Adult Separation Anxiety Disorder in Substance Use Disorder
The Role of Trauma and Attachment Styles in Mediating and Moderating Mechanisms
Bibliographic Data
| ID | 21645328 |
|---|---|
| Authors | Mustafa Kurt (0000-0002-2639-1850, Karadeniz Technical University, corresponding author), Ali Taşdemir (0000-0001-5014-9725, Adana Dr. Ekrem Tok Mental Health and Diseases Hospital) |
| Year | 2026 |
| Volume | 61 |
| Issue | 8 |
| Pages | 1221-1229 |
| Publication date | 2026-07-03 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Substance Use & Misuse (JOURNAL) |
| Journal identifiers | ISSN: 1082-6084 • E-ISSN: 1532-2491 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/10826084.2025.2601320 |
| PMID | 41430641 |
| OpenAlex | W7116910861 |
| Language | EN |
| References cited | 28 |
Objective Adult Separation Anxiety Disorder (ASAD) is a clinically significant yet understudied comorbidity in individuals with Substance Use Disorder (SUD). The study aimed to assess the comorbidity of ASAD in individuals with SUD and to examine the association of trauma and attachment to this relationship.Method This study included 168 inpatients diagnosed with SUD in an addiction treatment unit. Participants were assessed using self-report scales such as the Adult Separation Anxiety Questionnaire, Childhood Trauma Questionnaire, Three-Dimensional Attachment Style Scale, and Addiction Profile Index.Findings The SUD sample revealed prevalence of clinical ASAD (26.8%). ASAD severity was negatively correlated with secure attachment (r=-0.549, p < 0.001) and positively correlated with insecure attachment styles and addiction severity. Regression analysis confirmed that insecure attachment styles and emotional neglect independently predicted higher ASAD scores (p < 0.001). Mediation analysis was rejected; the direct effect of emotional neglect on clinical ASAD remained significant (OR = 1.11, p = 0.038), indicating a parallel risk path. Moderation analysis revealed that secure attachment significantly reduced the negative impact of emotional neglect on ASAD (β=-0.09, p = 0.026).Conclusion This study suggests that ASAD is not merely a comorbid condition in SUD but a important emotional regulation mechanism associated with the maintenance of addiction. The results support the parallel risk model in which emotional neglect appears to be independently associated with ASAD risk. Clinically, interventions that focus solely on reducing substance use may be insufficient; instead, therapies that enhance secure attachment skills and emotional regulation processes may be crucial to improving treatment outcomes and reducing the risk of relapse
Anxiety · Attachment theory · Neglect · Psychological intervention · Substance abuse · Substance use · Attachment and Relationship Dynamics · Child Abuse and Trauma · Posttraumatic Stress Disorder Research
Diagnostic and Statistical Manual of Mental Disorders
Self-medication with alcohol or drugs for mood and anxiety disorders
A network theory of mental disorders
Attachment Patterns in Subjects Diagnosed With a Substance Use Disorder
Childhood Trauma, Personality, and Substance Use Disorder
Psychobiology of Attachment and Trauma—Some General Remarks From a Clinical Perspective
Early social deprivation and the social buffering of cortisol stress responses in late childhood
Beyond diathesis stress
A meta-analysis of longitudinal associations between substance use and interpersonal attachment security
| Citation velocity | historical |
|---|---|
| Highly cited | No |