Relationships between posttraumatic stress disorder, attachment, self-blame, and social support among women veterans with a history of childhood and/or military sexual trauma

Abstract: The present study examined the relationships between posttraumatic stress disorder (PTSD) symptom severity, trauma-related self-blame, perceived social support, and attachment among women veterans with a history of childhood trauma and/or military sexual trauma (MST), using self-reported inventories. Adult attachment was measured with the Relationship Scales Questionnaire, PTSD symptom severity with the PTSD Checklist - Civilian version, trauma-related self-blame with the Posttraumatic Cognitions Inventory, perceived social support with the Kessler’s Perceived Social Support scale, and the Brief Symptom Inventory-18 was used to assess general psychological maladjustment. Extending results from previous studies on PTSD, the positive relationships between PTSD symptom severity and attachment-related avoidance, as well as with trauma-related self-blame were found among women veterans with prior trauma history. There were non-significant relationships between a history of childhood trauma and trauma-related self-blame, perceived social support, PTSD symptom severity, and attachment-related anxiety and attachment-related avoidance. However, MST was positively related to PTSD symptom severity, trauma-related self-blame and attachment-related anxiety. Attachment-related avoidance better predicted PTSD symptom severity, and was significantly associated with a decreased perceived social support. Mean scores on the two dimensions of attachment studied did not significantly differ among women veterans with histories of childhood trauma and MST, a history of childhood trauma, or a history of MST. The two dimensions of attachment also did not differentially affect treatment, as measured by pre- to post-treatment changes in symptomatology. Twelve weeks of multimodality treatment significantly shifted self-reported attachment scores of women veterans with a history of trauma towards attachment security. Furthermore, trauma-related self-blame fully mediated the negative relationship between attachment-related anxiety and perceived social support after treatment, a relationship that did not exist prior to treatment. Results also indicated potential restoration of the protective effect of perceived social support on PTSD symptomatology discussed in PTSD research for women veterans with a higher score on attachment-related avoidance post-treatment. Treatment recommendations for women veterans with a history of childhood and/or MST are discussed.