The role of attachment and social support for the psychological and physiological health of adolescents and young adults

Introduction: Extensive theoretical evidence has emphasized the benefits of social support for health, by attenuating the negative effects of stress; however, the empirical research is characterised by inconsistent and contradictory findings. Though scholars have begun to incorporate attachment theory to account for individual differences among the effects of support on health, this literature is still in its infancy, and specific gaps are yet to be addressed. To address these gaps, firstly, this thesis builds on the support literature to focus on the source and quality of social relationships by examining variations in attachment bonds across different relationship figures (i.e., parents, peers, and partners). Secondly, it explores the impact of relationships on both psychological and physiological health, paying particular attention to cardiovascular reactivity (CVR); an area not examined in research integrating support and attachment. Thirdly, it incorporates methodological advancements in attachment research by including traditional, discrete, categorisations (i.e., anxious, avoidant, and secure styles) of attachment, and a continuous, multi-dimensional approach. Finally, it focuses on transitional stages of development where individuals may be particularly vulnerable to stress, and where changes in relationship networks are most likely to occur. Methods: Three empirical studies are reported. Using a nationally representative sample of 7525 13-year-olds, Study 1 examined the quality of adolescents’ relationships with their parents and their peers as potential mediators explaining the association between stressful life events (SLEs) and psychological well-being. To build on the source and quality of relationships in Study 2 (N = 138), and moving towards physiological health, the association between attachment bonds to key relationship figures (mother, father, partner and best friend) and CVR were examined, with social support explored as a mediator. Finally, to experimentally test the interaction between attachment and social support on CVR, Study 3 (N = 138) manipulated the provision of support across individuals with secure, anxious and avoidant attachment styles. In both Study 2 and 3, young adults were subject to a standardized stress testing protocol where cardiovascular indices (systolic and diastolic blood pressure (SBP; DBP) and heart rate (HR)) were continuously monitored. Results: Study 1 showed that the negative association between SLEs and the psychological well-being of adolescents is mediated by peer relationship quality, but only for girls (i.e., more SLEs were associated with poorer quality relationships with peers, which in turn, was linked to lower levels of psychological well-being). Results from Study 2 showed that insecure attachment bonds was associated with lower CVR, with perceived support mediating this association (i.e., insecure attachment was linked to lower levels of perceived social support, which in turn, was associated with lower CVR). Interestingly, for anxious attachment, this was only noted for mother, father and best friend relationships, and only father and partner relationships, for avoidant attachment. Finally, in Study 3, contrary to our expectations, results from a factorial ANOVA showed no significant interaction between support and attachment on any CVR parameter (SBP, DBP, HR) or any main effect of attachment, or support. Conclusion: This research sets a foundation for recognising attachment as a potential ‘driving force’ behind the perceptions of support, and provides a valuable insight into the effectiveness of support as a protective factor for health. While we cannot conclusively determine which attachment style may benefit from, or is damaged by support, we point to future directions integrating the attachment and social support literatures which can provide further insights into the effects of social relationships for health.</p

Stressful life events and adolescent well-being: the role of parent and peer relationships

It is well established that stressful life events (e.g., family bereavements or moving to a new country) are damaging to psychological health and well-being. Indeed, social relationships are often noted as an important factor that can influence well-being and buffer the negative effects of stress. However, the quality and source of these relationships, particularly for adolescents, are often overlooked. Using the Growing Up in Ireland Survey, a population-based study of 13-year-old Irish adolescents (N = 7,525; 51.1% female), the current study examines the quality of both parent and peer relationships as potential mechanisms explaining the association between stressful life events and psychological well-being indices in adolescents. As expected, results showed that stressful life events negatively impacted the psychological well-being of adolescents. Parallel mediation analyses indicated that both parent and peer relationship quality mediated this association. Further exploratory analyses found that for girls, greater numbers of stressful life events were associated with poorer quality relationships with both their parents and peers, and in turn, these were linked to lower levels of psychological well-being. For boys, this effect was only evident for parental relationship quality, but not peers. The implication of these findings for adolescent's psychological well-being, particularly for girls, is discussed

Disruption to well-being activities and depressive symptoms during the COVID-19 pandemic: The mediational role of social connectedness and rumination

Background Disruption to everyday routine during the COVID-19 pandemic has resulted in considerable implications for global mental health. The inter- and intra-personal mechanisms by which disrupted routine can contribute to elevated depressive symptoms has not been well-explored. The present study aimed to examine how feelings of social (dis)connectedness and rumination, as a maladaptive coping strategy, could explain the association between disrupted well-being activities and depressive symptoms. Methods Participants (N = 496) ranging in age from 18 to 73 years (M = 28.73, SD = 10.93) completed an online survey within the first 3 months of the COVID-19 pandemic, which included measures of disruption to usual psychological and physical well-being activities, social connectedness, rumination, and depressive symptoms. Social connectedness and rumination were investigated as serial mediators of the association between disrupted well-being activities and depression using Hayes' PROCESS macro. Results 39.5% of the sample reported clinically significant levels of depression. Disruption to well-being activities predicted higher depressive symptoms, and this was partially explained by feelings of social disconnectedness and subsequent rumination. Rumination, alone, was not a significant mediator between disrupted routine and depressive symptoms. Limitations The cross-sectional survey design does not preclude the possibility of bidirectional effects. Conclusion The social distancing public health measures to combat COVID-19 have contributed to widespread disrupted routine, and in turn, elevated symptoms of depression. Social disconnectedness plays a particularly important role in this association. Intervention strategies should consider social factors as a ‘social cure’ for mass, positive mental health promotion during COVID-19.</p

PROTOCOL: Group‐based interventions for posttraumatic stress disorder: A systematic review and meta‐analysis of the role of trauma type

This is the protocol for a Campbell systematic review. The primary objective is to assess the effects of group‐based treatments on posttraumatic stress disorder (PTSD) symptomology in people diagnosed with PTSD (by a clinician or screening instrument) or referred to a PTSD treatment group for their symptoms by a medical professional. We will also examine a range of moderators that may affect the efficacy of group‐based treatments, including the nature of the trauma (inter-personal, stigmatized) and the group fit (in terms of gender and shared vs. unshared trauma). Further, we will also explore what, if any, group‐based and social identity factors are recorded and how they relate to PTSD outcomes.</p

Sexual violence and traumatic identity change: evidence of collective post-traumatic growth

Recent research indicates that social identities play a crucial role in the connection between adversity, post-traumatic stress, and overall psychological well-being. Understanding of how trauma influences collective dimensions of the self, positively or negatively, is limited. This study focuses on analysing publicly accessible narratives of four women who chose to waive their anonymity after the conviction of the men who had attacked and sexually assaulted them in Ireland. Thematic analysis highlighted two themes that signal (i) collective dimensions to this personal trauma, (ii) attempts to reconstruct social identities in the aftermath of trauma. Women presented their experiences as having the potential to amplify positive connections with others despite the wider embedded sociocultural understanding of sexual assault. These changes were associated with redefinition of social identities. Discussion highlights the potential for personal and intimate trauma to result in positive social identity change; a phenomenon that we label collective post-traumatic growth.</p