Attachment organization in Vietnam combat veterans with posttraumatic stress disorder

Nye, Ella C.; Katzman, Jeffrey; Bell, Jordan B.; Kilpatrick, Julie; Brainard, Marythelma; Haaland, Kathleen Y.

doi:10.1080/14616730701868613

Cited by 25 publications

(12 citation statements)

References 40 publications

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“…This finding is consistent with prior research (Ein-Dor et al 2010;Renaud 2008), but also suggests an additional hypothesis to evaluate in future studies: whether avoidant attachments towards partner prevented trauma processing or if combat exposure fundamentally changed ones attachment to partner behaviors to align with avoidance. There were no significant correlations between any of the three secure attachment scales and PTSD severity, which also supports previous research on the relationship between secure attachment and PTSD with veterans (Harari et al 2009;Nye et al 2008). Additionally, there were no significant correlations between PTSD symptoms and the father attachment scales, which is consistent with the attachment literature that shows that mother attachments are generally more predictive than father attachments (see Cassidy and Shaver 2008 for several examples of this).…”

Section: Discussionsupporting

confidence: 90%

“…Whereas one study found a relationship between secure attachment style and fewer PTSD symptoms in active duty service members (Escolas et al 2012), other studies did not find relationships between secure attachment and PTSD (Harari et al 2009;Nye et al 2008). Using the Adult Attachment Interview (AAI; see Hesse 1999) with Vietnam veterans, Nye et al (2008) found no differences in level of secure attachment with veterans diagnosed with PTSD compared to those not diagnosed with PTSD. Instead, the authors found that unresolved/ disorganized AAI scores related to the trauma loss (referencing the combat experience) were related to more PTSD avoidance and numbing symptomatology.…”

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confidence: 95%

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An Exploratory Study of Attachments and Posttraumatic Stress in Combat Veterans

et al. 2015

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The purpose of this exploratory study was to evaluate the potential value of comparing specific attachments to posttraumatic stress disorder (PTSD) symptomatology in combat veterans with a new measure of attachments. A case series of 22 combat veterans in a Veterans Affairs Medical Center clinic completed PTSD Checklist -Military Version (PCL-M), Trauma Symptom Inventory -2nd Edition, and the Attachment and Clinical Issues Questionnaire (ACIQ) as part of a pilot study for a larger project. Descriptive statistics and Pearson correlations were used to examine the data. Although there were significant negative correlations between self-rated PTSD symptoms and avoidant (r = −0.44) and ambivalent (r = −0.55) attachment scores towards their mothers, suggesting a novel type of enmeshment, positive correlations were found between PTSD symptoms and avoidant partner attachments scores (r = 0.47). There were no significant correlations between the attachment scales to father and PTSD symptoms. The ACIQ Ambivalent Partner scale was only related to TSI-2 scales Intrusive Experiences (r = −0.44) and Defensive Avoidance (r = −0.44). An exploratory regression model using attachment variables identified from correlations and predicting PCL scores was significant (R 2 = 0.48); however, only Avoidant Partner scale contributed significant variance (β = 0.42, p = 0.024). The potency of the partner scale suggests a potential target for future research and intervention. These data point to new questions to be explored with larger samples and more sophisticated statistical techniques, and further highlighting the complexity of attachment and PTSD. Research suggests that the prevalence rate of posttraumatic stress disorder (PTSD) in combat veterans is approximately 16 % (Gates et al. 2012). Between 2004 and 2009, the Veterans Health Administration spent approximately $1.4 billion on PTSD treatment (Congressional Budget Office 2012), PTSD research expenditures by the US government were $24.5 million in 2009 (Monegain 2011), and $45 million in research funding was more recently awarded to form the Consortium to Alleviate PTSD in a joint effort by the Department of Veterans Affairs and the Department of Defense (U.S. Department of Veterans Affairs, National Center for PTSD 2015). Despite increased research and treatment efforts related to PTSD in veterans, it remains unclear why some suffer a greater number and/or more severe PTSD symptoms than others following similar combat experiences. The relationship of attachments in significant social relationships is one area of research that has received relatively little attention in the literature. If found significant, the contribution of attachment factors to the risk for developing PTSD could provide researchers additional information with which to understand PTSD etiology, and thus inform prevention and policy. Additionally, identification of significant and maladaptive attachment factors in this population could allow clinicians to improve care of veterans by adding specific attachment issue...

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Section: Discussionsupporting

confidence: 90%

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confidence: 95%

An Exploratory Study of Attachments and Posttraumatic Stress in Combat Veterans

et al. 2015

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“…The unresolved classification was associated with the presence of a PTSD diagnosis in a sample of Dutch veterans (Harari et al, 2009), as well as with a greater likelihood of comorbid anxiety and PTSD in a sample of Vietnam combat veterans (Nye et al, 2008). Finally, among women with a history of childhood abuse, unresolved states of mind were associated with more comorbid anxiety disorders and with increased likelihood of a PTSD diagnosis, specifically (Stovall-McClough & Cloitre, 2006).…”

Section: Introductionmentioning

confidence: 99%

Quality of attachment relationships and peer relationship dysfunction among late adolescents with and without anxiety disorders

Brumariu

Obsuth

Lyons‐Ruth

2013

Journal of Anxiety Disorders

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Little is known about the links between anxiety disorders and parent-child attachment disorganization and quality of peer relationships in late adolescence. This study examined the quality of attachment and peer relationships among adolescents with and without anxiety disorders in a sample of 109 low-to moderate-income families. Psychopathology was assessed with the SCID-I. Attachment disorganization and dysfunction in peer relationships were measured using semi-structured interviews and behavioral observations. Adolescents with anxiety disorders and comorbid conditions showed higher levels of attachment disorganization across three measurement approaches, as well as higher levels of dysfunction in peer relationships than those with no Axis I diagnosis. Adolescents without anxiety disorders but with other Axis I disorders differed only in the quality of school relationships from those with no diagnoses. The pattern of results suggests that pathological anxiety, in the context of other comorbidities, may be a marker for more pervasive levels of social impairment.

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“…This includes studies of depression (Cole-Detke & Kobak, 1996;Rosenstein & Horowitz, 1996), bipolar disorder (Morriss, van der Gucht, Lancaster, & Bentall, 2009), eating disorders (Tasga & Balfour, 2014), substance use (Schindler & Browning, 2015), and per-sonality disorders (Fonagy et al, 1996). Interestingly, while some studies of PTSD (Woodhouse, Ayers, & Field, 2015) demonstrate similar results, other studies with combat veterans reveal high levels of security relative to childhood events in a three-way classification despite high levels of symptoms (Nye et al, 2008). …”

Section: Relationship To Dsm Conceptsmentioning

confidence: 84%

Attachment in the Psychiatric Curriculum

Katzman

Fabbro

2017

Psychodynamic Psychiatry

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Psychiatric trainees are expected to learn the fundamental concepts of psychodynamic psychotherapy, but they often struggle to understand and appreciate the relevance of this work. An introduction to attachment theory can go a long way toward assisting our trainees in understanding the relevance of psychodynamic psychiatry. To help programs develop this component of their curriculum, we summarize the history of the development of the attachment paradigm including the Strange Situation and Adult Attachment Interview (AAI), useful tools to teach these concepts, as well as ramifications of this work. We provide a summary of information regarding the evidence base connected to this paradigm, potential clinical relevance, health implications, work from neuroscience, and infant intervention models to assist in bringing psychodynamic concepts to life. Exposure to the attachment paradigm provides a model of intervention, prevention, and hope for our trainees as they transition from learning phenomenologic models of psychiatric diagnostics to other paradigms of human development and intervention.

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Attachment organization in Vietnam combat veterans with posttraumatic stress disorder

Cited by 25 publications

References 40 publications

An Exploratory Study of Attachments and Posttraumatic Stress in Combat Veterans

An Exploratory Study of Attachments and Posttraumatic Stress in Combat Veterans

Quality of attachment relationships and peer relationship dysfunction among late adolescents with and without anxiety disorders

Attachment in the Psychiatric Curriculum

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