An Attachment-Based Model of the Relationship Between Childhood Adversity and Somatization in Children and Adults. Issue 5 (June 2017)

• Record Type: Journal Article
• Authors: Maunder, Robert G.; Hunter, Jonathan J.; Atkinson, Leslie; Steiner, Meir; Wazana, Ashley; Fleming, Alison S.; Moss, Ellen; Gaudreau, Helene; Meaney, Michael J.; Levitan, Robert D.
• Is Part Of: Psychosomatic medicine. Volume 79:Issue 5(2017)
• Publication Date: 2017-06
• Subjects: somatization -- attachment theory -- maternal sensitivity -- development -- childhood adversity -- AC = adult cohort -- CBCL = Child Behavior Checklist -- MAVAN = Maternal Adversity, Vulnerability and Neurodevelopment -- MBQS-25 = 25-item Maternal Behaviour Q-sort; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000437
• Languages: English
• ISSNs: 0033-3174

Abstract

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. Abstract : Supplemental digital content is available in the text.