Article

Exposure to interpersonal trauma, attachment insecurity, and depression severity

Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Electronic address: .
Journal of Affective Disorders (Impact Factor: 3.71). 03/2013; 149(1-3). DOI: 10.1016/j.jad.2013.01.045
Source: PubMed

ABSTRACT BACKGROUND: Exposure to traumatic events is a nonspecific risk factor for psychiatric symptoms including depression. The trauma-depression link finds support in numerous studies; however, explanatory mechanisms linking past trauma to current depressive symptoms are poorly understood. This study examines the role that attachment insecurity plays in mediating the relationship between prior exposure to trauma and current expression of depression severity. METHODS: Past trauma and attachment anxiety and avoidance were assessed at baseline in a large cohort (N=705) of adults admitted to a specialized adult psychiatric hospital with typical lengths of stay ranging from 6 to 8 weeks. Depression severity was assessed at day 14 of treatment using the Beck Depression Inventory-II. RESULTS: Interpersonal trauma (e.g., assaults, abuse) was correlated with depression severity, whereas exposure to impersonal trauma (e.g., natural disasters, accidents) was not. Adult attachment partially mediated the relationship between past interpersonal trauma and depression severity at day 14 among psychiatric inpatients. LIMITATIONS: Measure of trauma exposure did not systematically differentiate the age of exposure or relationship to the perpetrator. Individuals scoring high on the self-report attachment measure may be prone to over-report interpersonal traumas. CONCLUSIONS: Treatment of depression in traumatized patients should include an assessment of attachment insecurity and may be fruitful target for intervention.

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    • "Despite research examining trauma within close interpersonal relationships among adults, to date, research has not yet examined the role of interpersonal proximity, trauma experience, and mental health problems among children and adolescents. Although Freyd and colleagues have examined the impact of traumas involving different levels of perpetratorinduced betrayal on mental health symptoms in adults (Freyd, Klest, & Allard, 2005; Martin, Cromer, DePrince, & Freyd, 2013), most researchers to date have examined interpersonal traumas dichotomously (i.e., interpersonal vs. non-interpersonal traumas; e.g., Forbes et al., 2012; Ford et al., 2011a,b; Fowler, Allena, Oldham, & Frueh, 2013; Lilly & Valdez, 2011; Luthra et al., 2009). While such studies have produced robust findings, there is a dearth of knowledge regarding the effects of traumas involving differing levels of interpersonal closeness. "
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