The mediating role of coping on the relationship between attachment style and posttraumatic stress disorder among suicidal African American women.

摘要

The literature on clinical interventions for suicide prevention indicates that low-income, suicidal African American females are an historically underserved population. Contributing to this lack of service are the intersecting influences of race, ethnicity, culture, gender, sexual orientation, socioeconomic status and related oppressions (APA, 2007). In suicidal African American females, a higher level of reported symptoms of posttraumatic stress disorder has been found in suicide attempters as compared to nonattempters (Kaslow et al., 2000), and PTSD has been shown to be associated with heightened risk of an ensuing suicide attempt (Wilcox, Storr, & Breslau, 2009). One factor affecting manifestation of PTSD symptoms is attachment style. When a person with an insecure attachment style experiences a traumatic event(s), they are more likely to develop PTSD (Dieperink, Leskela, Thuras, & Engdahl, 2001). However, if effective coping methods are learned, more severe symptoms of PTSD are less likely (e.g., DeRoma et al., 2003; Johnsen, Eid, Laberg, & Thayer, 2002). Multiple studies examining the relationship between attachment style and coping find insecure attachment linked to poor coping skills (e.g., Schmidt, Nachtigall, Wuethrich-Martone, & Strauss, 2002; Yih-Lan, 2003). Those with insecure attachment styles are more likely to employ less effective coping methods leading to increased distress and interpersonal problems. However, there is research to support the possibility of insecure attachment style shifting to a more secure form, potentially through learning coping skills that offset maladaptive coping. This study examined the mediating role of coping on the relationship between attachment style and PTSD symptoms. One hundred and African American women enrolled in a project designed to understand the experiences of low income, African American women completed a Demographic Data Questionnaire, The Relationship Style Questionnaire (RSQ) (Griffin & Bartholomew, 1994), The Ways of Coping, Revised (Folkman & Lazarus, 1985), and The Posttraumatic Diagnostic Scale (PDS) (Foa, Cashman, Jaycox, & Perry, 1997). The relationships among factors were examined using Structural Equation Modeling. Results indicated a significant direct path between Insecure Attachment and PTSD Symptoms of moderately weak strength, between Insecure Attachment and Emotion-Focused Coping of moderate strength, and between Insecure Attachment and Problem-Focused Coping of moderately weak strength. However, neither Emotion-Focused nor Problem-Focused Coping mediated the relationship between Insecure Attachment and PTSD symptoms. Clinical implications, limitations of the study, and future directions are discussed in terms of these results.