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Full-Length Research Report

Trauma and Attachment in Older Patients with Common Mental Disorders

Published Online:July 04, 2022https://doi.org/10.1024/1662-9647/a000294

Abstract

Abstract. The question of the consequences of earlier traumatic experiences in older age cannot be limited to a symptomatic level but should also include additional psychological functions. Of particular interest here is attachment orientation. The present study investigates the question of the connection between potentially traumatic events experienced in the course of life and attachment orientations in old age in a sample of patients of a psychosomatic clinic (N = 150). The results show that such events are associated with reduced attachment security in older adulthood. However, I could not confirm that this connection becomes more vital in old age. Nevertheless, the results also have a high clinical significance. Finally, I discuss the therapeutic consequences.

References

  • Adam, E. K., Hawkley, L. C., Kudielka, B. M., & Cacioppo, J. T. (2006). Day-to-day dynamics of experience–cortisol associations in a population-based sample of older adults. Proceedings of the National Academy of Sciences, 103(45), 17058–17063. First citation in articleCrossref, Google Scholar

  • Aiken, A. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Sage. First citation in articleGoogle Scholar

  • Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., Ausín, B., Canuto, A., Crawford, M., Da Ronch, C., Grassi, L., Hershkovitz, Y., Munoz, M., Quirk, A., Rotenstein, O., Belén Santos-Olmo, A., Shalev, A., Strehle, J., Weber, K., Wegscheider, K., Wittchen, H. U., & Härter, M. (2016). Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study. The British Journal of Psychiatry, 210(2), 125–131. https://doi.org/10.1192/bjp.bp.115.180463 First citation in articleCrossref, Google Scholar

  • Bachem, R., Levin, Y., & Solomon, S. (2018). Trajectories of attachment in older age: Interpersonal trauma and its consequences. Attachment & Human Development. https://doi.org/10.1080/14616734.2018.1479871 First citation in articleGoogle Scholar

  • Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2009). The first 10,000 Adult Attachment Interviews: Distributions of adult attachment representations in clinical and nonclinical groups. Attachment & Human Development, 11(3), 223–263. https://doi.org/10.1080/14616730902814762 First citation in articleCrossref, Google Scholar

  • Blanchard-Fields, F., Stein, R., & Watson, T. L. (2004). Age differences in emotion-regulation strategies in handling everyday problems. Journal of Gerontology: Psychological Sciences, 59B(6), 261–269. First citation in articleCrossref, Google Scholar

  • Bodner, E., & Cohen-Fridel, S. (2010). Relations between attachment styles, ageism and quality of life in late life. International Psychogeriatrics, 22, 1253–1361. First citation in articleGoogle Scholar

  • Böttche, M., Kuwert, P., & Knaevelsrud, C. (2011). Posttraumatic stress disorder in older adults: An overview of characteristics and treatment approaches. International Journal of Geriatric Psychiatry, 27, 230–239. First citation in articleCrossref, Google Scholar

  • Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748–766. First citation in articleCrossref, Google Scholar

  • Cicirelli, V. G. (2010). Attachment relationships in old age. Journal of Social and Personal Relationships, 27, 191–199. First citation in articleCrossref, Google Scholar

  • Collins, N. L., & Feeney, B. C. (2004). Working models of attachment shape perceptions of social support: Evidence from experimental and observational studies. Journal of Personality & Social Psychology, 87(3), 363–383. https://doi.org/10.1037/0022-3514.87.3.363 First citation in articleCrossref, Google Scholar

  • Consedine, N. S., & Fiori, K. L. (2009). Gender moderates the association between attachment and discrete emotions in late middle and late life. Aging & Mental Health, 13, 847–862. First citation in articleCrossref, Google Scholar

  • Consedine, N. S., Fiori, K. L., & Magai, C. (2012). Regulating emotion expression and regulating emotion experience: Divergent associations with dimensions of attachment among older women. Attachment & Human Development, 14(5), 477–500. First citation in articleCrossref, Google Scholar

  • Crowell, J. A., Fraley, R. Ch., & Roisman, G. I. (2018). Measurement of individual differences in adult attachment. In J. CassidyP. R. ShaverEds., Handbook of attachment. Theory, research and clinical applications (pp. 598–635). Guilford Press. First citation in articleGoogle Scholar

  • De Vries, G. J., & Olff, M. (2009). The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands. Journal of Traumatic Stress, 22(4), 259–267. https://doi.org/10.1002/jts.20429 First citation in articleCrossref, Google Scholar

  • Dinnen, S. T., Simiola, V., & Cook, J. M. (2015). Posttraumatic stress disorder in older adults: A systematic review of the psychotherapy treatment literature. Aging & Mental Health, 19(2), 144–150. First citation in articleCrossref, Google Scholar

  • Ehrenthal, J. C., Dinger, U., Lamla, A., Funken, B., & Schauenburg, H. (2009). Evaluation der deutschsprachigen Version des Bindungsfragebogens “Experiences in Close Relationships – Revised” (ECR-RD) [Evaluation of the German version of the Attachment Questionnaire “Experiences in Close Relationships – Revised” (ECR-RD)]. Psychotherapie & Psychosomatische Medizin, 59, 215–223. First citation in articleCrossref, Google Scholar

  • Fraley, R. Ch., Heffernan, M. E., & Brumgauh, M. E. (2011). The experiences in close relationships: Relationship structures. Psychological Assessment, 23(3), 615–625. First citation in articleCrossref, Google Scholar

  • Franz, C. E., Lyons, M. J., Spoon, K. M., Hauger, R. L., Jacobson, K. C., Lohr, J. B., & Kremen, W. S. (2014). Posttraumatic stress symptoms and adult attachment: A 24-year longitudinal study. The American Journal of Geriatric Psychiatry, 22(12), 1603–1612. First citation in articleCrossref, Google Scholar

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental-State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. First citation in articleCrossref, Google Scholar

  • Glaesmer, H., Sierau, S., & Böttche, M. (2020). Die Konsequenzen traumatischer Erfahrungen: Eine Lebensspannenperspektive [The consequences of traumatic experiences: A life span perspective]. Trauma & Gewalt, 14, 266–276. First citation in articleCrossref, Google Scholar

  • Jain, E., & Labouvie-Vief, G. (2010). Compensatory effects of emotion avoidance in adult development. Biological Psychology, 84, 497–513. First citation in articleCrossref, Google Scholar

  • Kooiman, C., Klaassens, E. R., Lugt, H., & Kamperman, A. M. (2013). Psychometrics and validity of the Dutch experiences in Close Relationships – Revised (ECR-R) in an outpatient mental health sample. Journal of Personality Assessment, 95(2), 217–224. First citation in articleCrossref, Google Scholar

  • Magai, C., Hunziker, J., Mesias, W., & Culver, L. (2000). Adult attachment styles and emotional biases. International Journal of Behavioral Development, 24, 301–309. First citation in articleCrossref, Google Scholar

  • Magai, C., Frias, M. T., & Shaver, P. R. (2018). Attachment in middle and later life. In J. CassidyP. R. ShaverEds., Handbook of attachment. Theory, research and clinical applications (pp. 534–553). Guilford Press. First citation in articleGoogle Scholar

  • Maercker, A. (2015). Belastungs- und Traumafolgestörungen [Stress and trauma disorders]. In A. MaerckerEd., Alterspsychotherapie und klinische Gerontopsychologie (pp. 182–204). Springer. First citation in articleCrossref, Google Scholar

  • Maercker, A., Forstmeier, S., Wagner, B., Glaesmer, H., & Brähler, E. (2008). Posttraumatische Belastungsstörungen in Deutschland [Post-traumatic stress disorders in Germany]. Nervenarzt, 79, 577–586. First citation in articleCrossref, Google Scholar

  • McCarthy, G., & Davies, S. (2003). Some implications of attachment theory for understanding psychological functioning in old age: An illustration from the long-term psychological effects of World War Two. Clinical Psychology and Psychotherapy, 10, 144–155. First citation in articleCrossref, Google Scholar

  • Mikulincer, M., & Shaver, P. R. (2018). Adult attachment and emotion regulation. In J. CassidyP. ShaverEds., Handbook of attachment (pp. 507–534). Guilford Press. First citation in articleGoogle Scholar

  • Ogle, C. M., Rubin, D. C., & Siegler, I. C. (2015). Cumulative exposure to traumatic events in older adults. Aging & Mental Health, 38(1), 316–325. First citation in articleGoogle Scholar

  • Ogle, C. M., Rubin, D. C., & Siegler, C. (2015). The relation between insecure attachment and posttraumatic stress: Early life versus adulthood traumas. Psychological Trauma, 7(4), 324–332. First citation in articleCrossref, Google Scholar

  • Palgi, Y., Shrira, A., & Shmotkin, D. (2016). Aging with trauma across the lifetime and experiencing trauma in old age: Vulnerability and resilience intertwined. In K. E. CherryEd., Traumatic stress and long-term recovery: Coping with disasters and other negative life events (pp. 293–308). Springer. First citation in articleGoogle Scholar

  • Palgi, Y., Bensimon, M., & Bodner, E. (2017). Motives of mentalization among older adults exposed in adulthood to potentially traumatic life events: A qualitative exploration. Traumatology, 23(4), 273–281. First citation in articleCrossref, Google Scholar

  • Pearse, E., Bucci, S., Raphael, J., & Berry, K. (2020). The relationship between attachment and functioning for people with serious mental illness: A systematic review. Nordic Journal of Psychiatry, 74(8), 545–557. https://doi.org/10.1080/08039488.2020.1767687 First citation in articleCrossref, Google Scholar

  • Peters, M. (2018). Das Trauma von Flucht und Vertreibung. Psychotherapie älterer Menschen und der nachfolgenden Generationen [The trauma of flight and expulsion]. Klett-Cotta. First citation in articleGoogle Scholar

  • Peters, M. (2019). Bindung und Alter. Entwicklungspsychologische Grundlagen und klinische Anwendung [Attachment and age. Developmental psychology basics and clinical application]. Psychodynamische Psychotherapie, 18, 193–211. First citation in articleGoogle Scholar

  • Peters, M. (2021a). Trauma and mentalization ability in older patients. An empirical contribution to the effect of trauma in old age. GeroPsych, 34(4), 189–201. https://doi.org/10.1024/1662-9647/a000267 First citation in articleLink, Google Scholar

  • Peters, M. (2021b). Psychische Erkrankungen im Alter – Empirische Befunde zur Theorie sekundärer Strukturdefizite [Mental illness in old age – Empirical findings on the theory of secondary structural deficits]. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 67, 451–467. First citation in articleCrossref, Google Scholar

  • Peters, M. (2021c). Mentalisierungsorientierte Psychotherapie im Alter [Mentalization-oriented psychotherapy in age]. Psychodynamische Psychotherapie, 20, 220–233. First citation in articleCrossref, Google Scholar

  • Peters, M. (2022). Ältere Patienten in der Psychosomatischen Klinik – Gesundheit, Bindung und Mentalisierung [Older patients in the psychosomatic clinic – Health, attachment and mentalization]. Psychotherapie Psychosomatik Medizinische Psychologie, 72, 1–11. First citation in articleGoogle Scholar

  • Peters, M., & Schulz, H. (2021). Theory-of-mind abilities in elderly patients with common mental disorders: A cross-sectional study. Aging and Mental Health. https://doi.org/10.1080/13607863.2021.1935461 First citation in articleCrossref, Google Scholar

  • Peters, M., Budde, A., Jeising, A., Lindner, J., & Schulz, H. (in press). Behandlungsergebnisse in der Psychosomatischen Rehabilitation – Die Hersfelder Katamnesestudie [Treatment outcomes in psychosomatic rehabilitation – The Hersfeld Catamnesis Study]. Die Rehabilitation. First citation in articleGoogle Scholar

  • Rabung, S., Harfst, T., Kawski, S., Koch, U., Wittchen, H.-U., & Schulz, H. (2009). Psychometrische Überprüfung einer verkürzten Version der “Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis” (HEALTH-49) [Psychometric testing of an abbreviated version of the “Hamburg modules for the assessment of general aspects of psychosocial health for therapeutic practice” (HEALTH-49)]. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 55(2), 162–179. https://doi.org/10.13109/zptm.2009.55.2.162 First citation in articleCrossref, Google Scholar

  • Radebold, H. (2006). Der dunkle Schatten der Vergangenheit [The dark shadow of the past]. Klett-Cotta. First citation in articleGoogle Scholar

  • Sable, P. (2000). Attachment and adult psychotherapy. Jason Aronson. First citation in articleGoogle Scholar

  • Sadavoy, J. (1997). Survivors: A review of the late-life effects of prior psychological trauma. The American Journal of Geriatric Psychiatry, 5, 287–301. First citation in articleCrossref, Google Scholar

  • Shrira, A. (2014). Greater age-related decline in markers of physical, mental and cognitive health among Israeli older adults exposed to lifetime cumulative adversity. Aging & Mental Health, 18(5), 610–618. First citation in articleCrossref, Google Scholar

  • Spence, R., Jacobs, C., & Bifulco, A. (2018). Attachment style, loneliness and depression in older age women. Aging & Mental Health, 24(5), 837–839. First citation in articleCrossref, Google Scholar

  • Spitzer, C., Barnow, S., Völzke, H., John, U., Freyberger, H. J., & Grabe, H. J. (2008). Trauma and posttraumatic stress disorder in the elderly: Findings from a German community study. Journal of Clinical Psychiatry, 69(5), 693–700. First citation in articleCrossref, Google Scholar

  • Strauß, B., & Schwark, B. (2007). Die Bindungstheorie und ihre Relevanz für die Psychotherapie [Attachment theory and its relevance for psychotherapy]. Psychotherapeut, 52, 405–425. First citation in articleCrossref, Google Scholar

  • Stoval-McClough, K., & Dozier, M. (2018). Attachment states of mind and psychopathology in adulthood. In J. CassidyP. R. ShaverEds., Handbook of attachment: Theory, research, and clinical applications (3rd ed., pp. 715–739). Guilford Press. First citation in articleGoogle Scholar

  • Tagay, S., & Senf, W. (2014). Essener Trauma-Inventar. Ein Verfahren zur Identifikation von traumatischen Ereignissen und Traumafolgestörungen [The Essen Trauma-Inventory (ETI) – A Screening instrument of identification of traumatic events and posttraumatic disorders]. Hogrefe. First citation in articleGoogle Scholar

  • Van Assche, L., Luyten, P., Bruffaerts, R., Persoons, Ph., van den Ven, L., & Vandenbulcke, M. (2013). Attachment in old age: Theoretical assumptions, empirical findings and implications for clinical practice. Clinical Psychology Review, 33, 67–81. First citation in articleCrossref, Google Scholar

  • Van Assche, L., van de Ven, L., Vandenbulcke, M., & Luyten, P. (2020). Ghost from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life. Aging & Mental Health, 24(6), 898–905. First citation in articleCrossref, Google Scholar

  • Van Zelst, W. H., de Beursc, A., Beekmana, T. F., Deega, D., & Dyckb, R. (2003). Prevalence and risk factors of posttraumatic stress disorder in older adults. Psychotherapy and Psychosomatics, 72, 333–342. First citation in articleCrossref, Google Scholar

  • Wallin, D. J. (2016). Bindung und Veränderung in der psychotherapeutischen Beziehung [Attachment in Psychotherapy]. Probst. First citation in articleGoogle Scholar

  • Zech, E., De Ree, F., Berenschot, F., & Stroebe, M. (2006). Depressive affect among health care seekers: How it is related to attachment style, emotional disclosure, and health complaints. Psychology, Health & Medicine, 11(1), 7–19. First citation in articleCrossref, Google Scholar