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Does Attachment Mediate PTSD and Suicidality in a Sample of Global War on Terrorism (GWOT) Combat Veterans? Cover

Does Attachment Mediate PTSD and Suicidality in a Sample of Global War on Terrorism (GWOT) Combat Veterans?

Open Access
|May 2022

Figures & Tables

Table 1

Sample Demographics.

CHARACTERISTICSAMPLE
Age (Years)
    Mean37.34
    Median35.50
    SD8.73
    Range42
Time in Service (Years)
    Mean8.68
    Median6.25
    SD6.39
    Range35–58
Branch of Military N (%)
    Air Force9 (13.8%)
    Army34 (52.3%)
    Navy6 (9.2%)
    Marine Corps14 (21.5%)
    Coast Guard1 (1.5%)
    Two or more1 (1.5%)
Component of Military
    Active7 (10.8%)
    Discharged45 (69.2%)
    Reserve3 (4.6%)
    Retired10 (15.4%)
Number of Deployments
    One35 (53.8%)
    Two18 (27.7%)
    Three5 (7.7%)
    Four3 (4.6%)
    Five or more4 (6.2%)
Gender N (%)
    Female13 (20.0%)
    Male52 (80.0%)
Ethnicity (%)
    African American/Black5 (7.7%)
    Latino(a)/Hispanic8 (12.3%)
    Multiple Ethnicities4 (6.2%)
    White48 (73.8%)
Table 2

Mental Health Assessment Correlations.

ECR-AVOIDECR-ANXPCL-5SBQ-RGAD-7PHQ-9
ECR-AVOID1.1538**.07.29*.28*
ECR- ANX1.31*.12.20.17
PCL-51.40**.70***.78***
SBQ-R1.34**.39**
GAD-71.84***
PHQ-91

[i] Note: ECR-AVOID= Experiences in Close Relationships avoidant secondary strategy. ECR-ANX= Experiences in Close Relationships anxiety secondary strategy. PHQ-9 = Patient Health Questionnaire-9. PCL-5 = PTSD Checklist-5. GAD-7 = Generalized Anxiety Disorder-7. SBQ-R = Suicidal Behaviors Questionnaire-Revised. *** p < .001 (two tailed) ** p < .01 (two tailed), * p < .05 (two tailed).

Table 3

Attachment Avoidance as the Mediating Variable to PTSD.

MODELCoef.SEtpR2Adj. R2Fdf1df2
Model 1: attachment anxiety as a covariate
    IV (SBQ-R) to mediator (a path).02.04.40.70
    Direct effect of mediator on DV (b path)5.061.673.03.004
    Total effect of IV on DV (c path)1.88.583.24.002
    Direct effect of IV on DV (c’ path)1.80.553.29.002
    Partial effect of control variable on DV
        Attachment anxiety4.081.942.10.04
        Model Summary.001.23.209.13262
Model 2: attachment anxiety as a covariate
    IV (GAD-7) to mediator (a path).06.032.20.03
    Direct effect of mediator on DV (b path)2.761.421.94.06
    Total effect of IV on DV (c path)2.34.327.36.001
    Direct effect of IV on DV (c’ path)2.17.326.72.001
    Partial effect of control variable on DV
        Attachment anxiety3.241.641.97.05
        Model Summary.001.52.5033.31262
Model 3: attachment anxiety as a covariate
    IV (PHQ-9) to mediator (a path).05.022.11.04
    Direct effect of mediator on DV (b path)2.491.232.02.05
    Total effect of IV on DV (c path)2.28.249.53.001
    Direct effect of IV on DV (c’ path)2.16.248.91.001
    Partial effect of control variable on DV
        Attachment anxiety3.381.422.38.02
        Model Summary.001.63.6253.66262

[i] Note: DV = Dependent Variable. SBQ-R = Suicidal Behaviors Questionnaire-Revised. GAD-7 = Generalized Anxiety Disorder-7. PHQ-9 = Patient Health Questionnaire-9.

Table 4

Attachment Anxiety as the Mediating Variable to PTSD.

MODELCoef.SEtpR2Adj. R2Fdf1df2
Model 1: attachment avoidance as a covariate
    IV (SBQ-R) to mediator (a path).03.04.86.39
    Direct effect of mediator on DV (b path)4.081.942.10.04
    Total effect of IV on DV (c path)1.93.563.44.001
    Direct effect of IV on DV (c’ path)1.80.553.29.002
    Partial effect of control variable on DV
        Attachment avoidance5.551.703.27.002
        Model Summary.001.28.259.95262
Model 2: attachment avoidance as a covariate
    IV (GAD-7) to mediator (a path).03.031.35.18
    Direct effect of mediator on DV (b path)2.951.611.83.07
    Total effect of IV on DV (c path)2.27.327.00.001
    Direct effect of IV on DV (c’ path)2.17.326.72.001
    Partial effect of control variable on DV
        Attachment avoidance3.011.452.08.04
        Model Summary.001.52.5133.73262
Model 3: attachment avoidance as a covariate
    IV (PHQ-9) to mediator (a path).02.021.08.28
    Direct effect of mediator on DV (b path)3.081.402.21.03
    Total effect of IV on DV (c path)2.23.259.02.001
    Direct effect of IV on DV (c’ path)2.16.248.91.001
    Partial effect of control variable on DV
        Attachment avoidance2.781.272.19.03
        Model Summary.001.63.6252.63262

[i] Note: DV = Dependent Variable. SBQ-R = Suicidal Behaviors Questionnaire-Revised. GAD-7 = Generalized Anxiety Disorder-7. PHQ-9 = Patient Health Questionnaire-9.

Table 5

Attachment Avoidance as the Mediating Variable to Suicidality.

MODELCoef.SEtpR2Adj.R2Fdf1df2
Model 1: attachment anxiety as a covariate
    IV (PCL5) to mediator (a path).02.012.97.004
    Direct effect of mediator on DV (b path)–.29.38–.76.45
    Total effect of IV on DV (c path).08.023.24.002
    Direct effect of IV on DV (c’ path).08.033.29.002
    Partial effect of control variable on DV
        Attachment anxiety–.02.43–.05.96
        Model Summary.01.16.135.74262
Model 2: attachment anxiety as a covariate
    IV (GAD-7) to mediator (a path).06.032.20.03
    Direct effect of mediator on DV (b path)–.13.38–.33.74
    Total effect of IV on DV (c path).23.082.75.01
    Direct effect of IV on DV (c’ path).24.092.71.01
    Partial effect of control variable on DV
        Attachment anxiety.18.43.41.68
        Model Summary.02.12.094.25262
Model 3: attachment anxiety as a covariate
    IV (PHQ-9) to mediator (a path).05.022.11.04
    Direct effect of mediator on DV (b path)–.16.37–.42.68
    Total effect of IV on DV (c path).23.073.24.002
    Direct effect of IV on DV (c’ path).24.073.22.002
    Partial effect of control variable on DV
        Attachment anxiety.18.42.44.66
        Model Summary.01.16.135.76262

[i] Note: DV = Dependent Variable. PCL-5 = PTSD Checklist-5. GAD-7 = Generalized Anxiety Disorder-7. PHQ-9 = Patient Health Questionnaire-9.

Table 6

Attachment Anxiety as the Mediating Variable to Suicidality.

MODELCoef.SEtpR2Adj. R2Fdf1df2
Model 1: attachment avoidance as a covariate
    IV (PCL5) to mediator (a path).02.012.30.03
    Direct effect of mediator on DV (b path)–.01.43–.03.98
    Total effect of IV on DV (c path).08.023.44.001
    Direct effect of IV on DV (c’ path).08.033.29.002
    Partial effect of control variable on DV
        Attachment avoidance–.29.38–.77.44
        Model Summary (try to put this in the text).01.16.146.09262
Model 2: attachment avoidance as a covariate
    IV (GAD-7) to mediator (a path).03.031.35.18
    Direct effect of mediator on DV (b path).19.43.44.66
    Total effect of IV on DV (c path).24.082.85.01
    Direct effect of IV on DV (c’ path).24.092.71.01
    Partial effect of control variable on DV
        Attachment avoidance–.11.38–.29.77
        Model Summary (try to put this in the text).02.12.094.21262
Model 3: attachment avoidance as a covariate
    IV (PHQ-9) to mediator (a path).02.021.08.28
    Direct effect of mediator on DV (b path).20.42.48.63
    Total effect of IV on DV (c path).24.073.34.001
    Direct effect of IV on DV (c’ path).24.073.22.002
    Partial effect of control variable on DV
        Attachment avoidance–.14.37–.38.71
        Model Summary (try to put this in the text).01.16.135.73262

[i] Note: DV = Dependent Variable. PCL-5 = PTSD Checklist-5. GAD-7 = Generalized Anxiety Disorder-7. PHQ-9 = Patient Health Questionnaire-9.

Figure 1

Suicidality Parallel Mediation Model.

Note: (N = 65) Attachment Avoidance = Experiences in Close Relationships avoidant secondary strategy. Attachment Anxiety = Experiences in Close Relationships anxiety secondary strategy. GAD-7 = Generalized Anxiety Disorder-7. Depression = Patient Health Questionnaire-9. PTSD = PTSD Checklist-5. Suicidality = Suicidal Behaviors Questionnaire-Revised. Path c’ = direct effect. All coefficients are unstandardized. * p < .05, ** p < .01, *** p < .001.

Figure 2

PTSD Parallel Mediation Model.

Note: (N = 65) Attachment Avoidance = Experiences in Close Relationships avoidant secondary strategy. Attachment Anxiety = Experiences in Close Relationships anxiety secondary strategy. GAD-7 = Generalized Anxiety Disorder-7. Depression = Patient Health Questionnaire-9. PTSD = PTSD Checklist-5. Suicidality = Suicidal Behaviors Questionnaire-Revised. Path c’ = direct effect. All coefficients are unstandardized. * p < .05, ** p < .01, *** p < .001.

Language: English
Page range: 208 - 221
Submitted on: Jul 20, 2021
Accepted on: Apr 4, 2022
Published on: May 30, 2022
Published by: Virginia Tech Publishing
In partnership with: Paradigm Publishing Services

© 2022 Jose Carbajal, Warren N. Ponder, published by Virginia Tech Publishing
This work is licensed under the Creative Commons Attribution 4.0 License.