Attachment Orientations Mediate the Effect of World Assumptions on Posttraumatic Stress in Survivors of Childhood Sexual Abuse

Recent research indicates that world assumptions are broad cognitive-affective schemas that affect attachment orientations in close relationships which in turn affect psychological symptoms severity. The present study analyzed if adult attachment mediated the effect of world assumptions (worthiness of the self, benevolence and meaningfulness of the world) on PTSD symptoms (PTS), in survivors of childhood sexual abuse during treatment for PTSD. Sample included 327 individuals who were sexually abused in childhood. Variables were assessed using self-report measures. Structural equation modeling was conducted to examine if the effect of world assumptions at the beginning of psychotherapeutic treatment (T1) on PTS levels 12 months after the beginning of psychotherapeutic treatment (T3) was mediated by both attachment avoidance and attachment anxiety six months after the beginning of treatment (T2). Attachment avoidance fully mediated the effect of both worthiness of the self and benevolence of the world at T1 on PTS at T3 was mediated by both attachment anxiety and attachment avoidance at T2. Findings suggest that world assumptions are broad cognitive-affective schemas about the self and the world that have their actual expression in close relationships which mediate the effect of world assumptions on PTS levels.