1
|
Flemming E, Lübke L, Müller S, Rümler LPS, Spitzer C. [Validation of a German version of the self-rating Adult Disorganized Attachment scale (ADA-D)]. Psychother Psychosom Med Psychol 2023; 73:473-479. [PMID: 37666268 DOI: 10.1055/a-2140-8260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Disorganized attachment represents the greatest risk factor for psychopathology compared to the "organized" insecure attachment dimensions in various meta-analyses. Recently, the Adult Disorganized Attachment Scale (ADA) was developed as a self-rating scale for measuring disorganized attachment in romantic partnerships. However, a translation and evaluation in German-speaking samples is not yet available. METHODS A German Translation of the scale (ADA-D) comprising nine items was assessed in a general population sample (N=1101) and in a student sample (N=328). The factor structure, psychometric properties, and validity of the scale with respect to psychopathology and the Experiences in Close Relationships questionnaire (ECR-RD) were examined. The differential associations of ADA-D and ECR-RD with psychopathology were determined using linear regression models. RESULTS The unidimensional factor structure of the original version could be confirmed for the ADA-D and the instrument exhibited high internal consistency (McDonalds ω=0.91 / 0.89). Compared to attachment anxiety and avoidance, ADA-D was the strongest predictor of dissociative symptoms (Sample 1: β=0.48; p<0.001; Sample 2: β=0.23; p<0.01) and, in Sample 1, additionally for physical aggression (β=0.37; p<0.001). DISCUSSION The ADA-D exhibits good psychometric properties that are comparable to the original version of the scale. The associations with aggressiveness and dissociation are in line with previous findings regarding the unresolved attachment status in the Adult Attachment Interview. CONCLUSION The ADA-D can be recommended for further use in research as a screening instrument for disorganized attachment in adulthood. An application in psychotherapeutic diagnostics seems promising, however, evaluations in clinical samples are necessary beforehand.
Collapse
Affiliation(s)
- Eva Flemming
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| | - Laura Lübke
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| | - Sascha Müller
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
- Institut für Psychologie, Universität Kassel
| | - Lisa Petra Sophia Rümler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| | - Carsten Spitzer
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| |
Collapse
|
2
|
Li A, Wang S, Paetzold RL, Rholes WS, Liu X. Childhood Trauma and Its Link to Adult Dissociation: The Role of Mentalizing and Disorganized Attachment in a Chinese Adult Sample. J Trauma Dissociation 2023; 24:559-574. [PMID: 36975105 DOI: 10.1080/15299732.2023.2195395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/03/2023] [Indexed: 03/29/2023]
Abstract
Based on previous findings in a U.S. sample, the present study validated the relationship between childhood trauma and dissociation, as well as the mediating role of disorganized attachment and the moderating role of mentalizing (i.e. self-concept clarity and reflective functioning) in a group of 569 Chinese adults (i.e. a community sample). Results demonstrated a mediating role for disorganized attachment relationships in linking childhood maltreatment and dissociative symptoms. Moreover, self-concept clarity moderated this mediating relationship. An interesting finding that differs from the U.S. sample is that reflective functioning did not play a moderating role between insecure attachment and dissociation in Chinese adults. Chinese culture places greater emphasis on collectivism, altruism, and other-oriented, and thus the protective effect of the reflective function may not be as effective as in an individualistic culture. This study provides evidence for a better understanding of the relationship between childhood trauma, attachment, dissociation, and the moderating role of mentalizing in an Eastern culture, and it opens the door to further research examining whether more Western (such as the U.S.) and Eastern (particularly Chinese) relationships are similar in both social and clinical psychology.
Collapse
Affiliation(s)
- Angyang Li
- School of Teacher Education, Nanjing University of Information Science & Technology, Nanjing, P.R.China
| | - Shuo Wang
- Faculty of Education, Beijing Normal University, Beijing, China
| | - Ramona L Paetzold
- Department of Management, Mays Business School, Texas A & M University, College Station, Texas, USA
| | - W Steven Rholes
- Department of Psychological and Brain Sciences, Texas A & M University, College Station, Texas, USA
| | - Xiangping Liu
- Faculty of Psychology, Beijing Key Laboratory of Applied Experimental Psychology, Beijing Normal University, Beijing, P.R.China
| |
Collapse
|
3
|
Dirican AH, Kozak ED, Kavakcı Ö, Sönmez B. The Association of Child Abuse Experiences and Intolerance of Uncertainty in Young Adults. Psychiatry 2023; 86:214-228. [PMID: 37130031 DOI: 10.1080/00332747.2023.2205800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Objective: Drawing upon the identity disruption model, we investigated the association between child abuse experiences (emotional, physical, and sexual) and intolerance of uncertainty. We also addressed demographic differences in uncertainty intolerance in this study. Methods: Using online survey questionnaires, we collected data from a sample of 302 young adults in Turkey. The data were analyzed using confirmatory factor analysis, structural equation modeling, one-way analysis of variance, and independent samples t-test. Results: The results showed that of the three types of child abuse analyzed, only emotional abuse was significantly and positively associated with intolerance of uncertainty. In contrast, age was negatively associated with intolerance of uncertainty. Regarding demographic differences, we found that the level of intolerance of uncertainty differed based on young adults' gender, psychiatric diagnosis, and education. Specifically, our findings indicated that intolerance of uncertainty is significantly higher in females compared to males. It is also significantly higher in young adults with a diagnosis for psychiatric disorders than those without. Moreover, intolerance of uncertainty is significantly higher in young adults who have a high school graduate degree than their undergraduate and graduate counterparts. We discussed how child abuse is associated with heightened intolerance of uncertainty in young adulthood as well as why demographic differences may exist in uncertainty intolerance. Conclusions: The present study expanded the existing research on the psychological consequences of childhood abuse experiences by linking child abuse to intolerance of uncertainty. Particularly, exposure to emotional abuse in early life can be a risk factor to cope with uncertainty in later life.
Collapse
|
4
|
d'Huart D, Hutsebaut J, Seker S, Schmid M, Schmeck K, Bürgin D, Boonmann C. Personality functioning and the pathogenic effect of childhood maltreatment in a high-risk sample. Child Adolesc Psychiatry Ment Health 2022; 16:95. [PMID: 36451183 PMCID: PMC9710065 DOI: 10.1186/s13034-022-00527-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND While the psychopathological sequalae of childhood maltreatment are widely acknowledged, less is known about the underlying pathways by which childhood maltreatment might lead to an increased risk for mental health problems. Recent studies indicated that impaired personality functioning might mediate this relationship. The aim of the present paper was to extend the current literature by investigating the mediating effect of impaired personality functioning between different types of childhood maltreatment and self-reported mental health problems in a high-risk sample. METHODS Overall, 173 young adults (mean age = of 26.61 years; SD = 3.27) with a history of residential child welfare and juvenile justice placements in Switzerland were included in the current study. The Childhood Trauma Questionnaire (CTQ-SF), Semi-structured Interview for Personality Functioning DSM-5 (STiP-5.1) and the self-report questionnaires of the Achenbach System of Empirically Based Assessment scales (ASEBA) were used. Mediation analyses were conducted through structural equation modeling. RESULTS Overall, 76.3% (N = 132) participants indicated at least one type of childhood maltreatment, with emotional neglect being most commonly reported (60.7%). A total of 30.6% (N = 53) participants self-reported mental health problems. Emotional abuse (r = 0.34; p < .001) and neglect (r = 0.28; p < .001) were found to be most strongly associated with mental health problems. In addition, impaired personality functioning was fond to be a significant mediator for overall childhood maltreatment (β = 0.089; p = 0.008) and emotional neglect (β = 0.077; p = 0.016). Finally, impaired self-functioning was found to be a significant mediator when both self-functioning and interpersonal functioning were included as potential mediators in the relationship between overall childhood maltreatment (β1 = 0.177, p1 = 0.007) and emotional neglect (β1 = 0.173, p1 = 0.003). CONCLUSION Emotional neglect may be particularly important in the context of childhood maltreatment, personality functioning, and mental health problems and, therefore, should not be overlooked next to the more "obvious" forms of childhood maltreatment. Combining interventions designed for personality functioning with trauma-informed practices in standard mental health services might counteract the psychopathological outcomes of maltreated children and adolescents.
Collapse
Affiliation(s)
- Delfine d'Huart
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Hospitals Basel, Basel, Switzerland.
| | - Joost Hutsebaut
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Viersprong Institute for Studies on Personality Disorders, De Viersprong, Halsteren, The Netherlands
| | - Süheyla Seker
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Hospitals Basel, Basel, Switzerland
| | - Marc Schmid
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Hospitals Basel, Basel, Switzerland
| | - Klaus Schmeck
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Hospitals Basel, Basel, Switzerland
| | - David Bürgin
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Hospitals Basel, Basel, Switzerland
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Cyril Boonmann
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Hospitals Basel, Basel, Switzerland
- LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
5
|
Affiliation(s)
- Sarah J Harsey
- Center for Institutional Courage, USA.,Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Jennifer J Freyd
- Center for Institutional Courage, USA.,Department of Psychology, University of Oregon, Eugene, Oregon, USA.,Stanford School of Medicine, Palo Alto, California, USA
| |
Collapse
|
6
|
Abstract
Post-traumatic Stress Disorder is a chronic condition that occurs following a traumatic experience. Information processing models of PTSD focus on integrating situationally triggered sensory-emotional memories with consciously accessible autobiographical memories. Review of the nature of implicit memory supports the view that sensory-emotional memories are implicit in nature. Dissociation was also found to be associated with the development and severity of PTSD, as well as deficits in autobiographical memory. Moreover, disorganized attachment (DA) was associated with greater degrees of dissociation and PTSD, and like the defining neural activation in PTSD, was found to be associated with basal ganglia activity. In addition, subcortical neuroception of safety promotes a neurophysiological substrate supportive of social engagement and inhibition of fear-based responses. Furthermore, activation of representations of co-created imagined scenes of safety and secure attachment are associated with increases in this neurophysiological substrate. Repeated priming of secure attachment imagery was associated with modification of internal working models of DA along with reductions in dissociation and recovery from complex PTSD. In conclusion, it is posited that adequate recovery from extensive trauma experiences requires more than conscious elaboration of traumatic autobiographical memories and that the application of implicit nonconscious memory modification strategies will facilitate more optimal recovery.
Collapse
|
7
|
Baek J, Kim KA, Kim H, Kim O, Ko M, Kim SH, Sohn IB, Shin BK, Jeon WT, Chu SH. The validity of ICD-11 PTSD and complex PTSD in North Korean defectors using the International Trauma Questionnaire. Eur J Psychotraumatol 2022; 13:2119012. [PMID: 36237828 PMCID: PMC9553178 DOI: 10.1080/20008066.2022.2119012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: The International Trauma Questionnaire (ITQ) is a self-report assessment focused on the core features of Post-Traumatic Stress Disorder (PTSD) and complex Post-Traumatic Stress Disorder (CPTSD). It is consistent with the organizing principles of the 11th revision to the WHO's International Classification of Diseases (ICD-11). Since the 1990s, the number of North Korean defectors (NKD) entering South Korea to escape human rights violations has been increasing rapidly, with 33,815 NKD settled by 2021. The South Korean government faces an important challenge in supporting NKD to successfully adapt and settle in South Korean society. NKD experience various traumatic events during the process of defecting and repatriation. Therefore, it is essential to understand the psychological disorders of NKD, especially PTSD and CPTSD. Objective: This study aimed to test the validity of the ITQ assessment and explore the differences in symptoms and quality of life between PTSD and CPTSD. Method: The study sample comprised 503 trauma-exposed NKD. Confirmatory factor analysis (CFA) and latent class analysis (LCA) were used to evaluate the validity of ITQ. One-way analysis of variances and post-hoc analyses revealed the difference in the Depression and Somatic Symptoms Scale (DSSS) and WHOQOL-BREF results among PTSD and CPTSD symptom LCA classes. Results: The CFA and LCA results supported the ICD-11 conceptualization of PTSD and CPTSD in NKD. The CFA results confirmed that both the first- and second-order models were statistically fit, but for community-dwelling NKD the first-order model had better model fit than the second-order model. The LCA findings revealed a four-class model with 'PTSD', 'CPTSD', 'DSO', and 'low symptom' classes. Compared to the PTSD class, CPTSD class had higher levels of depression and somatic symptoms and a lower quality of life. Conclusion: This study provided evidence that ITQ is a valid tool to assess PTSD or CPTSD in community-dwelling NKD.
Collapse
Affiliation(s)
- Jiwon Baek
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Kyoung-A Kim
- Department of Nursing, Gachon University College of Nursing, Gyeonggi-do, Republic of Korea
| | - Hokon Kim
- Department of Nursing, Yonsei University College of Nursing and Brain Korea 21 FOUR Project, Seoul, Republic of Korea
| | - Ocksim Kim
- Department of Nursing, Yonsei University College of Nursing and Brain Korea 21 FOUR Project, Seoul, Republic of Korea
| | - Minjeong Ko
- Department of Nursing, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - In Bae Sohn
- Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bo Kyung Shin
- Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Taek Jeon
- Department of Medical Education, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.,Department of Nursing, Yonsei University College of Nursing, Seoul, Republic of Korea
| |
Collapse
|
8
|
Li A, Wang S, Paetzold RL, Liu X. Validity and reliability of the Chinese version of adult disorganized attachment scale in Chinese adults. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02041-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|