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However, psychotherapy seems to improve not only PTSS but also attachment insecurities. In a large multicenter, randomized clinical trial, the attachment characteristics and PTSS of 85 adolescents and young adults (aged 14\u201321\u00a0years) with clinically relevant abuse-related PTSS were assessed at study entry, at the end of treatment, and 3\u00a0months after the end of treatment. Participants were randomized either to a developmentally adapted cognitive processing therapy (D-CPT) or to a wait-list with treatment advice (WL\/TA). The purpose of the study was to analyze the association between PTSS and attachment at study entry as well as changes in attachment during the trial. We found that attachment-related avoidance (AR avoidance) was positively associated with PTSS from both self-reports and clinician ratings, whereas attachment-related anxiety (AR anxiety) was only related to self-reported PTSS (Pearson correlation coefficients between 0.37 and 0.46). Changes in AR anxiety occurred in both conditions at some point during the study (baseline to 3-month follow-up effect size was<jats:italic>d<\/jats:italic>\u2009=\u20090.60 for D-CPT and<jats:italic>d<\/jats:italic>\u2009=\u20090.44 for WL\/TA) whereas for AR avoidance, only participants in D-CPT improved significantly (baseline to 3-month follow-up effect size was<jats:italic>d<\/jats:italic>\u2009=\u20090.75). The results indicate that PTSS and attachment are connected. Positive changes in attachment insecurities brought about by trauma-focused psychotherapy seem possible.<\/jats:p><jats:p><jats:bold><jats:italic>Trial registration<\/jats:italic><\/jats:bold>: German Clinical Trials Register (DRKS); Germanctr.de; identifier: DRKS00004787; date of registration: 18 March 2013.<\/jats:p>","DOI":"10.1007\/s00787-020-01637-x","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T03:47:28Z","timestamp":1599882448000},"page":"1591-1601","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0983-0118","authenticated-orcid":false,"given":"Eline","family":"Rimane","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Steil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babette","family":"Renneberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Rosner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,9,12]]},"reference":[{"issue":"9657","key":"1637_CR1","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/S0140-6736(08)61706-7","volume":"373","author":"R Gilbert","year":"2009","unstructured":"Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S (2009) Burden and consequences of child maltreatment in high-income countries. 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