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Andrea Oskis
Neuroendocrine correlates of insecure attachment in adolescents
Psychophysiology and Stress Research
Group
Attachment theory as a stress theory
Bowlby’s original theory: a biobehavioural safety-regulating system
Activated in times of threat or stress
Internal working model
Activates our body’s ‘stress hormone hotline’
The Hypothalamic-Pituitary-Adrenal (HPA) axis
Secretes the hormone cortisol
STRESS!
Cortisol is not just a stress hormone...
Based on Genuth (2008)
Bone formation and resorption
Bone formation and resorption
Decrease connective
tissue
Decrease connective
tissue
Maintain muscle function; decrease
muscle mass
Maintain muscle function; decrease
muscle mass
Maintain cardiac output
Maintain cardiac output
Modulate emotional tone,
wakefulness
Modulate emotional tone,
wakefulness
Support glucose synthesis
Support glucose synthesis
Inhibit inflammatory and
immune responses
Inhibit inflammatory and
immune responses
Increase glomerular filtration and free water clearance
Increase glomerular filtration and free water clearance
Cortisol
An excellent way to measure cortisol
The diurnal cortisol rhythm
0 3 6 9 12
0
5
10
15
20
25
30
wake-up
Hours post-awakening
Cor
tiso
l (nm
ol/l)
Oskis et al. (2009)
Cortisol Awakening Response
(CAR)
Especially post-awakening
... In women with early life attachment adversity
... and also with anxious insecure attachment style
Meinlschmidt and Heim (2005)
Quirin et al. (2008)
Cortisol rhythms matter...
...especially immediately post-awakening
Kudielka & Kirschbaum (2003)
Shirtcliff and Essex (2008)
...especially in adolescence...
General methods
Participants: 60 healthy female adolescents aged 9-18 yrs, mean age 14.16 (± 2.63) years
Key measures:• Attachment Style Interview (ASI)• Saliva samples
The importance of adherence
Participant 35C,
28/02/07, age 17
Morning Andrea! Woke up 0702,
sample 1 done @ 0702. All going well!
Its 12:35 so I’ve just done tube 6. I’ll b ready 4 tube
7 at 3:35. Thanx 4 messages, hope ur havin
a good day! xXx
Participant 26C,
28/02/07, age 17
• Personalised text message prompts for each saliva sample sent over the day
The Attachment Style Interview
Assesses current relationship behaviour & attitudes
Mild Moderate
Marked
Mild Moderate
Marked
The Attachment Style Interview
Assesses current relationship behaviour & attitudes
Mild Moderate
Marked
Mild Moderate
Marked
Results
Securely attached
Attachment style
Insecure Anxious
Insecure Avoidant
Secure(n = 30)
Anxious(n = 13)
Avoidant(n = 17)
Age in years 14.70 (± 2.56) 13.39 (± 2.72) 13.12 (± 2.55)
Eating disorder risk (EDI-3)
27.93 (± 6.21) 26.92 (± 7.75) 25.18 (± 4.56)
General psychological maladjustment
34.80 (± 4.66) 37.23 (± 6.00) 36.65 (± 6.14)
STAI trait 33.50 (± 6.16) 33.62 (± 9.93) 35.65 (± 7.58)
STAI state am† 29.42 (± 6.74) 29.23 (± 7.21) 30.85 (± 6.60)
STAI state pm† 28.50 (± 7.34) 27.42 (± 7.11) 29.32 (± 6.06)
Participant characteristics
Secure(n = 30)
Anxious(n = 13)
Avoidant(n = 17)
Age in years 14.70 (± 2.56) 13.39 (± 2.72) 13.12 (± 2.55)
Eating disorder risk (EDI-3)
27.93 (± 6.21) 26.92 (± 7.75) 25.18 (± 4.56)
General psychological maladjustment
34.80 (± 4.66) 37.23 (± 6.00) 36.65 (± 6.14)
STAI trait 33.50 (± 6.16) 33.62 (± 9.93) 35.65 (± 7.58)
STAI state am† 29.42 (± 6.74) 29.23 (± 7.21) 30.85 (± 6.60)
STAI state pm† 28.50 (± 7.34) 27.42 (± 7.11) 29.32 (± 6.06)
Participant characteristics
All within age-appropriate All within age-appropriate normative rangenormative range
No significant differences No significant differences between attachment style between attachment style groupsgroups
CAR and attachment style
0 15 30 45
5
10
15
20
25
*
*Avoidant insecurely attachedAnxious insecurely attached
Securely attached
Minutes post-awakening
Co
rtis
ol
(nm
ol/
l)
Oskis et al. (2012)
Daytime cortisol and attachment style
3 6 9 12
0
2
4
6
8
10Secure
Anxious
Avoidant
Hours post-awakening
Co
rtis
ol
(nm
ol/
l)
Oskis et al. (2012)
Attachment style groups differed in the dynamic of the CAR
Anxious insecure: awakening
45 min post-awakening
No significant difference in subsequent daytime cortisol secretion
The CAR as a distinct and especially sensitive part of the diurnal cortisol cycle?
Summary and implications:Cortisol and attachment style
A prognostic ‘non-healthy’ CAR?
Kudielka & Kirschbaum (2003)
Similarity to anxious insecure adolescent profile
