Article

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: 3.27). 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.

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    • "While throughout life, social bonds between people are established and maintained, especially experiences in early childhood are crucially responsible for social emotional functioning (Beck 1987, 2008). Attachment theory, a developmental psychological framework, suggests that interactions with attachment figures (e.g., parents), and the responses of the latter to the proximity-seeking attempts of the child, will induce the formation of differential cognitive schemata for representation of the self and others, and for behavior and affect regulation in interpersonal relationships later on in life (Cassidy 2008; Nolte et al. 2011; Vrticka and Vuilleumier 2012). Schema activation, as explained, for instance, in the cognitive model of depression (Disner et al. 2011) can be seen as a psychopathologically relevant " carry-over " effect of an environmental trigger. "

    Full-text · Dataset · Sep 2015
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    • "The corresponding neural networks involve those associated with arousal/salience (i.e., amygdala and ventral striatum), reflexive/instrumental caring behaviors such as nursing and carrying (i.e., hypothalamus), emotion regulation (i.e., medial prefrontal cortex [PFC] and anterior cingulate cortex), and cognition (i.e., dorsolateral PFC, insula, inferior frontal and orbitofrontal gyri, and temporoparietal junction ). Communication among these highly interconnected neural structures is regulated through a complex array of neurotransmitters (e.g., dopamine) and neuropeptides (e.g., oxytocin [OT]) (Nolte et al., 2011; Swain et al., 2014). Focusing on brain circuitry implicated in parental responsiveness, and on the biochemical communication network linking that circuitry generates hypotheses about the neurobiological infrastructure of FA. "
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    ABSTRACT: Anxiety disorders are the most common mental health concern for youth. Unfortunately, a substantial number of children and adolescents do not respond positively to current evidence-based interventions and/or relapse. As pediatric anxiety disorders are fundamentally a systemic phenomenon, focusing on the ways in which parents become involved in their children's anxiety symptoms may be a promising alternative approach to treatment. To inform psychiatric mental health nurse practitioners (PMHNPs) about the phenomenology, associated neurobiology, and assessment of family accommodation (FA) as well as clinical interventions targeting FA. FA refers to ways that parents adapt their own behaviors to reduce their children's anxiety-related distress. A literature search was performed using Psyc-INFO and PubMed. Current findings indicate a high prevalence of FA associated with pediatric anxiety disorders. FA has a potentially deleterious impact on course of illness and treatment response and is associated with greater caregiver burden. Potential neurobiological underpinnings of FA include dysregulation of parent cortico-limbic circuitry and the oxytocinergic system. PMHNPs are in a unique position to identify families engaged in problematic FA, educate their clientele, provide psychotherapy services with the goal of reducing FA, and consult with multidisciplinary team members. © 2015 Wiley Periodicals, Inc.
    Full-text · Article · Aug 2015 · Journal of Child and Adolescent Psychiatric Nursing
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    • "While throughout life, social bonds between people are established and maintained, especially experiences in early childhood are crucially responsible for social emotional functioning (Beck 1987, 2008). Attachment theory, a developmental psychological framework, suggests that interactions with attachment figures (e.g., parents), and the responses of the latter to the proximity-seeking attempts of the child, will induce the formation of differential cognitive schemata for representation of the self and others, and for behavior and affect regulation in interpersonal relationships later on in life (Cassidy 2008; Nolte et al. 2011; Vrticka and Vuilleumier 2012). Schema activation, as explained, for instance, in the cognitive model of depression (Disner et al. 2011) can be seen as a psychopathologically relevant " carry-over " effect of an environmental trigger. "
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    ABSTRACT: Introduction: To understand the interplay between affective social information processing and its influence on mental states we investigated changes in functional connectivity (FC) patterns after audio exposure to emotional biographic narratives. Methods: While lying in the 7T MR scanner, 23 male participants listened to narratives of early childhood experiences of three persons, each having either a secure, dismissing, or preoccupied attachment representation. Directly after having listened to each of the prototypical narratives, participants underwent a 10-minute resting-state fMRI scan. To study changes in FC patterns between experimental conditions, three post-task conditions were compared to a baseline condition. Specific local alterations, as well as differences in connectivity patterns between distributed brain regions, were quantified using Network-based statistics (NBS) and graph metrics. Results: Using NBS, a nine-region subnetwork showing reduced FC after having listened to the dismissing narrative was identified. Of this subnetwork, only the left Supplementary Motor Area (SMA) exhibited a decrease in the nodal graph metrics degree and strength exclusively after listening to the dismissing narrative. No other region showed post-task changes in nodal metrics. A post hoc analysis of dynamic characteristics of FC of the left SMA showed a significant decrease in the dismissing condition when compared with the other conditions in the first three minutes of the scan, but faded away in the two subsequent intervals the differences. Conclusions: Nodal metrics and NBS converge on reduced connectivity measures exclusively in left SMA in the dismissing condition, which may specifically reflect ongoing network changes underlying prolonged emotional reactivity to attachment-related processing.
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