Heart rate variability in response to the recall of attachment memories

Adult attachment assessed via the ASA and AAI: Empirical convergence and links with autonomic physiological responding during attachment assessments

This study examined the empirical convergence of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous scripts with conceptually corresponding attachment patterns assessed via the Adult Attachment Interview (AAI), and the significance of ASA dimensions for autonomic physiological reactivity during adult attachment assessments. Young adults' (50% male; Mage = 19 years; 80% White/European American) ASA deactivation, hyperactivation, and anomalous content were significantly associated with AAI dismissing (r = .26-.38), preoccupied (r = .31-.35), and unresolved (r = .37) states of mind, respectively. ASA hyperactivation and anomalous content were associated with heightened RSA reactivity to the AAI and ASA, aligning with expectations that these attachment patterns capture the tendency to heighten expressions of negative, traumatic experiences. ASA deactivation was associated with smaller increases in electrodermal activity to the ASA-indicative of less sympathetic arousal-converging with the tendency of individuals higher in deactivation to avoid discussing attachment themes in the ASA.

Altered EEG Patterns in Individuals with Disorganized Attachment: An EEG Microstates Study

Over the past years, different studies provided preliminary evidence that Disorganized Attachment (DA) may have dysregulatory and disintegrative effects on both autonomic arousal regulation and brain connectivity. However, despite the clinical relevance of this construct, few studies have investigated the specific alterations underlying DA using electroencephalography (EEG). Thus, the main aim of the current study was to investigate EEG microstate parameters of DA in a non-clinical sample (N = 50) before (pre) and after (post) the administration of the Adult Attachment Interview (AAI). Two EEG eyes-closed Resting State (RS) recordings were performed before and after the AAI, which was used for classifying the participants [i.e., Disorganized/Unresolved (D/U) or Organized/Resolved (O/R) individuals] and to trigger the attachment system. Microstates parameters (i.e., Mean Duration, Time Coverage and Occurrence) were extracted from each recording using Cartool software. EEG microstates clustering analysis revealed 6 different maps (labeled A, B, C, D, E, F) in both groups (i.e., D/U and O/R individuals) and in both conditions (i.e., pre-AAI and post-AAI). In the pre-AAI condition, compared to O/R individuals, D/U participants showed a shorter Mean Duration and Time Coverage of Map F; in the post-AAI condition, a significant reduction in the Mean Duration of Map E was also observed in D/U individuals. Finally, in the "within" statistical analysis (i.e., pre-AAI vs. post-AAI), only the D/U group exhibited a significant increase in Time Coverage of Map F after the AAI. Since these maps are associated with brain networks involved in emotional information processing and mentalization (i.e., Salience Network and Default Mode Network), our result might reflect the deficit in the ability to mentalize caregiver's interaction as well as the increased sensitivity to attachment-related stimuli typically observed in individuals with a D/U state of mind.

Attachment-Related Differences in Emotion Regulation in Adults: A Systematic Review on Attachment Representations

In recent years, there has been an increase in the prevalence of mental disorders connected with affective dysregulation and insecure attachment. Therefore, it is even more important to understand the interplay between an individual's attachment representation and patterns of emotion regulation. To our knowledge, this is the first systematic review to examine this association. PsycInfo, PsyArticles, and PubMed were searched for studies that examined attachment-related differences in emotion regulation in adults. To examine the unconscious attachment representation, only studies using the Adult Attachment Interview or the Adult Attachment Projective Picture System were included. Thirty-seven peer-reviewed studies (with a total of 2006 subjects) matched the PICO criteria. Emotion regulation was measured via four objective approaches: autonomic nervous system, brain activity, biochemistry, or nonverbal behavior. Across all measurements, results reveal a significant correlation between attachment representation and emotion regulation. Secure attachment correlates consistently with balanced emotion regulation, whereas it is impaired in insecure and dysfunctional in unresolved attachment. Specifically, unresolved individuals display counterintuitive responses and fail to use attachment as a resource. Insecure-dismissing attachment is associated with an emotionally deactivating strategy, while on a physiological, biochemical, and nonverbal level, emotional stress is still present. There is still a lack of studies examining preoccupied individuals. In addition to interpreting the results, we also discuss the risk of bias, implications for psychotherapy and coaching, and an outlook for future research.

Decreased brain network global efficiency after attachment memories retrieval in individuals with unresolved/disorganized attachment-related state of mind

The main aim of the study was to examine how brain network metrics change after retrieval of attachment memories in individuals with unresolved/disorganized (U/D) attachment-related state of mind and those with organized/resolved (O/R) state of mind. We focused on three main network metrics associated with integration and segregation: global (E_glob) efficiency for the first function, local (E_loc) efficiency and modularity for the second. We also examined assortativity and centrality metrics. Electroencephalography (EEG) recordings were performed before and after the Adult Attachment Interview (AAI) in a sample of 50 individuals previously assessed for parenting quality. Functional connectivity matrices were constructed by means of the exact Low-Resolution Electromagnetic Tomography (eLORETA) software and then imported into MATLAB to compute brain network metrics. Compared to individuals with O/R attachment-related state of mind, those with U/D show a significant decrease in beta E_glob after AAI. No statistically significant difference among groups emerged in E_loc and modularity metrics after AAI, neither in assortativity nor in betweenness centrality. These results may help to better understand the neurophysiological patterns underlying the disintegrative effects of retrieving traumatic attachment memories in individuals with disorganized state of mind in relation to attachment.

At the heart of change: Differences in young offenders' HRV patterns after the delivery of the PSYCHOPATHY.COMP program

INTRODUCTION

Literature has pointed the need for intervention programs specifically tailored to target the treatment needs of young offenders, as well as the need to test the efficacy of such programs through physiological indexes of emotion regulation (e.g., heart rate variability; HRV), complementing self-reports typically used as outcome measures. The PSYCHOPATHY.COMP is a 20-session individual intervention program based on Compassion Focused Therapy aiming to reduce psychopathic traits and disruptive behavior among young offenders through the development of a compassionate motivation, while stimulating the soothing system as a strategy to improve emotion regulation. Previous research with young offenders has shown decreases in vagally mediated HRV (vmHRV) when the soothing system is activated. This physiological pattern seems to mirror threat-like responses that contrast with relaxed states.

METHODS

To test the efficacy of the PSYCHOPATHY.COMP, a clinical trial was implemented encompassing a treatment (n = 56) and a control group (n = 53). Treatment participants attended the PSYCHOPATHY.COMP, while controls received the Treatment As Usual (TAU) delivered in Portuguese juvenile detention facilities. HRV data was collected throughout a standardized procedure (encompassing resting, reactivity and recovery phases) specifically designed to trigger the soothing system. Participants were assessed at pre-treatment, post-treatment and 6-months follow-up.

RESULTS

Although treatment participants continued to process the soothing system as unpleasant (with decreased vmHRV), they seem to become able to adaptively recover from the stimuli without avoiding it or resorting to maladaptive coping strategies. The physiological pattern was in line with participants' decreases in difficulties in emotion regulation across the assessment periods. In contrast, controls seemed to have actively employed coping strategies associated with increases in vmHRV not only when the soothing system was triggered, but also when recovering from the stimuli. Congruently, for controls, increases in difficulties in emotion regulation were found, with increases in the lack of emotional clarity across the assessment periods.

DISCUSSION

Findings offer new evidence for the efficacy of the PSYCHOPATHY.COMP program in improving emotion regulation in young offenders, assessed through both self-report and physiological measures. Additionally, findings support the assessment of the autonomic balance as a treatment efficacy index in future research, targeting the rehabilitation of these youth.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT03971682.

Physiological Factors Linking Insecure Attachment to Psychopathology: A Systematic Review

Although many studies have documented associations between insecure attachment and psychopathology, attachment may not confer risk for psychopathology independently, but rather through its interaction with emotional, social, and biological factors. Understanding the variables through which attachment may lead to psychopathology is therefore important. Within this domain of research, the role of physiological factors is poorly investigated. What are the relevant domains and why, when, or for whom do they influence mental disorders relating to attachment? The current systematic review aims to answer these questions. Results reveal that physiological indices of emotional regulation play a role in explaining and/or determining the relationship between attachment and psychopathology. Specifically: (1) combined with insecure attachment, higher skin conductance level (SCL), lower cardiac slowing, and respiratory sinus arrhythmia modulation (RSA) contribute to different psychopathological indicators and behavioral/psychological dysfunctions, although the latter predicts a contradictory pattern of findings; (2) insecure-avoidant attachment is more consistently linked with stress and emotional dysregulation when combined with RSA, while anxious attachment confers risk of depressive symptoms when combined with SCL. We concluded our discussion of the results of seven studies by outlining a plan to move the field forward. We discuss the quality of the assessment, methodological limitations, and future directions, highlighting the need to extend the research to clinical samples.

Affective temperaments and depressive symptoms: The mediating role of attachment

BACKGROUND

Studies showed that affective temperaments and attachment are associated with depressive symptoms, and that they bi-directionally influence each-other. The aim of this study is to explore mechanisms underlying the relationship between the affective temperaments (i.e., depressive, cyclothymic, irritable, hyperthymic and anxious), interview-based attachment, and depressive symptoms.

METHODS

A sample of 61 adolescents and young adults outpatients were asked to complete the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A) and the Hamilton Rating Scale for Depression (HAM-D). Attachment was assessed through the Adult Attachment Interview (AAI) and employing a dimensional approach to obtain continuous measures. Mediation models were performed with the affective temperaments as predictor, depressive symptoms as the criterion variable, and attachment dimensions as mediators.

RESULTS

Findings showed significant direct effects between all the affective temperaments and depressive symptoms. Only the cyclothymic (β = 0.22; SE = 0.1; 95% IC = 0.05, 0.42) and irritable (β = 0.21; SE = 0.09; 95% IC = 0.04, 0.4) temperaments showed an indirect effect on depressive symptoms through secure-insecure attachment. Dismissing attachment did not predict either the affective temperaments nor depressive symptoms. Preoccupied attachment significantly predicts depressive symptoms and, when controlling for it, the hyperthymic temperament no longer directly associates with depressive symptoms.

LIMITATIONS

The cross-sectional study design limit conclusion about causation and directionality.

CONCLUSIONS

Secure attachment could be a protective factor for depressive symptoms for individuals with a cyclothymic or irritable temperament. Differently, the hyperthymic temperament loses its protective role toward depressive symptoms when accounting for preoccupied attachment.