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Videnscenter for Psykotraumatologi

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.

 

Aktuelle projekter

 

Afsluttede projekter

Formålet med dette projekt er at undersøge traumatisering, tilknytning og stigmatisering blandt unge i Danmark. Der ønskes en forståelse for sammenhængen mellem de tre faktorer blandt traumatiserede unge. Dataindsamlingen er udført i form af en spørgeskemaundersøgelse udfyldt af 340 unge i Danmark.


 

Relevante publikationer:
Ferrajão, P., & Elklit, A. (2021). Attachment Orientations Mediate the Effect of World Assumptions on Posttraumatic Stress in Survivors of Childhood Sexual Abuse. Illness, Crisis & Loss. Doi: 10.1177/10541373211050498

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

Seksuelle overgreb i barndommen (CSA) er en ekstremt traumatisk oplevelse, som er forbundet med en række langvarige vanskeligheder og symptomer (f.eks. Herman, 1992). Disse omfatter blandt andet forstyrrelser i grundlæggende interpersonelle tilknytningsstrukturer (Rumstein-McKean & Hunsley, 2001) samt nedsat mental integration, som kommer til udtryk gennem dissociation (Van Den Bosch et al., 2003). Teoretisk er tilknytningsusikkerhed og dissociation nært forbundet, da dissociation opstår som en måde, hvorpå det misbrugte barn forsøger at håndtere de konfliktfyldte tilknytningskrav (f.eks. Liotti, 1992). Ikke desto mindre er retningen i sammenhængen mellem tilknytningsusikkerhed og dissociation under behandling af voksne, der har overlevet CSA, i høj grad uafklaret.

For at udfylde denne videnkløft undersøgte det aktuelle prospektive studie kvindelige voksne CSA-overlevere, som var ambulante patienter på fire behandlingscentre i Danmark (n = 407). Data blev indsamlet ved behandlingsstart (T1), 6 måneder efter behandlingsstart (T2) og 12 måneder efter behandlingsstart (T3). Resultaterne viste, at både tilknytningsusikkerhed og dissociation faldt over tid i løbet af behandlingen. Høj tilknytningsusikkerhed var forbundet med høj dissociation ved alle måletidspunkter. Derudover fandtes en gensidig sammenhæng mellem tilknytningsundgåelse og dissociation under behandlingen. Lave niveauer af tilknytningsundgåelse forudsagde et fald i dissociation – og omvendt.

Resultaterne antyder, at behandling skaber en helbredende cyklus, hvor genetablering af tilknytning fremmer mental reintegration, hvilket igen uddyber gendannelsen af sunde tilknytningsmønstre. 


 

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, der har mistet et spædbarn, oplever en bred vifte af symptomer, herunder posttraumatisk stresslidelse (PTSD), som kan vare ved i flere år efter tabet. Der er kun udført begrænset forskning om PTSD hos fædre, der har mistet et spædbarn. Mødre rapporterer generelt flere symptomer end fædre, men der vides stadig relativt lidt om andre kønsforskelle efter spædbarnsdød. Det nuværende tværsnitsstudie undersøgte kønsforskelle i PTSD samt kønsforskelle i forholdet mellem PTSD-sværhedsgrad og relaterede variable.
Deltagerne var 361 mødre og 273 fædre, der havde mistet et spædbarn enten sent i graviditeten, under fødslen eller i barnets første leveår. Deltagerne udfyldte spørgeskemaer mellem 1,2 måneder og 18 år efter tabet (gennemsnit = 3,4 år). Mødre rapporterede signifikant flere PTSD-symptomer, højere tilknytningsangst, mere følelsesfokuseret mestring og i højere grad en følelse af at være svigtet, men signifikant lavere niveauer af tilknytningsundgåelse end fædre. Tilknytningsangst, tilknytningsundgåelse og følelsesfokuseret mestring var signifikant stærkere forbundet med PTSD-sværhedsgrad hos mødre end hos fædre – men kun når disse faktorer blev undersøgt enkeltvis. Når alle variable samt tid siden tabet blev analyseret samlet, fandtes der ikke længere nogen signifikante modererende effekter af køn.

Vedvarende posttraumatiske symptomer forekommer hos både mødre og fædre lang tid efter tabet. Der er flere kønsforskelle i sværhedsgrad og relaterede faktorer ved PTSD, og enkelte modererende effekter blev identificeret for tilknytning og følelsesfokuseret mestring. Overordnet set fandtes dog flere ligheder end forskelle mellem mødre og fædre i sammenhængene mellem PTSD og relaterede faktorer. 

 

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.

5–15 % af personer med hjernerystelse oplever post-commotio symptomer (PCS) mere end 3 måneder efter skaden. Ætiologien bag PCS er kompleks og involverer et samspil mellem biologiske, psykologiske og miljømæssige faktorer. Tilknytningsstil (AS) er forankret i barndommen og aktiveres, når man udsættes for stressende situationer for at opnå tryghed. AS kan være vigtig for at forstå, hvordan interpersonelle processer påvirker udviklingen af PCS og sygdomsreaktioner. Formålet med dette studie var at undersøge sammenhængen mellem AS, sygdomsopfattelse, sygdomsadfærd og symptomrapportering hos unge med en nylig hjernerystelse.
Projektet er en del af det danske EPIC-studie og inkluderer 3080 personer i alderen 15–30 år, der er diagnosticeret med hjernerystelse. Tre måneder efter skaden modtog alle spørgeskemaer om: generel sundhed, PCS (målt med Rivermead Post-Concussion Symptoms Questionnaire (RPQ)), AS (målt som angst- og undgåelsesdimensioner via Experiences in Close Relationships – Relationship Structure (ECR-RS) spørgeskema), sygdomsopfattelse (Brief Illness Perception Questionnaire (B-IPQ)) og sygdomsadfærd (Behavioural Responses to Illness Questionnaire (BRIQ)).
1101 patienter svarede. Ved brug af lineære regressionsmodeller blev det fundet, at ECR-RS-angstscoren var positivt associeret med PCS-scoren: 2,1 (95 %CI 1,6; 2,6), p < 0,001, mens ECR-RS-undgåelsesscoren var negativt associeret med PCS-scoren: −3,3 (95 %CI −4,3; −2,3), p < 0,001. Analyser med strukturelle ligningsmodeller viste signifikante sammenhænge mellem ECR-RS-dimensionerne og B-IPQ-, BRIQ- og RPQ-scorer. Detaljerede resultater vil blive præsenteret.

Viden om forskellige tilknytningsstiles rolle i udviklingen af vedvarende PCS kan bidrage til forståelsen af, hvorfor unge med hjernerystelse har meget forskellige sygdomsforløb


 

Relevante publikationer:
Tuborgh, A., Svendsen, S. W., Elklit, A., Hunter, J., Jensen, J. S., Schröder, A., Nielsen, J. F., Thastum, M. M., Næss-Schmidt, E. T., & Rask, C. U. (2021). Attachment and symptom reporting in adolescents and young adults after a concussion. Journal of psychosomatic research150, 110603. Doi: 10.1016/j.jpsychores.2021.110603

Det aktuelle studie vurderer sammenhænge mellem gentagen oplevelse af traumatiske begivenheder (polyviktimisering), PTSD-symptomer (PTSS) og psykiatriske symptomer i den tidlige ungdom, og undersøger de medierende roller, som tilknytningsorienteringer og oplevet social støtte spiller i sammenhængene mellem polyviktimisering, PTSS og psykiatriske symptomer.

I 2001 gennemførte et repræsentativt nationalt udsnit af 390 danske elever i ottende klasse (M = 13,95, SD = 0,37) validerede selvrapporteringsskemaer. Polyviktimisering var forbundet med højere niveauer af PTSS og psykiatriske symptomer. Vigtigt er det, at polyviktimisering var signifikant forbundet med høj tilknytningsangst, som var forbundet med lav oplevet social støtte, hvilket igen var forbundet med høje niveauer af PTSS og psykiatriske symptomer. Polyviktimisering kan have alvorlige konsekvenser i den tidlige ungdom. En persons høje tilknytningsangst kan være relateret til mangel på oplevet social støtte, hvilket bør ses som en mulig psykologisk belastningsmekanisme efter eksponering for en række potentielt traumatiske hændelser.


 

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

Udviklingen af vedvarende smerter efter piskesmældsskade er stadig et uløst mysterium, selvom cirka 50 % af personer, der rapporterer piskesmæld, udvikler vedvarende smerter. Der er enighed om, at stærke oprindelige smerter og PTSD-symptomer er indikatorer på en dårlig prognose efter en piskesmældsskade. For nylig er usikker tilknytningsstil blevet foreslået som en sårbarhedsfaktor for både smerte og PTSD. For at kunne vejlede behandlingen er det vigtigt at undersøge mulige mekanismer, som kan føre til vedvarende smerter og medicinsk uforklarede symptomer efter en piskesmældsskade.

Det aktuelle studie undersøger tilknytningsusikkerhed og PTSD-symptomer som mulige sårbarhedsfaktorer i relation til høje niveauer af smerte og somatisering efter sub-akut piskesmældsskade. Data blev indsamlet fra 327 patienter (kvinder = 204), som blev henvist løbende til akutmodtagelsen efter en akut piskesmældsskade. Inden for en måned efter skaden besvarede patienterne et spørgeskema vedrørende usikker tilknytningsstil, smerte, somatisering og PTSD-symptomer. Der blev udført multiple meditationsanalyser for at vurdere, om PTSD-symptomklynger medierede sammenhængen mellem tilknytningsusikkerhed, smerte og somatisering. I alt opfyldte 15 % kriterierne for en mulig PTSD-diagnose ifølge DSM-IV’s symptomklynger, og 11,6 % opfyldte kriterierne for somatisering. PTSD øgede sandsynligheden for at tilhøre gruppen med moderate til svære smerter op til 3 gange så meget som hvis ikke PTSD var tilstede. I forhold til somatisering blev sandsynligheden for at tilhøre gruppen næsten firedoblet. PTSD-symptomklyngerne undgåelse og hyperarousal medierede sammenhængen mellem tilknytningsdimensionerne, smerte og somatisering. En anerkendelse af, at PTSD er en del af ætiologien bag vedvarende symptomer efter piskesmæld, kan hjælpe de ramte med at få tidlig og mere passende behandling, hvilket igen kan forebygge, at tilstanden bliver kronisk.


 

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

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.

Videnscenter for Psykotraumatologi har udarbejdet flere projekter, der undersøger PTSD-symptomer hos kroniske smertepatienter. 

Følgende er en beskrivelse af et projekt, der undersøgte sammenhæng ml. PTSD-sværhedsgrad efter piskesmæld samt tilknytningen:

I mere end 90% af piskesmældulykker er der ikke givet en god forklaring på sammenhængen mellem traumamekanisme, patologi og vedvarende symptomer. Formål: Vi forudså, at sværhedsgraden af kronisk piskesmældsrelateret lidelse (WAD), målt som antal piskesmældssymptomer, smertens varighed, smerte-relateret funktionsevne og grad af somatisering, ville være forbundet med antallet af posttraumatisk stresslidelse-symptomer (PTSD). For det andet forventede vi, at tilknytningsangst ville være en sårbarhedsfaktor i relation til både PTSD og WAD. Design: Data blev indsamlet fra 1.349 kvinder og 360 mænd, der led af WAD, fra Dansk Polio-, Trafik- og Ulykkespatientforening. PTSD-symptomerne blev målt ved Harvard Trauma Questionnaire. Alle tre kerne-PTSD-klustre blev inkluderet: genoplevelse, undgåelse og hyperarousal. Tilknytningssikkerhed blev målt langs de to dimensioner, tilknytningsangst og tilknytningsundgåelse, ved hjælp af den reviderede Adult Attachment Scale. Resultater: PTSD-symptomer var signifikant relateret til sværhedsgraden af WAD. Især PTSD-klustrene for undgåelse og hyperarousal var forbundet med antal piskesmældssymptomer, funktionsevne og somatisering. Tilknytningsangst var signifikant forbundet med PTSD-symptomer og somatisering, men ikke med smerte og funktionsevne. Der blev fundet en komorbiditet på 38,8% mellem PTSD-diagnosen og WAD, og cirka 20% af prøven kunne karakteriseres som sikkert tilknyttet. Konklusioner: PTSD-klustrene for undgåelse og hyperarousal var signifikant forbundet med sværhedsgraden af WAD. Studiet understreger vigtigheden af at vurdere PTSD-symptomatologi efter piskesmældsskader. Yderligere fremhæver det, at tilknytningsteori kan facilitere forståelsen af, hvorfor nogle mennesker er mere tilbøjelige til at udvikle PTSD og WAD end andre.


 

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.

Elklit, A. (2000). Følger af whiplash. København: PTU.

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. Doi: 10.3402/ejpt.v2i0.5633

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

 

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

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


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

Denne undersøgelses primære formål var at undersøge (a) sammenhængen mellem tilknytningsstil, bekymring og sundhedsforbrug i tredje trimester af første graviditet (n = 567) og (b) sammenhængen mellem tilknytningsstil i tredje trimester og tilfredshed i parforhold samt forældrestress ét år efter fødslen (n = 1069). Baseret på Bowlbys tilknytningsteori forventede vi, at tilknytningsangst og tilknytningsundgåelse ville adskille sig i forhold til kortsigtet vurdering af trussel og interpersonelle behov, mens dimensionerne forventedes at have en tilsvarende negativ effekt på længerevarende udfald i parforholdsrelationer. Et tværsnitsstudie indlejret i et randomiseret kontrolleret forsøg. Et vurderingsbatteri bestående af tre skalaer ved T1 og T2.
Resultaterne bekræftede, at tilknytningsangst var signifikant forbundet med høj grad af graviditetsbekymring sammenlignet med tilknytningsundgåelse. Ingen af tilknytningsdimensionerne var forbundet med brug af sundhedsydelser. Både tilknytningsangst og tilknytningsundgåelse var forbundet med højt forældrestress ét år efter fødslen, mens kun tilknytningsangst var forbundet med lav parforholdstilfredshed.

Disse fund bekræfter delvist de konceptuelle forskelle mellem de to tilknytningsdimensioner og peger på voksentilknytning som en vigtig faktor i forståelsen af, hvordan kvinder håndterer overgangen til moderskab.


 

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

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

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

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

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


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.

 

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

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: 10.1037/trm0000060.

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