Childhood maltreatment, complex trauma symptoms, and unresolved attachment in an at-risk sample of adolescent mothers
Abstract
Associations between unresolved attachment, abuse history, and a wide range of trauma-related symptomatology were examined in an at-risk sample (N = 62). Fifty percent reported severe childhood physical and/or sexual abuse. An independent trauma interview elicited more reports of childhood sexual abuse than the Adult Attachment Interview (AAI); conversely, the AAI elicited more reports of physical abuse. Childhood physical abuse, sexual abuse, and general maltreatment were associated with unresolved status. Furthermore, sexual abuse history and general maltreatment predicted unresolved loss, suggesting that they adversely affected the integration of other emotional and/or traumatic experiences. Women classified as Unresolved reported higher levels of dissociation, confusion regarding self-identity, and relationship problems. Findings complement and extend empirical support for the theorized association between dissociative processes and unresolved attachment.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Factors involving dissociation, child development, attachment security, and wider systemic factors such as family environment may explain the relationship between complex trauma and CPTSD.
“Evidence suggests that factors involving dissociation (4), child development (17), attachment security (18; 19), and wider systemic factors such as family environment (20, 21) may explain the relationship between complex trauma and CPTSD.”
From Tracing the paths: a systematic review of mediators of complex trauma and complex post-traumatic stress disorder (2024) · cites this paper as [19]
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
Complex PTSD: A syndrome in survivors of prolonged and repeated trauma
Herman, J. L. (1992) · Journal of Traumatic Stress · doi:10.1002/jts.2490050305 · Cited by 2,609 · see citing works
Childhood traumas: an outline and overview
Terr, L. C. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.1.10 · Cited by 2,207 · see citing works
Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae
VAN IJZENDOORN, M. H., SCHUENGEL, C., & BAKERMANS–KRANENBURG, M. J. (1999) · Development and Psychopathology · doi:10.1017/s0954579499002035 · Cited by 1,625 · see citing works
Childhood trauma in borderline personality disorder.
Herman, J., Perry, J., & van der Kolk, B. A. (1989) · American Journal of Psychiatry · doi:10.1176/ajp.146.4.490 · Cited by 1,277 · see citing works
Main, M., & Hesse, E. (1990) · Cited by 1,203 · see citing works
The relation of attachment status, psychiatric classification, and response to psychotherapy.
Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.1.22 · Cited by 1,124 · see citing works
The relation of attachment status, psychiatric classification, and response to psychotherapy.
Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. J. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.1.22 · Cited by 1,083 · see citing works
Child neglect: developmental issues and outcomes☆
Hildyard, K. L., & Wolfe, D. A. (2002) · Child Abuse & Neglect · doi:10.1016/s0145-2134(02)00341-1 · Cited by 994 · see citing works
A meta-analytic examination of assumed properties of child sexual abuse using college samples.
Rind, B., Tromovitch, P., & Bauserman, R. L. (1998) · Psychological Bulletin · doi:10.1037/0033-2909.124.1.22 · Cited by 982 · see citing works
Recognizing emotion in faces: Developmental effects of child abuse and neglect.
Pollak, S. D., Cicchetti, D., Hornung, K., & Reed, A. J. (2000) · Developmental Psychology · doi:10.1037/0012-1649.36.5.679 · Cited by 869 · see citing works
Emotional abuse and neglect (psychological maltreatment): a conceptual framework
Glaser, D. (2002) · Child Abuse & Neglect · doi:10.1016/s0145-2134(02)00342-3 · Cited by 725 · see citing works
Zanarini, M. C., Williams, A. A., Lewis, R. E., Reich, R., Vera, S. C., Marino, M. F., Levin, A., Yong, L., & Frankenburg, F. R. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.8.1101 · Cited by 717 · see citing works
Shields, A., & Cicchetti, D. (2001) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3003_7 · Cited by 671 · see citing works
OGAWA, J. R., SROUFE, L. A., WEINFIELD, N. S., CARLSON, E. A., & EGELAND, B. (1997) · Development and Psychopathology · doi:10.1017/s0954579497001478 · Cited by 649 · see citing works
Dissociation in children and adolescents: a developmental perspective
(1998) · Choice Reviews Online · doi:10.5860/choice.35-4803 · Cited by 590 · see citing works
Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, F. S. (1997) · Journal of Traumatic Stress · doi:10.1002/jts.2490100403 · Cited by 581 · see citing works
Disorganized Infant, Child, and Adult Attachment: Collapse in Behavioral and Attentional Strategies
Hesse, E., & Main, M. (2000) · Journal of the American Psychoanalytic Association · doi:10.1177/00030651000480041101 · Cited by 577 · see citing works
Maughan, A., & Cicchetti, D. (2002) · Child Development · doi:10.1111/1467-8624.00488 · Cited by 532 · see citing works
Effect of incest on self and social functioning: A developmental psychopathology perspective.
Cole, P. M., & Putnam, F. W. (1992) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.60.2.174 · Cited by 528 · see citing works
Complex trauma, complex reactions: Assessment and treatment.
Courtois, C. A. (2004) · Psychotherapy: Theory, Research, Practice, Training · doi:10.1037/0033-3204.41.4.412 · Cited by 508 · see citing works
Attachment Studies with Borderline Patients: A Review
Agrawal, H. R., Gunderson, J., Holmes, B. M., & Lyons-Ruth, K. (2004) · Harvard Review of Psychiatry · doi:10.1080/10673220490447218 · Cited by 495 · see citing works
Lyons‐Ruth, K., & Jacobvitz, D. B. (1999) · Cited by 472 · see citing works
Cicchetti, D., & Valentino, K. (2015) · Wiley eBooks · doi:10.1002/9780470939406.ch4 · Cited by 469 · see citing works
Fink, L., Bernstein, D. P., Handelsman, L., Foote, J. P., & Lovejoy, M. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.9.1329 · Cited by 453 · see citing works
Frightening maternal behavior linking unresolved loss and disorganized infant attachment.
Schuengel, C., Bakermans-Kranenburg, M. J., & Van IJzendoorn, M. H. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.1.54 · Cited by 419 · see citing works
ATTACHMENT AND BORDERLINE PERSONALITY DISORDER
Fonagy, P., Target, M., & Gergely, G. (2000) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70146-5 · Cited by 347 · see citing works
Briere, J. (2002) · Cited by 333 · see citing works
LYONS–RUTH, K., YELLIN, C., MELNICK, S., & ATWOOD, G. (2005) · Development and Psychopathology · doi:10.1017/s0954579405050017 · Cited by 330 · see citing works
van der Kolk, & Bessel, A. (1996) · Cited by 330 · see citing works
Identity Disturbance in Borderline Personality Disorder: An Empirical Investigation
Wilkinson‐Ryan, T., & Westen, D. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.4.528 · Cited by 322 · see citing works
DiLillo, D. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(99)00072-0 · Cited by 314 · see citing works
JAFFEE, S., CASPI, A., MOFFITT, T. E., BELSKY, J., & SILVA, P. (2001) · Development and Psychopathology · doi:10.1017/s0954579401002103 · Cited by 312 · see citing works
Beeghly, M., & Cicchetti, D. (1994) · Development and Psychopathology · doi:10.1017/s095457940000585x · Cited by 303 · see citing works
Trull, T. J. (1995) · Psychological Assessment · doi:10.1037/1040-3590.7.1.33 · Cited by 294 · see citing works
Gershuny, B. S. (1999) · Clinical Psychology Review · doi:10.1016/s0272-7358(98)00103-2 · Cited by 292 · see citing works
Personality disorder and the mental representation of early social experience
Patrick, M. P. H., Hobson, R. P., Castle, D. J., Howard, R. J., & Maughan, B. (1994) · Development and Psychopathology · doi:10.1017/s0954579400004648 · Cited by 283 · see citing works
Post-traumatic stress in sexually abused, physically abused, and nonabused children
Deblinger, E., McLeer, S. V., Atkins, M. S., Ralphe, D. L., & Foa, E. B. (1989) · Child Abuse & Neglect · doi:10.1016/0145-2134(89)90080-x · Cited by 272 · see citing works
Toth, S. L., Cicchetti, D., Macfie, J., & Emde, R. N. (1997) · Development and Psychopathology · doi:10.1017/s0954579497001430 · Cited by 267 · see citing works
Dissociation and the Parent-Infant Dialogue: a Longitudinal Perspective From Attachment Research
Lyons‐Ruth, K. (2003) · Journal of the American Psychoanalytic Association · doi:10.1177/00030651030510031501 · Cited by 252 · see citing works
Stability of attachment representations: The transition to marriage.
Crowell, J. A., Treboux, D., & Waters, E. (2002) · Developmental Psychology · doi:10.1037//0012-1649.38.4.467 · Cited by 234 · see citing works
Unresolved attachment, PTSD, and dissociation in women with childhood abuse histories.
Stovall-McClough, K. C., & Cloître, M. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.2.219 · Cited by 223 · see citing works
Michelson, L. K., & Ray, W. J. (1996) · Springer eBooks · doi:10.1007/978-1-4899-0310-5 · Cited by 223 · see citing works
Adolescent Physical Abuse: Risk for Adolescent Psychiatric Disorders
Kaplan, S. J., Pelcovitz, D., Salzinger, S., Weiner, M., Mandel, F. S., LESSER, M. L., & Labruna, V. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.7.954 · Cited by 222 · see citing works
Post-Traumatic Stress Disorder in Physically Abused Adolescents
Pelcovitz, D., Kaplan, S. J., Goldenberg, B., Mandel, F. S., Lehane, J., & GUARRERA, J. (1994) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199403000-00002 · Cited by 198 · see citing works
Attachment and Traumatic Stress in Female Holocaust Child Survivors and Their Daughters
Sagi‐Schwartz, A., van IJzendoorn, M. H., Grossmann, K. E., Joels, T., Grossmann, K., Scharf, M., Koren‐Karie, N., & Alkalay, S. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.6.1086 · Cited by 198 · see citing works
Hesse, E. (1996) · Infant Mental Health Journal · doi:10.1002/(sici)1097-0355(199621)17:1 · Cited by 176 · see citing works
Disorganization and Disorientation in Infant Strange Situation Behavior
Main, M., & Morgan, H. J. (1996) · Springer eBooks · doi:10.1007/978-1-4899-0310-5_6 · Cited by 158 · see citing works
Trauma Assessments: A Clinician's Guide
Carlson, E. B. (1997) · Cited by 151 · see citing works
Stability of attachment representations: The transition to marriage.
Crowell, J. A., Treboux, D., & Waters, E. (2002) · Developmental Psychology · doi:10.1037/0012-1649.38.4.467 · Cited by 145 · see citing works
Lyons‐Ruth, K., Bronfman, E. T., & Atwood, G. (1999) · Cited by 143 · see citing works
Lyons‐Ruth, K., Yellin, C., Melnick, S. M., & Atwood, G. (2003) · Attachment & Human Development · doi:10.1080/14616730310001633410 · Cited by 139 · see citing works
Attachment organization and history of suicidal behavior in clinical adolescents.
Adam, K. S., Sheldon-Keller, A., & West, M. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.2.264 · Cited by 134 · see citing works
Riggs, S. A., & Jacobvitz, D. B. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.1.195 · Cited by 127 · see citing works
Dissociation in maltreated versus nonmaltreated preschool-aged children
Macfie, J., Cicchetti, D., & Toth, S. L. (2001) · Child Abuse & Neglect · doi:10.1016/s0145-2134(01)00266-6 · Cited by 123 · see citing works
Attachment Organization and Adaptation in Sexually-Abused Women
Carol, A. S., & Davies, F. (1995) · The Canadian Journal of Psychiatry · doi:10.1177/070674379504000503 · Cited by 87 · see citing works
Effects of abuse on attachment representations: narrative assessments of abused children
Hodges, J., & Steele, M. (2000) · Journal of Child Psychotherapy · doi:10.1080/00754170010003674 · Cited by 87 · see citing works
Emotion Socialization as a Framework for Understanding the Development of Disorganized Attachment
DeOliveira, C. A., Bailey, H. N., Moran, G., & Pederson, D. R. (2004) · Social Development · doi:10.1111/j.1467-9507.2004.00276.x · Cited by 81 · see citing works
Self-citationThe Prevalence of Coercive Sexual Experience Among Teenage Mothers
Gershenson, H. P., Musick, J. S., Ruch‐Ross, H. S., Magee, V. L., RUBINO, K. K., & Rosenberg, D. L. (1989) · Journal of Interpersonal Violence · doi:10.1177/088626089004002005 · Cited by 72 · see citing works
Psychopathology as adaptive development along distinctive pathways
Fischer, K. W., AYOUB, C. C., Singh, I., Noam, G. G., Maraganore, A., & Raya, P. (1997) · Development and Psychopathology · doi:10.1017/s0954579497001429 · Cited by 70 · see citing works
Cognitive perspectives on unresolved loss: Insights from the study of PTSD
Fearon, P. R. M., & Mansell, W. (2001) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.65.3.380.19845 · Cited by 60 · see citing works
Turton, P., Hughes, P. M., Fonagy, P., & Fainman, D. (2004) · Attachment & Human Development · doi:10.1080/14616730412331281575 · Cited by 44 · see citing works
Landecker, H. (1992) · Psychotherapy · doi:10.1037/0033-3204.29.2.234 · Cited by 40 · see citing works
The Council on Economic Affairs
FINK, P. J. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.2.309 · Cited by 40 · see citing works
PTSD in physically and sexually abused psychiatrically hospitalized children
Adam, B. S., Everett, B. L., & O'Neal, E. (1992) · Child Psychiatry & Human Development · doi:10.1007/bf00706695 · Cited by 38 · see citing works
Attachment Disorganization and Dissociative Symptoms in Clinically Treated Adolescents
West, M., Adam, K. S., Spreng, S., & Rose, S. (2001) · The Canadian Journal of Psychiatry · doi:10.1177/070674370104600707 · Cited by 38 · see citing works
Attachment, borderline states and the representation of emotions and cognitions in self and other
Fonagy, P., Kennedy, R., Leigh, T., et al. (1995) · UCL Discovery (University College London) · Cited by 31 · see citing works
Trauma, memory, and dissociation: An integrative formulation.
Bremner, J. D., Vermetten, E. H. G. J. M., Southwick, S. M., Krystal, J. H., & Charney, D. S. (1998) · Cited by 31 · see citing works
Fearon, P. R. M. (2004) · Attachment & Human Development · doi:10.1080/14616730412331281502 · Cited by 7 · see citing works
Representational models of relationships: Links between caregiving and attachment
George, C., & Solomon, J. (1996) · Infant Mental Health Journal · doi:10.1002/(sici)1097-0355(199623)17:3
Flagged first, then by citations
Cited by
Sorted by citations
D'Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.2012.01154.x · Cited by 703 · see citing works
Bailey, H. N., DeOliveira, C. A., Wolfe, V. V., Evans, E. M., & Hartwick, C. (2012) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2011.11.005 · Cited by 232 · see citing works
Self-citationSpinazzola, J., van der Kolk, B., & Ford, J. D. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22320 · Cited by 187 · see citing works
Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought
Kearney, C. A., Wechsler, A., Kaur, H., & Lemos-Miller, A. (2010) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-009-0061-4 · Cited by 169 · see citing works
Pierrehumbert, B., Torrisi, R., Laufer, D., Halfon, O., Ansermet, F., & Beck Popovic, M. (2010) · Neuroscience · doi:10.1016/j.neuroscience.2009.12.016 · Cited by 139 · see citing works
Fuchs, A., Möhler, E., Resch, F., & Kaess, M. (2015) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2015.05.023 · Cited by 103 · see citing works
van Dijke, A., Hopman, J. A. B., & Ford, J. D. (2018) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1400878 · Cited by 80 · see citing works
Koren-Karie, N., Oppenheim, D., & Getzler-Yosef, R. (2008) · Attachment & Human Development · doi:10.1080/14616730802461482 · Cited by 75 · see citing works
Huth-Bocks, A. C., Muzik, M., Beeghly, M., Earls, L., & Stacks, A. M. (2014) · Attachment & Human Development · doi:10.1080/14616734.2014.967787 · Cited by 70 · see citing works
Kliethermes, M., Schacht, M., & Drewry, K. (2014) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2013.12.009 · Cited by 69 · see citing works
Byun, S., Brumariu, L. E., & Lyons-Ruth, K. (2016) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2016.1141149 · Cited by 65 · see citing works
Zajac, L., Raby, K. L., & Dozier, M. (2019) · Development and Psychopathology · doi:10.1017/s0954579418001554 · Cited by 31 · see citing works
Attachment Representations and Autonomic Regulation in Maltreating and Nonmaltreating Mothers
Reijman, S., Alink, L. R. A., Compier-De Block, L. H. C. G., Werner, C. D., Maras, A., Rijnberk, C., Van Ijzendoorn, M. H., & Bakermans-Kranenburg, M. J. (2017) · Development and Psychopathology · doi:10.1017/s0954579416001036 · Cited by 26 · see citing works
Moser, D. A., Aue, T., Wang, Z., Rusconi Serpa, S., Favez, N., Peterson, B. S., & Schechter, D. S. (2013) · Stress · doi:10.3109/10253890.2013.816280 · Cited by 26 · see citing works
Cirasola, A., Hillman, S., Fonagy, P., & Chiesa, M. (2017) · Personality and Mental Health · doi:10.1002/pmh.1365 · Cited by 24 · see citing works
Harris, J., Loth, E., & Sethna, V. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1331256 · Cited by 18 · see citing works
“…between complex trauma and CPTSD. Evidence suggests that factors involving dissociation (4), child development (17), attachment security (18; 19), and wider systemic factors such as family environment (20, 21) may explain the relationship between complex trauma and CPTSD. Due to the nature…”
Background
- Authors
- Bailey, H. N., Moran, G., & Pederson, D. R.
- Affiliations
- University of Guelph (CA)
- Western University (CA)
- Corresponding author
- Bailey, Heidi Neufeld
- Venue
- Attachment & Human Development
- Publisher
- Informa UK Limited
- Published
- 2007-05-16
- Volume
- 9
- Issue
- 2
- Pages
- 139-161
- ISSN
- 1461-6734 (ISSN-L)
- 1469-2988
- OpenAlex
- W1981705504
- Cited by
- 173
- References
- 73
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 11 · 2023: 11 · 2022: 10 · 2021: 6 · 2020: 11 · 2019: 7 · 2018: 15 · 2017: 11 · 2016: 13 · 2015: 9 · 2014: 11 · 2013: 13 · 2012: 11
- FWCI
- 6.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Attachment & Human Development (publishedVersion)
- PubMed (publishedVersion)
- Scholarship@Western (Western University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- child abuse, complex trauma, unresolved attachment, adolescent mothers, child sexual abuse, child physical abuse, dissociation, relationship problems, Adult Attachment Interview, at-risk youth
- MeSH terms
- Adult, Child, Child Abuse, Child Abuse, Sexual, Female, Humans, Interview, Psychological, Male, Mothers, Object Attachment, Risk Factors, Stress Disorders, Post-Traumatic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review