The Relationship Among Adult Attachment Styles, Shame, Dissociation, and Abuse Characteristics

205 Pages·2016·0.45 MB·English

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Grace H. Tomas-Tolentino
Loyola University Chicago
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Tomas-Tolentino, Grace H., "The Relationship Among Adult Attachment Styles, Shame, Dissociation, and
Abuse Characteristics in Women Survivors of Intrafamilial Child Sexual Abuse Perpetrated by a Parental-
Figure" (2010). Dissertations. 262.
https://ecommons.luc.edu/luc_diss/262
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Copyright © 2010 Grace H. Tomas-Tolentino
LOYOLA UNIVERSITY CHICAGO

THE RELATIONSHIP AMONG ADULT ATTACHMENT STYLES, SHAME,
DISSOCIATION, AND ABUSE CHARACTERISTICS IN WOMEN SURVIVORS OF
INTRAFAMILIAL CHILD SEXUAL ABUSE PERPETRATED BY A PARENTAL-
FIGURE

A DISSERTATION SUBMITTED TO
THE FACULTY OF THE GRADUATE SCHOOL
IN CANDIDACY FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY

PROGRAM IN SOCIAL WORK

BY
GRACE H. TOMAS-TOLENTINO

CHICAGO, ILLINOIS
MAY 2010
Copyright by Grace H. Tomas-Tolentino, 2010
All rights reserved
ACKNOWLEDGEMENTS
The journey and completion of this project would not have been possible without
the love and support of the people in my life. I am grateful to my husband Gerry for his
patience and endless support throughout the stages of this project. His encouragement
and reassurance in my ability to achieve this goal, especially during my pregnancy and
through the birth of our first child, were tremendously helpful. The unconditional support
from my family and friends provided the replenishment I needed to make this
accomplishment feasible.
Becoming a mother in midst of this project has undoubtedly both complicated my
life and further enhanced my senses as a clinician, a researcher, and in general as a
human being. My son Grad is the ultimate joy in my life. He has constantly been the
antidote to the overwhelmingness and doubtfulness I’ve intermittently felt in the stages of
this project. He has unknowingly played a significant role in getting me through these
past three years.
I’d like to extend my sincere gratitude to my committee in their support and
guidance through this process. Dr. Marta Lundy has been a long time mentor from whom
I’ve sought and received valuable input. Our common devotion in working with women
has maintained our connection throughout the years. Her contributions in these past years
are greatly appreciated. Dr. Susan Grossman provided guidance and significant
contributions to this project. I have high regards for her competence and have
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tremendously valued her reassurance and confidence in me accomplishing this goal.
Finally, Dr. James Marley has been truly gracious in being a member of this committee
and my previous committee. He provided valuable insights and clear directions in seeing
through the completion of this project. I very much look forward to maintaining collegial
relationships with my committee in the coming years.
This project would not have been possible without the help of the women who
participated in this study. Their courage to share their experiences will forever be
appreciated. My work with adult survivors of childhood abuse has prompted inquiries on
the impact of abuse in women’s lives. Tremendous growth has come about for me as a
clinician in working with women who continue to survive through the traumatic impact
of their abuse experiences. Through a collaborative manner, they have essentially taught
me how to help them be of a healing tool for themselves. My willingness to experience
relationships with them and their desire for attachment- either articulated or not- anchor
the progression of the work. More specifically, the effectiveness of the work centers on
both our abilities to sustain the therapy relationship.
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TABLE OF CONTENTS
ACKNOWLEDGEMENT iii

LIST OF TABLES viii

LIST OF FIGURES x

ABSTRACT xi

CHAPTER ONE: INTRODUCTION 1
Statement of Problem 1
Overview of CSA 5
Prevalence of CSA 5
Intrafamilial CSA 7
Trauma 9
Long-Term Sequelae of CSA 13
Purpose of Research 15
Research Questions and Hypotheses 15

CHAPTER TWO: LITERATURE REVIEW 17
Attachment 18
Introduction to Attachment Theory and its Concepts 18
Attachment Styles 19
Attachment Perspectives on CSA 29
Affect Regulation and Interpersonal Difficulties in Adult Survivors of
Childhood Sexual Abuse 31
Shame 35
The Affect of Shame 36
Shame and Affect Regulation 37
Shame, Attachment, and CSA 38
Shame and Dissociation 42
Dissociation 43
The Concept of Dissociation 43
Dissociation and Trauma 47
Dissociation and CSA 49
Dissociation and Attachment 51
CSA Characteristics 53
CSA Characteristics and Attachment 55
CSA Characteristics and Shame 56
CSA Characteristics and Dissociation 57

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CHAPTER THREE: METHODOLOGY 59
Research Design 59
Conceptual and Operational Definitions of Variables 59
Major Variables 59
Control Variables 62
Data Collection Instruments 62
Demographic Questionnaire (QQ) 62
Relationship Questionnaire (RQ) 63
Internalized Shame Scale (ISS) 64
Dissociative Experiences Scale (DES) 65
Population 67
Sampling Procedures 69
Ethical Issues and Concerns 71
Data Collection Procedures 72
Data Analysis Procedures 72

CHAPTER FOUR: RESULTS 74
Descriptive Data 74
Demographics 74
CSA Characteristics 77
Treatment 80
RQ, ISS, and DES scores 83
Bivariate Analyses 84
CSA Characteristics 84
Adult Attachment Styles 86
Shame 90
Dissociation 94
Treatment 98

CHAPTER FIVE: DISCUSSION 104
Limitations 104
Summary of Findings 105
Implications for Clinical Social Work 107
Adult Attachment Styles and CSA Characteristics 107
Adult Attachment Styles and Shame 110
Adult Attachment Styles and Dissociation 113
Shame and Dissociation 114
Other Findings 116
Treatment 117
Conclusion 122
Recommendations for Future Research 123

APPENDIX A: RESEARCH STUDY FLYER 127
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APPENDIX B: INFORMATION SHEET FOR THERAPISTS 129
APPENDIX C: INFORMATION SHEET FOR PARTICIPANTS 132
APPENDIX D: LOTTERY PARTICIPATION FORM 137
APPENDIX E: MAILING INSTRUCTION SHEET 139
APPENDIX F: DEMOGRAPHIC QUESTIONNAIRE (DQ) 141
APPENDIX G: RELATIONSHIP QUESTIONNAIRE (RQ) 145
APPENDIX H: INTERNALIZED SHAME SCALE (ISS) 148
APPENDIX I: DISSOCIATIVE EXPERIENCES SCALE (DES) 154
REFERENCE LIST 162

VITA 192

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LIST OF TABLES

1. Demographic Characteristics 76
2. Age at Onset of CSA 77
3. Parental-Figure Perpetrator of CSA 78
4. Other Types of Abuse 79
5. Frequency of CSA 80
6. Duration of CSA 80
7. Type of Treatment at the Current Agency 82
8. Frequency of Treatment at the Current Agency 82
9. Total Duration of Treatment from Previous and Current Agencies 82
10. Adult Attachment Styles Assessed through Relationship Questionnaire (RQ) 83
11. Levels of Shame and Dissociation Assessed through Internalized Shame Scale
(ISS) and Dissociative Experiences Scale (DES) 83

12. Fearful Adult Attachment Style and CSA Characteristics 88
13. Dismissing Adult Attachment Style and CSA Characteristics 89
14. Preoccupied Adult Attachment Style and CSA Characteristics 89
15. Shame and CSA Characteristics 91
16. Shame and Adult Attachment Styles 93
17. Dissociation and CSA Characteristics 95
18. Dissociation and Adult Attachment Styles 97
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19. Dissociation and Shame 98
20. Frequency of Treatment (IT-Individual Therapy) and CSA Characteristics 99
21. Duration of Treatment (IT-Individual Therapy) and CSA Characteristics 100
22. Frequency of Treatment (IT-Individual Therapy) and Adult Attachment
Styles 101

23. Duration of Treatment (IT-Individual Therapy) and Adult Attachment Styles 101
24. Frequency of Treatment (IT-Individual Therapy) and Shame 102
25. Duration of Treatment (IT-Individual Therapy) and Shame 102
26. Frequency of Treatment (IT-Individual Therapy) and Dissociation 103
27. Duration of Treatment (IT-Individual Therapy) and Dissociation 103

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