Clinicians and researchers have increasingly identified that individuals often co-present with sensory processing and attachment difficulties. To understand and support clients with difficulties related to sensory processing and/or attachment, more research is needed to understand how and why these two constructs are related, particularly in the context of contemporary research on psychophysiology and childhood adversity. The purpose of this thesis is to investigate the ways in which sensory processing and attachment patterns are related, the reasons they may be related, and to examine the implications of this relationship for areas of functioning and wellbeing.
A scoping review was undertaken to examine evidence for a relationship between sensory processing and attachment patterns across the lifespan. There is emerging evidence in children that attachment security is related to better sensory modulation (i.e., self-regulation in response to sensations). In adults, there is also evidence that having a low sensory threshold (i.e., easily noticing and/or becoming overwhelmed by sensory stimuli) is related to attachment anxiety and, to a lesser extent, attachment avoidance. Findings from this review highlighted a need for further research in this area, including research: (1) examining the impact of childhood experiences on the relationship between sensory processing and attachment patterns; (2) investigating the psychophysiological underpinnings of sensory processing; and (3) exploring the implications for sensory processing and attachment on functioning and wellbeing. Based on the findings of this scoping review and a broader review of relevant research and theories, three cross-sectional studies were designed to address these gaps in the literature and lay the foundation for the proposition of a new model to understand the complex interactions between these factors.
The first study was a laboratory-based study with a non-clinical young adult sample. This study aimed to determine whether different sensory processing patterns were associated with differences in autonomic functioning before, during and after a physical stressor. In the study, a low sensory threshold was related to unique patterns of autonomic activity and reactivity, which varied by gender. Previous studies have found that autonomic arousal may underpin patterns of attachment insecurity and explain the behavioural patterns of people who have experience childhood adversity. This study therefore indicates that autonomic arousal may be a potential psychophysiological factor that underpins the relationship between these constructs.
The second study was an online survey with a non-clinical adult sample designed to investigate the links between sensory processing patterns, attachment patterns, and childhood experiences. In this study, it was found that childhood adversity predicted more attachment anxiety in adulthood for highly sensitive individuals. However, childhood adversity predicted more attachment avoidance for individuals with low levels of sensitivity. These findings indicate that sensory processing sensitivity interacts with childhood adversity to shape the type of attachment pattern an individual experiences in adulthood. The second study also produced a second paper that investigated the interaction effect between childhood adversity and sensory processing sensitivity on meaningful activity engagement in adulthood. Sensory processing sensitivity was not related to meaningful activity engagement and did not moderate the relationship between childhood adversity and meaningful activity engagement. Childhood adversity did, however, directly affect an individual’s level of meaningful activity engagement in adulthood. This finding supports the involvement of early intervention occupational therapists for individuals who experience childhood adversity as they are more likely to have long-term difficulties with meaningful activity engagement, which has important implications for their health and wellbeing.
The third study investigated the implications of sensory processing and attachment patterns for functioning in families of children with persistent pain. Pain is a sensory experience that can trigger an individual’s threat response and activate their attachment system. Children with persistent pain often co-present with sensory processing and attachment difficulties, which impact their wellbeing and functioning. Because it was theorised that a child’s sensory processing and attachment patterns impact the child-caregiver relationship, it was expected that the child’s sensory processing and attachment patterns may also affect caregiver functioning in this context. However, it was found that the children’s sensory processing patterns were not related to parent functioning. Child and parent attachment avoidance were, however, significantly related to poorer parent functioning in a range of domains. Because the study did not investigate parent sensory processing patterns, further research is needed to understand how the interaction between child and caregiver sensory processing patterns may affect the attachment relationship and family functioning.
When considering the findings of these studies alongside the contemporary literature, there is growing evidence that sensory processing, attachment patterns, and childhood experiences are interrelated factors that may be underpinned by autonomic arousal. However, it is evident that there is a need for an integrative model that conceptualises sensory processing in the context of attachment, childhood experiences, and autonomic functioning. The Dyadic Model of Sensory Modulation is therefore proposed in the fourth and final section of this thesis. Clinical implications and future areas of study are discussed that may help to further understand this emerging area of research and practice.