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

TitleAn Attachment-Based Model of the Relationship Between Childhood Adversity and Somatization in Children and Adults.
Publication TypeJournal Article
Year of Publication2017
AuthorsMaunder RG, Hunter JJ, Atkinson L, Steiner M, Wazana A, Fleming AS, Moss E, Gaudreau H, Meaney MJ, Levitan RD
JournalPsychosom Med
Volume79
Issue5
Pagination506-513
Date Published2017 Jun
ISSN1534-7796
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.

DOI10.1097/PSY.0000000000000437
Alternate JournalPsychosom Med
PubMed ID27941580