The relationship between adult attachment style and post-traumatic stress symptoms: a meta-analysis

There is increasing evidence that adult attachment plays a role in the development and perseverance ofsymptoms of posttraumatic stress disorder (PTSD). This meta-analysis aims to synthesise this evidenceand investigate the relationship between adult attachment styles and PTSD symptoms. A random-effectsmodel was used to analyse 46 studies (N = 9268) across a wide range of traumas. Results revealed amedium association between secure attachment and lower PTSD symptoms (?ˆ = -.27), and a mediumassociation, in the opposite direction, between insecure attachment and higher PTSD symptoms (?ˆ = .26).Attachment categories comprised of high levels of anxiety most strongly related to PTSD symptoms, withfearful attachment displaying the largest association (?ˆ = .44). Dismissing attachment was not signifi-cantly associated with PTSD symptoms. The relationship between insecure attachment and PTSD wasmoderated by type of PTSD measure (interview or questionnaire) and specific attachment category (e.g.secure, fearful). Results have theoretical and clinical significance.