Attachment mediates the impact of previous trauma on posttraumatic symptoms during the COVID-19 pandemic.

Abstract

Objective: There is some evidence that individuals previously been exposed to traumatic events may present higher vulnerability to PTSD because of the COVID-19 outbreak. Furthermore, exposure to traumatic events may cause changes in attachment orientations which might influence levels of PTSD symptoms (PTSS) in populations subjected to "stay-home" measures related to the COVID-19 outbreak. Method: The present study analyzed interrelations of number of traumatic events, attachment orientations, and PTSS during the COVID-19 in a group of Portuguese participants. The study comprised 2 time points: 3 days after the beginning of the lockdown (time 1) and 3 days before the end of the lockdown (time 2). Sample included 736 Portuguese participants who completed the questionnaires at both time points. Data were collected through a survey that included self-reported questionnaires. Structural equation modeling was conducted to examine if effect of number of traumatic events on PTSS at T2 was mediated attachment orientations at T1. Results: Higher exposure to traumatic events was associated with higher levels of PTSS. Attachment anxiety at T1 partially mediated the effect of number of traumatic events on PTS at T2. Conclusion: Findings suggest that PTSS is a risk induced by the establishment of a total lockdown and that individuals with higher exposure to traumatic events and higher attachment anxiety levels present increased risk of higher levels of PTSS at the end of the lockdown. Clinical Impact StatementThe assessment of posttraumatic stress disorder symptoms (PTSS) in individuals presenting psychological problems associated with the COVID-19 should be conducted. The risk of higher PTSS symptoms related to COVID-19 seems to be higher in individuals previously exposed to traumatic events. Clinicians should assess previous exposure to traumatic events for planning specific clinical interventions among individuals with psychological disorders associated with the COVID-19. Additionally, intervention to decrease attachment anxiety should be implemented to promote individuals' abilities to mobilize resources to cope with stressors associated with the COVID-19.

Changes in attachment dimensions during the treatment of acute post-traumatic stress disorder in sexually assaulted Brazilian women

“…Attachment has been shown to interfere with the response and adherence to treatment ( Forbes et al, 2010 ). Overall, studies indicate that insecure attachment styles are associated with a higher risk of developing PTSD and a worse prognosis of the disorder ( Levy et al, 2011 ; Woodhouse et al, 2015 ; Ferrajão, 2022 ). Considering that the relationship of attachment and trauma is bidirectional, it is also relevant to investigate the effect of trauma and PTSD on attachment styles.…”