Attachment style, emotion dysregulation, peritraumatic dissociation, and affective vulnerabilities: a cognitive-affective model

Peritraumatic dissociation is an experience of derealization and depersonalization in response to a traumatic event and is a significant predictor of Posttraumatic Stress Disorder (PTSD). While links between dissociation and anxiety-related pathology have received attention, questions remain regarding moderators and mediators of this relationship. The current study hypothesized that trauma-exposed individuals with low attachment security would experience higher rates of peritraumatic dissociation and affective consequences as a function of emotion dysregulation strategies characteristic of insecure attachment. Primary hypotheses were rejected as the predicted interaction between traumatic effect and insecure attachment on peritraumatic dissociation was not significant. Exploratory analyses showed this interaction could be conditional to the type of trauma experienced. Results indicated that victims of physical/sexual assault with high anxious attachment had higher rates of dissociation that increased difficulties managing distress, but only when victims strongly utilized thought suppression as an attempt to regulate posttraumatic outcomes. This suggests anxiously attached victims of physical/sexual assault dissociate more during a traumatic event and use thought suppression to maladaptively manage residual distress leading to PTSD development. Treatment implications targeting insecure attachment, dissociation, and their relevance to prolonged posttraumatic difficulties are discussed.