Introduction: Attachment orientations are associated with the severity of posttraumatic stress disorder (PTSD).
However, the mediator role of trauma type in the association between attachment orientation and PTSD remains
Method: The relationship between trauma type, attachment, and PTSD was investigated in a large multiple
trauma sample (n=3735). All participants were assessed for PTSD using the Harvard Trauma Questionnaire (HTQ)
and for attachment orientations utilizing the Revised Adult Attachment Scale (RAAS).
Results: Overall, a secure attachment style was related to lower PTSD severity, while insecure attachment
styles were related to higher PTSD severity. Although both attachment dimensions were related to PTSD severity,
attachment anxiety had greater contribution in predicting PTSD. PTSD symptom clusters were not found to depend on
attachment dimensions. Finally, type of traumatic event moderated the association between attachment dimensions
and PTSD severity. While among trauma survivors of family illness, the securely attached group showed the lowest
PTSD severity, among trauma survivors of disease and physical health, the dismissively attached individuals showed
the lowest level of PTSD severity, compared to other attachment groups.
Conclusion: The results underscore the importance of taking into account the nature of the traumatic event
while assessing the effects of attachment in posttraumatic reactions. Moreover, dismissing attachment style might
be adaptive when facing the trauma of disease.