The Association between Attachment-Related Trauma and Adult Representations of Attachment

197 Pages·2017·0.78 MB·English

Eastern Michigan University
DigitalCommons@EMU
Master's Theses, and Doctoral Dissertations, and
Master's Theses and Doctoral Dissertations
Graduate Capstone Projects
7-2013
The association between attachment-related
trauma and adult representations of attachment and
the role of maternal mental health
Syreeta Scott
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Recommended Citation
Scott, Syreeta, "The association between attachment-related trauma and adult representations of attachment and the role of maternal
mental health" (2013).Master's Theses and Doctoral Dissertations. 503.
http://commons.emich.edu/theses/503
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Running Head: ATTACHMENT-RELATED TRAUMA AND ATTACHMENT
REPRESENTATIONS

The Association between Attachment-Related Trauma and Adult Representations of Attachment
and the Role of Maternal Mental Health

by

Syreeta Scott, M.S.

Dissertation

Submitted to the Department of Psychology

Eastern Michigan University

in partial fulfillment of the requirements for the degree of

DOCTOR OF PHILOSOPHY

Clinical Psychology

Dissertation Committee:

Alissa Huth-Bocks, PhD, Chair
Stephen Jefferson, PhD
Heather Janisse, PhD
Joshua Ehrlich, PhD

July, 2013

Ypsilanti, Michigan
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ATTACHMENT-RELATED TRAUMA AND ATTACHMENT REPRESENTATIONS

ACKNOWLEGEMENTS
To my Lord and savior Jesus Christ, there is no separation between my ability and your doing.

Dr. Huth-Bocks, this dissertation project simply would not have been possible without
you. Thank you for your caring commitment, support, and generosity. To my committee, the
parenting project, family, and friends, I am truly grateful for all of the efforts you made on my
behalf and the sustained encouragement you provided in hopes that I would see this moment. I
hope to get the opportunity to personally share with many of you just how important you have
been to this accomplishment. I am also grateful for the participants of this study. Thank you for
letting us into your homes and lives.
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ATTACHMENT-RELATED TRAUMA AND ATTACHMENT REPRESENTATIONS

ABSTRACT
Despite longstanding theoretical associations in the attachment literature between early
experiences of trauma, unresolved attachment representations, and mental health symptoms, few
studies have explored associations between these variables, and findings amongst current studies
are inconsistent. This study aimed to examine these relationships in a high-risk sample of
mothers. It also explored relationships between aspects of trauma, such as type, severity, and age
of exposure in relation to unresolved attachment representations. Possible moderating effects of
mental health were also examined. Data for the study were collected as part of a larger
longitudinal study on women’s transition to motherhood. The present study used data from the
third trimester of pregnancy (T1) and 1-year (T3), 2-years (T4), and 3-years (T5) postpartum.
Participants in this study included 74 diverse, primarily low-income women between the ages of
18 – 41 years (M = 27, SD = .35). Adult representations were assessed by a relatively new
measure of adult attachment, called the Adult Attachment Projective Picture System (AAP;
George, West & Pettem, 1999), which has not yet been widely used in the literature but has
potential as a valuable research tool in the attachment field. Attachment-related traumas
conceptualized by Kobak, Cassidy, and Ziv (2004) were examined and included physical abuse,
physical neglect, sexual abuse, emotional abuse, loss, and prolonged separations. Mental health
symptoms of depression and posttraumatic stress disorder were also obtained. It was
hypothesized that attachment-related trauma and mental health difficulties would be significantly
related to unresolved representations. Unexpectedly, results revealed no significant differences
between unresolved and resolved mothers on cumulative trauma or mental health (i.e.,
depression and PTSD symptoms). However, attachment security, as a continuous variable, was
significantly related to mental health, such that higher security was related to fewer depression
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ATTACHMENT-RELATED TRAUMA AND ATTACHMENT REPRESENTATIONS

and PTSD symptoms. The results are discussed in relation to two formal definitions of
attachment trauma that have been articulated in the attachment literature. Recent theoretical
developments about attachment trauma and the need for further investigations about the
influence of childhood experiences on adulthood attachment representations are also discussed.
v

TABLE OF CONTENTS
ABSTRACT ............................................................................................................................. iii
LIST OF TABLES ................................................................................................................... ix
LIST OF FIGURES ................................................................................................................. xi
INTRODUCTION .....................................................................................................................1
CHAPTER 1: DEVELOPMENT OF ATTACHMENT THEORY ...........................................4
Introduction ............................................................................................................................4
Internal Working Models .......................................................................................................5
Mary Ainsworth’s Contribution to Attachment Theory ....................................................9
Adult Attachment Representations .................................................................................12
Adult Attachment Interview .....................................................................................13
Adult Attachment Projective .....................................................................................15
Stability of Attachment ....................................................................................................18
CHAPTER 2: ATTACHMENT REPRESENTATIONS AND ATTACHMENT-RELATED
TRAUMAS ..............................................................................................................................20
Attachment-Related Traumas ..........................................................................................20
Attachment-Related Traumas and Disorganized Infant Attachment .......................24
Attachment-Related Traumas and Unresolved Adult Attachment ..........................26
Challenges with Assessment of Attachment-Related Traumas and Unresolved
Representations ................................................................................................................28
CHAPTER 3: MENTAL HEALTH OUTCOMES OF ATTACHMENT-RELATED TRAUMA
AND ADULT ATTACHMENT REPRESENTATIONS ........................................................32
Introduction .......................................................................................................................32
Attachment-Related Trauma and Later Psychopathology ................................................32
vi

Attachment Representations and Psychopathology .........................................................35
Associations between Attachment-Related Trauma, Unresolved Representations and
Psychopathology ...............................................................................................................38
CHAPTER 4: THE PRESENT STUDY ..................................................................................43
Summary and Conclusions ..............................................................................................43
Hypotheses .......................................................................................................................46
CHAPTER 5: RESEARCH DESIGN AND METHODS ........................................................48
Participants .......................................................................................................................48
Procedures ........................................................................................................................49
Tracking Procedures ................................................................................................56
Measures ..........................................................................................................................57
Adult Attachment Representations ..........................................................................57
Childhood Attachment-Related Trauma ..................................................................63
Maternal Psychopathology ......................................................................................69
CHAPTER 6: RESULTS .........................................................................................................73
Missing Data ....................................................................................................................73
Descriptive Statistics ........................................................................................................74
Distribution of Attachment Classifications ......................................................................75
Correlations between Study Variables .............................................................................75
Hypothesis 1.....................................................................................................................77
Hypothesis 2.....................................................................................................................79
Hypothesis 3.....................................................................................................................80
Additional Exploratory Analyses .....................................................................................82
vii

CHAPTER 7: DISCUSSION ...................................................................................................86
Introduction ......................................................................................................................86
Characteristics of the Sample and Bivariate Associations between Attachment-Related
Trauma and Mental Health Sequelae ...............................................................................88
Unresolved Attachment and Attachment Related Traumas .............................................93
Unresolved Attachment and Mental Health .....................................................................96
Moderation of Attachment-Related Traumas and Unresolved Attachment ....................98
Associations between Indices of Attachment Security and Other Study Variables ........98
Defining and Assessing Attachment-Related Trauma ...................................................101
Strengths of the Present Study .......................................................................................107
Limitations of the Present Study ....................................................................................108
Conclusions ....................................................................................................................109
REFERENCES ......................................................................................................................112
Appendix A ............................................................................................................................138
Appendix B ............................................................................................................................140
Appendix C ............................................................................................................................144
Appendix D ............................................................................................................................146
Appendix E ............................................................................................................................148
Appendix F.............................................................................................................................150
Appendix G ............................................................................................................................154
Appendix H ............................................................................................................................155
Appendix I .............................................................................................................................156
Appendix J .............................................................................................................................158
viii

Appendix K ............................................................................................................................160
Appendix L ............................................................................................................................163
Appendix M ...........................................................................................................................165
Appendix N ............................................................................................................................169
ix

LIST OF TABLES
Table Page
1 AAP Discourse and Content Dimensions ......................................................................170
2 Measures and Waves of Data Collection .......................................................................171
3 Descriptive Statistics for Continuous Variables ............................................................172
4 Correlation Table for Study Variables ...........................................................................174
5 Logistic Regression Analyses of Mental Health Composite as Moderator of
Cumulative Trauma and Maternal Attachment Classification.......................................176
6 Logistic Regression Analyses of Depression as Moderator of Cumulative
Trauma and Maternal Attachment Classification ..........................................................177
7 Logistic Regression Analyses of PTSD as Moderator of Cumulative Trauma
and Maternal Attachment Classification ........................................................................178
8 Descriptive Statistics for Additional Continuous Variables ..........................................179
9 Correlation Table for Continuous Attachment Variables, Demographic Variables,
and Childhood Maltreatment and Cumulative Trauma .................................................180
10 Correlation Table for Continuous Attachment Variables and Mental Health
Variables ........................................................................................................................181
11 Correlation Table for Continuous Attachment Variables and Age of Onset of
Attachment-Trauma Variables .......................................................................................182
12 Logistic Regression Analyses of Mental Health Composite as Moderator of
Childhood Maltreatment Severity and Maternal Attachment Classification .................183
13 Logistic Regression Analyses of Depression as Moderator of Childhood
Maltreatment Severity and Maternal Attachment Classification ...................................184
14 Logistic Regression Analyses of PTSD as Moderator of Childhood Maltreatment