Predicting Posttraumatic Stress Symptoms in War-Affected Students Based on Attachment Styles and Negative Meta-Emotions: The Mediating Role of Psychological Flexibility
Keywords:
posttraumatic stress symptoms, attachment styles, negative meta, emotions, psychological flexibility, adolescents, war, affected studentsAbstract
Purpose: This study examined whether psychological flexibility mediated the associations between attachment styles, negative meta-emotions, and posttraumatic stress symptoms among students affected by the 2026 armed conflict involving the United States, Israel, and Iran in Tehran, Iran.
Methods and Materials: This cross-sectional predictive study included 280 students aged 14–18 years who resided in Tehran during 2026. Participants were recruited through purposive sampling from a cooperating mental health clinic and affiliated educational settings. Data were collected using the Child PTSD Symptom Scale for DSM-5—Self-Report, the Attachment Style Questionnaire, the Meta-Emotions Scale, and the Acceptance and Action Questionnaire-II. The proposed model was tested using structural equation modeling and bias-corrected bootstrapping with 5,000 resamples.
Findings: The structural model demonstrated acceptable fit, χ²(259) = 492.76, CFI = .93, TLI = .92, RMSEA = .060, and SRMR = .061. Secure attachment was positively associated with psychological flexibility (β = .28, p < .001), whereas fearful, preoccupied, and dismissing attachment styles were negatively associated with psychological flexibility (β = −.31, −.22, and −.18, respectively; ps ≤ .007). Negative meta-emotions were also negatively associated with psychological flexibility (β = −.46, p < .001). Psychological flexibility was negatively associated with posttraumatic stress symptoms (β = −.39, p < .001). Secure attachment showed a negative direct association with posttraumatic stress symptoms, whereas insecure attachment styles and negative meta-emotions showed positive direct associations. Psychological flexibility significantly mediated all hypothesized associations. The model explained 38% of the variance in psychological flexibility and 57% of the variance in posttraumatic stress symptoms.
Conclusion: Insecure attachment styles and negative meta-emotions may increase posttraumatic stress symptoms partly by reducing psychological flexibility. Interventions should aim to strengthen flexible coping, emotional acceptance, and secure relational functioning among war-affected students.
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Copyright (c) 2025 Nahid Yousefpour, Seyedeh Maryam Mousavi, Shabnam Mohammadi Khanqah (Author); Zahra Mirzaei
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