11/25/23, 5:03 PM Adverse Childhood Experiences and Insecure Attachment

Psychology » Clinical Psychology

Adverse Childhood Experiences And Insecure

Attachment
By Saul Mcleod, PhD Updated on
Reviewed by Olivia Guy-Evans, MSc

Adverse Childhood Experiences (ACEs) refer to stressful or traumatic events that children face
before reaching 18. These include various forms of abuse (physical, emotional, sexual), neglect
(emotional, physical), and household challenges such as witnessing domestic violence, living with
substance abusers, having an incarcerated relative, or experiencing family separation.

Studies have shown that individuals with a high number of ACEs are at an increased risk for
negative outcomes in adulthood, including chronic diseases, mental illness, substance misuse,
and reduced life potential. The more ACEs one has, the greater the risk for these outcomes.

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Snyder, K. S., Luchner, A. F., & Tantleff-Dunn, S. (2023). Adverse childhood experiences
and insecure attachment: The indirect effects of dissociation and emotion regulation
difficulties. Psychological Trauma: Theory, Research, Practice, and Policy. Advance
online publication. https://doi.org/10.1037/tra0001532

Key Points
The study examined how dissociation and emotion regulation difficulties indirectly impact the
relationship between adverse childhood experiences (ACEs) and anxious and avoidant
attachment patterns in adulthood.

ACEs predicted anxious attachment through dissociation and emotion regulation difficulties.

ACEs predicted avoidant attachment through dissociation but not through emotion regulation
difficulties.

The results highlight the importance of dissociation and emotion regulation as factors
influencing insecure attachment patterns in adulthood after ACEs.

Limitations include the use of self-report measures, a cross-sectional rather than longitudinal
design, and a non-clinical sample.

Rationale
Past research shows links between ACEs and later difficulties like dissociation, emotion
regulation problems, and insecure attachment patterns (anxious and avoidant; Corcoran &
McNulty, 2018).

However, few studies have examined the specific indirect roles of dissociation and emotion
regulation together in explaining the relationship between ACEs and adult attachment insecurity,
especially in non-clinical groups (Hébert et al., 2018; Poole et al., 2018).

This study aimed to address this gap by exploring whether dissociation and emotion regulation
difficulties help explain how ACEs relate to anxious and avoidant attachment tendencies in
adulthood.

Understanding these connections better informs intervention and prevention efforts targeting
resilience after adversity.

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Method
Online questionnaire measuring key variables

Mediation analysis testing indirect effects

Variables: ACEs, dissociation, emotion regulation difficulties, adult attachment insecurity

Sample
253 adults from an online participant pool

18-77 years old (M = 33.05 years)

Mostly Caucasian (70%) and single (53.4%)

45.5% reported current/past mental health treatment

Statistical Analysis
Pearson correlations

Hayes’ (2013) PROCESS macro for mediation models

Bootstrapping with 10,000 samples to test for indirect effects

Results
In mediation modeling, dissociation and emotion regulation difficulties explained the link
between greater ACEs and increased anxious adult attachment when controlling for mental
health treatment.

Dissociation mediated the relationship between more adverse childhood experiences and
higher avoidant attachment in adulthood, but emotion regulation difficulties did not show this
significant mediating effect for avoidant attachment.

ACEs did not directly predict anxious nor avoidant attachment when accounting for the effects
of the mediators, suggesting the attachment insecurities are shaped by the
dissociation/regulation problems stemming from early adversity.

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Insight
This study uniquely demonstrates how both dissociation and emotion dysregulation together help
explain why adults exposed to adversity in childhood later struggle in close relationships, desiring
extreme closeness due to anxieties or avoiding intimacy altogether.

Even small psychological disruptions after adversity can accumulate and manifest interpersonal.

Strengths
Examined understudied explanatory roles of dissociation and emotion regulation together

Community sample extends literature beyond clinical groups

Highlighted adult attachment patterns as an outcome affected by childhood adversity

Limitations
Self-report measures prone to bias

Cross-sectional design prohibits causal conclusions

Non-clinical sample limits clinical interpretation

Implications
The findings suggest clinicians should assess dissociation, emotion regulation capacities, and
attachment styles when treating adults with childhood adversity histories.

Enhancing emotion regulation skills and resolving dissociative tendencies may mitigate later
social challenges. Prevention efforts with children should prioritize cultivating healthy
attachment relationships and building coping skills.

Conclusion
This study advances understanding of how early adversity disrupts developmental processes,
identifying new explanatory mechanisms for lasting interpersonal effects.

The mediating roles of dissociation and emotional dysregulation in linking adverse experiences to
adult attachment styles warrant further investigation, especially clinically.

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Future Research
Continued research on resilience factors fostering secure attachment after adversity is vital.
Though complex, making progress in mitigating the intergenerational effects of childhood
adversity remains imperative.

To build on this study, future research should utilize longitudinal designs tracking individuals
over time to establish temporal sequencing between early adversity, mediating factors like
dissociation and emotion dysregulation, and adult attachment outcomes.

Additionally, recruited samples should include wider demographic variability and specifically
target clinical populations with confirmed trauma histories to determine generalizability of the
mediation results.

Studies must move beyond self-reporting, incorporating clinician assessments, observational

measures of functioning, and physiological indicators of stress systems.

Treatment outcome research could also examine whether directly intervening to improve
emotion regulation abilities and resolve dissociative tendencies helps ameliorate insecure
attachment patterns following childhood adversity.

References

Primary Paper

Snyder, K. S., Luchner, A. F., & Tantleff-Dunn, S. (2023). Adverse childhood experiences
and insecure attachment: The indirect effects of dissociation and emotion regulation
difficulties. Psychological Trauma: Theory, Research, Practice, and Policy. Advance
online publication.

Other References
Corcoran, M., & McNulty, M. (2018). Examining the role of attachment in the relationship
between childhood adversity, psychological distress and subjective well-being. Child Abuse &
Neglect, 76, 297–309. https://doi.org/10.1016/j.chiabu.2017.11.012

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A

regression-based approach. Guilford Press.

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11/25/23, 5:03 PM Adverse Childhood Experiences and Insecure Attachment

Hébert, M., Langevin, R., & Oussaïd, E. (2018). Cumulative childhood trauma, emotion
regulation, dissociation, and behavior problems in school-aged sexual abuse victims. Journal of
Affective Disorders, 225, 1–20. https://doi.org/10.1016/j.jad.2017.08.044

Poole, J. C., Dobson, K. S., & Pusch, D. (2018). Do adverse childhood experiences predict adult
interpersonal difficulties? The role of emotion dysregulation. Child Abuse & Neglect, 80, 123–
133. https://doi.org/10.1016/j.chiabu.2018.03.006

Further Reading
Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004).
Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of
affective disorders, 82(2), 217-225.

Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003).
Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the
adverse childhood experiences study. Pediatrics, 111(3), 564-572.

Ehrenthal, J. C., Levy, K. N., Scott, L. N., & Granger, D. A. (2018). Attachment-related
regulatory processes moderate the impact of adverse childhood experiences on stress reaction
in borderline personality disorder. Journal of Personality Disorders, 32(Suppl.), 93–114.

Felitti, V. J. (2009). Adverse childhood experiences and adult health. Academic

pediatrics, 9(3), 131-132.

Hamai, T. A., & Felitti, V. J. (2022). Adverse childhood experiences: Past, present, and
future. Handbook of interpersonal violence and abuse across the lifespan: a project of the
national partnership to end interpersonal violence across the lifespan (NPEIV), 97-120.

Kong, S. S., Kang, D. R., Oh, M. J., & Kim, N. H. (2018). Attachment insecurity as a mediator of
the relationship between childhood trauma and adult dissociation. Journal of Trauma &
Dissociation, 19(2), 214–231.

Lavi, I., Katz, L. F., Ozer, E. J., & Gross, J. J. (2019). Emotion reactivity and regulation in
maltreated children: A meta-analysis. Child Development, 90(5), 1503–1524.

Murphy, A., Steele, M., Dube, S. R., Bate, J., Bonuck, K., Meissner, P., Goldman, H., & Steele,
H. (2014). Adverse childhood experiences (ACEs) questionnaire and adult attachment

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interview (AAI): Implications for parent child relationships. Child Abuse & Neglect, 38(2),224–
233.

Learning Check

1. What role might a person’s support system outside the family play in mediating
ACEs effects?

2. Could attachment insecurity and emotion dysregulation have bidirectional

impacts across development?

3. Might the study variables function differently across unexamined cultural

groups?

4. What inferences can reasonably be made applying these non-clinical white

sample findings to specialized clinical populations?

5. How might self-report measurement limitations related to psychological

constructs like dissociation impact interpretations?

Reviewer Author

Olivia Guy-Evans, MSc

BSc (Hons) Psychology, MSc Psychology of Education
Associate Editor for Simply Psychology

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously
worked in healthcare and educational sectors.

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