Investigating the Relationship between Trauma, Attachment, Rejection Sensitivity, Interpersonal Relationships: The Mediating Role of Mentalization in Women and Men Referring to Psychology and Counseling Clinics
Objective: Individuals seeking help at psychology clinics often encounter complicated problems that can offer valuable perspectives on the factors influencing mental well-being and interpersonal relationships. The goal of this study was to investigate how trauma, attachment issues, and rejection sensitivity impact interpersonal relationships, and how mentalization plays a role in mediating these effects among both male and female clients at psychology and counseling clinics.
Methods and Materials: The current research was a descriptive-correlational study utilizing a cross-sectional research design. The structural model method and path analysis were employed to investigate the impact of the mediator variable. The statistical population for this study comprised all male and female individuals seeking services at psychology and counseling clinics in Tehran from July to October 2023 (Male (%49.7) and female (%50.3)). A total of 191 participants were randomly selected to form the statistical sample. Research instruments utilized in this study included the Revised Adult Attachment Scale (RAAS), Childhood Trauma Questionnaire (CTQ), Rejection Sensitivity Questionnaire (RSQ), Communication Skills Questionnaire (CSQ), and Reflective Function Questionnaire (RFQ). Data analysis was performed in the descriptive statistics and Pearson correlation section using SPSS version 27 software, and path analysis and model fitting were performed using SMARTPLS version 4. Statistical analysis was performed with a p-value of 0.05.
Findings: According to the study results, rejection sensitivity adversely affected interpersonal relationships through mentalization (β = -0.087, p = 0.002). Similarly, trauma was correlated to a detrimental impact on interpersonal relationships via mentalization (β = -0.132, p = 0.001). Additionally, research showed that individuals with an avoidant attachment style experienced significant negative consequences in their interpersonal relationships (β = -0.229, p = 0.001). On the other hand, mentalization was discovered to have a favorable impact on interpersonal relationships (β = 0.303, p < 0.001).
Conclusion: This research underscores the significance of mentalization and secure attachment style in enhancing interpersonal relationships and brings attention to the detrimental impact of rejection sensitivity and trauma. These results have the potential to assist psychologists and counselors in offering more efficient therapies through a focus on mentalization, attachment style, and minimizing the repercussions of trauma and rejection sensitivity.
Downloads
1. Araújo E, Santos A, Oliveira C, Cruz OS, Moreira D. Beliefs and Violent Behavior in Interpersonal Relationships of Young Adults: A Systematic Review. International Journal of Environmental Research and Public Health. 2024 Nov 12;21(11):1500. https://doi.org/10.3390/ijerph21111500
2. Chen X, Huang B, Lin W. The effect of interpersonal relationship and epidemic attention on negative emotion among medical students: the mediating role of social satisfaction. BMC psychiatry. 2023 Aug 21;23(1):610. https://doi.org/10.1186/s12888-023-05113-z
3. Zhang X, Huang PF, Li BQ, Xu WJ, Li W, Zhou B. The influence of interpersonal relationships on school adaptation among Chinese university students during COVID-19 control period: Multiple mediating roles of social support and resilience. Journal of affective disorders. 2021 Apr 15;285:97-104. https://doi.org/10.1016/j.jad.2021.02.040
4. Zhao G, Wang M, Xu J, Lu J, Akezhuoli H, Wang F. Health status and association with interpersonal relationships among Chinese children from urban migrant to rural left-behind. Frontiers in Public Health. 2022 Mar 29;10:862219. https://doi.org/10.3389/fpubh.2022.862219
5. Saunders KR, McGuinness E, Barnett P, Foye U, Sears J, Carlisle S, Allman F, Tzouvara V, Schlief M, Vera San Juan N, Stuart R. A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care. BMC psychiatry. 2023 Aug 7;23(1):567. https://doi.org/10.1186/s12888-023-05016-z
6. Hardy A, Keen N, van den Berg D, Varese F, Longden E, Ward T, Brand RM. Trauma therapies for psychosis: A state‐of‐the‐art review. Psychology and Psychotherapy: Theory, Research and Practice. 2024 Mar;97(1):74-90. https://doi.org/10.1111/papt.12499
7. Liu H, Li TW, Liang L, Hou WK. Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis. Clinical Psychology Review. 2021 Nov 1;89:102069. https://doi.org/10.1016/j.cpr.2021.102069
8. Hughesdon KA, Ford JD, Briggs EC, Seng JS, Miller AL, Stoddard SA. Interpersonal trauma exposure and interpersonal problems in adolescent posttraumatic stress disorder. Journal of traumatic stress. 2021 Aug;34(4):733-43. https://doi.org/10.1002/jts.22687
9. Long M, Verbeke W, Ein-Dor T, Vrtička P. A functional neuro-anatomical model of human attachment (NAMA): Insights from first-and second-person social neuroscience. cortex. 2020 May 1;126:281-321. https://doi.org/10.1016/j.cortex.2020.01.010
10. Bosmans G, Bakermans-Kranenburg MJ, Vervliet B, Verhees MW, van IJzendoorn MH. A learning theory of attachment: Unraveling the black box of attachment development. Neuroscience & Biobehavioral Reviews. 2020 Jun 1;113:287-98. https://doi.org/10.1016/j.neubiorev.2020.03.014
11. Parada‐Fernández P, Herrero‐Fernández D, Oliva‐Macías M, Rohwer H. Analysis of the mediating effect of mentalization on the relationship between attachment styles and emotion dysregulation. Scandinavian Journal of Psychology. 2021 Jun;62(3):312-20. https://doi.org/10.1111/sjop.12717
12. Rasooli MZ. Comparing Interpersonal Problems and Attachment Styles in Adults With and Without Attention-Deficit/Hyperactivity Disorder. https://www.sid.ir/paper/1120947/fa#downloadbottom
13. Mishra M, Allen MS. Rejection sensitivity and romantic relationships: A systematic review and meta-analysis. Personality and Individual Differences. 2023 Jul 1;208:112186. https://doi.org/10.1016/j.paid.2023.112186
14. Sahi RS, Eisenberger NI. Why don’t you like me? The role of the mentalizing network in social rejection. The neural basis of mentalizing. 2021 May 12:613-28. https://doi.org/10.1007/978-3-030-51890-5_32
15. Hou Y, Li T. The Relationship Between Rejection Sensitivity and Dormitory Interpersonal Relations in Female College Students: The Mediating Effect of Coping Style. In2020 3rd International Seminar on Education Research and Social Science (ISERSS 2020) 2021 Jan 20 (pp. 181-186). Atlantis Press. 10.2991/assehr.k.210120.035
16. Ramadas L, Doba K, Mesquita AR, Wawrziczny É, Nandrino JL. Role of emotion regulation and mentalizing in rejection sensitivity: The specific relationship to potentially psychologically traumatic event. Personality and Individual Differences. 2024 Feb 1;218:112461. https://doi.org/10.1016/j.paid.2023.112461
17. Borroni S, Ruotolo G, Geminiani C, Masci E, Fossati A. DSM-5 Personality Dysfunction in a mentalization perspective: the interplay among personality dysfunction, emotion dysregulation and mentalization ability in a sample of Italian community dwelling-adults. Mediterranean Journal of Clinical Psychology. 2024;12(1):1-37. https://hdl.handle.net/20.500.11768/165296
18. Oehlman Forbes D, Lee M, Lakeman R. The role of mentalization in child psychotherapy, interpersonal trauma, and recovery: A scoping review. Psychotherapy. 2021 Mar;58(1):50. https://psycnet.apa.org/buy/2020-65098-001
19. Kumpasoğlu GB, Saunders R, Campbell C, Nolte T, Montague R, Pilling S, Leibowitz J, Fonagy P. Mentalizing, epistemic trust and interpersonal problems in emotion regulation: A sequential path analysis across common mental health disorders and community control samples. Journal of Affective Disorders. 2024 Dec 16. https://doi.org/10.1016/j.jad.2024.12.050
20. Cohen J. Statistical power analysis for the behavioral sciences. routledge; 2013 May 13. https://doi.org/10.4324/9780203771587
21. Collins NL. Revised adult attachment scale. Behavior therapy. 1996.https://psycnet.apa.org/doi/10.1037/t19162-000
22. Seyed Hashemi SG, Fathi Ahmadabadi Z, Yaghoubi H, Hosseinzadeh Khanmiri B, Shokrani R. Explaining hypersexual behaviors based on attachment styles, psychological dysregulation, and coping strategies in Iranian adolescents. Knowledge & Research in Applied Psychology. 2022 Aug 23;23(2):169-79. https://doi.org/10.30486/jsrp.2020.1892094.2278
23. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child abuse & neglect. 2003 Feb 1;27(2):169-90. https://doi.org/10.1016/S0145-2134(02)00541-0
24. Behrouzi H, Pakdaman M, Sahebdel H. Prediction of psychological security of secondary school students based on childhood trauma and cognitive errors. Rooyesh-e-Ravanshenasi Journal (RRJ). 2023 Oct 10;12(6):133-40. URL: http://frooyesh.ir/article-1-4728-en.html
25. Downey G, Feldman SI. Implications of rejection sensitivity for intimate relationships. Journal of personality and social psychology. 1996 Jun;70(6):1327. https://psycnet.apa.org/fulltext/1996-01769-019.html
26. Ebrahimi S, Mousavian Khatir SE. The mediating role of rejection sensitivity and self-esteem in relationship between mindfulness and psychological well-being among adolescents. Journal of Modern Psychological Researches. 2023 Feb 20;17(68):1-1. https://dorl.net/dor/20.1001.1.27173852.1401.17.68.17.1
27. Burton GE. Exercises in management. Houghton Mifflin; 1990.
28. Hosseini J, Hosseini SA, Dosti M. The relationship between communication skills and interpersonal relationships of sport managers in Guilan province. Sport Management and Development. 2014 Dec 31;3(2):91-104. https://jsmd.guilan.ac.ir/article_1224_en.html
29. Ha C, Sharp C, Ensink K, Fonagy P, Cirino P. The measurement of reflective function in adolescents with and without borderline traits. Journal of adolescence. 2013 Dec 1;36(6):1215-23. https://doi.org/10.1016/j.adolescence.2013.09.008
30. Asadi S S, Bakhshipour Roudsari A, Mahmoud Alilou M, Seyed Mousavi P S. The relationship between attachment security and emotional dysregulation of adolescent: The mediating role of mentalization ability. Rooyesh. 2022 Dec 15 (pp. 85-96). URL: http://frooyesh.ir/article-1-3190-fa.html
31. Chelouche-Dwek G, Fonagy P. Mentalization-based interventions in schools for enhancing socio-emotional competencies and positive behaviour: a systematic review. European Child & Adolescent Psychiatry. 2024 Sep 12:1-21. https://doi.org/10.1007/s00787-024-02578-5
Copyright (c) 2025 International Journal of Body, Mind and Culture
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
