Andrea Oskis Neuroendocrine correlates of insecure attachment in adolescents Psychophysiology and Stress Research Group.

Andrea Oskis

Neuroendocrine correlates of insecure attachment in adolescents

Psychophysiology and Stress Research

Group

Attachment theory as a stress theory

Bowlby’s original theory: a biobehavioural safety-regulating system

Activated in times of threat or stress

Internal working model

Activates our body’s ‘stress hormone hotline’

The Hypothalamic-Pituitary-Adrenal (HPA) axis

Secretes the hormone cortisol

STRESS!

Cortisol is not just a stress hormone...

Based on Genuth (2008)

Bone formation and resorption

Bone formation and resorption

Decrease connective

tissue

Decrease connective

tissue

Maintain muscle function; decrease

muscle mass

Maintain muscle function; decrease

muscle mass

Maintain cardiac output

Maintain cardiac output

Modulate emotional tone,

wakefulness

Modulate emotional tone,

wakefulness

Support glucose synthesis

Support glucose synthesis

Inhibit inflammatory and

immune responses

Inhibit inflammatory and

immune responses

Increase glomerular filtration and free water clearance

Increase glomerular filtration and free water clearance

Cortisol

An excellent way to measure cortisol

The diurnal cortisol rhythm

0 3 6 9 12

0

5

10

15

20

25

30

wake-up

Hours post-awakening

Cor

tiso

l (nm

ol/l)

Oskis et al. (2009)

Cortisol Awakening Response

(CAR)

Especially post-awakening

... In women with early life attachment adversity

... and also with anxious insecure attachment style

Meinlschmidt and Heim (2005)

Quirin et al. (2008)

Cortisol rhythms matter...

...especially immediately post-awakening

Kudielka & Kirschbaum (2003)

Shirtcliff and Essex (2008)

...especially in adolescence...

General methods

Participants: 60 healthy female adolescents aged 9-18 yrs, mean age 14.16 (± 2.63) years

Key measures:• Attachment Style Interview (ASI)• Saliva samples

The importance of adherence

Participant 35C,

28/02/07, age 17

Morning Andrea! Woke up 0702,

sample 1 done @ 0702. All going well!

Its 12:35 so I’ve just done tube 6. I’ll b ready 4 tube

7 at 3:35. Thanx 4 messages, hope ur havin

a good day! xXx

Participant 26C,

28/02/07, age 17

• Personalised text message prompts for each saliva sample sent over the day

The Attachment Style Interview

Assesses current relationship behaviour & attitudes

Mild Moderate

Marked

Mild Moderate

Marked

The Attachment Style Interview

Assesses current relationship behaviour & attitudes

Mild Moderate

Marked

Mild Moderate

Marked

Results

Securely attached

Attachment style

Insecure Anxious

Insecure Avoidant

Secure(n = 30)

Anxious(n = 13)

Avoidant(n = 17)

Age in years 14.70 (± 2.56) 13.39 (± 2.72) 13.12 (± 2.55)

Eating disorder risk (EDI-3)

27.93 (± 6.21) 26.92 (± 7.75) 25.18 (± 4.56)

General psychological maladjustment

34.80 (± 4.66) 37.23 (± 6.00) 36.65 (± 6.14)

STAI trait 33.50 (± 6.16) 33.62 (± 9.93) 35.65 (± 7.58)

STAI state am† 29.42 (± 6.74) 29.23 (± 7.21) 30.85 (± 6.60)

STAI state pm† 28.50 (± 7.34) 27.42 (± 7.11) 29.32 (± 6.06)

Participant characteristics

Secure(n = 30)

Anxious(n = 13)

Avoidant(n = 17)

Age in years 14.70 (± 2.56) 13.39 (± 2.72) 13.12 (± 2.55)

Eating disorder risk (EDI-3)

27.93 (± 6.21) 26.92 (± 7.75) 25.18 (± 4.56)

General psychological maladjustment

34.80 (± 4.66) 37.23 (± 6.00) 36.65 (± 6.14)

STAI trait 33.50 (± 6.16) 33.62 (± 9.93) 35.65 (± 7.58)

STAI state am† 29.42 (± 6.74) 29.23 (± 7.21) 30.85 (± 6.60)

STAI state pm† 28.50 (± 7.34) 27.42 (± 7.11) 29.32 (± 6.06)

Participant characteristics

All within age-appropriate All within age-appropriate normative rangenormative range

No significant differences No significant differences between attachment style between attachment style groupsgroups

CAR and attachment style

0 15 30 45

5

10

15

20

25

*

*Avoidant insecurely attachedAnxious insecurely attached

Securely attached

Minutes post-awakening

Co

rtis

ol

(nm

ol/

l)

Oskis et al. (2012)

Daytime cortisol and attachment style

3 6 9 12

0

2

4

6

8

10Secure

Anxious

Avoidant

Hours post-awakening

Co

rtis

ol

(nm

ol/

l)

Oskis et al. (2012)

Attachment style groups differed in the dynamic of the CAR

Anxious insecure: awakening

45 min post-awakening

No significant difference in subsequent daytime cortisol secretion

The CAR as a distinct and especially sensitive part of the diurnal cortisol cycle?

Summary and implications:Cortisol and attachment style

A prognostic ‘non-healthy’ CAR?

Kudielka & Kirschbaum (2003)

Similarity to anxious insecure adolescent profile

Thank you for listening

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