Posttraumatic Stress Disorder in Adulthood After the Experience of Childhood Maltreatment: Does Attachment to Foster or Biological Parents Make a Difference?

Objective: Childhood maltreatment (CM) is associated with disorganized attachment which, in turn, is linked to a range of negative outcomes including posttraumatic stress disorder (PTSD). When maltreatment within the family leads to out-of-home placement, examining the effects of multiple attachment relationships on children's outcomes seems appropriate. This study examined whether (a) attachment to each biological parent mediates the association between CM and PTSD and whether (b) attachment to a foster parent mitigates the effects of CM and of attachment to biological parents on PTSD. Method: Ninety-six adults placed during childhood responded to the Attachment Multiple Model Interview to assess attachment to each biological parent and to the foster parent, the Mini International Neuropsychiatric Interview for PTSD, and the Childhood Trauma Questionnaire for CM. Past records were used to substantiate responses on factual information regarding CM. Results: Partial Least Squares Path Modeling analyses show that (a) attachment (insecurity and disorganization) with the biological mother partially mediates the link between maltreatment and PTSD and that (b) attachment to the foster parent moderates the link between attachment to the mother and PTSD. Although attachment insecurity to the father is associated with maltreatment severity, it does not mediate its effect on PTSD. Conclusions: Findings suggest that secure and organized attachment with the mother or with an alternative caregiver is associated with a reduced risk of PTSD following maltreatment.