Attachment style in patients with unexplained physical complaints

Taylor, R.; Mann, Anthony; White, Naomi; Goldberg, David

doi:10.1017/s0033291799002317

Cited by 84 publications

(53 citation statements)

References 17 publications

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“…Taylor et al (13) surveyed more than 2,000 patients in primary care offices and found that those who endorsed insecure attachment styles were significantly more likely than securely attached adults to present with medically unexplained physical symptoms. In a large (n ϭ 701) sample of female primary care patients in a health maintenance organization, Ciechanowski and colleagues (14) found that patients with insecure attachment styles reported a significantly greater number of physical symptoms than those with a secure attachment style, and the strongest association was between fearful attachment style and greater symptom reporting.…”

Section: Attachment and Somatizationmentioning

confidence: 99%

Mapping the Road From Childhood Trauma to Adult Somatization: The Role of Attachment

Waldinger

Schulz

Barsky

et al. 2006

Psychosomatic Medicine

229

125

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Objective: This study tested whether insecure attachment mediates the link between childhood trauma and adult somatization. Methods: A community sample of 101 couples completed self-report measures, including the Relationship Scales Questionnaire, the Childhood Trauma Questionnaire, the Somatic Symptom Inventory, the Beck Depression Inventory, and the Conflict Tactics Scale. Results: Childhood trauma was associated with higher levels of somatization and insecure attachment. Insecure attachment style was also associated with higher levels of somatization. Controlling for age, income, and recent intimate partner violence, analyses showed that fearful attachment fully mediated the link between childhood trauma and somatization for women. For men, there was no such mediation, but both childhood trauma and insecure attachment styles made independent contributions to predicting levels of somatization. Conclusions: Findings are consistent with the hypothesis that, for women, childhood trauma influences adult levels of somatization by fostering insecure adult attachment. For men, findings suggest that trauma and attachment are both important independent predictors of adult somatization. Study results support the idea that childhood trauma shapes patients' styles of relating to others in times of need, and these styles, in turn, influence the somatization process and how patients respond to providers. Screening for attachment style may provide information that could allow health care providers to tailor treatment more effectively.

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Section: Attachment and Somatizationmentioning

confidence: 99%

Mapping the Road From Childhood Trauma to Adult Somatization: The Role of Attachment

Waldinger

Schulz

Barsky

et al. 2006

Psychosomatic Medicine

229

125

View full text Add to dashboard Cite

show abstract

“…Preliminary investigations have found insecure attachment styles in patients with unexplained symptoms and those with hypochondriasis [87, 88]. The preoccupied style appears to be associated with increased symptom reporting and utilization of health care, the dismissive style with the avoidance of care [88,89,90,91]. Based on limited evidence, one might hypothesize links between hypochondriasis and the preoccupied style, and between somatization disorder and the dismissive style.…”

Section: Domains In Which Differences May Be Foundmentioning

confidence: 99%

Distinguishing between Hypochondriasis and Somatization Disorder: A Review of the Existing Literature

Noyes

Stuart

Watson³

et al. 2006

Psychother Psychosom

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A valid classification is important for further understanding of the somatoform disorders. The main disorders in this grouping – somatization disorder and hypochondriasis – have lengthy historical traditions and are defined in a contrasting manner. Various authors point to distinguishing demographic and clinical features, but there have been few direct comparisons of patients with these disorders. A review of the literature indicates those domains where differences are most likely to be found. Research assessing these may serve to refine and validate these key somatoform categories and/or dimensions.

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“…In a similar study [18], diabetics with dismissing styles had poorer control of their symptoms than those who were securely attached, and dismissing patients were again noted to be poorly compliant with treatment. In sum, patients with less secure attachment appear to be more likely to experience and report physical symptoms [19, 20]. Those with preoccupied attachments are more likely to seek medical care; those with avoidant styles tend to avoid care, and those with dismissing styles are likely to be noncompliant with care and to have poorer health outcomes.…”

Section: Attachment Theory: a Conceptualization For Psychosomatic Symmentioning

confidence: 99%

Interpersonal Psychotherapy for Somatizing Patients

Stuart¹,

Noyes²

2006

Psychother Psychosom

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The interpersonal model is important for understanding somatizing behavior. According to this model, somatizing behavior is a form of interpersonal communication driven by insecure attachment. Interpersonal psychotherapy (IPT) is a time-limited, manual-based treatment designed to relieve symptoms and improve interpersonal functioning. Based on our experience using IPT with somatizing patients, we recommend a series of strategies for its successful implementation. These strategies include an emphasis on the therapeutic alliance within a bilaterally negotiated treatment contract, and aiming for improvement in interpersonal functioning rather than for alleviation of physical symptoms. Specific techniques include the use of bridging metaphors, communication analysis, and genuine positive reinforcement. With a focus on communication in a time-limited frame, fostered by a strong collaborative relationship, IPT appears to be a promising method of reducing somatizing behavior. We urge further research on the efficacy of this form of therapy.

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Attachment style in patients with unexplained physical complaints

Cited by 84 publications

References 17 publications

Mapping the Road From Childhood Trauma to Adult Somatization: The Role of Attachment

Mapping the Road From Childhood Trauma to Adult Somatization: The Role of Attachment

Distinguishing between Hypochondriasis and Somatization Disorder: A Review of the Existing Literature

Interpersonal Psychotherapy for Somatizing Patients

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