Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder
Abstract
Objective: This review integrates recent advances in attachment theory, affective neuroscience, developmental stress research, and infant psychiatry in order to delineate the developmental precursors of posttraumatic stress disorder. Method: Existing attachment, stress physiology, trauma, and neuroscience literatures were collected using Index Medicus/Medline and Psychological Abstracts. This converging interdisciplinary data was used as a theoretical base for modelling the effects of early relational trauma on the developing central and autonomic nervous system activities that drive attachment functions. Results: Current trends that integrate neuropsychiatry, infant psychiatry, and clinical psychiatry are generating more powerful models of the early genesis of a predisposition to psychiatric disorders, including PTSD. Data are presented which suggest that traumatic attachments, expressed in episodes of hyperarousal and dissociation, are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. These enduring structural changes lead to the inefficient stress coping mechanisms that lie at the core of infant, child, and adult posttraumatic stress disorders. Conclusions: Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders.
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Dissociative symptoms are frequently associated with disrupted development of attachment relationships.
“In addition to their association with traumatic life events, dissociative symptoms are frequently associated with disrupted development of attachment relationships (Dutra et al., 2009;Liotti, 2006Liotti, , 2004;;Schore, 2002Schore, , 2009)).”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Schore, 2002
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- Authors
- Schore, A. N.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Schore, Allan N
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2002-02
- Volume
- 36
- Issue
- 1
- Pages
- 9-30
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2165237389
- Cited by
- 528
- References
- 25
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 18 · 2023: 13 · 2022: 14 · 2021: 14 · 2020: 20 · 2019: 14 · 2018: 19 · 2017: 23 · 2016: 24 · 2015: 47 · 2014: 32 · 2013: 27 · 2012: 32
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- post-traumatic stress disorder, right brain, limbic system, autonomic nervous system, early childhood abuse, hyperarousal, dissociation, stress coping, emotion regulation, intergenerational transmission, psychopathogenesis
- MeSH terms
- Adolescent, Adult, Arousal, Autonomic Nervous System, Brain, Child, Child Abuse, Child, Preschool, Dominance, Cerebral, Female, Humans, Infant, Male, Risk Factors, Stress Disorders, Post-Traumatic, Reactive Attachment Disorder
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