








































34

Ann. psychophysiol. 
ISSN 2412-3188 (Online)|2410-1354 (Print) 

APP| Published By AEIRC| https://doi.org/10.29052/2412-3188.v10.i1.2023.XX-XX 

Original Article 

Attachment Styles and Their Impact on Sleep 
Disturbances and Dissociation in Adults: A 
Comprehensive Study 
Areeja Shahid & Saima Massom 
Department of Psychology, University of Karachi, Karachi-Pakistan 

Abstract 
Background: Attachment theory posits that early attachment experiences 
significantly shape an individual's emotional well-being and relationships 
throughout life. This study explores the complex relationships between 
attachment styles, sleep disturbances, and dissociation in adults.  
Methodology: A sample of 50 participants with varying attachment styles was 
surveyed using standardized measures of attachment, sleep disturbances, and 
dissociation. Statistical analysis, including correlation tests, was conducted to 
investigate the relationships between these variables.  
Results: The findings indicate a strong positive correlation between anxious 
attachment and sleep disturbances, highlighting the lasting impact of childhood 
attachment experiences on sleep quality. Surprisingly, a negative relationship 
between anxious attachment and dissociation was observed, underscoring the 
intricate nature of attachment-related coping strategies. 
Conclusion: This study underscores the enduring consequences of early 
attachment experiences, emphasizing their influence on adult well-being. 
Recognizing these connections is vital for mental health professionals and 
practitioners in tailoring interventions to address attachment-related challenges. 
Further research is needed to deepen our understanding of these relationships and 
refine therapeutic strategies. 

Keywords 
Attachment Theory, Anxious Attachment, Sleep Disturbances, Dissociation, 

Adult Well-Being. 

Citation: Ali S, Ali SM, Zia A. The 
Relationship of Emotional Intelligence and 
Life Satisfaction with Resilience in 
Students. APP. 2023; 10(1): 35-44 

Corresponding Author Email: 
Saima.ali@uok.edu.pk 

DOI: 10.29052/2412-3188.v10.i1.2022.34-
43 

Received 16/03/2023 

Accepted 26/05/2023 

Published 01/06/2023 

Copyright © The Author(s). 2023. This is 
an open-access article distributed under 
the terms of the Creative Commons 
Attribution 4.0 International License, 
which permits unrestricted use, 
distribution, and reproduction in any 
medium, provided the original author and 
source are credited.  

Funding: The author(s) received no 
specific funding for this work. 

Conflicts of Interests: The authors have 
declared that no competing interests 
exist. 

https://doi.org/10.29052/2412-3188.v10.i1.2023.
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35 APP| Published By AEIRC| Volume 10 Issue 1 

Introduction 
Attachment, a fundamental aspect of human 
development, reflects the emotional bond 
formed between a child and their primary 
caregiver1. This connection serves as a secure 
base from which individuals explore the 
world and manage their emotions. 
According to attachment theory, children 
internalize their experiences in interactions 
with their primary caregivers and develop 
mental representations of these caregivers. 
These representations, known as internal 
working models, are subsequently used to 
navigate relationships with others 
throughout life. Early relationships with 
parents, including parental rearing styles 
and the household atmosphere, influence the 
formation of these internal working models. 
However, when this attachment is not 
securely established due to the inconsistency 
or unavailability of parents or caregivers, it 
can lead to an 'anxious attachment'2. Anxious 
attachment represents a rupture in the 
parent-child connection, resulting in 
psychological complexities that extend 
across various domains of life3. 

Attachment theory posits that an 
individual's attachment style is shaped by 
their interactions with primary caregivers 
and other significant individuals in their 
lives. These attachment styles then become 
integrated into an individual's interpersonal 
interactions, serving as a foundation for their 
future relationships4. They contribute to an 
individual's self-perception views of others, 
known as internal working models, and their 
generalized perspective on human bonds 
and connections3,5. 

Repetitive experiences of neglect and 
inconsistent care from attachment figures 
increase the likelihood of developing an 
insecure attachment style. Consequently, 
individuals with such attachment styles tend 
to form negative working models of 

themselves, others, and relationships in 
general. Those with anxious attachment 
tendencies often struggle with heightened 
distress and difficulties in regulating their 
emotions6,7. 

Research emphasizes that anxious 
attachment can lead to a form of 
developmental trauma8. Parental 
unavailability, inconsistency, or negative 
behavior and attitudes toward their children 
can result in trauma during childhood. The 
early childhood phase is particularly 
susceptible to experiencing traumatic 
events9. Studies suggest that traumatic 
experiences during childhood, including 
neglect and abuse, have enduring effects on 
adult life, especially in the context of 
romantic relationships4. 

Research findings indicate gender 
differences in attachment organization, with 
more men exhibiting an avoidant attachment 
style and more women falling into the 
anxious attachment category10. Research also 
underscores the strong connection between 
anxious attachment styles in females and 
sleep disturbances. There is a notable link 
between mental health disturbances and 
sleep problems, particularly in females11. 
Adult females often adopt an anxious 
approach in their romantic relationships, 
while males tend to lean toward an avoidant 
approach12, illustrating how females may 
tend to exhibit an anxious attachment style. 

Attachment insecurity in intimate adult 
relationships is associated with increased 
physical illness and psychological issues13. 
Both physical health conditions and mental 
disorders are recognized factors linked to 
disruptions in sleep patterns14. The 
relationship between sleep disturbances and 
these conditions is intricate because sleep 
problems are often considered an outcome of 
various health and mental disorders15. 



36 APP| Published By AEIRC| Volume 10 Issue 1 

Attachment insecurity has been identified as 
a potential contributory factor to sleep 
problems16. The attachment system becomes 
active in situations that increase 
vulnerability, such as loneliness, and 
attachment bonds reduce vulnerability 
during sleep17. While a secure attachment 
style may promote restful sleep, an insecure 
attachment style may heighten feelings of 
unease and alertness, interfering with the 
ability to sleep peacefully. 

Moreover, parental behaviors that foster 
secure attachment, such as providing 
comfort in times of distress, may facilitate 
the regulatory mechanisms that promote 
restful sleep. Some studies have indicated 
that insecure maternal attachment can 
influence and lead to the development of 
sleep disorders in infants18. Another notable 
study suggests that attachment styles 
developed during childhood can impact 
sleep quality. Children with more insecure 
attachment styles tend to exhibit greater 
resistance and fussiness during bedtime 
routines compared to children with secure 
attachment styles, as observed by their 
mothers19. Children experiencing sleep 
difficulties are more likely to have insecure 
attachment styles18. Additionally, women 
who experience severe separation anxiety, 
which hampers their ability to establish 
secure attachment, are more likely to have 
infants who wake up more frequently at 

night and experience poorer sleep quality20. 
In late adolescence, the relationship between 
insecure attachments and sleep disruptions 
persists21, extending into adult married 
couples and the elderly16. 

Sleep disturbances and dissociation are 
trauma symptoms that assess distress in 
adults stemming from childhood traumatic 
experiences22. Both sleep problems and 
dissociation are prevalent in the 
population23, leading researchers to study 
these variables together. There is a 
connection between dissociative symptoms 
and individuals reporting vivid dreams, 
nightmares, recurrent dreams, and other 
unusual sleep issues24. Dissociation is one of 
the coping strategies used to deal with the 
stress of unhealthy attachment8. Research 
findings suggest that traumatic events may 
contribute to the link between disorganized 
attachment during childhood and later 
dissociation25. Individuals with high 
attachment anxiety, avoidance, or both tend 
to experience feelings of insecurity and may 
adopt secondary attachment strategies, 
which include either dissociation or hyper-
activation of their attachment system as a 
means of coping with challenges26. 

Research findings consistently show a strong 
connection between emotional abuse, 
dissociation21,27,28, and insecure attachment29. 



37 APP| Published By AEIRC| Volume 10 Issue 1 

Figure 1: Theoretical Framework 

Childhood Attachment Development: 
Humans possess an internal system known 
as the attachment behavioral system. This 
system serves as a predictor and motivator 
for seeking care and affection from 
caregivers when needed1. When individuals 
receive adequate care from their attachment 
figures during times of need, they develop a 
secure attachment. This secure attachment 
leads individuals to believe that the world is 
a safe place free from threats, that 
attachment figures provide support during 
times of distress, and that people can be 
relied upon for interaction. 

Internal Working Models and Trauma: 
The formation and perception of a secure 
and safe environment are based on internal 
working models, which are mental 
representations of how individuals perceive 

the world and themselves30. These internal 
working models can become distorted when 
negative interactions with caregivers, such 
as neglect and avoidance during times of 
distress, occur. Conversely, when 
individuals consistently fail to receive care 
when needed and experience rejection from 
attachment figures throughout childhood 
interactions, they may develop an insecure 
attachment style3. Issues with adult 
relationships often stem from the 
development of an insecure attachment 
style, which results from traumatic 
interactions with caregivers during 
childhood1. 

Dissociation and Sleep Disturbances; 
Subscales of Trauma Symptom: 
Parental neglect and disrupted attachment 
patterns are significant factors in the 



38 APP| Published By AEIRC| Volume 10 Issue 1 

development of psychopathological 
conditions in children, such as dissociative 
identity disorder, which is an attachment 
disorder31. A disorganized attachment style 
is significantly associated with higher levels 
of dissociation32. Insecure attachment styles 
make individuals feel threatened and 
vulnerable in relationships, which 
contributes to sleep difficulties experienced 
by anxiously attached individuals3. 

In line with our research objectives, we 
formulated two hypotheses to guide our 
investigation. Firstly, we hypothesized that 
there exists a significant and noteworthy 
relationship between anxious attachment 
and sleep disturbances among the 
participants. This hypothesis stemmed from 
previous literature suggesting a connection 
between attachment styles, particularly 
anxious attachment, and disruptions in sleep 
patterns. Secondly, we hypothesized a 
significant relationship between anxious 
attachment and dissociation despite this 
relationship being expected to be negative. 
This hypothesis was rooted in the 
understanding that attachment styles can 
influence coping strategies, such as 
dissociation, as individuals navigate 
challenges related to their attachment 
patterns. These hypotheses served as the 
basis for our research and guided our 
exploration of the intricate relationships 
between attachment styles, sleep 
disturbances, and dissociation in adults. 

Methodology 
This study employs a quantitative research 
approach, utilizing surveys as the primary 
data collection method. A sample of 50 
individuals were selected from various 
universities and wellness centers for this 
study. Participants were chosen using a 
convenient purposive sampling method. The 
age range of the participants was limited to 
18 to 30 years. All participants were required 

to be female, capable of reading and 
comprehending English, and exhibit high 
scores on the insecure, anxious attachment 
style. 

The inclusion criteria for participant 
selection in this study were carefully 
defined. Individuals eligible to participate 
were required to fall within the age range of 
18 to 30 years and identify as female. 
Proficiency in reading and comprehending 
the English language was also a prerequisite, 
ensuring that participants could effectively 
engage with the study materials and provide 
meaningful responses. Additionally, 
participants needed to exhibit high scores on 
the anxious attachment style, reflecting a 
specific focus on individuals with this 
attachment pattern for the research 
investigation. These criteria were established 
to create a targeted and relevant participant 
group for the study's objectives. 

Measures: 

Consent Form/Demographic Sheet: 
Participants were asked to complete consent 
forms and demographic questionnaires. 

Adult Attachment Revised Scale (AAS): The 
AAS, initially developed in 1990 by Hazen & 
Shaver (1987) and Levy & Davis (1988), 
consists of 18 items. It measures three 
dimensions of relationship attachment: 
closeness, dependence, and anxiety. 

Trauma Symptom Checklist: The TSC-40 is a 
research tool used to assess various 
symptoms in adults associated with 
traumatic experiences. It is an updated 
version of the earlier TSC-33 (Briere & Runtz, 
1989). The TSC-40 demonstrates good 
reliability, with subscale alphas typically 
ranging from .66 to .77 and full-scale alphas 
averaging between .89 and .91. It comprises 
six subscales: Dissociation, Sleep 



39 APP| Published By AEIRC| Volume 10 Issue 1 

Disturbance, Anxiety, Depression, Sexual 
Abuse Trauma Index, and Sexual Problems. 

Procedure: 
Participants were first provided with 
informed consent forms and demographic 
questionnaires. Subsequently, they 
completed the Adult Attachment Revised 
Scale. Those participants who exhibited 
insecure, anxious attachment styles were 
further assessed using the Trauma Symptom 
Checklist to determine their scores on sleep 
disturbance and dissociation. SPSS software 
was employed to analyze the correlation 
between anxious attachment, sleep 
disturbance, and dissociation, which 
represent subscales of trauma symptoms. 

Result 
Table 1 presents demographic information 

for the participants in percentage form. Out 

of 150 potential participants, 50 were 

selected based on scoring a minimum of 24 

out of 30 on the Anxious Attachment 

subscale of the Adult Attachment Revised 

Scale (AAS). All selected participants were 

female. Specifically, 8 participants scored 24, 

5 scored 25, 30 scored 26, and 8 scored 27 out 

of the maximum score of 30 on the subscale. 

The age distribution was as follows: 15 

participants were aged 18-20, 18 were aged 

21-23, and 17 were aged 24-26. Regarding

education, 9 participants had completed 12

years, approximately 24 had completed 14

years, and 17 participants had completed 16

years of education.

Table 1: Descriptive Statistics of Demographic Information of Participants (N=50). 

Category Measure % 

Age 

18-20 30 

21-23 36 

24-26 34 

Gender Male 0 

Female 100 

Education in years 12 years 20 

14 years 46.67 

16 years 33.33 

Anxious Attachment 
Scores 

27/30 16 

26/30 60 

25/30 10 

24/30 14 

The results reveal a strong positive correlation between sleep disturbances and anxious 

attachment style, with a correlation coefficient of 0.694 (p = 0.02, p < 0.05). Additionally, a 

significantly moderate relationship exists between anxious attachment and dissociation, with a 

correlation coefficient of -0.518 (p = 0.03, p < 0.05). It's worth noting that this relationship is 

negative, consistent with previous research findings (Table 2). 



40 APP| Published By AEIRC| Volume 10 Issue 1 

Table 2: Correlation of Anxious Attachment, Sleep Disturbance & Dissociation. 

Variable n 1 2 3 

Anxious Attachment 

50 

1 - 

Sleep Disturbance 0.694** 1 - 

Dissociation -0.518** - 1
**Correlation is significant at the 0.01 level (2-tailed) 

The results reveal a strong positive correlation between sleep disturbances and anxious 

attachment style, with a correlation coefficient of 0.694 (p = 0.02, p < 0.05). Additionally, a 

significantly moderate relationship exists between anxious attachment and dissociation, with a 

correlation coefficient of -0.518 (p = 0.03, p < 0.05). It's worth noting that this relationship is 

negative, consistent with previous research findings. 

Discussion 
The present study delved into the 
association between attachment insecurity 
and sleep disturbances. The findings suggest 
a link between anxious attachment and sleep 
disruption, a pattern that may take root in 
early childhood and persist over time. 
Individuals exhibiting an insecure, anxious 
attachment style appear more susceptible to 
experiencing sleep disturbances18. 

This connection between attachment style 
and sleep issues mutually influencing each 
other is supported by a body of research 
focused on infants and children33. The 
burgeoning data suggests that the 
relationship between sleep quality and 
attachment style begins to form early in life 
and endures. Moreover, it seems that 
different aspects of this intricate relationship 
may vary in significance depending on the 
developmental stage. This is evidenced by 
research examining the link between sleep 
problems in adult couples. Inadequate sleep 
was found to be associated with more 
negative perceptions of partner interactions, 
suggesting that sleep interruptions can 
impact a person's ability to regulate 
relationships34. 

Additionally, anxiously attached individuals 
often hold negative views of themselves, 
leading to heightened self-doubt and 

ruminative thinking, which can contribute to 
sleep disturbances. Overthinking is a 
prominent symptom of anxiety, which is 
closely linked with sleep disruptions23. 

Another study suggests that females with 
insecure attachment tend to employ 
unhealthy coping strategies such as self-
punishment and excessive worry. These 
coping strategies are associated with 
emotional and mental issues35. Research 
indicates that females often feel that worry is 
beyond their control, leading to increased 
levels of worry and stress36. Elevated stress 
levels can interfere with sleep by prolonging 
the time it takes to fall asleep and disrupting 
sleep continuity37. 

The second hypothesis of our study posited 
a significant relationship between anxious 
attachment and dissociation, a relationship 
supported by our results. However, it's 
noteworthy that this relationship is negative, 
implying that more anxiously attached 
individuals exhibit fewer dissociative 
symptoms. 

This negative correlation aligns with 
previous research findings. Individuals with 
high scores in avoidant attachment often 
tend to adopt deactivating strategies in their 
relationships, such as dissociation. These 
strategies involve avoiding closeness, 
suppressing attachment needs, and evading 



41 APP| Published By AEIRC| Volume 10 Issue 1 

dependency in relationships. These 
behaviors often develop in response to 
attachment figures who disapprove of or 
penalize emotional closeness and the 
expression of needs or vulnerabilities3. 

Conversely, individuals with high levels of 
attachment anxiety are prone to employ 
hyper-activating strategies. These strategies 
involve intense efforts to seek closeness, 
support, and affection, coupled with 
uncertainty about receiving these resources. 
Feelings of frustration and anger can arise 
when these expected resources are not 
provided38. Consequently, there exists a 
negative relationship between anxious 
attachment and dissociation, as individuals 
with anxious attachment find it challenging 
to detach themselves from the 
overwhelming fear of abandonment and the 
need for constant closeness. 

The inconsistent parenting patterns 
experienced by children can lead them to 
perceive themselves as unlovable, 
prompting anxiously attached individuals to 
seek excessive attention and clinginess when 
seeking support from others. Conversely, 
those characterized by an avoidant 
attachment style often have a history of 
caregivers rejecting them, leading them to 
avoid seeking closeness and dissociating 
their need for love as they find safety in their 
independence39. 

One limitation of this study is the scarcity of 
longitudinal research involving adults or the 
elderly. This limitation hinders our ability to 
comprehensively assess the relationship 
between sleep disturbances and attachment 
styles over extended periods, leaving us with 
a limited understanding of the various 
underlying factors that may affect this 
relationship over time. 

Conclusion 
In summary, our study reveals that anxious 
attachment styles stemming from early 
childhood experiences are closely linked to 
sleep disturbances in adulthood. While a 
surprising negative relationship between 
anxious attachment and dissociation was 
discovered, it underscores the intricate 
nature of attachment-related coping 
mechanisms. These findings emphasize the 
lasting impact of attachment experiences on 
adult well-being, shedding light on the need 
for targeted therapeutic interventions that 
address the root causes of sleep disruptions 
and dissociation. Understanding these 
connections can significantly benefit mental 
health professionals and practitioners in 
providing effective support and treatment 
for individuals with attachment-related 
challenges. Further research is essential to 
delve deeper into these relationships and 
refine intervention strategies.   

Acknowledgment 
The Authors are thankful to all the study 
participants for their valuable time and 
cooperation.  

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