Childhood Victimization and Physical Health in Women: The Mediating Role of Adult Attachment.

Research has shown that female survivors of childhood abuse (CA) are more likely than nonabused women to experience long-term physical health concerns. Adult attachment may influence this relationship given that attachment insecurity has been linked to poorer physical health and postulated mechanisms of action are similar. This study used structural equation modeling to investigate whether adult attachment insecurity mediates the relationship between four types of CA and self-reported physical health in 538 undergraduate women. CA prevalence rates ranged from 11.7% (sexual abuse) to 34.9% (psychological abuse). In separate structural equation models, direct pathways were significant between CA and adult attachment insecurity, CA and adult physical health, and adult attachment insecurity and adult physical health. Adult attachment insecurity was found to partially mediate health outcomes in CA survivors, S-B χ2 = 116.60 (58), p < .001; comparative fit index = .95; Tucker-Lewis index = .94; root mean square error of approximation = .05; and confidence interval = [.03, .06]. Physical health is a significant concern for survivors of CA, and these results suggest improving attachment security may represent an important avenue of intervention.

The Disorganized Response Scale: Construct validity of a potential self-report measure of disorganized attachment.

OBJECTIVE: Based on the paucity of self-report measures of disorganized attachment (DA), we developed and tested a scale examining adults' self-reported disorganized verbalizations, cognitions, and behaviors when discussing their childhoods. METHOD: The Disorganized Response Scale (DRS) was created and administered to 640 university students, and its associations with variables known to covary with DA, such as childhood maltreatment, insecure attachment, and psychological symptoms, were examined. RESULTS: Factor analysis of DRS items revealed a single 15-item dimension that reflected participants' self-reported disorganized responses when discussing their childhoods. Structural equation modeling indicated a good fit to a model in which fearful caretaking and childhood abuse and neglect were associated with the DRS. In turn, the DRS, along with anxious and avoidant attachment, was independently related to symptoms and partially mediated the relationship between child maltreatment and symptomatology. Hierarchical multiple regression indicated that the DRS accounted for significant additional variance in posttraumatic stress, externalization, somatization, and, especially, dissociation, even after demographics and both anxious and avoidant attachment were taken into account. CONCLUSIONS: Analyses support the construct validity of the DRS as a measure of disorganized attachment-related responses in adults. Further research is indicated to replicate these findings and to evaluate their convergence with interview measures of DA. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Compensatory self-injury: Posttraumatic stress, depression, and the role of dissociation.

OBJECTIVE: Despite a number of studies, the reasons for self-injurious behavior (SIB) have yet to be clearly specified. Using path analysis, we sought to test the hypothesis that exposure to adverse events produces depression and posttraumatic stress, which in turn motivate dissociation that, when at high levels, supports the use of SIB. METHOD: A sample of 679 adults (54% female, mean age = 53 years) were recruited from the general population by a national survey company, and administered measures evaluating posttraumatic stress, depression, dissociation, and SIB. RESULTS: A total of 4.3% of participants reported some level of SIB within the prior 6 months. Younger age, exposure to adverse events, posttraumatic stress, depression, and dissociation were all related to SIB by univariate analyses. Path analyses revealed that although adverse events predicted posttraumatic stress and depression, which were then associated with SIB, these paths to SIB were no longer significant once dissociation was entered into the model, indicating full mediation. CONCLUSION: Rather than arising directly from posttraumatic stress or depression, SIB may occur most proximally in response to dissociation, with the pain associated with SIB potentially serving to interrupt or titrate unwanted hypoarousal and numbing. Clinicians should consider specifically targeting dissociation and its adversity-related antecedents when treating SIB. (PsycINFO Database Record

Posttraumatic stress symptoms as a mediator between sexual assault and adverse health outcomes in undergraduate women.

This study investigated the links between sexual assault experiences, posttraumatic stress symptoms, and adverse physical health outcomes among undergraduate women. Existing research has demonstrated that posttraumatic stress disorder mediates the relationship between trauma exposure and physical health in general, but this has yet to be tested for sexual assault specifically. Using structural equation modeling, support was found for a model in which posttraumatic stress symptom severity partially mediates the association between sexual assault severity and self-reported health outcomes. An alternative model using depression symptoms did not meet the criteria for mediation. Implications for the physical health of sexual assault survivors are discussed.