(PS14-53) The Role of Attachment Style in the Relationship Between Adverse Childhood Experiences and Affective Symptoms Among Trauma-exposed Adults

Exposure to adverse childhood experiences (ACE) can greatly affect many facets of life including executive functioning, emotional processing, behavioral and physical health, neurodevelopment, and social relationships. Among the many potential consequences of ACE, research has consistently demonstrated an impact on attachment styles, specifically anxious and avoidant attachment. While anxious attachment is characterized by fear of abandonment and reassurance seeking, avoidant attachment presents as withdrawal from emotional or physical closeness. These attachment styles have been linked to the development of internalizing symptoms across the lifespan. However, research has yet to examine the role of anxious and avoidant attachment tendencies in the relationship between adverse childhood experiences and specific internalizing symptoms. Therefore, the current study sought to examine differential relationships between adverse childhood experiences, anxious and avoidant attachment tendencies, and symptoms of anxiety, depression, and posttraumatic stress.

Participants (N = 77) were trauma-exposed adults recruited as part of an experimental study examining individual differences in threat responding. Participants completed a battery of self-report measures including demographics, adverse childhood experiences (ACES), anxious and avoidant attachments (AAS), posttraumatic stress symptoms (PCL-5), and depression and anxiety symptoms (DASS-21). Multiple linear regression analyses and an SPSS PROCESS dual mediation model were run to examine relationships between ACE, anxious and avoidant attachment tendencies, and symptoms.  

Results demonstrated effects of ACEs on anxious (t = 2.40, β = .26, p = .019) and avoidant attachment tendencies (t = 4.07, β = .42, p < .001) as well as posttraumatic stress (t = 5.14, β = .42, p < .001), anxiety (3.41, β = .29, p < .001), and depression symptoms (t = 3.69, β = .31, p < .001). PROCESS analyses indicated that anxious attachment tendencies mediate the relationship between ACE and posttraumatic stress symptoms (indirect effect: b = 0.93, 95%CI [0.13, 1.88]) as well as anxiety symptoms (indirect effect: b = 0.15, 95%CI [0.05, 0.39]). Meanwhile, avoidant attachment tendencies mediate the relationship between ACE and depressive symptoms (indirect effect: b = 0.26, 95%CI [0.05, 0.57]). 

These results provide initial evidence for the differential role of anxious and avoidant attachment tendencies in the relationship between ACE and posttraumatic stress, anxiety, and depression symptoms. Findings suggest that anxious and avoidant attachment tendencies may be ideal targets for prevention and intervention among individuals with a history of childhood abuse or neglect. Findings must be considered in light of study limitations including our use of a cross-sectional design. Future studies should examine the development of these attachment tendencies and affective symptoms over time, particularly among individuals exposed to adverse and potentially traumatic events in childhood.