Robert G Maunder1, Jonathan J Hunter, Leslie Atkinson, Meir Steiner, Ashley Wazana, Alison S Fleming, Ellen Moss, Helene Gaudreau, Michael J Meaney, Robert D Levitan. 1. From the Department of Psychiatry (Maunder, Hunter), Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada; Department of Psychology (Atkinson), Ryerson University, Toronto, Ontario, Canada; Departments of Psychiatry & Behavioural Neurosciences and Obstetrics & Gynecology (Steiner), McMaster University, Hamilton, Ontario, Canada; Centre for Child Development and Mental Health, McGill University, Montreal (Wazana), Quebec, Canada; Department of Psychology (Fleming), University of Toronto, Mississauga, Ontario, Canada; Department of Psychology (Moss), Université du Québec à Montreal, Montréal, Québec, Canada; Department of Psychiatry and Neurology (Gaudreau, Meaney), Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; and Centre for Addiction and Mental Health and Department of Psychiatry (Levitan), University of Toronto, Toronto, Ontario, Canada.
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.
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.
Authors: Michelle A Chen; Angie S LeRoy; Marzieh Majd; Jonathan Y Chen; Ryan L Brown; Lisa M Christian; Christopher P Fagundes Journal: Front Psychol Date: 2021-11-26
Authors: Robert G Maunder; Jonathan J Hunter; David W Tannenbaum; Thao Lan Le; Christine Lay Journal: BMC Health Serv Res Date: 2020-04-15 Impact factor: 2.655