This research investigated how spouses’ attachment styles jointly contributed to their stress responses. Newlywed couples discussed relationship conflicts. Salivary cortisol indexed physiological stress; observer-rated behaviors indexed behavioral stress; self-reported distress indexed psychological stress. Multilevel modeling tested predictions that couples including one anxious and one avoidant partner or two anxious partners would show distinctive stress responses. As predicted, couples with anxious wives and avoidant husbands showed physiological reactivity in anticipation of conflict: Both spouses showed sharp increases in cortisol, followed by rapid declines. These couples also showed distinctive behaviors during conflict: Anxious wives had difficulty recognizing avoidant husbands’ distress, and avoidant husbands had difficulty approaching anxious wives for support. Contrary to predictions, couples including two anxious partners did not show distinctive stress responses. Findings suggest that the fit between partners’ attachment styles can improve understanding of relationships by specifying conditions under which partners’ attachment characteristics jointly influence individual and relationship outcomes.

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This article examines how individual differences in adult attachment shape regulatory strategies and relationship behaviors, which in turn influence health-related responses, behaviors, and outcomes. We review links between attachment and physiological responses to stress (e.g., hypothalamic-pituitary-adrenal axis responses, cardiovascular responses, immune responses), health behavior (e.g., substance use, diet), and downstream health and disease outcomes. Recent evidence suggests that attachment insecurity (attachment anxiety and/or attachment avoidance) is associated with dysregulated physiological responses to stress, risky health behaviors, susceptibility to physical illness, and poorer disease outcomes. These associations depend, in part, on the relationship context, including the other partner's attachment style and behavior. We suggest that a dyadic approach considering both partners' attachment styles and behaviors will enhance interventions to promote health.

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