The Role of Attachment Styles and Childhood Trauma in Predicting the Tendency to Use Tobacco with the Mediating Role of Personality Organization
Keywords:
Attachment style, childhood trauma, Personality organization, tendency to smokeAbstract
Objective: This study aimed to examine the role of attachment styles and childhood trauma in predicting tobacco use tendency, emphasizing the mediating role of personality organization among young adults.
Methodology: This descriptive-correlational study was conducted on 200 university students and young adult tobacco users aged 18–30 in Tehran in 2025, selected via convenience sampling. Data were collected using the Childhood Trauma Questionnaire (CTQ), Adult Attachment Styles Questionnaire, and Personality Organization Questionnaire. Data were analyzed using descriptive statistics, Pearson correlation, and path analysis in SPSS 26 and AMOS 24.
Findings: Childhood trauma (β=0.34), avoidant attachment (β=0.21), and anxious attachment (β=0.28) had significant positive direct effects on tobacco use tendency, while secure attachment (β=−0.23) and personality organization (β=−0.35) had significant negative direct effects. Childhood trauma and insecure attachment styles also predicted tobacco use indirectly through lower personality organization. The model demonstrated acceptable fit indices (χ²/df=1.71, RMSEA=0.054, CFI=0.95).
Conclusion: The findings indicate that adverse childhood experiences and insecure attachment styles can increase the risk of tobacco use tendency through weakened personality organization, whereas secure attachment and integrated personality organization function as protective factors. Strengthening personality organization and fostering secure attachment could serve as key targets for tobacco use prevention and intervention programs.
Downloads
References
Aminzadeh, M., & Shah-Hosseini, M. (2019). Examining the relationship between childhood trauma and attachment styles with personality disorders in adolescents. Journal of Clinical Psychology, 24(3), 256-270. https://cwfs.ihu.ac.ir/article_201605.html
Burgkart, P. L. (2022). Attachment styles, personality organization, and emotional functioning after childhood trauma. Frontiers in Psychiatry. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.786045/full
Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (2020). Psychotherapy for borderline personality: Focusing on object relations. American Psychiatric Publishing. https://psychiatryonline.org/doi/full/10.1176/ajp.2006.163.5.944
Crittenden, P. M., & Landini, A. (2011). Assessing adult attachment: A dynamic approach. W. W. Norton & Company. https://ojs.interpersonajournal.com/index.php/ojs/article/view/300
de With, J. (2024). The association between childhood trauma and tobacco smoking in patients with psychosis. European Archives of Psychiatry and Clinical Neuroscience. https://doi.org/10.1007/s00406-023-01754-z
Duncan, J. (2024). The effects of childhood trauma and attachment on leadership styles in adults [Doctoral dissertation]. https://search.proquest.com/openview/94b865ae7e5d67ecfbb9fe4fa858c418/1?pq-origsite=gscholar&cbl=18750&diss=y
Duncan, J. S. (2024). Childhood trauma, attachment, and adult leadership styles. https://search.proquest.com/openview/94b865ae7e5d67ecfbb9fe4fa858c418/1?pq-origsite=gscholar&cbl=18750&diss=y
Fuchshuber, J. (2020a). Childhood trauma, personality, and substance use disorder. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2020.00531
Fuchshuber, J. (2020b). Childhood trauma, personality, and substance use disorder: The development of a neuropsychoanalytic addiction model. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2020.00531
Gerra, M. L. (2021). Early parent-child interactions and substance use disorder. Psychiatry research. https://pubmed.ncbi.nlm.nih.gov/34606823/
Karami, S., & Rezaei, M. (2020). The impact of attachment styles on substance use in adolescents. Quarterly Journal of Educational Psychology, 42(4), 310-325. https://elmnet.ir/article/21177163-39722
Kernberg, O. F. (2016). The treatment of patients with borderline personality disorder. American Journal of Psychotherapy. https://www.ofhills.com/wneip_scholars_character_course/Character_Fall_2013/01%20Week%20One/The%20Treatment%20of%20Patients%20with%20Borderline%20Personality%20Organization.pdf
Kianfarid, G., Sedaghat, N., & Jafari, S. (2023). Examining the effectiveness of intensive short-term psychodynamic psychotherapy on self-esteem and aggression in opioid addicts. Proceedings of the First International Conference on Psychology, Social Sciences, Educational Sciences, and Philosophy, Babol, https://civilica.com/doc/1698571
Lewis, A. J. (2020). Editorial: Addiction and attachment. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2020.612044
Macklem, G. L. (2015). Practitioner's guide to emotion regulation in school-aged children. Springer. https://books.google.com/books?hl=fa&lr=&id=ASn6t2-TH88C&oi=fnd&pg=PR3&dq=Practitioner%27s+guide+to+emotion+regulation+in+school-aged+children&ots=50njARmGFD&sig=PeK_9XBNvvNwKHrM4zkYcIKxMWU
Mohammadpour, M., & Khani, Z. (2022). The relationship between personality organization and attachment styles with tobacco use in adults. Journal of Clinical Psychology, 27(1), 234-247. https://sid.ir/paper/83101/fa
Nakhoul, L. (2020). Attachment style and addictions (alcohol, cigarette, waterpipe): A study among Lebanese adolescents. BMC psychology. https://doi.org/10.1186/s40359-020-00404-6
Rafiei, M., Salehi, A., Yousefi, T., Samadi, S., & Jafari, S. (2022). The effectiveness of emotion-focused and intensive short-term psychodynamic therapy on personality organization and ego strength in individuals with tension-type headaches. Journal of Mashhad University of Medical Sciences, 65(6). https://mjms.mums.ac.ir/article_23688.html
Schindler, A., & Bröning, S. (2014). A review on attachment and adolescent substance abuse: Empirical evidence and implications for prevention and treatment. Substance Abuse. https://doi.org/10.1080/08897077.2014.983586
Topchoglu, M. (2024). The relationship between childhood trauma, attachment styles, and substance use in adults. Journal of Clinical Psychology, 61(4), 339-344. https://cwfs.ihu.ac.ir/article_201605_fce64ebed2ed984014c12fdfe09eb344.pdf
Turliuc, M. N. (2024). The relationship between insecure attachment and nicotine dependence: The mediating role of emotion dysregulation. Frontiers in Psychiatry. https://link.springer.com/article/10.1186/s13011-024-00623-9
Yilmaz, H. (2022). The impact of traumatic experiences on attachment styles in adults. Journal of Clinical Psychology, 38(3), 489-500. https://doi.org/10.6018/analesps.489601
Yilmaz, H., Arslan, C., & Arslan, E. (2022). The effect of traumatic experiences on attachment styles. Anales de Psicología/Annals of Psychology, 38(3), 489-498. https://revistas.um.es/analesps/article/view/489601
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 محبوبه داودآبادی فراهانی, علیرضا آهنگران, فاطمه مسعودی¬بیدگلی, هانیه افضلی¬نژاد (Author); نازنین حقیقت¬بیان (Translator); سهیل جعفری (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.