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Tilknytning

Tidlige oplevelser med tilknytningsfigurer sætter præg på forventninger til omverden og sig selv.

Hvilken rolle spiller tilknytning i vores liv? Forskning viser, at tilknytning får en afgørende betydning for hvordan vi mennesker udvikler os gennem livet.

John Bowlby, psykolog og psykiater, lagde grundlaget for tilknytningsteorien gennem sine observationer af børn. Han har udforsket børns reaktioner på adskillelse fra forældrene. Han var især interesseret i børnenes reaktion på genforening med forældrene. Ifølge Bowlby, vil vores indre arbejdsmodeller udvikle sig i takt med de tilknytningsoplevelser, vi får med vores forældre og andre vigtige nære relationer i vores barndom.

Vores forskning viser at tilknytning er en central variabel i række traumerelaterede sammenhænge, ligesom at tilknytning ser ud til at være en central faktor ifm. at planlægge og gennemføre behandling. Særligt usikker tilknytning, (herunder ængstelig og undgående tilknytning) har vist at være en stærk prædiktor for udviklingen af PTSD og for den psykologiske belastning i en række forskellige sammenhænge. Tilknytning har ligeledes vist sig at være en medierende faktor for graden af posttraumatiske symptomer, for udviklingen af dissociative lidelser samt for angst og depressive lidelser. Tilknytning er ydermere medierende for graden af somatisering og smerter efter ulykker og i forbindelse med andre somatiske sygdomme.

 

Tilknytning

Ængstelig- og undgående tilknytningsstile forudsiger lav tilfredshed med forholdet hos mødre der lige har født

Objective: This study examined the link between new mothers' attachment orientation and the perceived cost of sole responsibility in housework and child care. Background: The transition to motherhood can be very stressful, and according to the Vulnerability Stress Adaptation Model (VSA model), the way it affects the couple relationship is likely to depend on interacting factors from different domains of risk (e.g. individual and couple level). We expected interactions to appear between domains of attachment and labour division. The hypothesis was that sole responsibility in child care and housework would predict lower relationship satisfaction, particularly among mothers who were high on attachment insecurity. Methods: Data from self-report measures of adult attachment, child care, housework and relationship satisfaction were collected from 255 first-time mothers at six months postpartum. Results: Sole responsibility in child care predicted lower relationship satisfaction, particularly among mothers who were high on attachment avoidance. This interaction effect was significant but small. Among main effects, higher levels of either attachment anxiety or avoidance were linked with lower relationship satisfaction and lower levels of sole responsibility in childcare was linked with higher relationship satisfaction. Conclusion: These findings provide new data on the how risk factors from separate domains combine, and implications are discussed in terms of applying the VSA model when developing preventive interventions for new mothers.


Relevante publikationer:
Trillingsgaard, T., Sommer, D., Lasgaard, M., & Elklit, A. (2014). Adult Attachment and Perceived Cost of Housework and Child Care. Journal of Reproductive and Infant Psychology, 32, 508-519. Doi 10.1080/02646838.2014.945516
Dissociation og tilknytning blandt incestofre

Childhood sexual abuse (CSA) is an extreme traumatic event associated with numerous long lasting difficulties and symptoms (e.g., Herman, 1992). These include, among other things, the impediment of basic interpersonal structures of attachment (Rumstein-McKean & Hunsley, 2001), as well as impairment of mental integration manifested in dissociation (Van Den Bosch et al., 2003). Theoretically, attachment insecurities and dissociation are closely linked, since dissociation is generated as a way to resolve the conflicted attachment demands faced by the abused child (e.g., Liotti, 1992). Nevertheless, the directionality of association between attachment insecurities and dissociation during treatment of adult CSA survivors remains largely uninvestigated. Filling this gap, the present prospective study assessed female adult survivors of CSA who were outpatients at four treatment centers in Denmark (n = 407), at the start of treatment (T1), 6 months after starting treatment (T2) and 12 months after starting treatment (T3). Results indicated that both attachment insecurities and dissociation reduced over time during treatment. Elevated attachment insecurities were associated with elevated dissociation at each of the measurements. Moreover, there was a reciprocal association between attachment avoidance and dissociation during treatment. Low levels of attachment avoidance predicted a decline in dissociation and vice versa. Findings suggest that treatment creates a cycle of healing in which rehabilitation of attachment fosters reintegration, which in turn deepens the restoration of attachment. 


Relevante publikationer: 
Lahav, Y. & Elklit, A. (2016). The cycle of healing - dissociation and attachment during treatment of CSA survivors. Child Abuse and Neglect, 60, 67-76. Doi: 10.1016/j.chiabu.2016.09.009

Forældre til spædbarnsdød: kønsforskelle i PTSD-sværhedsgrad, tilknytning, coping og social støtte
Parents bereaved by infant death experience a wide range of symptomatology, including posttraumatic stress disorder (PTSD) that may persist for years after the loss. Little research has been conducted on PTSD in fathers who have lost an infant. Mothers report most symptoms to a greater extent than fathers, but not much is known about other sex differences following infant death. The present cross-sectional study examined sex differences in PTSD and sex differences in the relationship between PTSD severity and related variables. Subjects were 361 mothers and 273 fathers who had lost an infant either late in pregnancy, during birth or in the first year of life. Participants filled out questionnaires between 1.2 months and 18 years after the loss (M = 3.4 years). Mothers reported significantly more PTSD symptoms, attachment anxiety, emotion-focused coping and feeling let down, but significantly lower levels of attachment avoidance than fathers. Attachment anxiety, attachment avoidance and emotion-focused coping were significantly more strongly associated with PTSD severity in mothers than fathers, but only when examined alone. When all variables and time since the loss were examined together, there were no longer any significant moderation effects of sex. Persistent posttraumatic symptomatology exists in both mothers and fathers long after the loss. There are several sex differences in severity and correlates of PTSD, and a few moderation effects were identified for attachment and emotion-focused coping. Overall, more similarities than differences were found between mothers and fathers in the associations between PTSD and covariates. 

Relevante publikationer: 
Christiansen, D., Olff, M. & Elklit, A.: (2014). Parents bereaved by infant death: Sex differences and moderation in PTSD, attachment, coping, and social support. General Hospital Psychiatry, 36, 655–66136. Doi: 10.1016/j.genhosppsych.2014.07.012.
Sammenhængen mellem PTSD-symptomer og polyviktimisering i det tidlige voksenliv

The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.


Relevante publikationer:
Zerach, G., & Elklit, A. (2019). Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence. International Journal of Psychology. Doi: 10.1002/ijop.12590
PTSD og tilknytning som risikofaktor for udviklingen af kroniske smerter piskesmældsulykker

The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.


Relevante publikationer:
Andersen, T. E., Elklit, A., & Brink O. (2013). PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash injury. Clinical Practice & Epidemiology in Mental Health, 9, 75-83. Doi: 10.2174/1745017901309010075

PTSD og tilknytningsstile hos voksne

The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.

 


Relevante publikationer: 

O’Connor, M. & Elklit, A. (2008). Attachment Styles, Traumatic Events and PTSD: A Cross-Sectional Investigation of Adult Attachment and Trauma. Attachment and Human Development, 10 (1), 59-71. Doi: 10.1080/14616730701868597.

 

PTSD-symptomer hos kroniske smertepatienter

 

Background: In more than 90% of whiplash accidents a good explanation regarding the association between trauma mechanism, organic pathology, and persistent symptoms has failed to be provided. Objective: We predicted that the severity of chronic whiplash-associated disorder (WAD), measured as number of whiplash symptoms, pain duration, pain-related disability, and degree of somatisation would be associated with the number of post-traumatic stress disorder symptoms (PTSD). Secondly, we expected attachment-anxiety to be a vulnerability factor in relation to both PTSD and WAD. Design: Data were collected from 1,349 women and 360 men suffering from WAD from the Danish Society for Polio, Traffic, and Accident Victims. The PTSD symptoms were measured by the Harvard Trauma Questionnaire. All three core PTSD clusters were included: re-experiencing, avoidance, and hyperarousal. Attachment security was measured along the two dimensions, attachment-anxiety and attachment-avoidance, by the Revised Adult Attachment Scale. Results: PTSD symptoms were significantly related to the severity of WAD. In particular, the PTSD clusters of avoidance and hyperarousal were associated with the number of whiplash symptoms, disability, and somatisation. Attachment-anxiety was significantly related to PTSD symptoms and somatisation but not to pain and disability. A co-morbidity of 38.8% was found between the PTSD diagnosis and WAD, and about 20% of the sample could be characterised as securely attached. Conclusions: The PTSD clusters of avoidance and hyperarousal were significantly associated with severity of WAD. The study emphasises the importance of assessing PTSD symptomatology after whiplash injury. Furthermore, it highlights that attachment theory may facilitate the understanding of why some people are more prone to develop PTSD and WAD than others.


Relevante publikationer:

O’Connor, M. & Elklit, A. (2008). Attachment Styles, Traumatic Events and PTSD: A Cross-Sectional Investigation of Adult Attachment and Trauma. Attachment and Human Development, 10 (1), 59-71. Doi: 10.1080/14616730701868597.

Rehabilitering af voksne kvinder med gynækologisk kræft – sammenhængen mellem tilknytning, PTSD og depression

We hypothesised that being diagnosed with gynaecological cancer influences adult attachment and occurrence of depression and post-traumatic stress disorder (PTSD). The main aim of the study was to assess changes in the attachment dimensions, PTSD and depression from baseline to 5-month post-treatment. Further, we evaluated the association between attachment avoidance/anxiety dimensions and PTSD/depression among women newly diagnosed with ovarian, endometrial, or cervical cancer. Consecutive Danish-speaking women aged 20 to 75 years and treated surgically for primary gynaecological cancer were eligible. All patients were offered a rehabilitation programme consisting of two face-to-face sessions and two phone calls carried out by a nurse. Patients were asked to complete the Revised Adult Attachment Scale, the Harvard Trauma Questionnaire and the Major Depression Inventory at baseline and at 5-month follow-up. In all, 151 women consent to participate in the sessions where 51 fulfilled Revised Adult Attachment Scale questionnaire and contribute with socio-demographic data. We found significant positive changes within the attachment anxiety dimension among women with ovarian cancer, a significant reduction of PTSD among endometrial cancer patients and insignificant changes in depression among all cancer types. The attachment anxiety dimension significantly increased the odds for PTSD and depression.



Relevante publikationer: 

Adellund Holt, K., Jensen, P. T., Gilså Hansen, D.4, Elklit, A., Mogensen, O. (2016). Rehabilitation of Women with Gynaecological Cancer – the association between Adult Attachment, Post-Traumatic Stress Disorder, and Depression. Psych-Oncology 25(6):691-8. Doi: 10.1002/pon.3996

Sammenhængen mellem lidelser associeret med piskesmæld og PTSD – Ængstelig tilknytningsstil som potentiel medierende faktor

Background: In more than 90% of whiplash accidents a good explanation regarding the association between trauma mechanism, organic pathology, and persistent symptoms has failed to be provided. Objective: We predicted that the severity of chronic whiplash-associated disorder (WAD), measured as number of whiplash symptoms, pain duration, pain-related disability, and degree of somatisation would be associated with the number of post-traumatic stress disorder symptoms (PTSD). Secondly, we expected attachment-anxiety to be a vulnerability factor in relation to both PTSD and WAD. Design: Data were collected from 1,349 women and 360 men suffering from WAD from the Danish Society for Polio, Traffic, and Accident Victims. The PTSD symptoms were measured by the Harvard Trauma Questionnaire. All three core PTSD clusters were included: re-experiencing, avoidance, and hyperarousal. Attachment security was measured along the two dimensions, attachment-anxiety and attachment-avoidance, by the Revised Adult Attachment Scale. Results: PTSD symptoms were significantly related to the severity of WAD. In particular, the PTSD clusters of avoidance and hyperarousal were associated with the number of whiplash symptoms, disability, and somatisation. Attachment-anxiety was significantly related to PTSD symptoms and somatisation but not to pain and disability. A co-morbidity of 38.8% was found between the PTSD diagnosis and WAD, and about 20% of the sample could be characterised as securely attached. Conclusions: The PTSD clusters of avoidance and hyperarousal were significantly associated with severity of WAD. The study emphasises the importance of assessing PTSD symptomatology after whiplash injury. Furthermore, it highlights that attachment theory may facilitate the understanding of why some people are more prone to develop PTSD and WAD than others.


Relevante publikationer: 
Andersen, T. E., Elklit, A. & Vase, L. (2011). The Relationship between Chronic Whiplash-Associated Disorder and Posttraumatic Stress - Attachment-Anxiety may be a Vulnerability Factor. European Journal of Psychotraumatology, 2: 5633. Doi: 10.3402/ejpt.v2i0.5633

Sammenhængen mellem PTSD-symptomer, tilknytning, psykologisk belastning og polyviktimisering i det tidlige voksenliv

The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.



Relevante publikationer:
Zerach, G., & Elklit, A. (2019). Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence. International Journal of Psychology. Doi: 10.1002/ijop.12590
Sammenligning af sportsafhængighed og spiseforstyrrelser
Exercise addiction is characterized by excessive exercise patterns with potential negative consequences such as overuse injuries. The aim of this study was to compare eating disorder symptoms, quality of life, personality traits and attachments styles in exercisers with and without indications of exercise addiction. A case-control study with 121 exercisers was conducted. The exercisers were categorized into an addiction group (n=41) or a control group (n=80) on the basis of their responses to the Exercise Addiction Inventory. The participants completed the Eating Disorder Inventory 2, the Short-Form 36, the NEO Personality Inventory Revised and the Adult Attachment Scale. The addiction group scored higher on eating disorder symptoms, especially on perfectionism but not as high as eating disorder populations. The characteristic personality traits in the addiction group were high levels of excitement-seeking and achievement striving whereas scores on straightforwardness and compliance were lower than in the exercise control group. The addiction group reported more bodily pain and injuries. This study supports the hypothesis that exercise addiction is separate to an eating disorder, but shares some of the concerns of body and performance. It is driven by a striving for high goals and excitement which results in pain and injuries from overuse.

Relevante publikationer:
Lichtenstein, M., Christiansen, E., Elklit, A., Bilenberg, N. & Støving, R. K. (2014). Exercise addiction: A study of eating disorder symptoms, quality of life, personality  traits and attachment styles. Psychiatry Research, 215(2), 410-416. Doi: 10.1016/j.psychres.2013.11.010
Tilknytning og PTSD hos unge voksne i tre nordiske lande
Studies of possible variables influencing development of posttraumatic stress (PTSD) are of great importance in the effort to enhance preventive and interventional methods in the aim to prevail this devastating condition. Despite the vast research in adults, little is still known of adolescents. Although research is scarce, attachment style has been identified to be an influencing factor in adults, and still research in adolescent is almost non-existent. To our knowledge, no prior study has been conducted, looking at the relationship between attachment style, exposure to a broad range of potentially traumatic events, and subsequent PTSD symptoms in a cross cultural perspective. This is the aim of the present study. Procedure: Data was collected from questionnaire surveys of 1283 adolescents (mean age 14.1 years). Measures: PTSD was measured with The Harvard Trauma Questionnaire-Part IV (HTQ); and attachment style was studied using the Revised Adult Attachment Scale (RAAS). Potentially traumatic events were examined using a broad event list of 19 events. Results: Contrary to what was expected, significant cross cultural differences were found in the distribution of securely, preoccupied, and dismissive attached. Around half of the Faroese population was securely attached, contrary to the Danish and Icelandic population, where the majority was dismissive attached. Cross cultural differences were also found in the distribution of attachment style among those adolescents with PTSD. The majority of the Danish adolescent population with PTSD was dismissive attached; the majority of the Faroese adolescent population with PTSD was securely attached, and in the Icelandic adolescents with PTSD were distributed somewhat even between the four attachment styles. Finally, cross cultural differences were identified in which potentially traumatic events had a significant contribution to the variation in PTSD. The results are discussed and clinical recommendations are presented.


Relevante publikationer:
Petersen, T., Elklit, A. & Olesen, J. G. (2013). Attachment Styles and PTSD in Adolescents in three Nordic Countries. Open Journal of Epidemiology, 3, 1-10. Doi:10.4236/ojepi.2013.32010

Tilknytningens betydning hos gravide kvinder

Primary objective: To study (a) the associations between attachment styles, worry, and care utilisation in third trimester of first pregnancy (n = 567) and (b) the associations between third trimester attachment style and one year postpartum relationship satisfaction and parenting stress (n = 1069). Based on Bowlby's attachment theory, we expected attachment anxiety and attachment avoidance to differ with regard to short-term appraisal of threat and interpersonal neediness, while the dimensions were expected to have similar deteriorating effect on longer-term outcomes in relationship functioning. Research design: A cross-sectional study nested within a randomised controlled trial. Methods and procedures: An assessment battery consisting of three scales at T1 and T2. Main outcome and results: Results confirmed that attachment anxiety was significantly associated with high pregnancy worry compared to attachment avoidance. None of the dimensions were associated with health care utility. Both attachment anxiety and attachment avoidance were associated with high parenting stress at one year postpartum, while only attachment anxiety was associated with low relationship satisfaction. Conclusion: These findings partly confirm conceptual distinctions between the two attachment dimensions, and point to adult attachment as an important factor in understanding the ways women cope with the challenges during the transition to motherhood.


Relevante publikationer:

Trillingsgaard, T., Elklit, A., Shevlin, M. & Maimburg, R. D. (2011). Adult Attachment Dimensions at the Transition to Motherhood: Predicting Worry, Health Care Utility, and Relationship Functioning. Journal of Reproductive and Infant Psychology, 29 (4), 354-363. Doi:10.1080/02646838.2011.611937

Sammenhængen mellem tilknytningsstile hos voksne og den psykologiske reaktion på spædbarnsdød

Objective: This study examined the link between new mothers' attachment orientation and the perceived cost of sole responsibility in housework and child care. Background: The transition to motherhood can be very stressful, and according to the Vulnerability Stress Adaptation Model (VSA model), the way it affects the couple relationship is likely to depend on interacting factors from different domains of risk (e.g. individual and couple level). We expected interactions to appear between domains of attachment and labour division. The hypothesis was that sole responsibility in child care and housework would predict lower relationship satisfaction, particularly among mothers who were high on attachment insecurity. Methods: Data from self-report measures of adult attachment, child care, housework and relationship satisfaction were collected from 255 first-time mothers at six months postpartum. Results: Sole responsibility in child care predicted lower relationship satisfaction, particularly among mothers who were high on attachment avoidance. This interaction effect was significant but small. Among main effects, higher levels of either attachment anxiety or avoidance were linked with lower relationship satisfaction and lower levels of sole responsibility in childcare was linked with higher relationship satisfaction. Conclusion: These findings provide new data on the how risk factors from separate domains combine, and implications are discussed in terms of applying the VSA model when developing preventive interventions for new mothers.


Relevante publikationer:
Shevlin, M., Boyda, D., Elklit, A. & Murphy. S. (2014). Adult attachment styles and the psychological response to infant bereavement. European Journal of Psychotraumatology. 5: 23295. Doi: 10.3402/ejpt.v5.23295
Tilknytningsstile og PTSD, depression og angst
Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post whiplash trauma.

Relevante publikationer:

Armour, C., Elklit, A. & Shevlin, M. (2011). Attachment Typologies and Posttraumatic Stress Disorder (PTSD), Depression, and Anxiety: A Latent Profile Analysis Approach. European  Journal of Psychotraumatology, 2: 6018. Doi: 10.3402/ejpt.v2i0.6018 

Tilknytningsstile og symptomer hos unge mennesker med hjernerystelser

5–15% of people with concussion experience post-concussion symptoms (PCS) >3 months post-injury. The etiology of PCS is complex, with interacting biological, psychological, and environmental factors. Attachment styles (AS) is grounded in childhood and activated when one is exposed to stressful situations in order to feel secure. AS may be important to understand how interpersonal processes affect the development of PCS and illness responses. The aim of this study was to explore the associations between AS, illness perception, illness behavior and symptom reporting in young persons with a recent concussion.

Knowledge about the role of various attachment styles for the development of persisting PCS may contribute to the understanding of why young persons with concussion have very different illness courses.


Relevante publikationer: 

Tuborgh, A., Svendsen, S. W., Schröder, A., Elklit, A., Hunter, J. & Rask, C. U., jun. (2019). Attachment style and symptom reporting in young persons with concussion. Journal of Psychosomatic Research. 121, 123. Doi: 10.1016/j.jpsychores.2019.03.072


Usikker tilknytning og psykologisk belasting blandt stalkede mødre
There is a lack of research about intimate partner stalking when victim and stalker have children together. The aim of the current study was to provide knowledge about the mental health status and attachment patterns of mothers stalked by the father of one or more of their children. One hundred ninety six Danish women, recruited via a closed social network for stalked mothers, completed an anonymous online questionnaire concerning their experiences of violence during and after the relationship with the stalker, relationship characteristics, attachment patterns, and psychological distress. Results indicated high exposure to psychological maltreatment during the victim–stalker relationship, harassing and violent stalking behaviors after relationship termination, and high levels of functional disabilities, PTSD (posttraumatic stress disorder), other trauma-related, affective, and somatization symptoms. Furthermore, the women retrospectively reported an increase in attachment insecurity from the time before their relationship with the stalker to the time of study participation (after they experienced relationship violence and/or stalking). Stalking behaviors uniquely contributed to the explanation of the mothers’ psychological distress above the effects of relationship violence. Moreover, attachment insecurity appeared to be the strongest predictor of psychological distress. Having children together with their stalker captures women in an ongoing situation of threat and interpersonal traumatization that differs from other forms of stalking in many respects. The present study is the first drawing attention to the experiences and suffering of stalked mothers, a particularly vulnerable group of stalking victims.

Relecante publikaitoner:

Schandorph, S., Wolf, N. M. & Elklit, A. (2018). Psychological Distress and Attachment Insecurity of Stalked Mothers. Journal of Interpersonal Violence. Doi: 10.1177/0886260518819883

Usikker tilknytning og PTSD hos ofre for seksuelt misbrug i barndommen
Adult attachment theory is increasingly being conceptualized within a traumatic framework, however, few studies have examined temporal relationships between the insecure attachment orientations (attachment anxiety and attachment avoidance) and symptoms of posttraumatic stress (PTS). PTS refers to symptoms associated with posttraumatic stress disorder (PTSD) in the absence of a clinical diagnosis of PTSD. This prospective study assesses the temporal relations between the 2 attachment dimensions of anxiety and avoidance and PTS among a treatment-seeking sample of female survivors of childhood sexual abuse (CSA). Cross-lagged panel analysis was employed to assess the temporal relations between insecure attachment orientations and PTS using the Revised Adult Attachment Scale (RAAS) and the Harvard Trauma Questionnaire (HTQ). Initial assessment was on average 23 years after the onset of abuse (N = 405), and participants were followed-up after 6 months (N = 245) and 12 months (N = 119). PTS levels and insecure attachment declined over the 12-month period. Cross lagged panel analyses indicated that over the longer-term course of PTS, insecure attachment orientations are significantly related to PTS. While these associations were relatively weak in magnitude, temporal relations nevertheless remain. Specifically attachment avoidance appears to be the more relevant orientation in PTS across the 3 time points in the study. Current results provide insight into the temporal relations between insecure attachment orientations and symptoms of PTS. The findings are discussed in terms of the existing trauma literature. (APA PsycInfo Database Record (c) 2018 APA, all rights reserved).

Relevante publikationer: 
Murphy, S., Elklit, A., Hyland, P. & Shevlin, M. (2016). Insecure attachment orientations and posttraumatic stress in a treatment-seeking sample of victims of childhood sexual abuse: A cross-lagged panel study. Traumatology, 22, 48–55. Doi: http://dx.doi.org/10.1037/trm0000060.



Validering af Experiences in Close Relationships - Relationship Structures (ECT-RS) hos unge

Emerging evidence points toward a two-dimensional attachment construct: avoidance and anxiety. The Experiences in Close Relationships-Relationship Structures scale (ECR-RS; Fraley, Heffernan, Vicary, & Brumbaugh, 2011) is a questionnaire assessing two-dimensional relationship-specific attachment structures in adults and, hence, moves beyond the traditional focus on romantic relationships. The present article explored the psychometric abilities of the ECR-RS across parental and best friend domains in a sample of 15 to 18-year-olds (n = 1999). Two oblique factors were revealed across domains, exhibiting satisfactory construct validity, including factor-specific links to the model of adult attachment (Bartholomew & Horowitz, 1991), and independent factor discrimination between subgroups. A robust validation supports the application of the ECR-RS to assessing relationship-specific adolescent attachment structures.


Relevante publikationer:
 Feddern, D. & Elklit, A. (2014). A Validation of the Experiences in Close Relationships – Relationship Structures (ECT-RS) in Adolescents. Attachment & Human Development, 16, 58-76. Doi: 10.1080/14616734.2013.850103