Functional Neuroimaging of Adult-to-Adult Romantic Attachment Separation, Rejection, and Loss: A Systematic Review.

Romantic attachment rejection (RAR) is a highly prevalent phenomenon among young adults. Rejection by a romantic attachment figure can be a painful and incapacitating experience with lasting negative mental health sequelae, yet the underlying neurobiology of RAR is not well characterized. We systematically reviewed functional neuroimaging studies of adult RAR. Four functional magnetic resonance imaging (fMRI) studies that measured participants' responses to real or imagined RAR and met inclusion criteria were evaluated. These included studies were published between 2004 and 2018. Brain activity in adult participants with an RAR appears to be influenced by the stimulus used to elicit a reaction as well as by attachment styles. Brain regions that show a significant change in activation following a rejection stimulus include cortical regions (cingulate, insular, orbitofrontal, and prefrontal), and subcortical regions (angular gyrus, hippocampus, striatum, tegmental area, and temporal pole) and correspond to (i) pain, distress, and memory retrieval; (ii) reward, romantic love, and dopaminergic circuits; and (iii) emotion regulation and behavioural adaptation. Further neuroimaging studies of adult RAR, as moderated by stimulus and attachment style, are needed to better understand the underlying neurobiology of RAR.