The associations between adult attachment, posttraumatic symptoms, and posttraumatic growth

Childhood Adversity and Engagement in Adulthood: The Role of Attachment as a Mediator

IMPORTANCE

A key assumption of occupational therapy is that engagement in meaningful activities is fundamental to one's health and well-being. Preliminary findings suggest a link between childhood adversity and engagement in meaningful activity. Childhood adversity is also linked to attachment insecurity in adulthood, and both represent barriers to health and well-being. It is unknown whether attachment insecurity is associated with meaningful activity engagement or how attachment insecurity influences the relationship between childhood adversity and meaningful activity engagement.

OBJECTIVE

To investigate the association between attachment insecurity and meaningful activity engagement and the role of attachment insecurity in the relationship between childhood adversity and engagement in meaningful activities in adulthood.

DESIGN

Cross-sectional online survey.

SETTING

Community.

PARTICIPANTS

Community-dwelling adults ages 18 yr or older, healthy, and able to understand standard English to complete the questionnaires. Participants were recruited through snowball sampling.

OUTCOMES AND MEASURES

Participants answered demographic questions and completed three questionnaires: the Engagement in Meaningful Activities Survey, Risky Families Questionnaire, and Experiences in Close Relationships-Short Form.

RESULTS

Participants (N = 329) completed at least two of the three surveys, with most (n = 312) completing all three. More insecurely attached participants reported less engagement in meaningful activities. Both attachment avoidance and attachment anxiety mediated the relationship between childhood adversity and meaningful activity engagement.

CONCLUSIONS AND RELEVANCE

The findings offer support for interrelations among childhood adversity, attachment insecurity, and engagement in meaningful activity. Further research is required to support the application of these findings in clinical settings. Plain-Language Summary: To our knowledge, this is the first study to establish a connection between attachment insecurity in adults and lower levels of engagement in meaningful activities during adulthood. The findings highlight the heightened vulnerability of adults who have a history of childhood adversity. The findings also emphasize the significance of (1) considering clients' childhood adversity and attachment patterns when assessing for and providing occupational therapy services and (2) advocating for the inclusion of trauma-informed practices for those with lower levels of meaningful occupational engagement.

Environmental and Genetic Contributions to Attachment in Late Adolescence and Young Adulthood

Adverse childhood experiences (ACEs) have been linked with attachment insecurity and psychopathology. However, some individuals remain securely attached and resilient following ACEs. Researchers have examined polymorphisms in the oxytocin receptor gene (OXTR), particularly rs53576, as a source of resilience, though examination of the biological mechanism by which rs53576 buffers the relation that would otherwise exist between ACEs and attachment insecurity is absent. The aim of the current study was to examine how ACEs interact with individual genetic and immune vulnerability to shape attachment security in older adolescents and young adults (n = 201). Moderated mediational models were tested in which ACEs acted as independent variables, attachment security acted as a dependent variable, inflammation (i.e., IL-6) was tested as a mediator, and rs53576 (i.e., AA, AG, GG genotypes) was tested as a moderator. Results indicated that physical abuse was significantly associated with decreased attachment security, with moderation by rs53576. A significant main effect of rs53576 on IL-6 was also noted. A similar pattern of results was evident across other ACEs and suggests that the effects of ACEs on attachment are buffered by the GG genotype. Association between GG and lower IL-6 suggests inflammation plays some role, though more research is needed.

Pathway linking attachment styles to post-traumatic growth among recovered COVID-19 patients: testing the mediating role of coping styles

Background: Research on post-disaster mental health shows that people have unique resources to undergo positive changes like posttraumatic growth (PTG) after facing adversities.Objective: This study aimed to investigate the relationship between attachment styles and PTG in COVID-19 survivors, with a focus on exploring the mediating role of coping strategies. Through examining these dynamics, the study seeks to contribute to deeper understanding of the psychological processes underlying growth in individuals recovering from the pandemic.Method: A total of 210 participants were enrolled from the hospitals in Tabriz, Iran, in January 2021, and completed self-report questionnaires. PTG, attachment styles, and coping strategies were assessed using Posttraumatic Growth Inventory (PTGI), Revised Adult Attachment Scale (RAAS), and Coping Inventory for Stressful Situations (CISS). Structural equation modelling (SEM) was used to assess the mediation models.Results: The direct effects of secure (β = 0.22, p < .001), and ambivalent-anxious attachment (β = -0.22, p < .001) on PTG were significant. Also, task-oriented coping significantly predicted PTG (β = .60, p < .001). The direct path from secure (β = 0.16, p < .05) and ambivalent-anxious attachment (β = -0.38, p < .001) to task-oriented coping was significant, as was direct impact of secure (β = -0.18, p < .01) and ambivalent-anxious attachment (β = 0.37, p < .001) to emotion-oriented coping. The association between secure attachment and PTG is significantly mediated by task-oriented coping (β = 0.1, (95% CI: 0.01-0.18)). Also, task-oriented coping was a significant negative mediator between ambivalent-anxious attachment and PTG (β = -0.24, (95% CI: -0.33 - -0.15)).Conclusions: Results support the mediating role of coping strategies in the relationship between attachment styles and PTG. It emphasizes the importance of interventions for improving coping resources in individuals with life-threatening illnesses, focusing on improving problem-focused coping and reducing maladaptive strategies.

Overcoming the civil wars: the role of attachment styles between the impact of war and psychological symptoms and post-traumatic growth among Libyan citizens

Background: Civil wars in Libya have impacted the mental health of the general population. The ways in which individuals cope with traumatic events are influenced by several psychological variables.Objectives: The present study aimed to investigate how post-traumatic stress symptoms (PTSS) are associated with psychological symptoms and post-traumatic growth (PTG), and to evaluate the role of avoidant and anxious attachment dimensions as mediators in these associations, among Libyan citizens.Method: Three-hundred participants (147 females; age 31.0 ± 8.4 years) completed the Impact of Event Scale - Revised, Experiences in Close Relationships, Patient Health Questionnaire, and Post-traumatic Growth Inventory - Short Form.Results: The structural equation model revealed that insecure attachment dimensions mediated the association between PTSS and psychological symptoms and PTG. PTSS were positively associated with psychological symptoms, PTG, and both insecure attachment dimensions. Insecure attachment dimensions were positively associated with psychological symptoms and negatively with PTG.Conclusion: The present findings contribute to growing empirical research on the roles of insecure attachment dimensions in the association between the impact of war, psychological symptoms, and PTG.

Resilience Mediates the Relationship Between Parental Attachment and Posttraumatic Growth in Adolescents: A Longitudinal Study

OBJECTIVE

Previous studies have shown that parental attachment was associated with higher levels of posttraumatic growth (PTG) in individuals who have experienced traumatic events. The aim of the current longitudinal study is to investigate resilience as one pathway through which parental attachment is related to PTG among Chinese adolescents following the Yancheng tornado.

METHODS

A total of 351 adolescent survivors participated in this longitudinal study. Participants completed the revised version of Inventory of Parent and Peer Attachment (IPPA-R) at 12 months (T1), and the revised Chinese version of the Post-Traumatic Growth Inventory (PTGI-R) and the Connor and Davidson's Resilience Scale (CD-RISC) at 18 months (T2) after the tornado, respectively.

RESULTS

It indicated that parental attachment at T1 has direct and positive effect on PTG at T2, and resilience at T2 fully mediated the relationship between parental attachment at T1 and PTG at T2.

CONCLUSION

The findings revealed that parental attachment and resilience are two key resources that promote adolescent's PTG, and parental attachment acts through resilience to promote PTG in adolescents.

Growth-Related Responses to the Threat of COVID-19 among Adolescents

The main objective of our study was to determine whether the experience of the types of pandemic threats included in the study, could activate development responses among adolescents and what the role of the level of stress experienced during the COVID-19 pandemic is in the process of post-traumatic PTG growth. We also made an attempt to investigate whether personality traits and gender were predictors of PTG growth in adolescents. Therefore, the theoretical bases for the interpretation of the obtained results are models of post-traumatic growth (PTG), mainly by Calhoun and Tedeschi. The research was conducted in March 2020. The study subjects were 405 adolescents aged 14 to 20 years, with an average age of 17 years, of whom 59% were females and 41% were males. The following methods were used in the study: IPIP-BFM-20 to estimate five personality traits, PSS- to diagnose perceived stress, and an in-house questionnaire of pandemic threats experienced by adolescents (KŻP). The results showed that the various types of 'pandemic' threats (threats to life, family, and lifestyle) are positive predictors of growth-related changes; additionally, such factors as personality traits (here: extroversion), stress level, and gender had a positive mediating effect on growth-related changes. It was also possible to show that out of the four dimensions of post-traumatic growth, three could be activated under pandemic conditions. These were: changes in relationships with others, greater appreciation of everyday life, and spiritual changes. Changes in self-perception-one of the dimensions of post-traumatic growth, were not activated due to experiencing three types of pandemic threats.

Adversity Interpreted: A Scoping Review of Adversity Appraisal Measurement

Although evidence suggests that individuals' appraisals (i.e., subjective interpretations) of adverse or traumatic life events may serve as a mechanism accounting for differences in adversity exposure and psychological adjustment, understanding this mechanism is contingent on our ability to reliably and consistently measure appraisals. However, measures have varied widely between studies, making conclusions about how best to measure appraisal a challenge for the field. To address this issue, the present study reviewed 88 articles from three research databases, assessing adults' appraisals of adversity. To be included in the scoping review, articles had to meet the following criteria: (1) published no earlier than 1999, (2) available in English, (3) published as a primary source manuscript, and (4) included a measure assessing for adults' (over the age of 18) subjective primary and/or secondary interpretations of adversity. Each article was thoroughly reviewed and coded based on the following information: study demographics, appraisal measurement tool(s), category of appraisal, appraisal dimensions (e.g., self-blame, impact, and threat), and the tool's reliability and validity. Further, information was coded according to the type of adversity appraised, the time in which the appraised event occurred, and which outcomes were assessed in relation to appraisal. Results highlight the importance of continued examination of adversity appraisals and reveal which appraisal tools, categories, and dimensions are most commonly assessed for. These results provide guidance to researchers in how to examine adversity appraisals and what gaps among the measurement of adversity appraisal which need to be addressed in the future research.

Insecure attachment styles as predictors of posttraumatic growth in a South African student sample

South Africa, as a developing country, is characterized by high levels of crime, partner violence, and other traumatic experiences. Exposure to these traumas may lead to the development of post-traumatic stress disorder or, conversely, post-traumatic growth. Citizens in developing African countries appear to be at risk for the development of insecure attachment styles due to the cumulative effects of socio-economic risk factors. The prevalence of many possible traumatic experiences along with the risk of more insecure attachments set the stage for investigating the impact of insecure attachment on post-traumatic growth. The aim of this study was thus to determine whether two insecure attachment styles, namely anxious and avoidant attachment, were significant predictors of post-traumatic growth. The sample consisted of 233 undergraduate students from a South African university who had experienced a traumatic event. Participants’ ages ranged from 18 to 33 years ( M = 21 years) and were from various ethnic backgrounds (81.5% Black African, 7.7% White, 9% Coloured, and 3.9% Asian/Indian). Two self-report measures were administered via an online survey to assess attachment styles and post-traumatic growth. Results showed that an anxious attachment style was a significant negative predictor of post-traumatic growth. Furthermore, individuals with an avoidant attachment style were significantly less likely to experience post-traumatic growth through relating to others, than along the other domains of post-traumatic growth. The findings contribute by highlighting the importance of considering how insecure attachment styles may impact post-traumatic growth, as this could inform the treatment of trauma victims.

Rejection sensitivity and vulnerable attachment: associations with social support and PTSD symptoms in trauma survivors

Background

Although social support has been consistently associated with recovery from psychological trauma and prevention of posttraumatic stress disorder (PTSD), individual differences in seeking or benefitting from social support in trauma survivors are not well understood. Factors associated with negative internal working models of self and others, emotion dysregulation, and interrupted bonds with an individual's social support groups such as vulnerable attachment and rejection sensitivity could contribute to lower experienced social support and higher levels of PTSD.

Objective

The objective of this study was to test a theoretically informed model and investigate how psychosocial variables such as vulnerable attachment styles, rejection sensitivity, and social support are associated with PTSD.

Method

Using a cross-sectional survey and path analyses in 141 survivors of trauma (aged 18-69, M = 25.20), the relationship between vulnerable attachment style, rejection sensitivity, and PTSD were investigated.

Results

Higher vulnerable attachment, rejection sensitivity, and lower social support were found to be significant predictors of PTSD symptoms (f2 = 0.75). The relationships from vulnerable attachment to PTSD were mediated by rejection sensitivity and perceived social support. The results supported and extend theoretical models of PTSD that posit a role for predisposing factors in the development and maintenance of the disorder.

Conclusion

The findings suggest a potential benefit of identifying vulnerable groups that could benefit from a refinement of existing PTSD interventions by targeting the maladaptive effects of vulnerable attachment and rejection sensitivity, thus allowing the individual to draw effectively on social support networks.

A meta-analytic review of the relationship between attachment styles and posttraumatic growth

OBJECTIVE

The present review aimed to examine the relationship between attachment styles and posttraumatic growth in adults exposed to traumatizing events.

METHOD

A systematic literature search resulted in the inclusion of 14 studies in the review. Four correlational meta-analyses of the relationship between the attachment styles of secure, dismissive, preoccupied, and fearful, and posttraumatic growth, were conducted.

RESULTS

These revealed a significant small positive relationship between secure attachment and posttraumatic growth (r =  0.21, p < 0.001); a significant small negative relationship between dismissive attachment and posttraumatic growth (r = -0.12, p < 0.001), and a weak relationship between preoccupied attachment and posttraumatic growth (r = -0.04, p = 0.235), and fearful attachment and posttraumatic growth (r = 0.08, p = 0.248).

CONCLUSIONS

The relationship between attachment styles and posttraumatic growth is modest and may be better explained by other variables. Nonetheless, findings provide useful information for clinicians regarding the potential small impact of attachment style following traumatizing exposure. Implications for future research are highlighted with respect to methodological rigor and the role of other potentially influential variables.

The effect of attachment security priming and oxytocin on physiological responses to trauma films and subsequent intrusions

To further understand protective mechanisms to prevent post-traumatic stress disorder or assist recovery from psychological trauma, this study investigated whether pharmacological and psychological activation of a secure attachment representation elicits higher felt-security and a related response pattern of reduced physiological arousal and increased parasympathetic activation; and whether it protects individuals from developing intrusions and experiencing distress in the week following exposure to a trauma film. Using a double-blind, experimental mixed factorial design, 101 volunteers received either oxytocin or placebo and either secure attachment or neutral priming before watching a trauma film. We measured felt security as an indicator of the strength of activation of a secure attachment representation, skin conductance and heart rate as indicators of physiological arousal, and high frequency heart rate variability as an indicator of parasympathetic activation during the priming and the film. Participants then completed a seven-day intrusion diary. Secure attachment priming, but not oxytocin administration or the combination of both, was associated with reduced physiological arousal and increased parasympathetic activity during priming. Although secure attachment priming was not related to the absolute number of intrusions or to less perceived distress or physiological arousal during the trauma film, it was associated with lower intrusion-related distress in the 7-days post-testing. Our findings extend previous research that suggests the importance of interventions that address intrusion-related distress for recovery from trauma, and suggest a promising role for secure attachment priming in trauma-focused psychological therapies. We contribute to the growing literature that finds that higher subjective distress during a trauma is associated with higher intrusion-related distress. We discuss theoretical implications and possible mechanisms through which secure attachment priming may exert potential beneficial effects.

The Differential Effects of Insecure Attachment on Post-Traumatic Stress: A Systematic Review of Extant Findings and Explanatory Mechanisms

It is well-documented that insecure attachment poses substantial risks to post-trauma recovery. Although attachment anxiety reliably predicts and is associated with elevated post-traumatic stress symptoms (PTSS), the attachment avoidance-PTSS link has been far less consistent. This suggests both attenuating and enhancing connections between attachment difficulties and post-trauma outcomes. The goal of this study is 2-fold: (a) to review and summarize extant evidence concerning the relation between insecure attachment and PTSS and (b) to review mechanism(s) underlying attachment anxiety and attachment avoidance that may explain the development of PTSS. Following a systematic review of the empirical literature investigating attachment, trauma, and post-trauma reactions, a total of 138 studies were identified and summarized. The review further identifies explanatory mechanisms underlying the association between insecure attachment and PTSS, including stress appraisals, cognitive factors, self-esteem, emotion regulation strategies, social factors, and trauma-specific factors (i.e., type of trauma, extreme stress). Implications for practice, policy, and research are discussed.

Neurobiology of BDNF in fear memory, sensitivity to stress, and stress-related disorders

Brain-derived neurotrophic factor (BDNF) is widely accepted for its involvement in resilience and antidepressant drug action, is a common genetic locus of risk for mental illnesses, and remains one of the most prominently studied molecules within psychiatry. Stress, which arguably remains the "lowest common denominator" risk factor for several mental illnesses, targets BDNF in disease-implicated brain regions and circuits. Altered stress-related responses have also been observed in animal models of BDNF deficiency in vivo, and BDNF is a common downstream intermediary for environmental factors that potentiate anxiety- and depressive-like behavior. However, BDNF's broad functionality has manifested a heterogeneous literature; likely reflecting that BDNF plays a hitherto under-recognized multifactorial role as both a regulator and target of stress hormone signaling within the brain. The role of BDNF in vulnerability to stress and stress-related disorders, such as posttraumatic stress disorder (PTSD), is a prominent example where inconsistent effects have emerged across numerous models, labs, and disciplines. In the current review we provide a contemporary update on the neurobiology of BDNF including new data from the behavioral neuroscience and neuropsychiatry literature on fear memory consolidation and extinction, stress, and PTSD. First we present an overview of recent advances in knowledge on the role of BDNF within the fear circuitry, as well as address mounting evidence whereby stress hormones interact with endogenous BDNF-TrkB signaling to alter brain homeostasis. Glucocorticoid signaling also acutely recruits BDNF to enhance the expression of fear memory. We then include observations that the functional common BDNF Val66Met polymorphism modulates stress susceptibility as well as stress-related and stress-inducible neuropsychiatric endophenotypes in both man and mouse. We conclude by proposing a BDNF stress-sensitivity hypothesis, which posits that disruption of endogenous BDNF activity by common factors (such as the BDNF Val66Met variant) potentiates sensitivity to stress and, by extension, vulnerability to stress-inducible illnesses. Thus, BDNF may induce plasticity to deleteriously promote the encoding of fear and trauma but, conversely, also enable adaptive plasticity during extinction learning to suppress PTSD-like fear responses. Ergo regulators of BDNF availability, such as the Val66Met polymorphism, may orchestrate sensitivity to stress, trauma, and risk of stress-induced disorders such as PTSD. Given an increasing interest in personalized psychiatry and clinically complex cases, this model provides a framework from which to experimentally disentangle the causal actions of BDNF in stress responses, which likely interact to potentiate, produce, and impair treatment of, stress-related psychiatric disorders.

Parental attachment, coping, and psychological adjustment among adolescents following an earthquake: a longitudinal study

Background and objective: The study aim was to examine the predictive effect of parental attachment on positive psychological outcomes (posttraumatic growth, PTG) and negative psychological outcomes (posttraumatic stress disorder (PTSD) and depression symptoms), and to test the mediating role of positive and negative coping in the relationship among adolescents following an earthquake in China. Design: The study used a longitudinal design with a 6-month time interval. Method: Data was collected from middle schools in the most severely affected areas at 18 and 24 months following an earthquake. Data were analyzed from 398 adolescents who completed self-report measures of parental attachment, coping, PTSD, depression, and PTG. Path analysis was conducted to examine the relationships among the main study variables. Results: Secure parental attachment predicted lower PTSD and depression symptoms at 24-months follow-up, and negative coping partly mediated the effects of parental attachment on PTSD and depression. No significant association was observed between parental attachment and PTG. Conclusions: The findings indicate that secure parental attachment had a protective effect for adolescents after the disaster. Such attachment may reduce the use of negative coping and in turn decrease psychological distress over time.

The intergenerational sequelae of war captivity: the impact of a self-amplifying cycle of PTSD and attachment insecurities on offspring's attachment orientations

Background: War captivity is one of the most severe human-made traumatic events which lead to self-amplifying cycle of post-traumatic stress disorder (PTSD) symptoms and attachment insecurities. Solid evidence in the literature pointed out on the intergenerational transmission of PTSD symptoms. However, no research has been conducted on the intergenerational transmission of attachment insecurities and the effect of the self-amplifying cycle among former prisoners of war (ex-POWs) and their offspring attachment insecurities. Objective: This research aims to explore the intergenerational impact of a self-amplifying cycle of PTSD and attachment insecurities among ex-POWs on their offspring's attachment orientations. Method: We sampled dyads of Israeli ex-POWs of the Yom Kippur war and their adult offspring (ex-POW group) (n = 80) as well as dyads of Israeli veterans who fought in the Yom Kippur war, but were never held captive, and their adult offspring (control group) (n = 40). Veterans reported on PTSD severity and attachment orientations (anxiety, avoidance). Offspring reported on attachment orientations. We conducted (a) hierarchical regressions to predict offspring attachment orientations as a function of veterans' attachment orientations, and (b) moderated mediation analyses examining the role of veterans' PTSD in the intergenerational transmission of attachment orientations. Results: Ex-POWs' attachment anxiety was associated with offspring's reports of higher attachment anxiety and avoidance, and this intergenerational transmission of attachment was mediated by ex-POWs' PTSD severity. These effects were not significant in the control group. Conclusions: Decades after the war end, the intergenerational sequelae of war captivity are evident by the impact of the self-amplifying cycle of PTSD and attachment insecurities among ex-POWs and their offspring's attachment insecurities. Therefore, it is imperative for clinicians to recognize the intergenerational transmission and to focus not only on the trauma but also on the traumatized person's attachment injuries and the shattering of core beliefs about the world, self, and others, in the context of attachment-based therapies.

Attachment Orientations Moderate the Self-Amplifying Cycle of Posttraumatic Stress Disorder and Negative Cognitions—A Seven-Year Longitudinal Study

Introduction: We examined whether attachment orientations moderated the self-amplifying cycle of Posttraumatic Stress Disorder (PTSD) and negative cognitions, decades after the trauma ended.

Method: We sampled Israeli veterans from the 1973 Yom Kippur War and assessed PTSD severity and cognitions about the self and the world, twice—35 (T1) and 42 (T2) years after the war. At T1, we assessed participants’ attachment orientations (anxiety, avoidance).

Results: Findings provided support for a self-amplifying cycle of PTSD severity and negative cognitions about others’ benevolence during the seven-year study period. Findings also indicated that this self-amplifying cycle was significant only among veterans who scored relatively high on attachment anxiety but not among those who had less anxious attachment. Attachment avoidance also moderated the prospective contribution of negative cognitions about the self and others to PTSD severity seven years later.

Discussion: The psychological mechanisms underlying the observed effects of attachment orientations were discussed.

Attachment Styles and Posttraumatic Growth Among Suicide-Loss Survivors

Abstract. Background and aims: The world loses approximately one million people to suicide every year, leaving behind many suicide-loss survivors, family members and friends, who are significantly affected by the traumatic loss. Yet some suicide-loss survivors not only manage to cope with the loss, but actually experience posttraumatic growth (PTG). To date, no studies have fully examined the psychological processes that underlie this personal positive change. We hypothesized that attachment style would predict PTG and this association would be mediated by self-disclosure and social support. Method: A community sample of 131 suicide-loss survivors (108 women), aged 18–70, self-reported on attachment style, self-disclosure, social support, and PTG. Results: Securely attached individuals scored highest on PTG compared with other attachment styles. A structural equation model confirmed that self-disclosure and social support mediated the association between attachment and PTG. Suicide-loss survivors with secure attachment tended to self-disclose more and to perceive greater support from others than did suicide-loss survivors with insecure attachment, thus enhancing their chances of PTG. Limitations: The sample comprised mostly female participants, and the findings may not be directly generalizable to male suicide-loss survivors. Conclusion: Our results suggest that different psychological interventions should be utilized for suicide-loss survivors with particular attachment styles. Psychotherapies aiming to modify internal working models may be useful for enhancing PTG among survivors characterized by insecure attachment styles.

How does parental attachment contribute to post-traumatic growth among adolescents following an earthquake? Testing a multiple mediation model

This study aimed to elucidate the mechanism underlying the effect of parental attachment on post-traumatic growth (PTG) among adolescents. Nine and a half years after the Wenchuan earthquake, 872 adolescents in China were assessed using self-reported questionnaires. The results showed that parental attachment had a direct association with PTG, two significant one-step indirect associations with PTG (through justice beliefs and cognitive reappraisal), two significant two-step indirect associations (through feelings of safety via justice beliefs and justice beliefs via cognitive reappraisal), and one significant three-step indirect association (through feelings of safety via justice beliefs by cognitive reappraisal). The results indicated that feelings of safety, justice beliefs, and cognitive reappraisal mediated the association between parental attachment and PTG. These findings highlight the importance of a family perspective and may help clinical psychologists to improve adolescents' PTG by helping them to build positive parental attachments.

Interpersonal theory dimensions facilitate posttraumatic growth among suicide-loss survivors: An attachment perspective

Many studies have highlighted the deleterious psychological impact of suicide on bereaved individuals. We examined the psychological processes facilitating posttraumatic growth (PTG) among 124 suicide-loss survivors, focusing on attachment styles, perceived burdensomeness, and thwarted belongingness. Securely attached individuals achieved higher PTG than insecurely attached individuals. Perceived burdensomeness and thwarted belongingness both mediated and moderated the associations between attachment and PTG. Anxiously or avoidantly attached individuals who also had a high level of perceived burdensomeness were the least likely to achieve PTG. Thus, these individuals may derive particular benefit from attachment-based therapeutic interventions focusing on interpersonal relationships.

Understanding posttrauma reactions within an attachment theory framework

The purpose of this paper is to review recent research on posttrauma reactions (i.e., posttraumatic stress disorder [PTSD] symptoms and self-reported posttraumatic growth [PTG]) using attachment theory as a framework. Attachment orientations are significantly related to PTSD symptoms: insecure attachment orientations (particularly attachment anxiety) are positively associated with PTSD symptoms whereas attachment security is negatively associated with PTSD symptoms. Although associations appear to be reciprocal, research typically focuses on insecure attachment orientations predicting PTSD symptoms and the possible mechanisms of those relations, particularly a lack of social support. Some trauma characteristics (e.g., trauma severity) also appear to moderate the association between attachment and PTSD symptoms. Research on attachment orientations and PTG, however, has yielded mixed results. More rigorous methods are needed to better understand the role of attachment orientations in actual growth from pre to post-trauma.

Dispositional mindfulness mediates the relationships of parental attachment to posttraumatic stress disorder and academic burnout in adolescents following the Yancheng tornado

Background: Previous studies have shown that parental attachment is associated with low severity of posttraumatic stress disorder (PTSD) and low academic burnout in individuals who have experienced traumatic events. Objective: The present study investigated the ways in which parental attachment is related to PTSD symptoms and academic burnout in Chinese traumatized adolescents by considering the role of dispositional mindfulness. Method: A total of 443 Chinese adolescents who had experienced a severe tornado one year prior to this study completed measures of parental attachment, dispositional mindfulness, PTSD and academic burnout. Results: The results showed that our model fitted the data well [χ²/df = 2.968, CFI = 0.971, TLI = 0.955, RMSEA (90% CI) = 0.067 (0.052-0.082)] and revealed that dispositional mindfulness partially mediates the relationship between parental attachment, PTSD severity and academic burnout. Conclusions: The findings suggested that dispositional mindfulness and parental attachment may be two critical resources in dealing with traumatization and academic burnout.

Correlation Between Posttraumatic Growth and Posttraumatic Stress Disorder Symptoms Based on Pearson Correlation Coefficient: A Meta-Analysis

The literature on posttraumatic growth (PTG) is burgeoning, with the inconsistencies in the literature of the relationship between PTG and posttraumatic stress disorder (PTSD) symptoms becoming a focal point of attention. Thus, this meta-analysis aims to explore the relationship between PTG and PTSD symptoms through the Pearson correlation coefficient. A systematic search of the literature from January 1996 to November 2015 was completed. We retrieved reports on 63 studies that involved 26,951 patients. The weighted correlation coefficient revealed an effect size of 0.22 with a 95% confidence interval of 0.18 to 0.25. Meta-analysis provides evidence that PTG may be positively correlated with PTSD symptoms and that this correlation may be modified by age, trauma type, and time since trauma. Accordingly, people with high levels of PTG should not be ignored, but rather, they should continue to receive help to alleviate their PTSD symptoms.