Attachment Representation and Illness Behavior in Somatoform Disorders

Abstract

Somatoform disorders are characterized by high health care utilization and conflictual interactions with health care providers. The aim of the present study was to explore whether patterns of insecure attachment are a prominent feature of somatoform disorder. In addition, the links between insecure attachment and health care utilization were evaluated. Thirty-seven patients with an International Classification of Diseases, 10th Revision diagnosis of somatoform disorders and 20 healthy control subjects matched for age, sex, and education were administered the Adult Attachment Interview. Psychological symptoms and health care utilization were assessed using various self-report measures. There was a clearly higher incidence of insecure attachment in the somatoform group compared with the nonclinical control subjects. In the somatoform group, dismissing attachment occurred approximately twice as frequently as the preoccupied pattern of attachment. The results provide evidence for an association between health care utilization and insecure attachment. Insecure attachment in somatoform disorder may underlie problems in interpersonal functioning and in health care behavior.

Distinguishing between Hypochondriasis and Somatization Disorder: A Review of the Existing Literature

“…Somatization and insecure attachment in adulthood are both consequences of adverse early environment and relationships with parents [86]. Preliminary investigations have found insecure attachment styles in patients with unexplained symptoms and those with hypochondriasis [87, 88]. The preoccupied style appears to be associated with increased symptom reporting and utilization of health care, the dismissive style with the avoidance of care [88,89,90,91].…”

“…Preliminary investigations have found insecure attachment styles in patients with unexplained symptoms and those with hypochondriasis [87, 88]. The preoccupied style appears to be associated with increased symptom reporting and utilization of health care, the dismissive style with the avoidance of care [88,89,90,91]. Based on limited evidence, one might hypothesize links between hypochondriasis and the preoccupied style, and between somatization disorder and the dismissive style.…”

Attachment Anxiety, Basic Psychological Needs Satisfaction and Depressive Symptoms in University Students: A Mediation Analysis Approach

“…Attachment theory proposes mental representations models of self and others, attachment styles, patterns of affect regulation and a system of behaviors in a developmental perspective (Shorey & Snyder, 2006). These styles of attachment and mental representations for self and others that are shaped in the beginning of life are transferred into adulthood and can affect the person's psychological functioning (Scharf, Mayseles, & Kivenson-Baron, 2004;Waller, Scheidt, & Hartmann, 2004).…”

Facial emotion recognition and alexithymia in adults with somatoform disorders

“…To date, no studies have addressed if other forms of SFD are associated with a similar deficit in facial emotion recognition (FER). This is an important avenue of research as such a deficit could contribute to the interpersonal problems that have been reported in patients with SFD [Waller et al, 2004].…”