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Emotion regulation strategies as mediators of the association between level of attachment security and PTSD symptoms following trauma in adulthood

Abstract Although, a link between attachment and posttraumatic stress disorder (PTSD) symptoms has been established, the mechanisms involved in this link have not yet been identified. Furthermore, attachment has been systematically measured by self-report questionnaires, which are prone to perceptual bias. The first goal of this study was to examine the link between PTSD symptoms and attachment security level, as measured with a security index created from the Adult Attachment Projective interview. The second goal was to test emotion regulation strategies as mediators of this link. Participants were recruited in hospital emergency rooms following trauma exposure in adulthood. The results showed that a higher level of attachment security was associated with fewer PTSD symptoms at one and three months posttrauma. The results also showed that substance use and emotion-focused strategies mediated the association between attachment and PTSD symptoms. Theoretical and clinical considerations that follow from these outcomes are discussed.