Self-reported attachment style, trauma exposure and dissociative symptoms among adolescents

The aim of this study was to analyze whether self-reported attachment style (measuring avoidance and anxiety) among adolescents was associated with dissociative symptoms, in addition to self-reported potentially traumatic experiences. A group consisting of 462 adolescents completed three self-assessment questionnaires: Linkoping Youth Life Experience Scale (LYLES), Experiences in Close Relationships, modified version (ECR) and Dissociation Questionnaire Sweden (Dis-Q-Sweden). Self-reported attachment style had a stronger association with dissociative symptoms than self reported traumas. It was also found that scores on a dissociation questionnaire correlated strongly with scores on self-reported attachment style in adolescence. Discussion concerns reasons why self-reported attachment style is an important factor that may influence dissociative symptoms during adolescence.     

Pathways from trauma to unusual perceptual experiences: Modelling the roles of insecure attachment,negative affect,emotion regulation and dissociation

Background

A range of traumas have been linked to voices (auditory verbal hallucinations) and unusual perceptual experiences (UPEs) in other perceptual-sensory domains. Models of PTSD and positive symptoms of psychosis are insufficient in explaining the relationship between trauma and voices. The trauma-related voices (TRV) model was developed to generate novel research in this area.

Aims

This study aimed to investigate pathways from trauma to the frequency of UPEs based on a subset of hypothesised relationships in the TRV model.

Materials

The PTSD Diagnostic Scale for DSM-5, State Adult Attachment Measure, Depression Anxiety and Stress Scales-21, Perth Emotion and Regulation Competency Inventory, Dissociative Experiences Measure Oxford, and Multi-modality Unusual Perceptual Experiences Questionnaire.

Methods

We used path analysis in a non-clinical sample (N = 528) to model indirect effects from diverse trauma experiences to the frequency of multi-sensory UPEs via a subset of mediators within the TRV model: insecure attachment, emotion regulation deficits, negative affect and dissociation.

Results

Our model was an excellent fit to the data and accounted for 37.1% of variance in UPE frequency, and all direct (βs = .14–.61) and indirect pathways (βs = .01–.08) were significant (ps < .001).

Discussion

Our findings suggest that insecure attachment may link diverse trauma experiences to emotion regulation deficits and negative affect, which are linked to UPE frequency via dissociation.

Conclusion

Our findings provide preliminary evidence for a subset of relationships within the TRV model. Future studies are needed to gather stronger evidence of temporality and causation between these factors, and to test broader pathways within the TRV model.     

Emotional reactivity,coping style and cancer trauma symptoms

Introduction

This article studies the relationship between emotional reactivity and coping style on the one hand and intensity of symptoms of trauma in adult patients with cancer on the other hand.

Material and methods

The study was conducted on 150 patients, 55 women and 95 men, hospitalized for diagnosed cancer. Temperament was assessed with the Formal Characteristics of Behaviour – Temperament Inventory (FCB-TI). Coping style was assessed with the Polish version of the Mental Adjustment to Cancer Scale (Mini-MAC). Intensity of intrusion/hyperarousal and avoidance/numbing was assessed with the Factorial Version Inventory (PTSD), a quantitative measure of trauma-related symptoms.

Results

The outcomes of this study suggest that individual coping style is what determines the intensity of trauma-related symptoms most strongly. Destructive coping style accounts for 49% of the variance of symptom intensity and emotional reactivity accounts for 6%. Combined, destructive coping style and emotional reactivity account for 55% of the variance of general post-traumatic stress symptoms.

Conclusions

Destructive coping style (more important determinant of trauma symptoms) and high emotional reactivity as one of temperament traits are conducive to intensification of cancer trauma symptoms in adult patients. Our findings suggest that constructive coping style and low emotional reactivity may act as a specific protector against cancer trauma symptoms in adults.     

Adult attachment style and cortisol responses across the day in older adults

The association between cortisol and adult attachment style, an important indicator of social relationships, has been relatively unexplored. Previous research has examined adult attachment and acute cortisol responses to stress in the laboratory, but less is known about cortisol levels in everyday life. The present study examined adult romantic attachment style and cortisol responses across the day. Salivary cortisol was collected at six time points during the course of the day in 1,807 healthy men and women from a subsample of the Whitehall II cohort. Significant associations were found between attachment on cortisol across the day and slope of cortisol decline. The lowest cortisol output was associated with fearful attachment, with preoccupied attachment having the highest levels and a flatter cortisol profile. The results tentatively support the proposition that attachment style may contribute to HPA dysregulation.     

The neural correlates of attachment style during emotional processing: an activation likelihood estimation meta-analysis

Attachment style is a relatively stable trait linked to emotion regulation and coping as measured by questionnaire responses. An increasing number of functional brain imaging studies have explored the neural underpinnings of attachment style during emotional processing. However, until now, an overall picture of brain regions involved in this trait remained unexplored. Here, we conducted a meta-analysis of 12 peer-reviewed studies on attachment style using activation likelihood estimation (ALE) in functional magnetic resonance imaging (fMRI). We observed a significant negative correlation between avoidance attachment scores and activation of left inferior frontal gyrus to emotional stimuli, implying an inhibition processing for emotional stimuli in people with high avoidance attachment. In addition, there was a significant positive correlation between anxiety attachment scores and activation of left amygdala during emotional processing, which suggested an increased vigilance to emotional stimuli.     

The role of disconnected and extremely insensitive parenting in the development of disorganized attachment: validation of a new measure

Early adverse caregiving experiences constitute an important risk factor for the development of disorganized attachment in infancy, especially extreme insensitivity and frightening behavior associated with an unresolved loss or trauma. Using existing measures for frightening parenting and disrupted communication, we developed a new measure assessing Disconnected and extremely Insensitive Parenting (DIP), in order to investigate the unique contribution of disconnected and extremely insensitive parenting behaviors to infant disorganization. Maternal behavior was assessed during a laboratory session in a low-risk sample of 202 mothers and their infants. Construct and discriminant validity of the DIP was established for both types of parental behavior. Disconnected parental behavior predicted infant disorganization but not organized attachment security, whereas extreme insensitivity was marginally related to organized attachment insecurity in boys but not to attachment disorganization.     

Childhood trauma and dissociative symptoms predict frontal EEG asymmetry in borderline personality disorder

Frontal EEG asymmetry (FEA) has been studied as both state and trait parameter in emotion regulation and affective disorders. Its significance in borderline personality disorder (BPD) remains largely unknown. Twenty-six BPD patients and 26 healthy controls underwent EEG before and after mood induction using aversive images. A slight but significant shift from left- to right-sided asymmetry over prefrontal electrodes occurred across all subjects. In BPD baseline FEA over F7 and F8 correlated significantly with childhood trauma and functional neurological “conversion” symptoms as assessed by respective questionnaires. Regression analysis revealed a predictive role of both childhood trauma and dissociative neurological symptoms. FEA offers a relatively stable electrophysiological correlate of BPD psychopathology that responds only minimally to acute mood changes. Future studies should address whether this psychophysiological association is universal for trauma- and dissociation-related disorders, and whether it is responsive to psychotherapy.     

Imaginative, dissociative, and schizotypal processes in obsessive-compulsive symptoms

This study investigates imaginative, dissociative, and schizotypal processes that are potentially relevant to obsessive-compulsive (OC) symptoms. Students (n = 377) completed questionnaires that assessed inferential confusion, absorption, schizotypal personality, and other domains. Hierarchical regression revealed that inferential confusion and absorption were the most consistent predictors of OC symptoms; other content predicted variance for specific OC symptoms. For example, schizotypal personality predicted checking and hoarding symptoms, but not cleanliness or ordering rituals. Immersive tendencies predicted cleanliness and hoarding but not checking or ordering rituals. Results are consistent with an inference-based model of OC, in which an overreliance on imagination during reasoning gives rise to experiences that are inconsistent with reality. This study suggests additional domains that may help explain why intrusive thoughts become obsessions.     

The association of family support and wellbeing in later life depends on adult attachment style

The current study examines the association between family support and wellbeing in the elderly, paying particular attention to the possible moderating role of attachment style. Data from a community-dwelling, ethnically diverse, elderly sample (N = 1118) were analyzed to determine the best linear combination of emotional support, instrumental support, and attachment styles predicting wellbeing. Emotional support generally was associated with higher wellbeing whereas instrumental support was related to decreased wellbeing. As expected, however, these associations were qualified by attachment style. Receiving emotional support had stronger positive and instrumental support less negative effects on the wellbeing of elderly individuals with higher attachment security. Given increased longevity, family networks may become important sources of support for the elderly. Work detailing when, how, and for whom particular types of family support are beneficial is a key agenda within developmental psychology and social gerontology.     

Attachment insecurity as a mediator of the relationship between childhood trauma and adult dissociation

This study aimed to investigate whether attachment insecurity mediates the relationship between childhood trauma and adult dissociation, specifically with regard to individual forms of childhood maltreatment. Psychiatric outpatients who visited a specialized trauma clinic (n = 115) participated in the study. Data were collected via the Childhood Trauma Questionnaire, Revised Adult Attachment Scale, and Dissociative Experience Scale. Structural equation modeling and path analysis were performed to analyze the mediating effects of attachment insecurity on the relationship between childhood trauma and adult dissociation. Greater childhood trauma was associated with higher dissociation, and the relationship between them was fully mediated by attachment anxiety. In path analysis of trauma subtypes, the effects of emotional abuse, physical abuse, and physical neglect as a child on adult dissociation were found to be fully mediated by attachment anxiety. The effect of sexual abuse on dissociation was mediated by a synergistic effect from both attachment anxiety and attachment avoidance. Regarding emotional neglect, a countervailing interaction was discovered between the direct and indirect effects thereof on dissociation; the indirect effect of emotional neglect on dissociation was partially mediated by attachment insecurity. Specific aspects of attachment insecurity may help explain the relationships between individual forms of childhood trauma and adult dissociative symptoms. Tailored treatments based on affected areas of attachment insecurity may improve outcomes among patients with dissociative symptoms and a history of childhood trauma.     

Self-reported trauma, cortisol levels, and aggression in psychopathic and non-psychopathic prison inmates

The relationship between self-reported traumatic childhood experiences, cortisol levels, aggression, and psychopathy was investigated in prison inmates (n=47) and healthy controls (n=27). Besides questionnaires, a brief salivary diurnal profile was measured. Results show that criminals (both psychopaths and non-psychopaths) demonstrate more traumatic childhood experiences than the control group. Within the group of criminals, psychopaths showed the lowest diurnal cortisol concentrations, whereas the non-psychopaths demonstrated highest daily average cortisol (DAC) scores. High levels of aggression were related to traumatic childhood experiences in non-psychopaths and control participants, but not in psychopaths. Although psychopathic offenders demonstrated low levels of cortisol, high levels of childhood traumatic experiences and high levels of aggression, cortisol was not a mediating factor between childhood traumatic experiences and aggression. Implications of the finding that psychopathic offenders displayed lower and non-psychopaths showed higher daily cortisol levels are discussed.     

The prevalence of deliberate self-harm and its relationships to trauma and dissociation among Iranian young adults

This study aims to investigate the prevalence of deliberate self-harm and its relationships to childhood and recent trauma and different patterns of dissociative features. A total of 100 male and 100 female college students were administered a 58-item questionnaire designed to detect the extent of dissociation, deliberate self-harm, and trauma history. Participants with deliberate self-harm behaviors reported more traumatic experiences and dissociative features than participants without such behaviors. Furthermore, the prevalence of deliberate self-harm (i.e., 40.5%) was similar to previous studies on college student populations. However, and contrary to earlier research, deliberate self-harm was significantly more prevalent among men (48%) than women (33%). The findings support the notion that trauma, pathological dissociation, and depersonalization/derealization play important functional roles in self-harm behaviors. From this perspective, it is feasible to understand individuals who engage in self-harm as either escaping from uncomfortable dissociative states or experiencing an infra-psychological conflict in which one dissociative part of the self is being abusive toward another.     

Dissociation and the Adult Attachment Interview in artists and performing artists

Attachment patterns were investigated in a group of professional and pre-professional artists (n = 51). Given the high level of absorption/imagination required of artists, this study examined normative and pathological dissociation (PD) and considered links with Adult Attachment Interview responses, with particular attention to the AAI classification Unresolved (U) for past loss or trauma. Results indicated: (1) artists had elevated mean scores for absorption/imagination, (2) all but one artist had adverse trauma or loss experiences, (3) 17 (36%) met criteria for PD and 9 (53%) of those in the PD range had a classification of Unresolved (U) on the Adult Attachment Interview (AAI), (4) U was associated with PD, but not normative dissociation (absorption/imagination), (5) even with a primary U classification many individuals had an alternate secure/autonomous classification, and (6) 88% of the artists were classified as secure/autonomous in a three-way analysis on the AAI, but in a four-way analysis 27.5% were classified as U. Although 36% presented with PD, the majority of artists studied were stable, coherent and autonomous.     

Evaluation of the Swedish Version of Dissociation Questionnaire (DIS-Q), Dis-Q-Sweden,Among Adolescents

ABSTRACT

The aim of this study was to investigate the psychometric properties of the Swedish version of the Dissociation Questionnaire in a normative adolescent population and also to investigate dissociative symptoms associated with trauma including sexual and physical abuse. A normative sample of 449 adolescents between the ages of 12 and 19 and a clinical group of 74 adolescents with known experiences of trauma, sexual and/or physical abuse was given Dis-Q-Sweden. A mixed group of 22 abused and non-abused adolescents who answered Dis-Q-Sweden was also interviewed by using the Structural Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). A test-retest procedure was conducted with 90 subjects from the normative group. The results showed good reliability concerning both internal consistency and test-retest stability. Validity was tested in several ways (criterion, predictive, construct and concurrent) and found to be satisfactory. Significant differences for the total sum scores of Dis-Q-Sweden were found between the normative group and the clinical group with known sexual abuse (p < 0.001). The prevalence of dissociative symptoms (cut-off score > 2.5) was 2.3% in the normative group and 50% in the clinical group. Dis-Q-Sweden has proven to be a screening instrument with good psychometric properties and has proven to be able to capture dissociative symptoms in adolescents with self-reported trauma and known trauma (sexual abuse).     

Maternal attachment style,sensitivity, and infant obesity risk in low-income,Latino families

ABSTRACT

Disparities in childhood obesity highlight the need for research to identify its early predictors in high-risk populations, such as low-income, Latino families. In the current study, the first of its kind in a low-income Latino sample (N = 55; M _{child age} = 12.74 months, SD = 3.96), we investigated whether mothers’ self-reported attachment style predicted their infants’ weight-for-length (WFL; an early indicator of childhood obesity). We also explored whether observed maternal sensitivity, coded from a video-recorded semi-structured play assessment, mediated this association. We found a significant direct effect of maternal attachment style on infants’ WFL z-scores (c’ = ?0.68, SE = 0.22, p = .004). Infants of mothers who classified themselves as secure had lower WFL z-scores than infants of insecure mothers (avoidant or anxious). Maternal sensitivity did not mediate this association, but was positively associated with infant WFL z-scores. We discuss implications of these findings for future research.     

Posttraumatic stress and depressive symptoms, alcohol use, and recurrent traumatic life events in a representative sample of hospitalized injured adolescents and their parents

OBJECTIVE: Few investigations have comprehensively assessed the scope of impairment of injured adolescents presenting to acute care inpatient settings. METHODS: Randomly sampled injured adolescent inpatients and their parents were screened for posttraumatic stress (PTS) and depressive symptoms, preinjury alcohol use, and preinjury trauma. Linear regression was used to assess which clinical, demographic, and injury characteristics were independently associated with increased levels of adolescent PTS and depressive symptoms. RESULTS: Seventy percent of adolescent-parent dyads endorsed high levels of PTS or depressive symptoms and/or high preinjury alcohol use. Adolescent female gender, greater levels of preinjury trauma, greater subjective distress at the time of the injury, and greater parental depressive symptoms were independently associated with increased levels of adolescent PTS and depressive symptoms. CONCLUSIONS: The adoption of early screening and intervention procedures that broadly consider the scope of impairment of injured adolescents and their family members could enhance the quality of acute care mental health service delivery.     

Hyposexuality and Hypersexuality Secondary to Childhood Trauma and Dissociation

SUMMARY

Childhood trauma can influence the bonding between the caretaker and the infant and thereby structure the stress response threshold. The capacity to utilize others as a form of self-soothing is determined by early attachments and also is critical to one's response to developmental stresses. The quality of early attachments strongly affects the capacity for adult intimacy. Early trauma and dissociative reactions have systematic effects on arousal, desire and pair-bonding, which are reviewed in this paper. A treatment model that addresses the early trauma and its aftereffects concerning intimacy and sexuality is discussed.     

Parent-adolescent communication and psychological symptoms among adolescents with chronically ill parents

OBJECTIVE: To examine the psychological adjustment of adolescents living with a chronically ill parent and the relationship between psychological symptoms and communication with both their healthy and ill parents. METHOD: Adolescents, healthy parents, and ill parents from 38 families completed questionnaires regarding adolescent psychological symptoms, including posttraumatic stress symptoms, and parent-adolescent communication. RESULTS: Adolescent anxiety, depression, and behavior problems were within the subclinical ranges while approximately one-third of adolescents reported clinical levels of posttraumatic stress symptoms. Openness, but not problems, in communication between adolescents and their parents varied as a function of the parent's health status (healthy or ill) and parent sex. Adolescents reported poorer communication with healthy mothers; however only the quality of communication with healthy parents was related to adolescent psychological symptoms. CONCLUSIONS: Many adolescents with severely ill parents appear to experience clinically significant posttraumatic stress symptoms, therefore assessment for these symptoms in this population is important. Communication with a healthy parent may serve significant and unique functions for adolescents with ill parents, making communication between adolescents and their healthy parent a potentially useful target for clinical intervention.