Unpacking the Association Between Attachment Insecurity and PTSD Symptoms (Using “QALMRI”)

Question:

Broad question - Is there a relationship between attachment styles and PTSD symptoms?

Specific - Are anxious coping behaviors associated with hyperactivation-type PTSD symptoms, and inversely - are avoidant behaviors associated with deactivation PTSD symptoms? Does trauma severity impact the intensity of different types of PTSD responses?

Alternative/Hypothesis:

[The alternative hypotheses]

H1) The researcher's prediction/hypothesis was that a positive relationship would be found between specific attachment styles - anxious & avoidant and hyperactive & deactivating coping strategies, respectively. In turn, a positive association between "type of activation" and "PTSD symptoms" was also predicted.

H2) Additionally, they predicted that there would be a relationship between trauma severity and PTSD symptoms - both styles. Meaning trauma severity causes worse PTSD symptoms in either direction - depending on the person's attachment style.

[The null hypotheses] 

The null hypothesis would be that there is no relationship between attachment styles and PTSD symptoms, and trauma severity does not mediate trauma responses.

Logic:

If the hypothesis is true then those who score higher on the anxious or avoidant attachment orientation measures - will score higher on the hyperactive and deactivating trauma coping strategies, respectively. A relationship will also be found between attachment orientation and PTSD symptoms. Additionally, we will observe a relationship between reported trauma severity and PTSD symptoms. 

If the hypothesis is incorrect, there will be no significant relationship in the survey results between attachment and PTSD coping mechanisms, and no evident relationship between trauma severity and PTSD symptoms.

Methods:

302 subjects were recruited via social media ads, mostly female and American. They were given a $10 amazon gift card... 

In order to assess the aforementioned attachment and PTSD related variables, the participants responded to surveys with specific questions on trauma severity, attachment orientations, coping strategies, and PTSD symptoms. 

Results:

H1) As predicted, hyperactivating coping was found to be related to individuals with anxious attachment styles. Likewise, deactivating coping behaviors was found to be associated with avoidant attachment styles.

Contrary to the hypothesis, deactivating coping was found to be connected to/mediate anxious attachment and PTSD symptoms. Consistent with the hypothesis, attachment avoidance was not found to interact with hyperactive coping or PTSD symptoms.

H2) In line with the hypothesis, trauma severity did affect PTSD symptoms that were moderated via attachment anxiety and avoidance coping styles. For those who scored lower on trauma severity, a lesser effect was detected on hyperactive coping and no effect was detected for deactivation coping behaviors. 

Inferences/Takeaways: 

This study provided concrete evidence for theories that have been assumed regarding the relationship between PTSD symptoms and attachment styles. Most of its predictions were supported by the resulting analyses, providing a good foundation for future research in this domain. Two points from the discussion section of this article stood out to me. Firstly, the realization based on the results - that anxious types can't always be anxious and therefore also rely on downregulating/deactivating strategies when coping with their trauma. I think that this bit of knowledge can be useful for clinicians who are trying to understand the behavior patterns of their clients. Lastly, the suggestion that these findings be tested in non-trauma contexts seems very sensible and may indeed prove useful for the broader community of individuals seeking mental healthcare. 

Original source - research article:

Marshall, E. M., Karantzas, G. C., Chesterman, S., & Kambouropoulos, N. (2022). Unpacking the association between attachment insecurity and PTSD symptoms: The mediating role of coping strategies. Psychological Trauma: Theory, Research, Practice, and Policy.