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Misiak B, Frydecka D, Piotrowski P, Rembacz K, Bielawski T, Samochowiec J, Tyburski E, Łaczmański Ł, Pawlak E. Coping styles do not interact with the association between childhood trauma history and the immune-inflammatory phenotype of schizophrenia: Findings from a cross-sectional study. Psychoneuroendocrinology 2024; 166:107062. [PMID: 38678733 DOI: 10.1016/j.psyneuen.2024.107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
Adverse childhood experiences (ACEs) are a well-known risk factor of schizophrenia. Moreover, individuals with schizophrenia are likely to use maladaptive stress coping strategies. Although it has been reported that a history of ACEs might be associated with a pro-inflammatory phenotype in patients with schizophrenia, the interacting effect of coping styles on this association has not been tested so far. In the present study, we aimed to investigate the levels of immune-inflammatory markers in patients with schizophrenia and healthy controls (HCs), taking into consideration a history of ACEs and coping strategies. Participants included 119 patients with schizophrenia and 120 HCs. Serum levels of 26 immune-inflammatory markers were determined. A history of any categories of ACEs was significantly more frequent in patients with schizophrenia. Moreover, patients with schizophrenia were significantly more likely to use emotion-focused coping and less likely to use active coping strategies compared to HCs. The levels of interleukin(IL)-6, RANTES, and tumor necrosis factor-α (TNF-α), appeared to be elevated in patients with schizophrenia after adjustment for potential confounding factors in all tested models. Participants reporting a history of any ACEs had significantly higher levels of TNF-α and IL-6. No significant main and interactive effects of active strategies as the predominant coping on immune-inflammatory markers with altered levels in patients with schizophrenia were found. Findings from the present study indicate that ACEs are associated with elevated TNF-α and IL-6 levels regardless of schizophrenia diagnosis and predominant coping styles.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Rembacz
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Ernest Tyburski
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Łukasz Łaczmański
- Laboratory of Genomics & Bioinformatics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Edyta Pawlak
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Fagnani C, Gigantesco A, Giacomini G, Medda E. Connecting psychosocial and personality characteristics with mental health outcomes. An Italian co-twin control study. Prev Med Rep 2024; 37:102559. [PMID: 38192297 PMCID: PMC10772814 DOI: 10.1016/j.pmedr.2023.102559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Exposure to stressful life events is common, and it is linked to increased psychological issues. As most likely people respond to stressors depending on environmental and genetic factors, we assessed in a twin study the association of some personal characteristics such as resilience and self-perception with anxiety, depression and stress in the late Covid pandemic period, to verify the underlying genetic and shared familial components. With this design, the strength of the associations was compared between individual-level and intrapair-level analyses. From June 2020 to December 2021, the Italian Twin Registry conducted a three-wave longitudinal study among adult twins using validated questionnaires, and 1,763 adult twins participated in the study (mean age 46 years, 67 % females, 70 % monozygotic). A regression-based within-pair differences model was applied to control for genetic and shared environmental confounding. Results showed that anxiety was linked negatively with resilience, social support and perceived health, and positively with risk perception and hypochondria. Depression was associated negatively with resilience, social support and perceived health, and positively with financial concern and hypochondria. Stress was associated negatively with resilience and perceived health, and positively with financial concern, risk perception and hypochondria. These results suggest potential etiological effects of the above-mentioned risk factors. While our findings need to be confirmed by longitudinal studies, they propose potential etiological models for mental disorders, indicating that addressing in the clinical practice factors such as self-perception, personality traits (resilience), environmental resources (social support), and comorbid disorders (hypochondria) could have therapeutic benefits while treating certain common mental disorders.
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Affiliation(s)
- Corrado Fagnani
- Centre of Reference for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy
| | - Antonella Gigantesco
- Centre of Reference for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy
| | - Gianmarco Giacomini
- Centre of Reference for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy
- Department of Public Health Sciences and Pediatrics, University of Turin, via Santena 5 bis, 10126 Turin, Italy
| | - Emanuela Medda
- Centre of Reference for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy
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Allen JP, Danoff JS, Costello MA, Loeb EL, Davis AA, Hunt GL, Gregory SG, Giamberardino SN, Connelly JJ. Adolescent peer struggles predict accelerated epigenetic aging in midlife. Dev Psychopathol 2023; 35:912-925. [PMID: 35379374 PMCID: PMC9532470 DOI: 10.1017/s0954579422000153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined struggles to establish autonomy and relatedness with peers in adolescence and early adulthood as predictors of advanced epigenetic aging assessed at age 30. Participants (N = 154; 67 male and 87 female) were observed repeatedly, along with close friends and romantic partners, from ages 13 through 29. Observed difficulty establishing close friendships characterized by mutual autonomy and relatedness from ages 13 to 18, an interview-assessed attachment state of mind lacking autonomy and valuing of attachment at 24, and self-reported difficulties in social integration across adolescence and adulthood were all linked to greater epigenetic age at 30, after accounting for chronological age, gender, race, and income. Analyses assessing the unique and combined effects of these factors, along with lifetime history of cigarette smoking, indicated that each of these factors, except for adult social integration, contributed uniquely to explaining epigenetic age acceleration. Results are interpreted as evidence that the adolescent preoccupation with peer relationships may be highly functional given the relevance of such relationships to long-term physical outcomes.
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Race moderates the association between adult attachment avoidance and the cortisol awakening response among young sexual minority men. Psychoneuroendocrinology 2022; 145:105899. [PMID: 36108460 DOI: 10.1016/j.psyneuen.2022.105899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 08/19/2022] [Indexed: 11/21/2022]
Abstract
Adult attachment, or the ways in which individuals develop and maintain trusting and loving relationships with peers and romantic partners, has been demonstrated to influence hypothalamic-pituitary-adrenal (HPA) axis functioning among young sexual minority men (YSMM). Theory and preliminary evidence suggest that differences in the lived experiences of White and Black sexual minority young adults may influence the way in which adult attachment influences the HPA-axis functioning. We sought to further this field of inquiry by examining if race moderates the association between adult attachment insecurity (i.e., avoidance and anxiety) and HPA-axis functioning among YSMM. Sixty-three YSMM participated in a 5-day daily diary study in which they completed a baseline survey to assess adult attachment orientation and provided saliva samples 4 times per day over a 5-day period in order to measure cortisol across the day. Three-level hierarchical linear modeling was used to examine the association between adult attachment, the cortisol awakening response (CAR), diurnal cortisol, and the moderating effect of race. We found no main effect of attachment anxiety or avoidance on HPA-axis functioning. However, we found that race moderated the association between adult attachment avoidance and the CAR such that Black YSMM with higher attachment avoidance had a lower CAR as compared to White YSMM. Results suggest that there may be key differences between White and Black YSMM men's lived experiences that should be explored in future research.
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Picardi A, Giuliani E, Gigantesco A. Genes and environment in attachment. Neurosci Biobehav Rev 2020; 112:254-269. [PMID: 32014527 DOI: 10.1016/j.neubiorev.2020.01.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/24/2019] [Accepted: 01/30/2020] [Indexed: 02/07/2023]
Abstract
In the last two decades, there has been increasing research interest in disentangling the contribution of genetic and environmental factors to individual differences in attachment, and in identifying the genes involved in shaping attachment. Twin studies suggest that as attachment changes during the course of development, genetic factors may play a progressively more important role, while shared environmental effects might decrease. However, most of this literature is limited by low power, measurement issues, and cross-sectional design. The findings of molecular genetic studies are, overall, inconclusive. The literature on main genetic effects and gene-by-environment interactions on attachment is filled with inconsistent and unreplicated findings. Also, most studies are underpowered. Challenges for future research are to identify the unshared environmental mechanisms involved in shaping attachment, and to better elucidate the genes involved and their interaction with the environment. Some pioneer studies suggested that the incorporation of epigenetic processes into G × E interaction models might represent a promising future way for investigating the complex, dynamic interplay between genes, environment, and attachment.
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Affiliation(s)
- Angelo Picardi
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Eugenia Giuliani
- Department of Molecular Medicine, Sapienza University, Viale Regina Elena, 291-293, 00161 Rome, Italy
| | - Antonella Gigantesco
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
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Picardi A, Pallagrosi M, Fonzi L, Martinotti G, Caroppo E, Meldolesi GN, Di Gennaro G, De Risi M, Biondi M. Attachment in Patients with Bipolar and Unipolar Depression: A Comparison with Clinical and Non-clinical Controls. Clin Pract Epidemiol Ment Health 2019; 15:143-152. [PMID: 32174996 PMCID: PMC7040468 DOI: 10.2174/1745017901915010143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 01/20/2023]
Abstract
Background A link between depression and insecure attachment has long been postulated. Although many studies examined the relationship between depressive symptoms and attachment, relatively few studies were performed on patients diagnosed with depression. Also, research on patients with bipolar disorder is scarce. Objective We aimed at testing the association between attachment insecurity and unipolar and bipolar depression. Methods We studied 21 patients with bipolar disorder, current episode depressed, and three age- and sex-matched groups, each consisting of 21 individuals: patients with major depressive disorder, recurrent episode; patients with epilepsy; non-clinical participants. The Experience in Close Relationships questionnaire was used to assess adult attachment style. Results Patients with both bipolar and unipolar depression displayed significantly higher scores on attachment-related avoidance as compared with patients with epilepsy and non-clinical participants. Also, patients with bipolar depression scored significantly higher on attachment-related anxiety than all other groups. In both psychiatric groups, attachment dimensions were not significantly correlated with global clinical severity or severity of depression. Conclusion Despite some study limitations, our results are consistent with some previous studies and provide support to Bowlby's seminal hypothesis that attachment insecurity may predispose to depression. Attachment theory may provide a valuable theoretical framework for future research and for guiding treatment.
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Affiliation(s)
- Angelo Picardi
- Centre of Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
| | - Mauro Pallagrosi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | - Giovanni Martinotti
- Department of Neuroscience and Imaging, University "G.d'Annunzio", Chieti, Italy
| | - Emanuele Caroppo
- Department of Mental Health, Rome 2 Local Health Unit, Catholic University of Sacred Heart, Rome, Italy
| | - Giulio Nicolò Meldolesi
- "Neurone" Foundation for Research in Neuropsychobiology and Clinical Neurosciences, Rome, Italy
| | | | - Marco De Risi
- Epilepsy Surgery Unit, IRCCS Neuromed, Pozzilli, Italy
| | - Massimo Biondi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
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Attachment and psychoneuroimmunology. Curr Opin Psychol 2019; 25:96-100. [DOI: 10.1016/j.copsyc.2018.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/26/2018] [Indexed: 12/13/2022]
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Picardi A, Gigantesco A, Tarolla E, Stoppioni V, Cerbo R, Cremonte M, Alessandri G, Lega I, Nardocci F. Parental Burden and its Correlates in Families of Children with Autism Spectrum Disorder: A Multicentre Study with Two Comparison Groups. Clin Pract Epidemiol Ment Health 2018; 14:143-176. [PMID: 30158998 PMCID: PMC6080067 DOI: 10.2174/1745017901814010143] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The effects of having a child with Autism Spectrum Disorder (ASD) on parents are multifaceted and pervasive. While ample evidence has been provided that these families are under severe stress, there are still several knowledge gaps and unresolved questions. OBJECTIVE This study aimed at quantifying the subjective and objective burden of ASD in mothers and fathers, and at improving the understanding of the interplay between parental burden, child's characteristics, and parents' coping resources and strategies. METHODS The parents of 359 children/adolescents with ASD were compared to parents of age-matched patients with Down syndrome (N=145) and Type 1 diabetes mellitus (N=155). Child's clinical characteristics and parents' caregiving burden, psychological distress, coping resources and strategies were assessed. RESULTS The parents of children with ASD reported higher objective and subjective burden, more frequent psychological distress, lower social support. Mothers reported greater subjective burden than fathers. Structural equation modeling showed that the most consistent positive and negative predictors of objective and subjective burden were ASD symptom severity and social support, respectively. Other positive predictors were engagement, distraction and disengagement coping, intellectual disability, and adaptive functioning. Other negative predictors were spiritual wellbeing and hardiness. Some effects were indirect through social support and coping strategies. CONCLUSION This study confirmed that parents of children with ASD carry a huge caregiving burden, and added to our understanding of the factors associated with burden. The findings may help inform the design of effective interventions aimed at reducing burden among the parents of children with ASD.
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Affiliation(s)
- Angelo Picardi
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome. Italy
| | - Antonella Gigantesco
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome. Italy
| | | | - Vera Stoppioni
- Department of Pediatrics and Child and Adolescent Neuropsychiatry, Marche Nord Hospital, Fano, Italy
| | - Renato Cerbo
- Child Neuropsychiatry Unit and Centre for Neurodevelopmental Disorders, Pescara, Italy
| | - Maurizio Cremonte
- Neurological and Psychiatric Child Unit, Pediatric Department, Alessandria Hospital, Alessandria, Italy
| | | | - Ilaria Lega
- Women’s Health Unit, National Centre of Epidemiology Surveillance and Health Promotion, Italian National Institute of Health, Rome. Italy
| | - Franco Nardocci
- Italian Society for Child and Adolescent Neuropsychiatry, Italy
- Italian Autism Foundation, Rome, Italy
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Adult attachment and physical health. Curr Opin Psychol 2018; 25:115-120. [PMID: 29734091 DOI: 10.1016/j.copsyc.2018.04.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/26/2018] [Accepted: 04/10/2018] [Indexed: 12/24/2022]
Abstract
This article examines how individual differences in adult attachment shape regulatory strategies and relationship behaviors, which in turn influence health-related responses, behaviors, and outcomes. We review links between attachment and physiological responses to stress (e.g., hypothalamic-pituitary-adrenal axis responses, cardiovascular responses, immune responses), health behavior (e.g., substance use, diet), and downstream health and disease outcomes. Recent evidence suggests that attachment insecurity (attachment anxiety and/or attachment avoidance) is associated with dysregulated physiological responses to stress, risky health behaviors, susceptibility to physical illness, and poorer disease outcomes. These associations depend, in part, on the relationship context, including the other partner's attachment style and behavior. We suggest that a dyadic approach considering both partners' attachment styles and behaviors will enhance interventions to promote health.
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Attachment orientations and emotion regulation. Curr Opin Psychol 2018; 25:6-10. [PMID: 29494853 DOI: 10.1016/j.copsyc.2018.02.006] [Citation(s) in RCA: 206] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/09/2018] [Indexed: 11/23/2022]
Abstract
According to attachment theory, individual differences in the availability and responsiveness of close relationship partners, beginning in infancy, and the resulting formation of fairly stable attachment orientations are crucial for understanding the ways people experience and regulate emotions. In this article, we review what has been learned during the last decade about attachment-related individual differences in emotion regulation. We begin with a brief account of the hypothesized links between different forms of attachment insecurity (anxiety, avoidance) and strategies people use in regulating distress and coping with threatening events. We then review findings from correlational and experimental studies showing that individual differences in attachment orientation are reflected in cognitive, behavioral, and neural patterns of emotion regulation.
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Stanton SCE, Zilioli S, Briskin JL, Imami L, Tobin ET, Wildman DE, Mair-Meijers H, Luca F, Kane HS, Slatcher RB. Mothers' Attachment is Linked to their Children's Anti-Inflammatory Gene Expression via Maternal Warmth. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2017; 8:796-805. [PMID: 30410663 DOI: 10.1177/1948550616687125] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research has demonstrated links between adult romantic attachment and one's own physical health; little is known about links between adult attachment orientations and offspring health. Prior work has shown that parents' greater attachment anxiety and avoidance predicts less warmth toward their children. Extensive work has also shown that lower maternal warmth has negative downstream effects on offspring health. We tested the novel hypothesis that mothers' dispositional romantic attachment would be linked-via maternal warmth-to their children's expression of the glucocorticoid receptor gene NR3C1, higher expression of which is associated with healthier stress-regulation and inflammatory response. In a sample of 132 youth with asthma, we found that mothers' attachment anxiety and avoidance were both negatively associated with children's expression of NR3C1, explained by lower youth-rated maternal warmth. Effects held after adjusting for demographic and psychosocial covariates. Implications for parents' attachment influencing the health of offspring are discussed.
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Laird KT, Preacher KJ, Walker LS. Attachment and adjustment in adolescents and young adults with a history of pediatric functional abdominal pain. Clin J Pain 2015; 31:152-8. [PMID: 24751542 PMCID: PMC4201885 DOI: 10.1097/ajp.0000000000000090] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This study tested predictions of the Attachment-Diathesis Model (ADM) of Chronic Pain in a cross-sectional sample of adolescents and young adults with a history of childhood functional abdominal pain (FAP). ADM posits that attachment anxiety is a diathesis for poor adjustment (physical health, mental health, and functioning) in the context of chronic pain and that pain self-efficacy, pain threat appraisal, and passive coping mediate this effect. METHODS Participants (N=261) were recruited from a database of consecutive new patients evaluated for abdominal pain at a pediatric gastroenterology clinic. Participants' mean age at the follow-up assessment was 21 years. Structural equation modeling was used to test the fit of our conceptual model to the data. RESULTS Model fit was good (comparative fit index=0.971, the Tucker-Lewis index=0.940, root mean square error of approximation=0.067). Attachment anxiety significantly predicted poorer health in both the mental and physical domains. Model fit was consistent with our hypothesis that pain self-efficacy mediates the effect of attachment anxiety on passive coping and that passive coping, in turn, mediates the effect of pain self-efficacy and pain threat appraisal on mental and physical health. DISCUSSION Among individuals with a childhood history of FAP, those with anxious attachment may be at higher risk for poor physical and mental health. Pain beliefs and coping may mediate the relation between anxious attachment and health outcomes and may serve as effective targets for intervention in chronic pain.
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Farinelli M, Panksepp J, Gestieri L, Maffei M, Agati R, Cevolani D, Pedone V, Northoff G. Do brain lesions in stroke affect basic emotions and attachment? J Clin Exp Neuropsychol 2015; 37:595-613. [DOI: 10.1080/13803395.2014.991279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Kidd T, Poole L, Leigh E, Ronaldson A, Jahangiri M, Steptoe A. Attachment anxiety predicts IL-6 and length of hospital stay in coronary artery bypass graft surgery (CABG) patients. J Psychosom Res 2014; 77:155-7. [PMID: 25077858 PMCID: PMC4121675 DOI: 10.1016/j.jpsychores.2014.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/02/2014] [Accepted: 06/05/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The mechanisms underlying the association between adult attachment and health are not well understood. In the current study, we investigated the relationship between attachment anxiety, attachment avoidance, inflammation, and length of hospital stay in coronary artery bypass graft (CABG) surgery patients. METHOD 167 CABG patients completed an attachment questionnaire prior to surgery, and blood samples were taken before and after surgery to assess inflammatory activity. RESULTS We found that attachment anxiety predicted higher plasma interleukin 6 (IL-6) concentration, and this association was mediated by self-reported sleep quality. Anxious attachment also predicted longer hospital stays following CABG surgery, even after controlling for demographic and clinical factors. CONCLUSION These data suggest that increased levels of IL-6 may be a process linking adult attachment anxiety with health outcomes.
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Affiliation(s)
- Tara Kidd
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Lydia Poole
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
| | - Elizabeth Leigh
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
| | - Amy Ronaldson
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
| | - Marjan Jahangiri
- Department of Cardiac Surgery, St. George's Hospital, University of London, Blackshaw Road, London SW17 0QT, United Kingdom
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
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