Childhood adversity and attachment anxiety predict adult symptom severity and health anxiety

Le, Thao; Geist, Rose; Bearss, Erin; Maunder, Robert G.

doi:10.1016/j.chiabu.2021.105216

Cited by 8 publications

(5 citation statements)

References 48 publications

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“…We recruited patients who had previously participated in a survey of childhood adversity, attachment insecurity, symptom severity and health anxiety. 27 Briefly, 712 patients were approached consecutively in the waiting room after checking in for an appointment. Of 647 meeting inclusion criteria (age ≥18 years and sufficient English skills to complete the survey), 234 declined to participate, 413 consented and 351 returned a completed survey.…”

Section: Methodsmentioning

confidence: 99%

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Multiple symptoms and health anxiety in primary care: a qualitative study of tensions and collaboration between patients and family physicians

Mylopoulos

Bearss

et al. 2022

BMJ Open

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BackgroundPatients with multiple, persistent symptoms and health anxiety often report poor health outcomes. Patients who are difficult to reassure are challenging for family physicians. The therapeutic alliance between a physician and a patient can influence the prognosis of these patients. Optimising the quality of the physician–patient alliance may depend on a better understanding of the interpersonal processes that influence this relationship.ObjectiveThe purpose of this study is to understand the experiences of patients who experience multiple persistent symptoms or high health anxiety and their physicians when they interact.Design, participants and settingA qualitative study was conducted using grounded theory of 18 patients, purposively sampled to select patients who reported high physical symptom severity, high health anxiety or both, and 7 family physicians in the same clinic. This study was conducted at a family medicine clinic in a teaching hospital.ResultsA model of interpersonal tension and collaboration for patients and physicians in primary care was developed. Helpful attitudes and actions as well as troublesome topics influence crucial dilemmas between patients and physicians. These dilemmas include if patients feel heard and validated and the alignment of goals and mutual respect of expertise and experience between patients and physicians. These experiences contribute to a constructive collaboration and in turn positive outcomes.ConclusionsThis model of patient–physician interaction may facilitate providers to turn their attention away from the contentious topics and towards actions and attitudes that promote beneficial outcomes.

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Section: Methodsmentioning

confidence: 99%

“…We recruited patients who had previously participated in a survey of childhood adversity, attachment insecurity, symptom severity and health anxiety 27. Briefly, 712 patients were approached consecutively in the waiting room after checking in for an appointment.…”

Section: Methodsmentioning

confidence: 99%

Multiple symptoms and health anxiety in primary care: a qualitative study of tensions and collaboration between patients and family physicians

Mylopoulos

Bearss

et al. 2022

BMJ Open

Self Cite

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“…Insecure attachment comprises three different categories, namely avoidant, fearful, and anxious attachment. There is a well-established relationship between childhood abuse and neglect and insecure attachment (Cook et al, 2005; Le et al, 2021; Roters, 2019; Roters & Book, 2023a; Yang & Perkins, 2021). In avoidant attachment, the individual sees no value in being close with others and views others negatively, however, sees themselves in a positive light (Bartholomew & Horowitz, 1991).…”

Section: Attachmentmentioning

confidence: 99%

Examining the complex relations between childhood adversity, mindfulness, attachment, and various personality outcomes: A Bayesian structural equation modeling approach.

Roters,

Book

2024

Psychological Trauma: Theory, Research, Practice, and Policy

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Research has demonstrated that childhood abuse and neglect can negatively impact individuals into adulthood. Abuse and neglect are associated with insecure attachment, lower mindfulness, and disordered personality traits, including borderline and psychopathic traits. Objective: The purpose of our present study was two-fold; first, we wanted to replicate the finding that the relationships between abuse and neglect and these traits are partly indirect through insecure attachment. Second, we wanted to determine whether mindfulness is an additional mediator in these relationships. Method: A sample of 291 undergraduate students participated in the current study (M age = 21.7, SD = 6.5). Results: Findings from a Bayesian Structural Equation Model supported the prediction that the relationship between childhood abuse and neglect and disordered personality traits was indirect through insecure attachment. More specifically, for borderline traits it was indirect through anxious attachment while interpersonal manipulation and callous affect psychopathic traits it was indirect through avoidant attachment. Importantly, mindfulness was not a significant mediator in the model for any of the outcome variables. Conclusions: Overall, there was support for the idea that insecure attachment was a potential mechanism in the relationship between childhood abuse and neglect and disordered personality traits, though there was no support for mindfulness as a potential mediator. Implications are discussed. Clinical Impact StatementChildhood abuse and neglect have been implicated in the development of disordered personality traits, including borderline and psychopathic traits. Such traits are related to various negative outcomes, including risk-taking, impulsivity, and hostility (American Psychological Association [APA], 2013), highlighting the need to find targets for intervention. Our findings indicate that the relationship between abuse/neglect and borderline traits appears to be indirect through anxious attachment while the relationship between abuse/neglect and psychopathic traits (interpersonal manipulation and callous affect) is mediated by avoidant attachment. Mindfulness was not a significant mediator in these relationships.

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“…Therefore, left-behind children generally face attachment disruption as a result of parental migration. Studies have shown that childhood adversity can exacerbate attachment insecurity, causing physical symptoms and higher levels of health anxiety [34], and left-behind children may face more severe situations because they are directly separated from their parents in geographic space which makes it di cult to create close connections and build attachments. When physical distance separation is unavoidable, active and effective family parent-child communication can still help left-behind children counteract the risk of depression [21].…”

Section: The Power Of Connection: Social Network and Depressionmentioning

confidence: 99%

The impact of left-behind experience on adulthood depression: the role of social networks, subjective well-being, and resilience

Wan-qing

Huang

2023

Preprint

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Background Although some studies have explored the relationship between left-behind experience and depression of adulthood, there is generally a lack of analysis of the mechanisms involved and insufficient attention to heterogeneous influences.Methods Using the China Labor-force Dynamics Survey in 2018 (CLDS 2018), we assessed depression level by the Center for Epidemiologic Studies Depression Scale (CES-D). The OLS regression was used to exam the effect of the left-behind experience, propensity score matching analyses were used to reduce selection bias. Mediation analysis was carried out using a multiple regression analysis to exam the mechanism of social support network, subjective wellbeing (happiness and life transaction). We also divide the sample into two groups according to the level of resilience, to investigate the role of resilience in resisting depression.Results Results show a positive relationship between the left-behind experience and adulthood depression, and longer left-behind duration associated with higher adulthood depression. Mediation analysis show that social networks and subjective well-being mediated the relationship between left-behind and adulthood depression; heterogeneity analysis show that left-behind stage, type (both or single parents migrated) had a heterogeneity effect on adulthood depression level: those people who had experienced the left-behind earlier have higher depression; the effect size of care type showing the characteristics of “single-parent guardianship > grandparent guardianship > parents guardianship”. Groups comparison show that higher resilience group had a lower effect of left-behind on adulthood depression.Conclusion This study demonstrates that left-behind experience could have long-term impact on individual’s mental health. When the left-behind grew up, they have higher depression level, and we found that those people experienced left-behind also have weaker social networks, lower subjective happiness and life satisfaction, these factors caused higher depression level. And higher resilience can help individuals to resist the impact of left-behind on depression. This study expands the knowledge and understanding of the mechanism about the left-behind experience impact on adulthood mental health, and revealed the protective role of resilience.

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Childhood adversity and attachment anxiety predict adult symptom severity and health anxiety

Cited by 8 publications

References 48 publications

Multiple symptoms and health anxiety in primary care: a qualitative study of tensions and collaboration between patients and family physicians

Multiple symptoms and health anxiety in primary care: a qualitative study of tensions and collaboration between patients and family physicians

Examining the complex relations between childhood adversity, mindfulness, attachment, and various personality outcomes: A Bayesian structural equation modeling approach.

The impact of left-behind experience on adulthood depression: the role of social networks, subjective well-being, and resilience

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