The Attachment Script Assessment: Introduction of a coding system to evaluate deactivation, hyperactivation, and anomalous content.

Although research on adult attachment has yielded insight into the legacy of attachment for functioning in adulthood, methodological challenges persist in the assessment of adult attachment. The Adult Attachment Interview (AAI) offers a rich assessment of secure, insecure, and unresolved states of mind. However, it is resource intensive to administer and code. Attachment Script Assessment (ASA) offers a resource-effective alternative to the AAI. However, the ASA coding system only yields a single, security-like dimension: secure base script knowledge. Here, we introduce a complementary coding system for the ASA to assess attachment deactivation (i.e. script characterized by limited interpersonal connection and minimization of attachment problems/emotions), hyperactivation (i.e. script in which attachment-relevant problems and negative emotions are heightened), and anomalous content (i.e. script in which attachment problems contain elements of fear and/or disorientation); and we discuss the conceptual convergence of these scripts with corresponding patterns of attachment insecurity and disorganization.

Mentalization, emotional dysregulation and attachment to alternative attachment figures in retrospectively defined earned secure adults.

BACKGROUND: Researchers have tried to identify mechanisms through which an individual overcomes negative life experiences, proposing earning security as one of them. Retrospectively defined earned secures are recognized as individuals exhibiting secure attachments to their parents while evaluating the quality of their childhood care as low. This study aimed to examine attachment, mentalization, and emotional dysregulation in this group. We hypothesized that earned secures will report better mentalizing, lower emotion dysregulation, and more secure attachment to figures other than parents than insecure individuals. PARTICIPANTS AND PROCEDURE: female adult sample (N = 272) completed the Experiences in Close Relationships-Relationship Structures questionnaire, Parental Bonding Instrument, Difficulties in Emotion Regulation Scale, and Mental State Task. The time devoted to psychotherapy and demographics were also controlled as contextual variables. RESULTS: We identified an 'earned secure' group (14% of the sample), exhibiting secure attachment to mothers in adulthood despite reported inadequate care during childhood, along with the continuously secure, insecure, and 'lost secure' groups. People from the earned secure and secure groups reported better emotional regulation and some aspects of mentalization than those in the insecure and lost secure groups. They equally frequently reported the presence of an adult other than parents who were important to them in childhood, but the attachment to them was more secure. We did not find evidence of differences between the groups in the duration of psychotherapy. CONCLUSIONS: Secure attachment to alternative attachment figures, along with some mentalization and emotional regulation aspects, may be considered significant factors for earning security.

Attachment insecurities, emotion dynamics and stress in intimate relationships during the transition to parenthood.

BACKGROUND: In intimate relationships, which are characterized by emotional interdependence, partners act as attachment figures which serve emotion regulation functions. The experience of emotions as well as the strategies that partners use to regulate them and to respond to relational experiences, especially during stressful periods, differ greatly according to their attachment orientation. An important aspect in emotion dynamics is emotional inertia, which reflects the degree to which a person's current affective state is resistant to change on a moment-to-moment basis. Inertia has been related to maladaptive emotion regulation strategies, like suppression and rumination, preferentially used by highly anxious and avoidant individuals. The aim of this study is to examine associations between attachment orientations and reports on the experience of positive and negative affect, and their dynamics in daily life across the transition to parenthood. METHODS: Longitudinal data from a sample of 152 mixed-gender couples collected across the transition to parenthood was analyzed. We predicted that individuals with a more insecure attachment would report more negative and less positive affect, and that their emotional experience would be more resistant to change over time. We explored effects when participants reported feeling stressed. RESULTS: The data suggested that attachment anxiety was associated with less positive and more negative affect and that attachment avoidance was associated with more positive affect. Anxious individuals showed lower emotional inertia and not higher as we expected. Reported stress for anxious and avoidant individuals was significantly associated with more negative but not less positive affect. CONCLUSIONS: Results are discussed in the light of their impact on couples during stressful periods. Differences between anxiety and avoidance are found, emphasizing the importance of attachment insecurities on the experience of emotion. Furthermore, our findings on momentary fluctuating affect offer complementary insight into the emotional functioning of individuals with different attachment orientations.

Integrating intra- and interpersonal perspectives on chronic low back pain: the role of emotion regulation and attachment insecurity.

Objective: Chronic low back pain (CLBP) is burdensome and interferes with psychological and physical functioning of those affected. Past research has examined interpersonal (e.g., attachment insecurity) or intrapersonal factors (e.g., emotion regulation [ER]) involved in chronic pain. However, to enhance our understanding of CLBP's biopsychosocial underpinnings, more empirical integration of both intra- and interpersonal factors involved in CLBP is needed. Thus, our study examined the independent and joint associations of insecure attachment dimensions and ER strategies with CLBP severity and interference. Methods: We recruited 242 US adults with CLBP through Prolific Academic, an online participant pool. Participants from Prolific Academic were eligible for the study if they were at least 18 years of age, resided in the US, reported CLBP at least half the days over the past 6 months (>3 months), and used prescribed pain medication for their CLBP. Data collection was between November 2021 and February 2022. Eligible participants filled out a Qualtrics survey which consisted of measures assessing insecure attachment dimensions, ER strategies, as well as demographical information. Outcome variables in the present study were CLBP severity and interference. We ran multiple linear regression models to examine the associations between ER strategies and insecure attachment dimensions as predictors, and CLBP severity or interference as predicted variables, after controlling for sex as a covariate; we also conducted moderation analyses to investigate the interactions between ER strategies and insecure attachment dimensions when testing associations with CLBP severity or interference. Results: Our results indicated that, after controlling for ER strategies, anxious attachment was positively associated with CLBP interference but not pain severity (CI: 0.101 to 0.569; CI: -0.149 to 0.186); avoidant attachment was not associated with CLBP interference or severity (CI: -0.047 to 0.511; CI: -0.143 to 0.256). After adjusting for anxious and avoidant attachment, emotional expression and expressive suppression were positively associated with CLBP severity (CI: 0.037 to 0.328; CI: 0.028 to 0.421) but not interference (CI: -0.003 to 0.403; CI: -0.406 to 0.143). Furthermore, emotional expression was associated with CLBP severity and interference at low and medium levels of avoidant attachment (CI: 0.165 to 0.682; CI: 0.098 to 0.455); expressive suppression and cognitive reappraisal did not interact with attachment dimensions when examining CLBP severity or interference (CIs: LLs ≤ -0.291 to ULs ≥ 0.030). Conclusion: Our study shows that anxious attachment may be an interpersonal risk factor related to CLBP, above and beyond intrapersonal ERs, as anxious attachment was associated with higher levels of pain interference. Furthermore, emotional expression was associated with increased CLBP severity and interference, particularly among individuals at low and medium levels of avoidant attachment. Existing studies on chronic pain have mostly focused on examining intrapersonal or interpersonal correlates in isolation. The present study extends our understanding of CLBP by considering the role of interpersonal factors (i.e., insecure attachment dimensions), in combination with intrapersonal ER strategies. Given the correlational nature of the present study, longitudinal studies are needed to establish causality between psychosocial correlates and CLBP symptoms. Ultimately, we hope our integrated approach will facilitate the development of treatments and interventions tailored to address patients' attachment-related needs, enhancing the management and maintenance of CLBP among patients.

The mediating role of attachment and anger: exploring the impact of maternal early-life maltreatment on child abuse potential.

Background: Maternal early-life maltreatment (ELM) increases the risk of subsequent child maltreatment, but the underlying mechanisms of these intergenerational effects remain largely unknown. Identifying these mechanisms is crucial for developing preventive interventions that can break the cycle of abuse. Notably, previous research has shown that ELM often results in attachment insecurity and altered anger characteristics. Therefore, this study determines whether these characteristics mediate the relationship between maternal history of ELM and child abuse potential. Methods: The study sample included 254 mothers, of whom 149 had experienced ELM to at least a moderate degree. Maternal ELM was assessed using the Childhood Experience of Care and Abuse (CECA) interview. Attachment insecurity, trait anger and anger expression, and maternal abuse potential were assessed using the Vulnerable Attachment Questionnaire (VASQ), State-Trait Anger Expression Inventory (STAXI), and Child Abuse Potential Inventory (CAPI), respectively. Results: The severity of maternal ELM predicted higher child abuse potential, with attachment insecurity and anger suppression mediating this effect. Specifically, higher levels of maternal ELM were associated with greater attachment insecurity and increased anger suppression, resulting in a higher child abuse potential. Although higher levels of trait anger were directly associated with higher child abuse potential, this parameter did not mediate the relationship with ELM. In addition, no significant associations were observed between outwardly expressed anger and ELM or child abuse potential. All analyses were adjusted for maternal mental disorders, years of education, and relationship status. Discussion: Attachment insecurity and anger suppression may serve as pathways linking the maternal history of ELM to the risk of child abuse, even when considering maternal psychopathology. Overall, our findings indicate that interventions aimed at strengthening attachment and improving anger suppression may be beneficial for all mothers with ELM history and high child abuse potential, not just those who suffer from mental illness.

Attachment insecurity and breadcrumbing engagement in young adults: a cross-sectional, cross-country study in India and Spain.

BACKGROUND: Breadcrumbing, defined as the act of sending out flirtatious, but non-committal text messages to lure a sexual/romantic partner without expending much effort, has gained attention in popular culture and the media due to its relevance to contemporary dating dynamics. However, there is lack of evidence of the association between attachment insecurity and breadcrumbing This study aims to uncover the potential relationship between breadcrumbing engagement and attachment insecurity among Indian and Spanish young adults. METHODS: Data were collected through an anonymous online survey answered by 334 adults in India and by 348 adults in Spain aged between 18 and 40 years old. A linear regression model in both countries was run to examine breadcrumbing engagement and its relationship with the set of sociodemographic variables included in the study (participants' age and sex, sexual orientation, relationship status and educational level) and the two dimensions of attachment insecurity (anxious and avoidant). RESULTS: The results showed that insecure attachment, both anxious and avoidant, were associated with engaging in breadcrumbing in both the countries. However, there was a stronger association between anxious attachment and breadcrumbing in India compared to Spain, where the association was stronger between avoidant attachment and breadcrumbing. CONCLUSIONS: Findings from this study offer insight into an under-studied practice in the context of interpersonal relationships (i.e., breadcrumbing behaviour) and show the importance of attachment theoretical framework to hypothesize and analyse expectations regarding strategies to negotiate intimate relationships and the breadcrumbing experience particularly.

Perceived parental depression and PTSD in adolescents: mediating roles of attachment insecurity and coping style.

Background: Earthquakes can cause negative psychological states in adolescents and their parents, such as post-traumatic stress disorder (PTSD) and depression. Previous cross-sectional studies have shown that adolescents who perceive parental depression after an earthquake are more likely to experience PTSD. However, the mechanism underlying this process remains unclear and previous studies have not examined the association between these factors.Objective: The current study explored the mediating roles of attachment insecurity and coping style in the association between perceived parental depression and PTSD in adolescents after the Jiuzhaigou earthquake.Method: In total, 391 participants completed follow-up questionnaires at 12, 21, and 27 months (T1-T3, respectively) after the Jiuzhaigou earthquake.Results: T1 perceived parental depression was not a direct predictor of T3 PTSD in adolescents. In the full mediation model, T1 perceived parental depression predicted T3 PTSD in adolescents indirectly via T2 attachment insecurities through T2 emotion-focused coping.Conclusion: The findings highlight that attachment insecurity and emotion-focused coping mediated the relationship between perceived parental depression and PTSD in adolescents following an earthquake. To alleviate PTSD in adolescents, efforts should be directed toward reducing perceived parental depressive symptoms and emotion-focused coping, and promoting the formation of secure attachment styles.

Perceived parental depression after an earthquake is associated with subsequent PTSD symptoms in adolescents indirectly.Attachment insecurity and coping styles mediate the relationship between perceived parental depression and PTSD in adolescents.Therapy should focus on adolescents' emotional processing after an earthquake to help them cope without resorting to emotion-focused coping.

Positive illusions about dyadic perspective-taking as a moderator of the association between attachment insecurity and marital satisfaction.

Attachment insecurity (i.e., attachment anxiety or avoidance) puts people at risk for dissatisfying relationships. However, the dyadic regulation model of insecurity buffering suggests that an understanding and responsive partner may help insecure individuals to regulate emotions, thus improving couples' relationships. It may also be that perceiving partners as understanding and empathic, especially in an exaggeratedly positive way (i.e., positive illusions) will buffer insecurity. In 196 mixed-gender newlywed couples, we investigated whether spouses' positive illusions about partner's dyadic perspective-taking moderated the association between spouses' attachment insecurity and spouses' and partners' marital satisfaction over two years. Positive illusions generally predicted more satisfying relationships and attachment avoidance consistently predicted more dissatisfying relationships. There were also several instances where multilevel modeling indicated that positive illusions of dyadic perspective-taking buffered the negative effects of attachment avoidance on relationship satisfaction. However, there was also potentiation such that in two instances, positive illusions about dyadic perspective-taking strengthened the association between spouses' insecurity (husbands' attachment anxiety and wives' attachment avoidance) and subsequent marital dissatisfaction. In the moment, positive illusions about dyadic perspective-taking may allow spouses to feel happy in their relationship despite fear of emotional intimacy; however, positive illusions may not continue to buffer effects of insecurity on subsequent relationship satisfaction and may even be harmful in the face of insecurity.

Romantic Duration, Relationship Quality, and Attachment Insecurity among Dating Couples.

For many young adults today dating is not taken as a path to marriage, but as a relationship to be considered on its own terms with a beginning, middle, and end. Yet, research has not kept pace as most studies that look at relationships over time focus on marriages. In the present study, we look at individual differences and normative patterns of dating relationship quality over time. We tested a path model of associations between relationship duration, attachment insecurity, and four relationship quality domains (sexual frequency, commitment, satisfaction, and companionship) among a large sample of dating young adults (N = 1345). Based on a conceptual model of romantic relationship development, results supported expectations that dating trajectories are curvilinear, with unique patterns of accent, peak, and decent for each relationship domain. Dating duration also moderated the relationship between dating quality and attachment insecurity with anxious attachment becoming a more salient predictor of lower satisfaction and lower commitment in long-term versus short-term relationships. A quadratic interaction with sexual frequency indicated that insecurity predicted less sexual activity in new relationships, more activity among relationships between two and four years, but then less again in longer-term relationships. Findings suggest patterns of stability and change in dating relationships during emerging adulthood that complement those observed from the marriage literature.

An innovative approach to lifelong delayed ejaculation: does attachment style play a role?

PURPOSE: To examine whether there is a correlation between attachment styles, which is a developmental psychology theory, and lifelong DE. METHODS: The research was planned as prospective, multi-centric and cross-sectional study. Thirty patients who were consecutively admitted to the urology outpatient clinic and diagnosed with lifelong DE and 30 age-matched healthy controls were included in the study. All participants gave a detailed medical history and underwent a complete physical examination, and their laboratory and endocrine (prolactin and testosterone) results were evaluated. Additionally, all patients had to fill out socio-demographic information form, the Experiences in Close Relationships-Revised (ECR-R) Questionnaire, Arizona Sexual Experiences Scale (ASEX), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). RESULTS: The mean age of the DE patients was 33.5 ± 7.5 years. In the DE group, insecure attachment (both anxious and avoidant attachment), anxiety and depression scores were found to be significantly higher (p < 0.001, effect size medium or large) than the control group. Ejaculation times (both for vaginal intercourse and masturbation) were correlated with both insecure (anxious and avoidant) attachment types, as well as their anxiety and depression scores (p < 0.001). The ASEX satisfaction, ejaculation and total scores were found to be higher in DE patients (higher scores indicating greater sexual dysfunction) than in the control group. CONCLUSION: The large and significant relationships found between lifelong DE and attachment insecurities point to childhood developmental processes. The findings may help us better understand lifelong DE. There is a need for further extensive research on this subject.

Testing the Compatibility of Attachment Anxiety and Avoidance with Cultural Self-Construals.

Insecure attachment has been associated with relatively more negative outcomes in mainstream attachment literature, yet several empirical studies show almost half of the populations globally are insecurely attached. Moreover, although attachment security is the universal norm, attachment anxiety and avoidance exhibit significant cultural variation. To explore how this variation can offer certain advantages to people with insecure attachment tendencies, we tested the novel idea that different insecure attachment behaviors can be differentially compatible with varying cultural senses of self (i.e. independent vs. interdependent self-construal) in an experimental setting. We manipulated cultural self-construal by exposing the participants (N = 164) to either an independence or an interdependence prime and asked them to evaluate vignettes depicting typical anxious and avoidant behaviors. The results showed that insecure attachment behaviors were evaluated as more favorable when they were compatible with one's own attachment tendency. Importantly, this trend was moderated by the cultural self-construal: Participants evaluated even those insecure attachment behaviors that were inconsistent with their own tendencies more favorably when these behaviors were compatible with the cultural self-construal that was experimentally induced. The findings are discussed in light of cultural implications.

Intranasal oxytocin administration but not peripheral oxytocin regulates behaviors of attachment insecurity: A meta-analysis.

In light of the roles of oxytocin (OT) in social bonding and interpersonal relationship, studies have examined the roles of OT in human attachment, but by and large previous findings are inconsistent. Here, we conducted - meta-analyses to estimate the associations between peripheral OT level (e.g., blood and salivary OT) and attachment (i.e., attachment dimensions and behaviors of attachment insecurity) and examine the effects of intranasal OT administration on behaviors of attachment insecurity. The analyses indicated that: (1) Peripheral OT level was not significantly associated with attachment dimensions (e.g., attachment anxiety and attachment avoidance) and behaviors of attachment insecurity; (2) intranasal OT administration significantly reduced behaviors of attachment insecurity of neutral contexts, particularly behaviors of attachment avoidance. The findings suggest that intranasal OT administration is an available approach for reducing behaviors of attachment insecurity of interpersonal situations with ambiguous social cues, which implicates suggestions for therapeutic treatments of attachment-related dysfunctions.

Childhood adversity and attachment anxiety predict adult symptom severity and health anxiety.

BACKGROUND: Childhood adversity is associated with somatization, including physical symptom burden and health anxiety. Attachment theory offers a developmental framework to understand adult somatization, as attachment phenomena are theoretically and empirically related to physiological regulation, affect regulation, and childhood adversity, all of which are relevant to somatization. OBJECTIVE: The purpose of this study was to identify the pathways by which childhood adversity and attachment insecurity influence physical symptom burden and health anxiety in adults. PARTICIPANTS AND SETTING: Three hundred and fifty-one family medicine patients from a teaching hospital in Toronto, Canada. METHODS: A cross-sectional survey study was conducted to assess adverse childhood experiences, attachment insecurity, health anxiety and physical symptom severity in primary care patients. Path Analysis using structural equation modeling (AMOS V.26, IBM, 2019) was used to test the model in which childhood adversity, attachment anxiety, attachment avoidance, symptom severity interact to influence health anxiety. RESULTS: The majority of the participants were white (66%), had completed post-secondary education (68%), and reported themselves to be in very good to excellent health (62%). Childhood adversity, attachment anxiety, attachment avoidance, health anxiety and symptom severity are all significantly correlated (ranges of rs = 0.29 to 0.63). Childhood adversity has a significant indirect effect on health anxiety with attachment anxiety and symptom severity as serial mediators (ßindirect = 0.237, p = .001 and ßdirect = 0.065, p = .244). CONCLUSIONS: Overall, this model extends our understanding of the processes underlying adult somatization. Findings support that childhood adversity and attachment anxiety are predictors of symptom severity and health anxiety.

The role of relationship dissatisfaction in the dyadic associations between attachment insecurity and intimate partner violence among couples seeking therapy.

For several decades, attempts have been made to understand the risk markers of intimate partner violence (IPV) to prevent its occurrence, but few studies have emphasized both partners' perspective in examining these markers. This study explored the associations between attachment insecurity (anxiety and avoidance) and the perpetration of psychological and physical IPV through relationship dissatisfaction in a sample of 88 couples seeking therapy for relationship difficulties. Results from path analyses based on the Actor-Partner Interdependence Model showed that participants' attachment avoidance was indirectly related to their own and their partner's higher perpetration of psychological IPV through higher relationship dissatisfaction. Participants' attachment avoidance was also associated with their own higher perpetration of physical IPV through their higher relationship dissatisfaction. The findings highlight that attachment insecurities and relationship dissatisfaction can both contribute to establishing dysfunctional and violent interaction patterns in couples.

Intertwined associations among attachment styles, emotional dysregulation, and ADHD: examining unique associations with general risk-taking behavior.

Attachment insecurity, emotional dysregulation, and attention-deficit/hyperactivity disorder (ADHD) have all been implicated across the literature with various forms of negative life outcomes and increased risk-taking behavior (RTB). Furthermore, abundant research has demonstrated that the three seem to go together. Given these intercorrelations, it is unclear if any of them possess exclusive links with RTB independent of the others across multiple life domains. The present study examined the relations among attachment styles, emotional dysregulation, ADHD symptoms, and hypothetical RTBs across multiple real-life domains. Including a total of 155 mostly undergraduate students, we found in the main analysis that only ADHD symptoms were associated with RTB over and above all other variables. Specifically, the links between both attachment insecurity and emotional dysregulation with RTB disappeared when ADHD symptoms were included in the final model, but not vice versa. An exploratory analysis suggested that attachment insecurity was linked to romantic/sexual RTB over and above the others. These results further substantiate the link between ADHD symptoms and a general propensity for RTB and demonstrate that the link between the two seems to be inherent to the disorder and independent of its co-occurrence with attachment insecurity and emotional dysregulation.

Satisfying and stable couple relationships: Attachment similarity across partners can partially buffer the negative effects of attachment insecurity.

Insecure attachment in couples is negatively associated with relationship functioning. Similarity of partner attachment on the other hand might attenuate such relationship outcomes. We tested the opposing insecurity and similarity hypotheses by examining associations of attachment with relationship satisfaction and instability in a representative community sample of couples (N = 1,014). We expected: (a) negative effects of insecure attachment (main effects of actor and partner avoidance and anxiety, and interaction effects consistent with fearful-avoidance and demand-withdraw patterns); and (b) positive effects of similarity in avoidance and anxiety. Actor-Partner-Interdependence Models showed clear support for the insecurity hypothesis. Main effects of avoidance and anxiety, explained 46.2% of the variance of satisfaction, and 17.9% of instability. We conclude that reducing insecurity of attachment, in particular avoidance, must be a central target in couple therapy. Interestingly, similarity of attachment can partially buffer the negative effects of attachment insecurity. Clinical implications are discussed.

Paternal and Maternal Harsh Parenting and Chinese Adolescents' Social Anxiety: The Different Mediating Roles of Attachment Insecurity With Fathers and Mothers.

Although negative parenting and attachment insecurity have been demonstrated to place children at risk for social anxiety, the different roles of fathers and mothers in this association need to be further clarified. This study examined the different mediating roles of attachment insecurity with fathers and mothers in the association between harsh parenting and social anxiety among Chinese adolescents. A sample of 395 students in the sixth through eighth grades with their parents was enlisted as participants of this survey from two public middle schools located in Northern China. Parents were required to report on their harsh parenting, and students were asked to report on their social anxiety and perceived attachment insecurity with both parents. The results demonstrated that both paternal harsh parenting and maternal harsh parenting were positively associated with attachment insecurity with both parents. More importantly, we found that attachment insecurity with mothers partially mediated the association between maternal harsh parenting and adolescent social anxiety but completely mediated the relation of paternal harsh parenting to adolescent social anxiety. These results expanded extant understandings on the associations among harsh parenting, attachment insecurity, and child social anxiety by taking the different roles of both parents into consideration.

Psychological Distress and Attachment Insecurity of Stalked Mothers.

There is a lack of research about intimate partner stalking when victim and stalker have children together. The aim of the current study was to provide knowledge about the mental health status and attachment patterns of mothers stalked by the father of one or more of their children. One hundred ninety six Danish women, recruited via a closed social network for stalked mothers, completed an anonymous online questionnaire concerning their experiences of violence during and after the relationship with the stalker, relationship characteristics, attachment patterns, and psychological distress. Results indicated high exposure to psychological maltreatment during the victim-stalker relationship, harassing and violent stalking behaviors after relationship termination, and high levels of functional disabilities, PTSD (posttraumatic stress disorder), other trauma-related, affective, and somatization symptoms. Furthermore, the women retrospectively reported an increase in attachment insecurity from the time before their relationship with the stalker to the time of study participation (after they experienced relationship violence and/or stalking). Stalking behaviors uniquely contributed to the explanation of the mothers' psychological distress above the effects of relationship violence. Moreover, attachment insecurity appeared to be the strongest predictor of psychological distress. Having children together with their stalker captures women in an ongoing situation of threat and interpersonal traumatization that differs from other forms of stalking in many respects. The present study is the first drawing attention to the experiences and suffering of stalked mothers, a particularly vulnerable group of stalking victims.

Mediational mechanisms involved in the relation between attachment insecurity and depression: A meta-analysis.

BACKGROUND: Several studies have investigated the intermediate variables or mediators through which attachment insecurity influence the development of depression. However, there has not been a systematic synthesis of this literature to date. The current meta-analytic review aimed at identifying such mediators and quantifying their effect size. METHODS: We systematically searched Medline, Pubmed, Psycinfo, Embase, Proceedings Web of Science and ProQuest Dissertations & Theses Global up until May 2019. 108 studies met inclusion criteria (i.e., investigated intermediate variables that explain the effect of attachment insecurity [exposure] on depressive symptoms [outcome]). Standardized regression coefficients of the indirect and total paths of mediation models of 80 studies were pooled using the inverse of their variance as a weight. Studies were coded and ranked for quality. RESULTS: Dysfunctional attitudes (ß = 0.10, 95% CI = 0.01 to 0.20), self-criticism (ß = 0.17, 95% CI = 0.04 to 0.28), low self-compassion (ß = 0.16, 95% CI = 0.02 to 0.29), and cognitive hyperactivating regulation strategies (ß = 0.13, 95% CI = 0.05 to 0.20), such as repetitive thinking (ß = 0.17, 95% CI = 0.07 to 0.28), and particularly, brooding rumination ß = 0.20, 95% CI = 0.07 to 0.32), mediated the association between insecure attachment and depressive symptoms. Indirect effects were only significant among adult populations. LIMITATIONS: The methodological quality of studies was mostly moderate to low and analyses revealed considerable heterogeneity. CONCLUSION: Our findings support the direct targeting of cognitive-emotional psychological mechanisms in prevention programs and treatment of depression. More longitudinal studies are needed to clarify the interplay of such mediators along with other interpersonal factors between insecure attachment and depression.

Understanding the impact of attachment insecurity on PTSD symptoms among male Veterans and military personnel.

Attachment insecurity (i.e., attachment anxiety and attachment avoidance) has been found to contribute to PTSD symptom severity in Veterans. However, little is known of the unique contribution of attachment insecurity on individual PTSD symptom clusters. In a community sample of 106 combat-deployed Veterans, active duty service members, and reservists, this study examined: (1) the relationships between childhood family experience, combat experience, attachment insecurity, and PTSD symptom clusters, and (2) the influence of attachment insecurity on PTSD symptom clusters. Results revealed significant correlations between attachment anxiety and all PTSD symptom clusters (rs = .22 -.43) and attachment avoidance and PTSD symptom clusters, except the avoidance cluster (rs = .21 -.36). Four multiple regression analyses were employed to address the second study aim. Childhood family experiences predicted negative alterations in cognitions and mood (ß = -.30) and alterations in arousal and reactivity (ß = -.20). Further, combat experience significantly predicted each symptom cluster of PTSD (ßs = .03 -.44). In the second step, attachment anxiety and attachment avoidance were added to each model. Attachment anxiety and attachment avoidance predicted negative alterations in cognitions and mood (ßs = .22 and .35) and alterations in arousal and reactivity (ßs = .27 and .17). Inconsistent with previous research, attachment insecurity did not predict symptoms of avoidance. These results highlight the impact of attachment among a diverse sample of trauma exposed individuals and may provide insights for clinical implications and therapeutic approaches when working with Veterans and military personnel high in attachment insecurity.