Interpersonal Stress Regulation and the Development of Anxiety Disorders: An Attachment-Based Developmental Framework

Research Department of Clinical, Educational and Health Psychology, University College London London, UK.
Frontiers in Behavioral Neuroscience (Impact Factor: 4.16). 09/2011; 5:55. DOI: 10.3389/fnbeh.2011.00055
Source: PubMed

ABSTRACT Anxiety disorders represent a common but often debilitating form of psychopathology in both children and adults. While there is a growing understanding of the etiology and maintenance of these disorders across various research domains, only recently have integrative accounts been proposed. While classical attachment history has been a traditional core construct in psychological models of anxiety, contemporary attachment theory has the potential to integrate neurobiological and behavioral findings within a multidisciplinary developmental framework. The current paper proposes a modern attachment theory-based developmental model grounded in relevant literature from multiple disciplines including social neuroscience, genetics, neuroendocrinology, and the study of family factors involved in the development of anxiety disorders. Recent accounts of stress regulation have highlighted the interplay between stress, anxiety, and activation of the attachment system. This interplay directly affects the development of social-cognitive and mentalizing capacities that are acquired in the interpersonal context of early attachment relationships. Early attachment experiences are conceptualized as the key organizer of a complex interplay between genetic, environmental, and epigenetic contributions to the development of anxiety disorders - a multifactorial etiology resulting from dysfunctional co-regulation of fear and stress states. These risk-conferring processes are characterized by hyperactivation strategies in the face of anxiety. The cumulative allostatic load and subsequent "wear and tear" effects associated with hyperactivation strategies converge on the neural pathways of anxiety and stress. Attachment experiences further influence the development of anxiety as potential moderators of risk factors, differentially impacting on genetic vulnerability and relevant neurobiological pathways. Implications for further research and potential treatments are outlined.

  • 06/2014; 16(1):29-33. DOI:10.1080/15294145.2014.900932
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    ABSTRACT: Attachment is a behavioral and physiological system, which enables individual's dynamic adaptation to its environment. Attachment develops in close interaction between an infant and his/her mother, plays an important role in the development of the infant's brain, and influences the quality of interpersonal relationships throughout life. Security of attachment is believed to influence individual response to stress, exposing insecurely organized individuals to deregulated autonomic nervous system and exaggerated hypothalamic-pituitary-adrenal activity, which, in turn, produces increased and prolonged exposure to stress-hormones. Such stress responses may have considerable implications for the development of diverse health-risk conditions, such as insulin resistance and hyperlipidemia, shown by numerous studies. Although the mechanisms are not yet fully understood, there is compelling evidence highlighting the role of psychological stress in the development of type 1 diabetes (T1D). One of the possible contributing factors for the development of T1D may be the influence of attachment security on individual stress reactivity. Thus, the suggestion is that insecurely attached individuals are more prone to experience increased and prolonged influence of stress hormones and other mechanisms causing pancreatic beta-cell destruction. The present paper opens with a short overview of the field of attachment in children, the principal attachment classifications and their historic development, describes the influence of attachment security on individual stress-reactivity and the role of the latter in the development of T1D. Following is a review of recent literature on the attachment in patients with T1D with a conclusion of a proposed role of attachment organization in the etiology of T1D. Navezanost je vedenjski in fiziološki sistem, ki posamezniku omogoča dinamično prilagajanje na okolje. Navezanost se razvija pri sovplivu med dojenčkom in materjo, igra pomembno vlogo pri razvoju otrokovih možgan in vpliva na kvaliteto posameznikovih socialnih odnosov vse življenje. Varnost ali oblika navezanosti vpliva na posameznikov odziv na stres (stresno reaktivnost). Tako pride pri negotovo navezanih posameznikih do slabše reguliranega avtonomnega živčnega sistema in pretirane reaktivnosti hipotalamo-hipofizno-suprarenalne osi, zaradi česar so ti v življenju pogosteje in dalj časa izpostavljeni delovanju stresnih hormonov. Tovrsten odziv na stres pa ima pomembno vlogo pri razvoju inzulinske rezistence, hiperlipidemije in drugih stanj, ki predstavljajo tveganje za zdravje. Čeprav natančni mehanizmi še niso znani, je vedno več dokazov, da psihološki stres pomembno prispeva k razvoju sladkorne bolezni tipa 1 (SBT1). Eden od mehanizmov razvoja te bolezni bi lahko bil tudi vpliv oblike navezanosti na posameznikovo stresno reaktivnost. Tako so lahko negotovo navezani posamezniki pogosteje, dlje in v večji meri izpostavljeni delovanju stresnih hormonov, ki skupaj z drugimi dejavniki povzročajo uničenje beta celic trebušne slinavke. Ta prispevek prikaže najprej kratek pregled področja navezanosti pri otrocih, glavne oblike navezanosti in njihov zgodovinski razvoj, oriše vpliv oblike navezanosti na posameznikovo stresno reaktivnost in vpliv te reaktivnosti na razvoj SBT1. Zaključi se s predlogom o vlogi oblike navezanosti pri razvoju SBT1 pri otrocih. ABSTRACT Keywords: attachment, children, type 1 diabetes, etiology, stress reactivity IZVLEČEK Ključne besede: navezanost, otroci, starši, sladkorna bolezen tipa 1, etiologija, stresna reaktivnost
    Slovenian Journal of Public Health 01/2015; 54(2):126-130. DOI:10.1515/sjph-2015-0019 · 0.45 Impact Factor
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    ABSTRACT: The co-occurrence of generalized anxiety disorder and personality disorders suggests the existence of association between the neurobiological predispositions leading to the development of these disorders and activation of cytokine system. Pro-inflammatory chemokines such as CCL-5/RANTES (regulated upon activation normal T cell expressed and secreted) and CXCL12/SDF-1 (stromal derived factor) play an important role in immune response. A total of 160 participants were enrolled in the study, 120 of whom comprised the study group (people with the dual diagnosis of personality disorder and generalized anxiety disorder). The mean age was 41.4±3.5 years (range: 20-44 years). The control group consisted of 40 healthy individuals in the mean age of 40.8±3.1 years (range: 20-43 years). A blood sample was collected from each participant and the plasma levels of the CCL-2/MCP-1 (monocyte chemoattractant protein-1), RANTES and SDF-1 chemokines were determined by ELISA. Increased levels of MCP-1 and SDF-1 were found both in women and in men versus the control group for all types of personality disorders. The levels of CCL-5 in men were significantly increased versus the control group and significantly higher in women than in men. Neither women nor men with avoidant or obsessive-compulsive personality disorder showed any significant differences in MCP-1 or SFD-1 levels. In subjects with borderline personality disorder, the levels of the study chemokines were higher in women than in men. Our study has shown the need for determination of proinflammatory interleukins which are considered as biomarkers of personality disorders and generalized anxiety disorders. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.
    Pharmacological reports: PR 02/2015; 67(1). DOI:10.1016/j.pharep.2014.08.006 · 2.17 Impact Factor

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