Unresolved Attachment Mediates the Relationship Between Childhood Trauma and Impaired Personality Functioning in Adolescence

Gander, Manuela; Buchheim, Anna; Bock, Astrid; Steppan, Martin; Sevecke, Kathrin; Goth, Kirstin

doi:10.1521/pedi_2020_34_468

Cited by 33 publications

(24 citation statements)

References 65 publications

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“…As expected, we found a strong significant association between CM experiences and unresolved attachment in mothers. This result is consistent with the results of previous studies using different samples representing various degrees and types of reported maltreatment ( Bakermans-Kranenburg and van IJzendoorn, 2009 ; Buchheim and Diamond, 2018 ; Gander et al, 2018 , 2020 , 2021 ). The prevalence rate in our study cohort with N = 158 participants was 44.9% CM, determined using the recommended cut-off classifications ( Koenig et al, 2016 ).…”

Section: Discussionsupporting

confidence: 92%

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Buchheim

Ziegenhain

Kindler

et al. 2022

Front. Hum. Neurosci.

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IntroductionChildhood maltreatment (CM) is a developmental risk factor and can negatively influence later psychological functioning, health, and development in the next generation. A comprehensive understanding of the biopsychosocial underpinnings of CM transmission would allow to identify protective factors that could disrupt the intergenerational CM risk cycle. This study examined the consequences of maternal CM and the effects of psychosocial and biological resilience factors on child attachment and stress-regulatory development using a prospective trans-disciplinary approach.MethodsMother-child dyads (N = 158) participated shortly after parturition (t0), after 3 months (t1), and 12 months later (t2). Mothers’ CM experiences were assessed at t0, attachment representation at t1 and psychosocial risk and social support were assessed at t1 and t2. At t2, dyads participated in the Strange Situation Procedure (SSP). Children’s attachmen status were classified as organized vs. disorganized, including their level of disorganized behavior, and heart rate (HR) and respiratory sinus arrhythmia (RSA) were recorded as stress response measures of the autonomic nervous system. Maternal caregiving during SSP was assessed using the AMBIANCE scale. Child’s single nucleotide polymorphisms rs2254298 within the oxytocin receptor (OXTR) and rs2740210 of the oxytocin gene (OXT) were genotyped using DNA isolated from cord blood.ResultsMaternal CM experiences (CM+) were significantly associated with an unresolved attachment status, higher perceived stress and more psychological symptoms. These negative effects of CM were attenuated by social support. As expected, maternal unresolved attachment and child disorganized attachment were significantly associated. Maternal caregiving did not mediate the relationship between maternal and child attachment but influenced children’s HR and RSA response and disorganized behavior. Moreover, the rs2254298 genotype of the OXTR gene moderated the stress response of children from mothers with CM. Children carrying the rs2740210 risk allele of the OXT gene showed more disorganized behavior independent from maternal CM experiences.ConclusionWe replicated and extended existing CM and attachment models by co-examining maternal attachment, social support, and child genetic susceptibility on child attachment and cardiovascular stress regulation. The findings contribute to an extended understanding of risk and resilience factors and enable professionals to target adequate services to parents and children at risk.

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Section: Discussionsupporting

confidence: 92%

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Buchheim

Ziegenhain

Kindler

et al. 2022

Front. Hum. Neurosci.

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“…Gander and colleagues [36]. Concerning the magnitude of the overall relationship between childhood trauma and personality dysfunction, this study demonstrated a strong correlation between the mean scores of the CTQ and LoPF-Q across the entire sample (r = .50) [33]. Examining the specificity of different traumatic effects, emotional trauma (including emotional abuse and neglect) was twice as strongly related to levels of personality dysfunction (r = .51) than physical traumata (including physical abuse, neglect, and sexual abuse; r = .25).…”

Section: Childhood Traumatic Experiences and Personality Functioning (Criterion A)mentioning

confidence: 51%

Childhood Traumatic Experiences and Dimensional Models of Personality Disorder in DSM-5 and ICD-11: Opportunities and Challenges

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Flechsenhar

Bertsch

et al. 2021

Curr Psychiatry Rep

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Purpose of Review Childhood trauma is an important risk factor for the development of personality disorders (PDs), yet most research has been devoted to categorical models of personality pathology. Considering the introduction of a dimensional PD model with ICD-11, we review current findings related to various forms of childhood trauma, and PDs, operationalized in the form of personality functioning and maladaptive traits. We focus on the magnitude of associations and examine specific relationships between emotional and physical trauma with areas of personality functioning and single traits. Recent Findings Two studies showed a strong association between childhood trauma and personality dysfunction. Seven studies, including clinical and forensic samples, demonstrated heterogeneous associations between various forms of childhood trauma and maladaptive traits. Overall, four studies indicated a slightly stronger association between personality dysfunction, maladaptive trait expression, and higher levels of emotional trauma than for physical or sexual trauma. Regarding specific trait domains and childhood trauma, most studies yielded the strongest associations for either psychoticism or detachment. Summary Research on childhood trauma and dimensional PD models (i.e., personality functioning and traits) has the potential to contribute to a better understanding of their complex relationship. However, high intercorrelations among different types of childhood trauma, areas of personality functioning, and trait domains increase the difficulty of disentangling single effects. More research is needed including clinical and non-Western samples, especially considering the upcoming ICD-11 classification.

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“…Traumatic emotional abuse may be a form of attachment trauma when it occurs in the context of a primary caregiving relationship (Cyr et al., 2010 ). Childhood emotional abuse also is associated with insecure attachment and identity, intimacy, empathy, and self‐direction problems in adolescence (Gander et al., 2020 ; Goulter et al., 2019 ; Riva Crugnola et al., 2019 ) as well as with adult insecure attachment and dissociation, hopelessness, substance abuse, psychosis, and borderline personality disorder (Frias et al., 2016 ; Goodall et al., 2015 ; Kong et al., 2018 ; Scott et al., 2020 ). Thus, emotional abuse may represent both aspects of trauma exposure in DTD Criterion A (i.e., traumatic victimization and attachment disruption).…”

Section: Discussionmentioning

confidence: 99%

Developmental Trauma Disorder: A Legacy of Attachment Trauma in Victimized Children

Spinazzola¹,

Kolk

Ford

2021

Journal of Traumatic Stress

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Developmental trauma disorder (DTD) and posttraumatic stress disorder (PTSD) have been found to have both shared and unique traumatic antecedents. The present study was an independent replication, with the DTD Structured Interview and the Traumatic Events Screening Instrument administered to 271 children in mental health treatment in six U.S. sites. On an unadjusted basis, DTD (27.3% prevalence, N = 74) and PTSD (40.2% prevalence, N = 109) both were associated with traumatic physical assault or abuse, family violence, emotional abuse, caregiver separation or impairment, and polyvictimization. After controlling for PTSD, DTD was associated emotional abuse, OR = 2.9, 95% CI [1.19, 6.95], and traumatic separation from a primary caregiver, OR = 2.2, 95% CI [1.04. 4.60], both of which also were associated with caregiver impairment, physical assault/abuse, and witnessing family/community violence. Three traumatic antecedents associated with PTSD were not associated with DTD: noninterpersonal trauma, sexual trauma, and traumatic loss. Children exposed to both traumatic victimization and attachment trauma (36.2%) or attachment trauma alone (32.5%) were more likely than children exposed only to victimization (17.5%) or those with no history of victimization or attachment trauma (8.1%) to meet the symptom criteria for DTD, χ²(3, N = 271) = 17.68, p < .001. Study findings replicate and extend prior DTD field trial study results, showing that, although PTSD and DTD share traumatic antecedents, DTD is uniquely associated with traumatic emotional abuse and caregiver separation. Further research is needed to examine how specific trauma types contribute to the risk, course, and severity of DTD.

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Unresolved Attachment Mediates the Relationship Between Childhood Trauma and Impaired Personality Functioning in Adolescence

Cited by 33 publications

References 65 publications

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Childhood Traumatic Experiences and Dimensional Models of Personality Disorder in DSM-5 and ICD-11: Opportunities and Challenges

Developmental Trauma Disorder: A Legacy of Attachment Trauma in Victimized Children

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