Pathways Linking Childhood Maltreatment and Adolescent Sexual Risk Behaviors: The Role of Attachment Security

Previous research has shown an association between child maltreatment (sexual abuse, physical abuse, neglect, or witnessing interparental violence) and adolescent sexual risk behaviors (SRBs). The mechanisms explaining this association are not well understood, but attachment theory could provide further insight into them. This study examined the relationships between child maltreatment and SRBs and investigated anxious and avoidant attachment as mediators. The sample comprised 1,900 sexually active adolescents (13 to 17 years old; 60.8% girls) attending Quebec high schools. The results of path analyses indicated that neglect was associated with a higher number of sexual partners, casual sexual behavior, and being younger at first intercourse. Anxious attachment mediated the relation between neglect and number of sexual partners, whereas avoidant attachment explained the relation between neglect and number of sexual partners, casual sexual behavior, and age at first intercourse (for boys only). Sexual abuse was directly associated with all three SRBs. Neither anxious attachment nor avoidant attachment mediated these associations. Youth with a history of neglect and sexual abuse represent a vulnerable population that is likely to engage in SRBs. Interventions designed to induce a positive change in attachment security may reduce SRBs among victims of neglect.     

Personality disorders, coping strategies, and posttraumatic stress disorder in women with histories of childhood sexual abuse

Using a treatment-seeking sample of adult female survivors of childhood sexual abuse, the relationships between coping strategies, personality disorders (PD) and Posttraumatic Stress Disorder (PTSD) were explored. A variety of PDs were found to exist in this population, with avoidant, antisocial, dependent PDs having higher frequencies than borderline PD. Avoidant coping and PTSD severity significantly correlated with many of these PDs. PTSD severity and avoidant coping were also significantly correlated. Additionally, women with PTSD displayed higher rates of avoidant and dependent PDs, as well as more avoidant coping, than did women without PTSD. Results support a more complex conceptualization of the trauma-related symptoms that occur in adult survivors of childhood sexual abuse that incorporate the relationships between avoidant coping, personality disorders, and PTSD.     

Boundary Ambiguity and Borderline Personality Traits: Implications for Treatment for Adolescent Girls in Foster Care

This article explores the relationship between boundary ambiguity and borderline personality traits in adolescent girls in foster care. Boundary ambiguity is a family systems concept: family members are uncertain about who is in or out of the family—in either psychological or physical presence or absence. In foster care, it can be assumed that an adolescent girl has experienced trauma significant enough to be removed from her family. The connection between early childhood trauma and attachment disruption in addition to the connection between insecure/disorganized attachment and borderline personality disorder leads to the conclusion that these same adolescents are at high risk for developing borderline personality traits. The sample consists of 40 caseworkers from New England’s child protection departments and therapists from residential programs working with adolescent girls. They completed the Shedler-Westen Assessment Procedure for Adolescents to determine the presence of personality disruption as well as a variation of Pauline Boss’s Boundary Ambiguity Scale #1, and demographic questionnaires. The results find a significant correlation between boundary ambiguity and borderline personality traits. These findings provide directions for future research in clinical treatment and child welfare policy making.     

An Explanatory Model of Dating Violence Risk Factors in Spanish Adolescents

Dating violence is a serious public health issue that needs further understanding in terms of risk factors that may be involved in it. The main goal of this study was to test a mediational model of dating violence risk factors. The sample was composed of 477 secondary and college students from Spain (59% females). A dynamic developmental explanatory model considering aggressiveness, insecure attachment, interparental conflict, and peer dating violence was tested using a multigroup structural equation model. Aggressiveness partially mediated the relation between anxious attachment and dating violence and fully mediated the association between interparental conflict resolution and dating violence. Furthermore, perceived peer dating violence was a direct predictor of dating violence. Implications for prevention and intervention plans are discussed.     

Early abuse experiences and subsequent gender differences in couple adjustment

The main purpose of the current study was to evaluate the relationship between early abusive experiences (sexual abuse, parental violence, and witnessing parental violence) and subsequent couple adjustment with a theoretical model that incorporates attachment and psychological distress as mediator variables. We specifically examined the variability in long-term psychosocial characteristics of child abuse survivors across women and men. A representative sample of French-Canadian couples composed of 632 men and women completed measures of child abuse, attachment, psychological distress, and dyadic adjustment. Structural equation analyses showed that, for both women and men, sexual abuse was related to dyadic adjustment through anxiety about abandonment and psychological distress. For men, experiencing physical or psychological violence was associated with dyadic adjustment through psychological distress. For women, there was an indirect relationship between witnessing physical violence and dyadic adjustment through abandonment anxiety. Differences between men and women in the long-term adjustment to childhood sexual abuse were small and not consistent with a gender-specific model of psychosocial repercussions.     

Forgiveness in Romantic Relationships: The Roles of Attachment,Empathy, and Attributions

Therapists can benefit from a more nuanced understanding of underlying processes associated with romantic partners forgiving one another. Greater understanding of the processes linked with forgiveness has the potential to improve therapists' facilitation of forgiveness between partners. Departing from the status quo, the purpose of this investigation was to explore benign attributions and empathy as mechanisms linking attachment with forgiveness. After conducting a longitudinal structural equation model with a sample of young adults in romantic relationships (N = 171), the results showed that benign attributions mediated the association between anxious attachment and forgiveness, and empathy mediated the association between avoidant attachment and forgiveness. Clinically, targeting working models of attachment that underlie benign attributions and empathy may facilitate forgiveness.     

Positive Interactions and Avoidant and Anxious Representations in Relationships with Parents,Friends, and Romantic Partners

We examined associations between positive interactions and avoidant and anxious representations in relationships with parents, friends, and romantic partners. Two hundred adolescents completed questionnaires, observations, and attachment interviews. From a between‐person perspective, those adolescents with more positive interactions overall had less avoidant representations. Within persons, the more positive interactions were relative to one's own average level in relationships, the less avoidant representations were for that type of relationship. Adolescents were less anxious about a particular type of relationship if they had positive interactions in their other types of relationships. Finally, representations were primarily predicted by interactions in the same type of relationship; interactions in other relationships contributed little. The findings underscore the importance of examining representations of particular types of relationships.     

Readiness to change, partner violence subtypes, and treatment outcomes among men in treatment for partner assault

Men court-mandated to attend a batterer's intervention program (BIP) were evaluated to determine whether pre-BIP readiness to change and the presence of partner violence subtypes predicted BIP completion, criminal recidivism, and postadjudication partner violence 6 months post-BIP. Of the 199 subject sample, 40% did not complete BIP. Four readiness-to-change clusters were found, with most men (76%) reporting change-resistant stages-of-change profiles. The partner violence typology reported by Holtzworth-Munroe et al. (2000) was supported with clustering into four subtypes: family only (FO), low-level antisocial (LLA), borderline/dysphoric (BD), and generally violent/antisocial (GVA). BIP completion was predicted by violence subtype (with BD and GVA more likely to drop out) but not by pre-BIP readiness to change. Men rearrested scored higher on the precontemplative stage of change and were more likely to be in the BD and GVA subtypes. Implications for counseling strategies are discussed.     

Co-Occurring Substance Use and Personality Disorders: Current Thinking on Etiology,Diagnosis, and Treatment

ABSTRACT

Despite the high prevalence of personality disorders among substance abusing individuals, the literature on these co-occurring disorders is limited. This paper reviews the literature and provides the most current data on the demographics, the criteria for diagnosing both personality disorders and substance use disorders, and the effects of substance abuse and co-occurring personality disorders, particularly antisocial and borderline, on prognoses and treatment approaches. Recommendations for further research on these co-occurring disorders are provided.     

Antisociality and intimate partner violence: the facilitating role of shame

Numerous theories classify distinct subtypes of men who perpetrate violence against female partners. These theories contend that a large portion of these men possess antisocial characteristics that may increase risk for violence. Affectively, these men have been found to externalize their emotions, including shame and guilt, and it has been suggested that this process contributes to the perpetration of partner violence. Therefore, this study sought to examine the role of shame and guilt in the association between antisociality and partner violence perpetration (i.e., psychological, physical, and sexual). Based on a sample of 423 undergraduate men, this study found that shame moderated the association between antisociality and partner violence perpetration such that as shame increases, the associations between antisociality and all three types of partner violence perpetration increase. These findings contribute to the theoretical understanding of typological models of partner violence and have clinical implications for batterer intervention programs.     

The Child in the Family of a Drug-Using Father: Attachment Styles and Family Characteristics

SUMMARY

The study examined the impact of family characteristics and parental attachment styles on the children of drug-using (DU) fathers in fifty-six families (n = 168) in Israel. Of the DU fathers, 60.7% were characterized by avoidant attachment style. Among the non-DU mothers, 53.6% were characterized by secure attachment style, 42.9% by avoidant style, and 3.6% by anxious/ambivalent style. Surprisingly, family cohesion and adaptability scores were similar to the Israeli norm, perhaps because the DUs had completed detoxification treatment and participated in rehabilitation programs. Of the children, 61.8% were characterized by secure attachment style, 21.8% by avoidant style, and 16.4% by anxious/ambivalent style. Stepwise regression to predict children's attachment styles revealed that maternal security of attachment and paternal anxious/ambivalent style predict similar attachment styles among the children. The important combined effects of spousal attachment styles on the children are discussed.     

The Role of Coping Strategies in Understanding the Relationship Between Parental Support and Psychological Outcomes in Anxious Youth

The current study examined the moderating role of coping strategies on psychological outcomes at varying levels of parental support in a sample of clinically anxious youth. Youth (N?=?174, mean age 11.89) completed the Children’s Coping Strategies Checklist, Child and Adolescent Social Support Scale, Multidimensional Anxiety Scale for Children and Children’s Depression Inventory. Data was gathered at a large, university-based anxiety disorders treatment clinic. This nonexperimental design analyzed the use of active and avoidant coping strategies as a moderator of anxiety and depression, while controlling for parental support. Results revealed active coping strategies did moderate the relationship between parental support and anxiety, however, not as expected while the significant moderation role of avoidance coping was mixed. Findings showed that anxious youth with more parental support and more active coping were at risk for higher levels of anxiety, yet protected from higher depression. Avoidant coping strategies did moderate in a manner that was predicted for higher anxiety symptoms. Results suggest increased need for parental involvement in the treatment of anxiety disorders in youth.     

An Empirical Study of Personality Disorders Among Treatment-Seeking Problem Gamblers

The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impulsivity, distress tolerance, substance use, PTSD symptoms, psychological distress and work/social adjustment) are associated with problem gambling. A secondary aim was to explore the strength of the relationships between these symptoms and problem gambling severity in problem gamblers with and without personality disorder pathology. Participants were 168 consecutively admitted problem gamblers seeking treatment from a specialist outpatient gambling service in Australia. The prevalence of personality disorders using the self-report version of the Iowa Personality Disorders Screen was 43.3 %. Cluster B personality disorders, but not Cluster A or C personality disorders, were associated with problem gambling severity. All psychological symptoms, except alcohol and drug use, were significantly higher among participants with personality disorder pathology compared to those without. Finally, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for problem gamblers with personality disorder pathology, while impulsivity, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for those without personality disorder pathology. High rates of comorbid personality disorders, particularly Cluster B disorders, necessitate routine screening in gambling treatment services. More complex psychological profiles may complicate treatment for problem gamblers with comorbid personality disorders. Future research should examine the applicability of the biosocial developmental model to problem gambling in community studies.     

Men who use violence: intimate violence versus non-intimate violence profiles

The current study examined the differences between three types of violent men based on Holtzworth-Munroe and Stuart's (1994) tripartite typology and a group of non-intimate violent men. First, a cluster analysis was conducted on a sample of 91 domestically violent men, resulting in three clusters that approximated the tripartite model for psychopathology as measured by the MMPI-2, that is, non-pathological, borderline/dysphoric, and antisocial. Based on the violence variables (i.e., severity of violence, family-only violence, and exposure to family of origin violence) only severity of violence approximated what would be expected across the three clusters, that is, the less the psychopathology, the less severe the violence. The other two violence variables had approximate frequencies/percentages of occurrence that would be expected for individual typologies with some but not all three typologies. In comparing the three intimate violent typologies to the non-intimate violent group, the non-intimate and non-pathological groups were within normal limits and did not differ significantly on any of the MMPI-2 scales. These non-intimate and non-pathological groups differed significantly from the antisocial and borderline/dysphoric groups on all the scales that defined the psychopathology of these two groups. On the violence variables, the non-intimate groups reported significantly less severe violence than the borderline/dysphoric and antisocial groups.     

A Typology of Maritally Violent Men and Correlates of Violence in a Community Sample

This study empirically tests A. Holtzworth‐Munroe and G. L. Stuart's (1994) typology of male batterers in a community sample. Latent class analyses based on severity of physical aggression, generality of violence, and psychopathology partially replicated the Holtzworth‐Munroe and Stuart typology by identifying 3 types of violent men: family‐only, medium‐violence, and generally violent/psychologically distressed. Separate groupings of borderline/dysphoric and generally violent/antisocial types were not found. In comparisons of batterer types to each other and to nonviolent men, generally violent/psychologically distressed men differed from other groups on psychological abuse, life stress, marital satisfaction, and attitudes about violence. Types also differed on wives' fearfulness of their husband and injury from marital aggression. Implications of conceptualizing marital violence from a multidimensional typology perspective are discussed.     

Borderline personality symptomatology and history of domestic violence among women in an internal medicine setting

In this study of primary care patients, we examined the relationship between a history of domestic violence (measured with the Severity of Violence Against Women Scale [SVAWS]) and borderline personality (measured with the Self-Harm Inventory [SHI] and the Personality Diagnostic Questionnaire-4 [PDQ-4]). We elected borderline personality for examination because several diagnostic criteria sets describe relationship features suggestive of partner abuse. In this study, both measures of borderline personality were highly related to each other (r = .73, p < .001) as well as to the SVAWS (r = .70, p < .001, for the SHI; r = .73, p < .001, for the PDQ-4). Using diagnostic cutoff scores on the measures for borderline personality, 64.0% of those with histories of domestic violence scored in the positive range on either or both measures, while only 11.1% of nonabused women did. We discuss the clinical implications of these findings.     

Female domestic violence offenders: their attachment security, trauma symptoms, and personality organization

Unlike male domestic violence offenders, female domestic violence offenders have traditionally been overlooked in research and theory, despite the fact that females also have high rates of domestic violence perpetration. Towards the aim of extending extant research on male and female pepetrators of domestic violence, we examined attachment style, trauma symptoms, and personality organization in 33 female offenders receiving mandated treatment for domestic violence. These offenders were compared to 32 nonoffending women receiving psychological treatment. The Experiences in Close Relationships Revised (ECR-Revised) was used to examine adult attachment, the Trauma Symptom Inventory (TSI) was used to examine trauma symptomology, and finally, the Millon Clinical Multiaxial Inventory III (MCMI-III) was used to examine cluster B personality traits. Analyses indicated that female domestic violence offenders reported less attachment security, more trauma-related symptoms, and more personality psychopathology (Antisocial, Borderline, and Dependent Subscales) than did nonoffender clinical comparison women.