TY - JOUR
T1 - Changes in attachment dimensions during the treatment of acute post-traumatic stress disorder in sexually assaulted Brazilian women
AU - Maciel, Mariana Rangel
AU - Calsavara, Vinicius Fernando
AU - Zylberstajn, Cecilia
AU - Mello, Marcelo Feijo
AU - Coimbra, Bruno Messina
AU - Mello, Andrea Feijo
N1 - Funding Information: The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Fundação de Apoio à Pesquisa do Estado de São Paulo (FAPESP), Project number 2014/12559–5; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), under Grant 303389/2016–8; and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES), Finance Code 001. Publisher Copyright: Copyright © 2023 Maciel, Calsavara, Zylberstajn, Mello, Coimbra and Mello.
PY - 2023
Y1 - 2023
N2 - Introduction: Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Methods: Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. Results: At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Discussion: Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD.
AB - Introduction: Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Methods: Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. Results: At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Discussion: Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD.
KW - attachment
KW - interpersonal psychotherapy
KW - post-traumatic stress disorder
KW - sexual assault
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85180423004&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fpsyg.2023.1325622
DO - https://doi.org/10.3389/fpsyg.2023.1325622
M3 - Article
C2 - 38130963
SN - 1664-1078
VL - 14
JO - Frontiers in psychology
JF - Frontiers in psychology
M1 - 1325622
ER -