Attachment and Health-Related Physiological Stress Processes

Abstract

People who are more securely attached to close partners show health benefits, but the mechanisms underlying this link are not well specified. We focus on physiological pathways that are potential mediators of the connection between attachment in childhood and adulthood and health and disease outcomes. Growing evidence indicates that attachment insecurity (vs. security) is associated with distinctive physiological responses to stress, including responses involving the HPA, SAM and immune systems, but these responses vary with type of stressor (e.g., social/nonsocial) and contextual factors (e.g., partner's attachment style). Taking this more nuanced perspective will be important for understanding the conditions under which attachment shapes health-related physiological processes as well as downstream health and disease consequences.

Figure 1

A conceptual model illustrating the links between attachment style and physiological stress responses as well as health and disease outcomes. Attachment styles promote particular strategies for regulating affect and the self as well as behavior patterns in close relationships. These regulatory processes and relationship behavior patterns, in turn, influence how individuals respond to stress at a physiological level (e.g., cortisol reactivity/recovery, cardiovascular reactivity, inflammation-related responses). Physiological stress responses (along with health behavior and affect) contribute to subsequent health outcomes over time, although these health behaviors and outcomes are not reviewed here. Importantly, the model is dyadic; attachment processes occur in the context of a relationship, and both partners may influence each other’s responses and outcomes reciprocally and/or interactively (e.g., Partner A’s attachment style in interaction with Partner B’s attachment style may produce distinctive physiological stress patterns for each partner). Also, other contextual factors (type of stressor, type of partner) can moderate associations between attachment and physiological stress responses. Adapted from “Health and Attachment Processes” by P. R. Pietromonaco, C. C. DeVito, F. Ge, & J. Lembke, in press/2015. In J. A. Simpson & W. S. Rholes (Eds.) Attachment theory and research: New directions and emerging themes. NY: Guilford. Permission pending.