Attachment Status Affects Heart Rate Responses to Experimental Ostracism in Inpatients with Depression

Abstract

Depression is assumed to be both a risk factor for rejection and a result of it, and as such constitutes an important factor in rejection research. Attachment theory has been applied to understand psychological disorders, such as depression, and can explain individual differences in responses to rejection. Research on autonomic nervous system activity to rejection experiences has been contradictory, with opposing strings of argumentation (activating vs. numbing). We investigated autonomic nervous system-mediated peripheral physiological responses (heart rate) to experimentally manipulated ostracism (Cyberball) in 97 depressed patients with organized (n = 52) and disorganized attachment status (n = 45). Controlling for baseline mean heart rate levels, depressed patients with disorganized attachment status responded to ostracism with significantly higher increases in heart rate than depressed patients with organized attachment status (p = .029; ηp2 = .051). These results suggest that attachment status may be a useful indicator of autonomic responses to perceived social threat, which in turn may affect the therapeutic process and the patient-therapist relationship.

Secure Attachment Representation in Adolescence Buffers Heart-Rate Reactivity in Response to Attachment-Related Stressors

“…This finding indicated that they rather share their thoughts and opinions with their marital partners when discussing an issue of disagreement than those with an insecure attachment pattern (Roisman, 2007). Comparable results were found by De Rubeis et al (2016). Using the AAP they reported significantly lower increases in HR during a rejection experience (Cyberball experiment) in depressed individuals with a resolved attachment pattern (F, Ds, and E) than in unresolved individuals using the AAP.…”

“…It can be assumed that even though the unresolved attachment status precludes the presence of any coherent strategy, these individuals might employ passive and disengaging coping strategies to deal with attachment-related distress that are similar to those displayed in insecure individuals (Reijman et al, 2017;White et al, 2020). However, other research findings report differences between resolved and unresolved groups when using other attachmentrelated paradigms like the Cyberball experiment (De Rubeis et al, 2016). Thus attachment dysregulation might be very brief in an attachment interview (Beijersbergen et al, 2008) and it is not yet clear how much intensity is needed to observe attachment dysregulation on a physiological level (Beijersbergen et al, 2008;Gander and Buchheim, 2015).…”

Attachment buffers the physiological impact of social exclusion

“…Some studies report HR acceleration to the Cyberball task in healthy subjects [ 10 ]. Another study in depressed participants found increased HR during the Cyberball amongst those with disorganized (or insecure) attachments compared to those with organized attachments [ 44 ]. However, there is also evidence to suggest HR decelerates in response to peer rejection, suggesting that unexpected exclusion can lead to the engagement of the parasympathetic nervous system and reduced sympathetic activation [ 45 ].…”

Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

“…was based on the daily clinical routine and also applied in comparable studies [see [52][53][54]. If necessary, the assessment was postponed to the following day.…”

“…sleeping problems, changes in appetite, fatigue, pain) are more pronounced in severe depression and are associated with a decrease in HRV [75]. An alternative explanation could be the processing of socially threatening stimuli, which are perceived stronger by depressive persons and therefore lead to a stronger autonomous reaction [53]. Patients experience worries and hypervigilance have particularly severe difficulties in deactivating threatening stimuli [76].…”