Study of the Association Between the Type of Attachment and the Risk of Post-Traumatic Stress Disorder (TRAUMAFFECT)

Study of the Association Between the Type of Attachment and the Risk of Post-Traumatic Stress Disorder: A Prospective Cohort Study in the Forensic Medicine Department of the Hospices Civils de Lyon

Attachment theory models the emotional bonding that is activated in situations of danger, via mental representations of self and others. Four types of attachment (TA) exist in adults: 3 insecure (Preoccupied, Detached, Fearful) and 1 secure. Attachment type is a major factor in the development of Post-Traumatic Stress Disorder (PTSD), a frequent and disabling mental disorder that occurs after a traumatic event. A meta-analysis based on Anglo-Saxon studies including various populations (general, military or clinical) (n=9268 patients) suggested an association between Fearful BP and high level of PTSD symptoms (r=0.44). Nevertheless, these results did not allow the identification of variations related to the individual risk factors (RDFs) of the subject and his environment, especially in the French socio-cultural context. The investigators propose to study the association between LDs and the risk of PTSD in the days following exposure, their mutual influence in the months following, and their associated factors. Thus, a prospective cohort study among French adult victims of a traumatic event could objectify the link between BP - as close as possible to the event - and the risk of PTSD.

Study Overview

• Status: Completed
• Conditions: Post-Traumatic Stress Disorder
• Intervention / Treatment: Diagnostic test: self-questionnaires on attachment and PTSD

• Study Type: Observational
• Enrollment (Actual): 268

Contacts and Locations

Study Locations

• France
  • Lyon, France, 69003
    • Service de médecine et santé au travail des HCL

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Having experienced a Potentially Traumatic Event within 3 days and according to DSM5 criterion A: Exposure to actual or potential death, serious injury, or sexual violence in one (or more) of the following ways: Directly experiencing the traumatic event, witnessing the event in person by others, learning that the traumatic event (violent or accidental) was experienced by a close family member or friend, experiencing repeated or extreme exposure to the harrowing details of the traumatic event (e.g., first responders or police officers) (exposure through electronic media, television, films, or photographs, if the exposure is work-related)

Description

Inclusion Criteria:

• Major patient
• Having experienced a Potentially Traumatic Event within 3 days and according to DSM5 criterion A: Exposure to actual or potential death, serious injury, or sexual violence in one (or more) of the following ways: Directly experiencing the traumatic event, witnessing the event in person by others, learning that the traumatic event (violent or accidental) was experienced by a close family member or friend, experiencing repeated or extreme exposure to the harrowing details of the traumatic event (e.g., first responders or police officers) (exposure through electronic media, television, films, or photographs, if the exposure is work-related)
• Good understanding of oral and written French
• Having given written consent
• Patient affiliated to a social security scheme

Exclusion Criteria:

• Psychiatric pathology with current clinical instability (agitation, maladaptive consciousness...) or patient unable to understand questionnaires
• Vulnerable adult (curatorship, guardianship)
• Non French resident

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Experiences in Close Relationships-Revised (ECR-R) attachment questionnaire	Type of attachment Disorder will be measured at inclusion by the ECR-R attachment questionnaire. Each item is rated on a 7-point scale where 1 = strongly disagree and 7 = strongly agree.	Day 30
Questionnaire Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)	Risk of developing Post Traumatic Stress Disorder. Items are rated on a 5 point scale. The maximum score is 80.	Day 30
Correlation between Questionnaire PCL-5 AND ECR-R attachment questionnaire	Correlation of outcome 1 and outcome 2	Day 30

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Questionnaire Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)	Risk of Post-Traumatic Stress Disorder at 90 days. Items are rated on a 5 point scale. The maximum score is 80.	Day 90
Questionnaire Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)	Type of attachment. Items are rated on a 5 point scale. The maximum score is 80.	Day 90
Correlation between PCL-5 questionnaire.And PCL-5 questionnaire.at D90	Correlation between the type of attachment and the risk of Post-Traumatic Stress Disorder	Day 90
Relationship Scales Questionnaire (RSQ)	30-item self-questionnaire that categorizes participants into four categories of attachment (secure or autonomous, avoiding or detached, preoccupied or ambivalent, fearful or disorganized)	Day 3
Relationship Scales Questionnaire (RSQ)	30-item self-questionnaire that categorizes participants into four categories of attachment (secure or autonomous, avoiding or detached, preoccupied or ambivalent, fearful or disorganized)	Day 30
Relationship Scales Questionnaire (RSQ)	Measure of Psychometric performance; 30-item self-questionnaire that categorizes participants into four categories of attachment (secure or autonomous, avoiding or detached, preoccupied or ambivalent, fearful or disorganized)	Day 90
Experiences in Close Relationships-Revised (ECR-R) attachment questionnaire	Attachment Type. Each item is rated on a 7-point scale where 1 = strongly disagree and 7 = strongly agree	Day 3
Experiences in Close Relationships-Revised (ECR-R) attachment questionnaire	Attachment Type. Each item is rated on a 7-point scale where 1 = strongly disagree and 7 = strongly agree	Day 30
Experiences in Close Relationships-Revised (ECR-R) attachment questionnaire	Attachment Type. Each item is rated on a 7-point scale where 1 = strongly disagree and 7 = strongly agree	Day 90
Questionnaire Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)	Risk of Post Traumatic Stress Disorder (D90). Items are rated on a 5 point scale. The maximum score is 80.	Day 90
Impact of Event Scale Revised	The IES-R consists of a list of 22 symptoms of PTSD. The person indicates the intensity with which each symptom has manifested itself over the past 7 days, by self-reporting their response on a 5-point Lykert-type scale, ranging from 0 ("Not at all") to 4 ( "Extremely"). The total IES-R score is calculated by adding the values obtained for the 22 items (scores 0-88).	Day 3
Relationship Scales Questionnaire (RSQ)	30-item self-questionnaire that categorizes participants into four categories of attachment (secure or autonomous, avoiding or detached, preoccupied or ambivalent, fearful or disorganized)	Day 90

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon
• Investigators: Principal Investigator: Ludivine NOHALES, MD, Service de médecine et santé au travail des HCL

Study record dates

Study Major Dates

• Study Start (Actual): March 23, 2022
• Primary Completion (Actual): November 7, 2024
• Study Completion (Actual): November 7, 2024

Study Registration Dates

• First Submitted: July 19, 2021
• First Submitted That Met QC Criteria: August 19, 2021
• First Posted (Actual): August 25, 2021

Study Record Updates

• Last Update Posted (Estimated): November 25, 2024
• Last Update Submitted That Met QC Criteria: November 21, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: PTSD; risk factor; Attachment
• Additional Relevant MeSH Terms: Trauma and Stressor Related Disorders; Mental Disorders; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
• Other Study ID Numbers: 69HCL20_0814

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No