Attachment and physical health: introduction to the special issue

Emotional and experiential factors that determine civilizational diseases

Background

The effects of adverse childhood experiences may persist in adult life and manifest themselves in various areas of function-ing. The aim of the study was to identify the emotional and experiential factors that determine civilizational diseases and the methods of regulating emotions and functioning in society.

Participants and procedure

The surveyed group was composed of 141 adults. The respondents defined the existence of adverse experiences and their attachment styles in retrospective. The methods of regulating emotions were also measured, as well as the presence of civilizational diseases.

Results

The authors found a correlation between the style of attachment and the traumatic events experienced during the first 18 years of life and the existence of civilizational diseases. Adverse experiences in childhood and attachment styles proved to be predictors of specific social behaviour aimed at regulating emotions.

Conclusions

The results emphasised the importance of the bond with a parent and of traumatic childhood experiences for the future health condition and for the social and emotional functioning. The study demonstrated that persons who experienced traumatic events in their families or in the peer environment in the first 18 years of their lives reported the presence of civilizational diseases. A correlation was found between peer violence, the threat of being abandoned by a caregiver, and diagnosed civilizational diseases in respondents. The fearful-ambivalent style in the relationship with the father proved to be a predictor of reported civilizational diseases. Adverse childhood experiences are linked to regulating emotions by tak-ing perspective. The attachment style developed in the relationship with parents determined the ways of regulating nega-tive and positive emotions in contact with other people. Persons who developed an avoidant attachment style in the rela-tionships with the mother or the father less frequently seek social support when they experience negative emotions.

The Role of Attachment Style, Adverse Childhood Experiences and Dissociation in Migraine

Migraine and chronic migraine are caused by a combination of modifiable and non-modifiable genetic, social, behavioral and environmental risk factors. Further research of possible modifiable risk factors for this headache disorder is merited, given its role as one of the leading causes of years lived with disability per year. The first aim of this online cross-sectional study was to investigate the psychosocial risk factors that predicted chronic migraine and severe migraine-related disability in 507 Irish and UK participants, focusing specifically on childhood maltreatment, attachment and tendency to dissociate, or experience depressed mood and/or anxiety. Additionally, this study aimed to examine variables that mediated the relationships between these psychosocial risk factors and migraine chronicity or severe migraine-related disability. Adjusted binary logistic regression revealed that shutdown dissociation (Odds Ratio [OR] 4.57, 95% Confidence Interval [CI] 2.66-7.85) and severe physical abuse (OR 4.30, 95% CI 1.44-12.83 had significant odds of predicting migraine chronicity, while depression (OR 3.28, 95% CI 1.86-5.77) significantly predicted severe migraine-related disability. Mediation analyses indicated that shutdown dissociation mediated the relationship between seven predictor variables and both chronicity and severe disability including possible predisposing factors emotional abuse, physical neglect, avoidant attachment and anxious attachment. These findings suggest that early life stressors (such as childhood trauma and avoidant attachment style), shutdown dissociation and depression may impact on migraine trajectory. To investigate whether these psychosocial factors are risk factors for migraine chronicity or disability, prospective research should be conducted in this area to account for fluctuations in migraine chronicity over time.

Parental incarceration and child physical health outcomes from infancy to adulthood: A critical review and multilevel model of potential pathways

BACKGROUND

There are currently 2.2 million people incarcerated in U.S. prisons and jails, representing a 500% increase over the past 40 years. An emerging literature suggests the impact of mass incarceration extends beyond the prison, jail, or detention center to the families of incarcerated individuals. Less scholarship has considered consequences of parental incarceration for their children's physical health.

METHODS

We conduct a critical review of the literature investigating an association between parental incarceration and children's physical health outcomes from infancy to adulthood.

RESULTS

Studies varied substantially in study design, sample composition, and methodological approach. Most studies suggest an association between parental incarceration and adverse physical health outcomes. Evidence is more consistent for outcomes such as infant and child mortality, lower healthcare access, and negative health behaviors and more mixed for measures such as self-reported/general health.

CONCLUSION

We propose a multilevel model of mechanistic pathways to stimulate future research on the potential pathways through which parental incarceration could influence children's physical health.

Does secure base script knowledge mediate associations between observed parental caregiving during childhood and adult romantic relationship quality and health?

Increasingly, attachment representations are being assessed via secure base script knowledge - the degree to which individuals show awareness of the temporal-causal schema that summarizes the basic features of seeking and receiving effective support from caregivers during times of need. Limited research has assessed the links between secure base script knowledge and aspects of adult functioning and the role that secure base script knowledge may play in accounting for associations between early caregiving quality and adulthood functioning. We used follow-up assessments of the NICHD Study of Early Child Care and Youth Development cohort (N = 585) to examine whether secure base script knowledge at age 18 years: (a) is associated with later romantic relationship quality, depressive symptoms, and body mass index (BMI) at age 26 years, and (b) mediates expected associations between the quality of maternal and paternal sensitivity across the first 15 years of life and age-26 outcomes. More access to, and elaborated knowledge of the secure base script predicted less extreme hostility with romantic partners, and better emotional and physical health. Moreover, secure base script knowledge mediated the links between early maternal and paternal sensitivity and both later romantic partner hostility and depressive symptoms, but not BMI.

Delivering Clinically on Our Knowledge of Oxytocin and Sensory Stimulation: The Potential of Infant Carrying in Primary Prevention

Oxytocin (OT) is one of the most intensively researched neuropeptides during the three past decades. In benign social contexts, OT exerts a range of desirable socioemotional, stress-reducing, and immunoregulatory effects in mammals and humans and influences mammalian parenting. Consequentially, research in potential pharmacological applications of OT toward human social deficits/disorders and physical illness has increased substantially. Regrettably, the results from the administration of exogenous OT are still relatively inconclusive. Research in rodent maternal developmental programming has demonstrated the susceptibility of offspring endogenous OT systems to maternal somatosensory stimulation, with consequences for behavioral, epigenetic, cognitive, and neurological outcomes. A translation of this animal research into practically feasible human parenting recommendations has yet to happen, despite the significant prevention potential implied by the maternal developmental programming research. Extended physical contact with full-term healthy infants in the months following birth (infant carrying) might constitute the human equivalent of those specific rodent maternal behaviors, found to positively influence emerging OT systems. Findings from both OT and maternal programming research parallel those found for infants exposed to such extended parental physical contact, whether through skin-to-skin contact or infant carrying. Clinical support of parents to engage in extended physical contact represents a feasible intervention to create optimum conditions for the development of infant OT systems, with potential beneficial long-term health effects.

L’attachement et la mentalisation en pédopsychiatrie : une fenêtre sur le fonctionnement des enfants et de leurs parents

Le travail auprès de la clientèle en pédopsychiatrie et les défis qu’il pose amènent à revoir les pratiques cliniques afin de prendre en compte de façon systématique les notions d’attachement et de mentalisation chez les enfants et leurs parents. L’article traite d’abord des concepts d’attachement et de mentalisation et fait un résumé de l’état des connaissances sur ces derniers. Il est ensuite question d’un projet de recherche développé en pédopsychiatrie à la clinique spécialisée 0-5 ans de l’Hôpital en santé mentale Albert-Prévost (HSMAP). Nous présentons les résultats préliminaires de cette recherche de même que les défis rencontrés dans l’implantation du projet. Enfin, nous développons sur la façon d’aborder le travail clinique en considérant de manière systématique l’attachement et la mentalisation dans l’évaluation et l’intervention auprès des familles référées en pédopsychiatrie.

Revisiting the roots of attachment: A review of the biological and psychological effects of maternal skin-to-skin contact and carrying of full-term infants

During the early period of hypothesis building and empirical testing of attachment theory, a major emphasis was placed on mother-infant physical contact. In spite of this, mother-infant contact has received scant attention amongst attachment and child development researchers in the past decades. Here, a brief theoretical framework for mother-infant contact is presented, drawing on animal studies as well as human studies of preterm infants and neonates. Salient mechanisms may include an extended sensitive period during early infancy, requiring specific somatosensory stimuli for bio-behavioral homeorhesis; oxytocinergic and epigenetic pathways; kinesthetic stimuli and face-to-face proximity allowing for increased social interaction. Studies of extended human mother-full-term infant physical contact have demonstrated positive effects in multiple domains. For infants, these include sleep organization, temperature and heart rate regulation, behavioral response, crying/colic, socio-emotional development, attachment quality, speech development opportunities and mother-child interactions. For mothers, studies demonstrate improved depressive symptomatology, physiological stress regulation, contingent responsivity, breastfeeding and mother-child interactions. Parent-infant attachment quality has gained prominence as a trauma-resilience factor as well as a predictor of adult physical health. The potential role of mother-infant contact as an attachment promoting intervention as well as future research subjects are discussed. Current evidence supports the original attachment research that early maternal touch provision may influence infant socio-emotional development and attachment quality, with positive implications for mother-child relationship functioning.

Individual differences in attachment anxiety shape the association between adverse childhood experiences and adult somatic symptoms

BACKGROUND

Although prior research has documented the link between adverse childhood experiences (ACEs) and somatic symptoms, it remains unclear why some individuals exposed to ACEs developed somatic symptoms while others did not.

OBJECTIVE

Framed by a biopsychosocial perspective, this study investigated the role of attachment anxiety in the association between ACEs and somatic symptoms in adulthood.

PARTICIPANTS AND SETTING

A total of 662 emerging adults attending college were recruited to respond to an online survey in a computer lab.

METHOD

The computer-based survey included demographic form, the Adverse Childhood Experience Scale, the Experience in Close Relationship Scale-Short Form, and the Somatization Scale of the Symptom Checklist-90-Revised for somatic symptoms. Multivariate regression analyses were used to examine the role of attachment anxiety in the association between ACEs and somatic symptoms.

RESULTS

The results indicated that ACEs positively correlated with attachment anxiety and somatic symptoms; and attachment anxiety and somatic symptoms were positively correlated. Moreover, the results indicated a significant effect of interaction between ACEs and attachment anxiety on somatic symptoms, suggesting a moderating role of attachment anxiety. Subsequent simple slope test revealed that attachment anxiety intensified the strength of relation between ACEs and somatic symptoms; but when the level of attachment anxiety was low, ACEs and somatic symptoms were not related.

CONCLUSION

Individual differences in attachment anxiety shape the association of adverse childhood experiences with somatic symptoms. Targeting and reformulating anxious working models of attachment may help ameliorate vulnerability to somatic symptoms in individuals exposed to ACEs.

Commentary: Money can't buy you love, but lack of love costs families and society plenty - a comment on Bachmann et al. (2019)

The target paper on the costs of (lack of) love underscores the ongoing need for early preventive interventions that support parents, both mothers and fathers, aiming to provide for their children. With effective targeting of such interventions, the emergence of children's antisocial behavioral problems may be greatly lessened. In addition to the economic costs to family and society of caring for children with moderate or severe antisocial behavior problems is substantial, the costs in terms of diminished health and well-being may persist across the lifespan. Recent research on attachment and physical health adds to the evidence base pointing to the substantial economic burdens, falling to families, schools, and health services, when insecurity or disorganization of attachment typifies early parent-child relationships. Further research ought to give consideration to potentially moderating or compensatory relationships that otherwise vulnerable youth may develop to supportive peers, siblings or teachers.

Attachment and physical health: introduction to the special issue

Over the last 40 years, researchers have made considerable progress identifying the ways in which attachment security shapes individuals' social and emotional functioning. In recent years, new investigations have shed light on connections between attachment and physiological systems in the body. The goal of this special issue is to focus attention on how attachment may be related to biological markers that relate to physical health, including inflammation, cortisol, and cardiometabolic risk. The papers in this special issue, highlighted in this introduction, demonstrate that these links may exist across the lifespan. We conclude with several examples of extensions of this work might emerge in the years to come.