Insecure Attachment and Therapeutic Bond as Mediators of Social, Relational, and Social Distress and Interpersonal Problems in Adult Females with Childhood Sexual Abuse History

ABSTRACT

Establishing trust is an important part of building the therapeutic relationships and achieving the goal of effective trauma treatment for individuals who have experienced childhood sexual abuse. The current study explored the associations between attachment style, therapeutic bond, distress, and interpersonal problems. This study investigated whether attachment style and therapeutic bond mediated the association between the level of early treatment emotional distress and later treatment interpersonal problems among two groups: clients reporting histories of childhood sexual abuse and clients not reporting histories of childhood sexual abuse. Research indicates that disruption of attachment security as well as the therapeutic relationship is common in survivors of childhood sexual abuse. We explored the mediating role of insecure attachment and the therapeutic bond on the predictive relationship between early treatment emotional distress and the interpersonal difficulties that one experiences in their daily life. For clients with histories of child sexual abuse, the model showed that anxious attachment and avoidant attachment mediated the associations between emotional distress and interpersonal relations. Therapeutic bond was not a significant mediator. For clients without histories of sexual abuse, results showed significant association between emotional distress and interpersonal relations, but insecure attachment or therapeutic bond did not mediate this relationship.

KEYWORDS:

• Adult Survivor
• sexual Abuse
• attachment
• therapeutic Bond
• therapeutic Alliance
• interpersonal
• anxious
• avoidant

Disclosure of Interest

No authors had any financial or personal relationships that might bias this work.

Ethical Standards and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Additional information

Notes on contributors

Jeffrey M. Sullivan

Jeffrey M. Sullivan, Ph.D., LPC-S, RPT, is an Associate Professor at Sam Houston State University, Huntsville, TX.

David M. Lawson

David M. Lawson, Ph.D., is a Professor and Director of the Center for Research and Training in Trauma at Sam Houston State University, Huntsville, TX.

Sinem Akay-Sullivan

Sinem Akay-Sullivan is an Assistant Professor and Assistant Director of the Center for Research and Training in Trauma at Sam Houston State University, Huntsville, TX.