The role of attachment in recovery after a school-shooting trauma

Figures & data

Fig. 1 Participation of the Kauhajoki Educational Centre in the study after the school-shooting incident, flow chart.

Table 1 Sociodemographic and clinical characteristics of the students at the Kauhajoki Educational Centre participating in the study

Characteristic	n	%
Gender
Male	11	4.7
Female	225	95.3
Age at the incident, M (SD)	24.9	(10.2)
SES
Entrepreneur	20	9.4
Upper middle class	23	10.8
Lower middle class	51	23.9
Working class	92	43.2
Student	26	12.2
Other^a	1	0.5
Living arrangements
With both biological parents	60	25.4
With one biological parent	20	8.5
With spouse	105	44.5
Alone or other arrangements^b	51	21.6
Received previous psychosocial support	33	14.0
Previous psychological treatment	26	11.3
Level of exposure
Mild	43	18.2
Moderate	71	30.1
Significant	102	43.2
Severe	11	4.7
Extreme	9	3.8

Note: SES=socioeconomic status.

^aHousewife or pensioner.

^bWith an adult other than a guardian, or with a child.

Table 2 Sum scores of the Attachment Style Questionnaire (ASQ) by predominant attachment style clusters

	Type of predominant attachment style
ASQ sum scores T1, 4 months	Secure n=99	Avoidant n=80	Preoccupied n=50	F
Secure items^a
M (SD)	21.4 (3.4)	19.5 (2.9)	19.7 (3.2)	9.39***
Min–Max	11–29	10–28	14–29
Median	22	20	19
Avoidant items^b
M (SD)	11.5 (2.2)	16.4 (2.3)	13.8 (2.8)	132.19***
Min–Max	6–16	12–23	9–22
Median	10	16	13.5
Preoccupied items^c
M (SD)	10.6 (2.3)	13.4 (2.1)	17.5 (2.6)	148.58***
Min–Max	5–16	9–19	13–23
Median	11	13	17
T2, 16 months	Secure n=79	Avoidant n=62	Preoccupied n=37
Secure items^d
M (SD)	21.9 (3.0)	20.3 (3.3)	19.4 (2.5)	10.50***
Avoidant items^e
M (SD)	12.1 (3.1)	15.5 (3.4)	13.9 (3.1)	18.64***
Preoccupied items^f
M (SD)	11.2 (2.8)	12.9 (2.9)	15.2 (3.6)	23.03***

^aThe Shceffé's post hoc analysis confirmed that the mean of the secure items was higher in the secure cluster than in the two insecure clusters. ^bThe mean of the avoidant items was highest in the avoidant cluster and lowest in the secure cluster. ^cThe mean of the preoccupied items was highest in the preoccupied cluster and lowest in the secure cluster. ^dThe mean of the secure items was higher in the secure cluster than in the two insecure clusters. ^eThe mean of the avoidant items was equally high in the avoidant cluster and preoccupied cluster and lower in the secure cluster. ^fThe mean of preoccupied items was highest in the preoccupied cluster and lowest in the secure cluster.

***p<0.001.

Table 3 Means and standard deviations (SD) of Impact of Event Scale (IES), Adolescent Dissociative Experiences Scale (A-DES), and Posttraumatic Growth Inventory (PTGI) in the different attachment style groups at 4 months (T1), 16 months (T2), and 28 months (T3) and ANOVA statistics for attachment effects with post hoc analyses to conclude which of the groups differ from each other

	Type of predominant attachment style
Measures	Secure n=99, 79, 64 M (SD)	Avoidant n=80, 62, 42 M (SD)	Preoccupied n=50, 37, 28 M (SD)	F	Post hoc analyses (Sheffé)
T1 IES-22	22.4 (20.7)	27.6 (21.8)	39.0 (25.7)	9.24***	Sec<Pre, Avo<Pre
T2 IES-22	13.1 (16.2)	18.7 (20.5)	24.8 (23.4)	4.73*	Sec<Pre
T3 IES-22	8.2 (13.3)	16.2 (21.7)	16.5 (19.6)	3.62*
T1 IES-Intrusive	7.7 (7.7)	9.7 (8.3)	12.7 (9.8)	5.76**	Sec<Pre
T2 IES-Intrusive	5.0 (6.2)	7.1 (8.1)	8.3 (8.3)	2.87
T3 IES-Intrusive	3.3 (5.3)	6.7 (8.9)	5.7 (6.1)	3.47*	Sec<Avo
T1 IES-Avoidance	8.8 (8.3)	10.5 (8.3)	16.3 (9.8)	12.66***	Sec<Pre, Avo<Pre
T2 IES-Avoidance	5.1 (6.9)	7.2 (9.0)	10.1 (9.9)	4.43**	Sec<Pre
T3 IES-Avoidance	3.5 (5.7)	5.7 (8.7)	6.8 (9.1)	2.34
T1 IES-Hyperarousal	5.9 (6.8)	7.4 (7.2)	10.1 (8.3)	5.48**	Sec<Pre
T2 IES-Hyperarousal	3.0 (4.6)	4.5 (5.7)	6.4 (6.9)	4.88**	Sec<Pre
T3 IES-Hyperarousal	1.4 (3.5)	3.7 (5.9)	4.0 (6.1)	4.04*
T1 A-DES	2.3 (3.8)	4.7 (6.5)	6.3 (11.2)	6.18**	Sec<Pre
T2 A-DES	1.5 (4.0)	2.5 (3.5)	5.7 (9.0)	8.00***	Sec<Pre, Avo<Pre
T3 A-DES	1.6 (6.0)	1.8 (3.3)	3.6 (6.8)	1.35
T2 PTGI	53.9 (14.2)	51.7 (14.3)	57.6 (15.1)	1.80
T3 PTGI	55.6 (15.7)	51.2 (13.5)	58.0 (13.2)	1.77
T2 relating to others	18.8 (5.0)	17.7 (5.0)	20.6 (4.9)	3.64*	Avo<Pre
T3 relating to others	19.3 (5.6)	16.9 (5.0)	20.6 (4.2)	4.24*	Avo<Sec, Avo<Pre
T2 new possibilities	10.0 (3.5)	9.9 (3.4)	11.4 (3.6)	2.49
T3 new possibilities	10.4 (3.7)	9.5 (3.6)	11.3 (2.7)	2.02
T2 personal strength	11.1 (3.6)	10.8 (3.9)	11.1 (3.8)	0.16
T3 personal strength	11.6 (4.1)	11.3 (3.4)	11.7 (3.8)	0.13
T2 spiritual change	3.2 (1.8)	3.3 (2.1)	3.7 (2.3)	0.63
T3 spiritual change	3.4 (1.8)	3.4 (2.2)	3.5 (2.2)	0.02
T2 appreciation of life	10.7 (2.9)	10.0 (2.7)	10.9 (3.1)	1.19
T3 appreciation of life	10.8 (2.9)	10.2 (2.5)	11.0 (2.6)	0.88

Note: T1=(first) questionnaire at 4 months, T2=(second) questionnaire at 16 months, T3=(third) questionnaire at 28 months. Sec=secure predominant attachment style, Avo=avoidant predominant attachment style, Pre=preoccupied predominant attachment style.

*p<0.05, **p<0.01, ***p<0.001.

Table 4 Multivariate regression for the posttraumatic symptoms measured by the Impact of Event Scale (IES) studying the effects of avoidant and preoccupied attachment styles compared to secure attachment on recovering from a school-shooting trauma

	Avoidant vs. secure				Preoccupied vs. secure
	R ^2	B	SE B	β	R ^2	B	SE B	β
IES-22
T1	0.22	5.17	2.93	0.12	0.29	5.04	1.90	0.20**
T2	0.16	3.47	3.05	0.09	0.29	2.43	1.82	0.12
T3	0.11	7.59	3.53	0.21	0.17	1.96	1.81	0.11
IES-Intrusive
T1	0.21	1.95	1.11	0.12	0.23	1.28	1.73	0.14
T2	0.14	1.0	1.20	0.08	0.25	0.51	0.68	0.07
T3	0.11	3.08	1.44	0.21	0.15	0.39	0.65	0.06
IES-Avoidance
T1	0.15	1.72	1.20	0.10	0.25	2.78	0.78	0.28***
T2	0.08	1.44	1.38	0.09	0.24	1.21	0.80	0.14
T3	0.08	2.38	1.48	0.16	0.17	0.77	0.81	0.10
IES-Hyperarousal
T1	0.21	1.50	0.97	0.11	0.27	0.97	0.62	0.12
T2	0.23	0.83	0.82	0.08	0.28	0.72	0.53	0.12
T3	0.12	2.13	0.93	0.22	0.15	0.81	0.53	0.16

Note: T1=(first) questionnaire at 4 months, T2=(second) questionnaire at 16 months, T3=(third) questionnaire at 28 months. Age, previous traumatization, previous psychosocial support or psychological treatment and level of exposure were controlled for. Gender and later traumatization could not be analyzed due to low numbers of males and new traumas in the sample.

**p<0.01, ***p<0.001.