the contribution of adult attachment style on the experience of posttraumatic growth among adult ...

289 Pages·2016·3.96 MB·English

by  Kristina Nelson

THE CONTRIBUTION OF ADULT ATTACHMENT STYLE
ON THE EXPERIENCE OF POSTTRAUMATIC GROWTH
AMONG ADULT SURVIVORS OF CHILDHOOD SEXUAL ABUSE

by

KRISTINA M. NELSON
B.A. University of Central Florida, 2008
M.A. University of Central Florida, 2011

A dissertation submitted in fulfillment of the requirements
for the degree of Doctor of Philosophy
in the Department of Child, Family and Community Sciences
in the College of Education and Human Performance
at the University of Central Florida
Orlando, Florida

Summer Term
2016

Major Professor: W. Bryce Hagedorn
© 2016 Kristina M. Nelson

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ABSTRACT
The purpose of this research study was to investigate the directional relationship
between adults’ attachment styles and perceived impact of childhood sexual abuse (CSA)
with their experience of posttraumatic growth. This investigation tested the theoretical
model that adults’ (N = 292) attachment styles as measured by the Experiences in Close
Relationships-Short Form ([ECR-S] Wei et al., 2007) and impact of childhood sexual
abuse as measured by the Impact of Event Scale-revised ([IES-R] Weiss & Marmar,
1997) contributed to their experience of posttraumatic growth as measured by the
Posttraumatic Growth Inventory ([PTGI] Tedeschi & Calhoun, 1996). Specifically, this
investigation tested the hypothesized directional relationship that adult survivors of CSA
scoring in the insecure attachment range (i.e., avoidant or anxious) with higher levels of
trauma would have lower levels of posttraumatic growth. In addition, this investigation
examined the differences in relationship between adults’ attachment styles, perceived
impact of CSA, and posttraumatic growth based on their reported demographic
information (e.g., age, race, and gender).
The results of the structural equation model (SEM) analyses identified that trauma
experienced by adult survivors of CSA contributed to 39% of the variance in the
attachment style (p < .000; standardized coefficient = .63), and the mediating effect of
attachment style contributed to 8% of the variance in the presence of PTG (p < .05;
standardized coefficient -.31), while trauma showed to have no significant influence on
the presence of PTG in this sample (p = .756). Implications of the findings from the study
include insight (a) for counselors to better understand the experiences of adult survivors

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of CSA and areas to address in treatment; (b) for counselor educators to better prepare
future counselors to work with adult survivors of CSA; and (c) insight into the instrument
development of the ECR-S, IES-R, and PTGI.

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This work is dedicated to my loving and supportive husband, Jon,
and our three children, Gage, Briar, and Riggs.
Your love and support have carried me through this whole process.

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ACKNOWLEDGMENTS
I would like to thank my committee for their work on this dissertation and their
individual contributions to my growth as a counselor educator. To Dr. W. Bryce
Hagedorn, thank you for being a constant support and an inspiration to all you encounter.
I am continually inspired by your strong character and supportive nature. Thank you for
supporting and challenging me throughout my time at UCF. To Dr. Glenn Lambie, your
knowledge, work ethic, and consistent encouragement have supported me throughout this
process. Thank you for always being available to help me, talk with me, and support me
through this process. To Dr. K. Dayle Jones, thank you for being supportive and
encouraging throughout my coursework and the dissertation process. Your feedback and
guidance have been greatly appreciated. It has been a joy to have you with me on this
journey. Dr. Lihua Xu, thank you for your statistical support as I navigated the SEM
process. Thank you for all the time you spent helping me understand SEM and supporting
statistical procedures to ensure a strong study. Dr. Jennifer Foster, thank you for serving
on the committee, providing helpful feedback, and being an inspiration to me throughout
my time at UCF. Your consistent passion and dedication to enhancing the field of
counseling in the way of helping survivors of childhood sexual abuse is an inspiration to
others.
There are many others who helped me along the way. To Dr. Bryan Zugelder,
thank you for your consistent support and encouragement. You are an amazing leader,
and I have learned from and been inspired by you. Ms. Andrea Small and Mrs. Jorri
Bright, thank you for your consistent support, encouragement, and inspiring

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conversations. Your support has meant so much to me. To Dr. Renee Sherrell your
positive outlook and support have been an inspiration to me. Thank you for always being
available to talk with me, and offer helpful resources and support throughout the
dissertation process. The Rape, Abuse, and Incest National Network (RAINN), thank
you for administering surveys to the Speakers Bureau and helping me attain my sample. I
appreciate your support of my study.
To my family and friends, thank you for your love, support and encouragement
over the past three years. The cards, prayers, texts and phone calls to check in were
always uplifting.
Special thanks are in order to my husband, Jon, for your unwavering support,
understanding, and encouragement. Thank you for working three jobs to support our
family so that I could earn a Ph.D., and for being my rock through this process. Special
thanks are also in order to my three children, Gage, Briar, and Riggs, for providing
continuous support, encouragement, and prayers that helped me to earn the Ph.D. You all
believed in me even when I didn’t believe in myself, cheered me on when I got
discouraged, and provided strength. I could not have done this without you all.

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TABLE OF CONTENTS
LIST OF FIGURES .......................................................................................................... xii
LIST OF TABLES ........................................................................................................... xiii
CHAPTER 1 THE PROBLEM AND ITS CLARIFYING COMPONENTS .................... 1
Introduction ............................................................................................................. 1
Background of the Study ........................................................................................ 3
Personal Growth.......................................................................................... 5
Theoretical Framework ........................................................................................... 7
Perception of Trauma .................................................................................. 8
Posttraumatic Growth ................................................................................. 9
Attachment ................................................................................................ 10
Statement of the Problem ...................................................................................... 12
Research Questions & Hypotheses ....................................................................... 13
Primary Research Question....................................................................... 13
Primary Hypothesis ................................................................................... 13
Exploratory Research Question 1 ............................................................. 19
Exploratory Research Hypothesis 1 .......................................................... 19
Exploratory Research Question 2 ............................................................. 19
Exploratory Research Hypothesis 2 .......................................................... 19
Exploratory Research Question 3 ............................................................. 20
Exploratory Research Hypothesis 3 .......................................................... 20
Significance of the Study ...................................................................................... 20
Limitations ............................................................................................................ 21
Operational Definition of Terms ........................................................................... 23
Summary ............................................................................................................... 24
CHAPTER 2 REVIEW OF THE LITERATURE ............................................................ 25
Introduction ........................................................................................................... 25
Childhood Sexual Abuse (CSA) as Trauma ......................................................... 28
Childhood Sexual Abuse (CSA) and Posttraumatic Stress Disorder
(PTSD) ...................................................................................................... 29
Empirical Support for Perceptions of CSA as Traumatic ......................... 31
Posttraumatic Growth (PTG) ................................................................................ 32
History of Posttraumatic Growth (PTG) ................................................... 34
Posttraumatic Growth (PTG) Compared to Resilience ............................. 36
Theory of Posttraumatic Growth (PTG) ................................................... 37
Empirical Research on Posttraumatic Growth .......................................... 40
Overview of Attachment Theory .......................................................................... 43
Infant Attachment ..................................................................................... 44
Adult Attachment ...................................................................................... 46
Empirical Support for Attachment Theory ............................................... 49

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Child Sexual Abuse (CSA), Posttraumatic Growth (PTG), and Attachment ....... 51
Child Sexual Abuse (CSA) and Attachment ............................................. 52
Post Traumatic Growth (PTG) and Child Sexual Abuse (CSA)............... 60
Posttraumatic Growth (PTG) and Attachment .......................................... 66
Posttraumatic Growth (PTG), Child Sexual Abuse (CSA) PTG, and
Attachment ................................................................................................ 70
Summary ............................................................................................................... 72
CHAPTER 3 RESEARCH METHODOLOGY .............................................................. 73
Introduction ........................................................................................................... 73
Primary Research Question................................................................................... 74
Research Hypothesis ............................................................................................. 75
Exploratory Research Questions ........................................................................... 81
Hypotheses ............................................................................................................ 82
Variables ............................................................................................................... 83
Population and Sampling Procedures ....................................................... 86
Desired Sample Size ................................................................................. 88
Recruitment Procedures ............................................................................ 90
Data Collection Procedures ................................................................................... 91
Assessment Procedures ......................................................................................... 95
Instruments ............................................................................................................ 95
Posttraumatic Growth Inventory (PTGI) .................................................. 97
Experiences in Close Relationships-S (ECR-S) ..................................... 102
Impact of Event Scale-Revised (IES-R) ................................................. 107
Demographic Questionnaire ................................................................... 110
Data Analysis ...................................................................................................... 111
Limitations/Challenges ....................................................................................... 113
Research Design Limitations .................................................................. 113
Sampling Limitations .............................................................................. 113
Data Collection Limitations .................................................................... 114
Ethical Considerations ........................................................................................ 114
Summary ............................................................................................................. 115
CHAPTER 4 RESULTS ................................................................................................ 116
Introduction ......................................................................................................... 116
Descriptive Data Results ..................................................................................... 119
Response Rate ......................................................................................... 119
Participant Demographics ....................................................................... 120
Attachment Style ..................................................................................... 124
Impact of Event ....................................................................................... 124
Posttraumatic Growth ............................................................................. 125
Data Analysis for the Research Questions and Hypotheses ............................... 126
Statistical Assumptions and Data Screening....................................................... 126
Research Questions and Research Hypotheses ....................................... 130

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Pearson Correlations ............................................................................... 132
Mediation Analysis ................................................................................. 139
Model Specification and Identification ................................................... 141
Exploratory Research Questions ............................................................. 160
Summary ............................................................................................................. 172
CHAPTER 5 SUMMARY, DISCUSSION, AND RECOMMENDATIONS ............... 173
Introduction ......................................................................................................... 173
Summary of the Study ........................................................................................ 173
Theoretical Constructs ............................................................................ 174
Participants .............................................................................................. 176
Discussion of Findings ........................................................................................ 178
Primary Hypothesis Discussion .............................................................. 178
Exploratory Hypothesis 1 Discussion ..................................................... 187
Exploratory Hypothesis 2 Discussion ..................................................... 189
Exploratory Hypothesis 3 Discussion ..................................................... 192
Limitations of the Study...................................................................................... 195
Research Design Limitations .................................................................. 195
Sampling Limitations .............................................................................. 196
Instrumentation Limitations .................................................................... 198
Recommendations for Future Research .............................................................. 199
Implications......................................................................................................... 202
Counselor Implications ....................................................................................... 202
Counselor Education Implications .......................................................... 206
Theoretical Significance ......................................................................... 211
Instrument Development Implications .................................................... 212
Summary ............................................................................................................. 212
APPENDIX A COMMUNICATIONS WITH PARTICIPANTS ............................... 215
APPENDIX B INSTITUTIONAL REVIEW BOARD APPROVAL ......................... 223
APPENDIX C PSYCHOLOGICAL RESOURCES .................................................... 225
APPENDIX D GENERAL DEMOGRAPHIC QUESTIONNAIRE ........................... 227
APPENDIX E ADVERSE CHILDHOOD EXPERIENCES SCALE ......................... 231
APPENDIX F POSTTRAUMATIC GROWTH INVENTORY ................................. 233
APPENDIX G EXPERIENCES IN CLOSE RELATIONSHIPS SCALE SHORT
FORM ............................................................................................................................. 236
APPENDIX H IMPACT OF EVENT SCALE-REVISED .......................................... 238

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