higher the women's attachment anxiety, the more their partners perpetrated psychological abuse, which in turn was negatively linked to partners' relationship satisfaction.ConclusionsResearch on attachment and psychological abuse within romantic relationships could benefit from including a dyadic perspective. Although seen as an invisible harm, psychological abuse is a distinct type of abuse. It has a unique role in fulfilling attachment needs, as well as potentially damaging consequences on the individual and the dyad.

Perceived Social Support Mediates the Negative Impact of Insecure Attachment Orientations on Internalized Homophobia in Gay Men

ABSTRACT The mediating effect of perceived social support on the influence of insecure attachment orientations on internalized homophobia was assessed in a group of 70 Italian gay men (mean age = 28.8, SD = 6.2, range: 19–46 years). Participants completed self-report measures of adult attachment (Experiences in Close Relationships—Revised), perceived social support (Multidimensional Scale of Perceived Social Support), and internalized homophobia (Measure of Internalized Sexual Stigma for Lesbians and Gay). Higher levels of attachment anxiety and avoidance, and perceptions of lower social support were correlated with higher levels of internalized homophobia. The mediation analyses showed that only attachment anxiety, but not avoidance, may have a direct link with internalized homophobia, while both anxiety and avoidance may have an indirect influence on internalized homophobia mediated by perceived social support. Improving social support can reduce the negative effects of homophobia on gay men, thus mitigating the detrimental fallout of any insecure attachment orientations.

Attachment, Sense of Entitlement in Romantic Relationships, and Sexual Revictimization Among Adult CSA Survivors.

Insecure attachment orientations are disproportionately frequent in child sexual abuse (CSA) survivors and have been found to mediate some of the effects of CSA on adult interpersonal and romantic difficulties, including sexual revictimization (SR). A sense of relational entitlement (SRE) has received growing attention in psychological discourse and research in recent years. It reflects both adaptive (assertive) and pathological (restricted or inflated) attitudes to the assertion of needs and rights and has not been studied in adult CSA survivors. The purpose of this study was to examine associations between CSA, attachment orientations, SR, and SRE. Sixty-seven Israeli women aged 25 ± 3.95 years (30 adult CSA survivors and 37 healthy female controls with no history of CSA) completed a demographic questionnaire and self-reported measures of adult attachment orientations, sense of entitlement in romantic relationships, and adult SR. CSA survivors reported greater attachment anxiety and attachment avoidance, more restricted SRE, and higher revictimization rates than control women. No difference was found between the groups in inflated SRE. In the CSA but not the control group, anxious and avoidant attachment orientations were significantly and negatively associated with assertive SRE. Insecure (anxious and avoidant) attachment fully mediated the association between CSA and restricted SRE. Our findings suggest that the interplay between insecure attachment and CSA is related to a sense of impaired assertive entitlement and elevated restricted entitlement in adult CSA survivors. This entitlement pattern can be destructive to survivors' romantic relationships and should be addressed in therapy.

Attachment orientation and relational intimacy: The mediating role of emotional competences

Because emotional exchanges are central in couple interactions, individual competences to manage one’s own emotions and those of others are important to develop a good relational intimacy with a romantic partner over time. It is assumed that individual differences in attachment orientation influence the development of emotional competences and intimacy between romantic partners. While emotional competences are important for the proper functioning of romantic relationships, little is known about their mediating role in the relationship between individual’s attachment orientation and relational intimacy. In five hundred and sixty-four heterosexual subjects, the present study aimed to assess the indirect effects of emotional competences (both intrapersonal and interpersonal) on the relationship between insecure attachment orientations (both avoiding and anxious dimensions) and relational intimacy (i.e., engagement, communication and shared friends dimensions). Direct effects between our variables of interest were also explored. The results highlighted a negative association between both insecure avoiding and anxious attachment orientations and intrapersonal emotional competences. However, only the avoiding orientation was negatively related to interpersonal emotional competences. Furthermore, the anxious attachment dimension was negatively related to a feeling of engagement, in contrast to the avoiding attachment dimension that was associated with a low level of engagement, positive communication, and shared friends. Multi-group analysis highlighted gender invariance in the model. The findings suggest that although insecure attachment has a negative effect on the couple relationship, the capacity to manage one’s own emotions appears to be a protective factor for relational intimacy regarding its mediating role in these associations.

The role of adult attachment orientation and coping in psychological adjustment to living with skin conditions

Skin conditions can impact significantly on everyday life, particularly relationships. However, some patients are more distressed by these problems than others, regardless of disease severity. There is some evidence that the extent to which patients seek support from friends and family (“attachment orientation”) predicts how well they cope with chronic health conditions, but there has been little previous research with regard to skin disorders. These psychologists in Sheffield, UK, investigated this using online questionnaires in 206 adults recruited through universities and patient support groups. Participants had to have been diagnosed with a skin condition by a health care professional and experiencing symptoms over the last 6 months. Psychological adjustment to their skin disorder was assessed using scores for appearance‐related distress and skin‐related quality of life (QoL). Two dimensions of attachment orientation were measured: fear of intimacy (“attachment avoidance”) and fear of abandonment (“attachment anxiety”). The use of 2 coping strategies was also studied: defeatism (e.g. giving up, denial or turning to drugs or alcohol) and activity (humour, venting, seeking help or coming up with a plan). They found that people showing higher attachment avoidance and attachment anxiety reported more defeatist attitudes, resulting in higher levels of appearance‐related distress and lower QoL, both emotional and functioning aspects. Surprisingly, people using active coping strategies also experienced more appearance‐related distress, perhaps being less accepting of their condition. The authors conclude that people with insecure attachment orientation are more troubled by their skin condition and might benefit from psychological interventions targeting underlying attachment orientation.

Sexual anxiety and sexual beliefs as mediators of the association between attachment orientation with sexual functioning and distress in university men and women

Previous research has demonstrated the association between sexual functioning and attachment orientation in women. However, the mechanisms of this relation are not yet well understood, and this effect has not been substantially investigated in men. The current study examines the role of sexual anxiety and dysfunctional beliefs about sexuality as mediators of the correlation of attachment orientation with sexual functioning and distress in both women and men. A university sample of men (n=307) and women (n=716) completed questionnaires assessing attachment orientation, sexual functioning, sexual distress, sexual anxiety, and dysfunctional sexual beliefs. Multiple regression analyses indicated that insecure attachment orientation significantly predicted poorer sexual functioning and higher sexual distress in both men and women. Path analyses showed partial mediation of these effects by sexual anxiety and dysfunctional sexual beliefs. Gender differences existed in the specific pattern of associations between the variables. These results suggest that attachment difficulties may facilitate the development of sexual difficulties through an increased vulnerability to maladaptive cognitions and negative affect (specifically anxiety) regarding sexuality.