An Attachment-Based Model of the Relationship Between Childhood Adversity and Somatization in Children and Adults.

Abstract:

OBJECTIVE:An attachment model was used to understand how maternal sensitivity and adverse childhood experiences are related to somatization. METHODS:We examined maternal sensitivity at 6 and 18 months and somatization at 5 years in 292 children in a longitudinal cohort study. We next examined attachment insecurity and somatization (health anxiety, physical symptoms) in four adult cohorts: healthy primary care patients (AC1, n = 67), ulcerative colitis in remission (AC2, n = 100), hospital workers (AC3, n = 157), and paramedics (AC4, n = 188). Recall of childhood adversity was measured in AC3 and AC4. Attachment insecurity was tested as a possible mediator between childhood adversity and somatization in AC3 and AC4. RESULTS:In children, there was a significant negative relationship between maternal sensitivity at 18 months and somatization at age 5 years (B = -3.52, standard error = 1.16, t = -3.02, p = .003), whereas maternal sensitivity at 6 months had no significant relationship. In adults, there were consistent, significant relationships between attachment insecurity and somatization, with the strongest findings for attachment anxiety and health anxiety (AC1, β = 0.51; AC2, β = 0.43). There was a significant indirect effect of childhood adversity on physical symptoms mediated by attachment anxiety in AC3 and AC4. CONCLUSIONS:Deficits in maternal sensitivity at 18 months of age are related to the emergence of somatization by age 5 years. Adult attachment insecurity is related to somatization. Insecure attachment may partially mediate the relationship between early adversity and somatization.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

Maunder RG,Hunter JJ,Atkinson L,Steiner M,Wazana A,Fleming AS,Moss E,Gaudreau H,Meaney MJ,Levitan RD

doi

10.1097/PSY.0000000000000437

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

506-513

issue

5

eissn

0033-3174

issn

1534-7796

journal_volume

79

pub_type

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