Academic journal article European Journal of Psychotraumatology

The Role of Attachment in Recovery after a School-Shooting Trauma

Academic journal article European Journal of Psychotraumatology

The Role of Attachment in Recovery after a School-Shooting Trauma

Article excerpt


The role of attachment in recovery after a school-shooting trauma

Tuija Turunen1,2*, Henna Haravuori3,4, Raija-Leena Punamäki2, Laura Suomalainen3,5 and Mauri Marttunen3,6

1Hospital District of South Ostrobothnia, Seinäjoki, Finland; 2Department of Psychology, School of Social Sciences and Humanities, University of Tampere, Tampere, Finland; 3Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; 4Department of Psychiatry, Helsinki University Central Hospital, Peijas, Finland; 5Department of Adolescent Psychiatry, Helsinki University Central Hospital, Espoo, Finland; 6Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland


Background : Survivors of life-endangering trauma use varying resources that help them to recover. Attachment system activates in the times of distress, and is expected to associate with stress responses, arousal regulation, and mental health.

Objective : We examined the associations of attachment style with posttraumatic stress disorders (PTSD) symptoms and dissociative symptoms, and posttraumatic growth (PTG) among students exposed to a school shooting in Finland in a three-wave follow-up setting.

Method : Participants were students (M age=24.9 years; 95% female) who were followed 4 (T1, N =236), 16 (T2, N =180), and 28 months (T3, N =137) after the shooting. The assessments included the Attachment Style Questionnaire, the Impact of Event Scale, part of the Adolescent Dissociative Experiences Scale and the Posttraumatic Growth Inventory.

Results : Securely attached survivors had lower levels of posttraumatic stress and dissociative symptoms than preoccupied at T1 and T2 as hypothesized. At T3 survivors with avoidant attachment style had higher levels of intrusive and hyperarousal symptoms than those with secure style. Concerning PTG, survivors with avoidant attachment style scored lower in PTG at T3 than survivors with both secure and preoccupied style.

Conclusion : Secure attachment style was beneficial in trauma recovery. A challenge to the health care systems is to acknowledge that survivors with preoccupied and avoidant attachment styles react uniquely to trauma, and thus need help in different doses, modalities, and timings.

Keywords: Attachment style; school violence; dissociation; posttraumatic stress symptoms; posttraumatic growth

Responsible Editor: Grete Dyb, Norwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Norway.

*Correspondence to: Tuija Turunen, Hospital District of South Ostrobothnia, Huhtalantie 53, FI-60220 Seinäjoki, Finland, Email:

For the abstract or full text in other languages, please see Supplementary files under Article Tools online

This paper is part of the Special Issue: Understanding terror and violence in the lives of children and adolescents . More papers from this issue can be found at

Received: 30 August 2013; Revised: 3 January 2014; Accepted: 3 January 2014; Published: 2 July 2014

European Journal of Psychotraumatology 2014. © 2014 Tuija Turunen et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported (CC BY 4.0) License (, allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. …

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