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

Abstract

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.

Potential Predictors Of Perceived Stress In Helping Profession

“…Mikulincer and Shaver (2012) expect both attachment anxiety and attachment avoidance to be connected to decreased capacity of trauma management. Recently published study by Kong et al (2017) support their assumptions by revealing a mediating effect of attachment style in the relationship between trauma and dissociation.…”

“…Natural, as well as manmade disasters and accidents disrupt person's stability. Studies have focused on the effect of early life trauma onto stress reaction, posttraumatic stress reaction, perception of pain, somatization and dissociation (Waldinger et al 2006;Mikulincer et al1999;Luecken, 1998;Kong et al, 2017). In some cases mental health and well-being is restored shortly after experiencing traumatic event, in others, however, negative consequences develop.…”

“…Attachment mediates relationship between trauma and its negative consequences (Kong, 2017). Additionally, modern applications of attachment theory propose its importance also in development of coherent self (Fonagy, 1999), physiological self-regulation (Maunder, Hunter, 2001) and affect-regulation (Casidy, 2008).…”

A meta-analytic study examining the relationship between alexithymia and dissociation in psychiatric and non-clinical populations

“…Dissociation can vary from normal experience ( e.g ., absorption/day dreaming) to severe pathology characterized by detachment from body and/or reality ( e.g ., Dissociative Identity Disorder). A higher rate of pathological dissociation is found in populations exposed to childhood trauma, particularly those with resulting attachment anxiety, and in psychiatric samples (Rafiq, Campodonico, & Varese, 2018 ; Dalenberg et al, 2012 ; Kong, Kang, Oh & Kim, 2018 ; Lyssenko et al, 2017 ). Attachment anxiety typically results when caregivers are inconsistent and unpredictable; thus are not attuned or responsive to the child’s emotions.…”

The wounds of childhood: Early trauma subtypes, salience and hyperarousal in a sample of adult psychiatric patients

“…Childhood trauma has been found strictly associated with long-term consequences for mental health in adulthood (Badr et al, 2018; Capaldo & Perrella, 2018; Kendall-Tackett, 2009; McLaughlin et al, 2010; Shonkoff et al, 2012) and represents a serious risk factor for adult psychiatric morbidity (Carr, Martins, Stingel, Lemgruber, & Juruena, 2013; Edwards, Holden, Felitti, & Anda, 2003; Van der Kolk, 2017). A large amount of literature has explored the potential pathways of early life adversity in later adult life; in particular, the most relevant associations were found with borderline personality disorder (Cattane, Rossi, Lanfredi, & Cattaneo, 2017), major depression (Infurna et al, 2016), bipolar disorder (Aas et al, 2016), anxiety disorders (Hovens, Giltay, Spinhoven, van Hemert, & Penninx, 2015), post-traumatic stress disorder (Messman-Moore & Bhuptani, 2017), schizophrenia (Isvoranu et al, 2017), substance abuse disorders (Edalati & Krank, 2016), eating disorders (Trottier & MacDonald, 2017), disruptive behavior disorders (Sege, Amaya-Jackson, & American Academy of Pediatrics Committee on Child Abuse Neglect, 2017) and dissociative disorders (Kong, Kang, Oh, & Kim, 2018). Beyond psychiatric disorders, early adverse life events have also been associated with an increased risk for the development of chronic medical conditions, such as pain disorders and irritable bowel syndrome (Gupta et al, 2014; Muscatello, Bruno, Mento, Pandolfo, & Zoccali, 2016; Muscatello, Bruno, Scimeca, Pandolfo, & Zoccali, 2014).…”