The relationship between adult attachment style and post-traumatic stress symptoms: A meta-analysis
Open accessAbstract
There is increasing evidence that adult attachment plays a role in the development and perseverance of symptoms of posttraumatic stress disorder (PTSD). This meta-analysis aims to synthesise this evidence and investigate the relationship between adult attachment styles and PTSD symptoms. A random-effects model was used to analyse 46 studies (N=9268) across a wide range of traumas. Results revealed a medium association between secure attachment and lower PTSD symptoms (ρˆ=-.27), and a medium association, in the opposite direction, between insecure attachment and higher PTSD symptoms (ρˆ=.26). Attachment categories comprised of high levels of anxiety most strongly related to PTSD symptoms, with fearful attachment displaying the largest association (ρˆ=.44). Dismissing attachment was not significantly associated with PTSD symptoms. The relationship between insecure attachment and PTSD was moderated by type of PTSD measure (interview or questionnaire) and specific attachment category (e.g. secure, fearful). Results have theoretical and clinical significance.
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Secure attachment is related to lower levels of posttraumatic stress symptoms and insecure attachment to higher levels.
“A recent review [19] and a meta-analysis [20], including both longitudinal and cross-sectional studies, summarized that secure attachment is related to lower levels of posttraumatic stress symptoms (PTSS) and insecure attachment to higher levels.”
From Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy. (2021) · cites this paper as [20]
Insecure attachment has been associated with higher PTSD symptom severity in trauma-exposed individuals.
“Attachment style may be particularly relevant in PTSD: insecure attachment, has been associated with higher PTSD symptom severity in trauma-exposed individuals (see Woodhouse et al, 2015 a meta-analysis).”
From Intranasal oxytocin administration dampens amygdala reactivity towards emotional faces in male and female PTSD patients (2016) · cites this paper as Woodhouse et al, 2015
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References 131 · Cited by 210
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- Authors
- Woodhouse, S., Ayers, S., & Field, A. P.
- Affiliations
- University of Sussex (GB)
- City, University of London (GB)
- Corresponding author
- Ayers, Susan
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 35
- Pages
- 103-117
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W1831545790
- Cited by
- 210
- References
- 131
- Citations by year
- 2026: 15 · 2025: 18 · 2024: 17 · 2023: 25 · 2022: 17 · 2021: 20 · 2020: 51 · 2019: 18 · 2018: 11 · 2017: 13 · 2016: 3 · 2015: 1
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- adult attachment, attachment styles, post-traumatic stress disorder, posttraumatic stress symptoms, secure attachment, insecure attachment, fearful attachment, dismissing attachment, attachment anxiety, trauma
- MeSH terms
- Adult, Anxiety Disorders, Fear, Female, Humans, Male, Middle Aged, Object Attachment, Surveys and Questionnaires, Risk Factors, Stress Disorders, Post-Traumatic
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