Change in Heart Rate Variability After the Adult Attachment Interview in Dissociative Patients

Abstract

The aim of this study was to assess heart rate variability (HRV) in individuals with dissociative disorders (DD) before and after the Adult Attachment Interview (AAI). Electrocardiograms were recorded before, during, and after the AAI in 13 individuals with DD and 13 healthy participants matched for age and gender. Significant change in HRV was observed only in the DD group. After the AAI, those with DD showed significant increases in the low frequency/high frequency ratio (pre-AAI = 1.91 ± 1.19; post-AAI = 4.03 ± 2.40; Wilcoxon test = -2.76, p = .005). Our results suggest that the retrieval of childhood attachment experiences in individuals with DD is associated with a change in HRV patterns that could reflect the emotion dysregulation of dissociative psychopathological processes.

Secure Attachment Representation in Adolescence Buffers Heart-Rate Reactivity in Response to Attachment-Related Stressors

“…Another important aspect is that we did not subdivide the AAP into subphases with standardized time intervals. Although this is in line with other studies assessing physiological parameters during attachment interviews (i.e., Beijersbergen et al, 2008;Farina et al, 2015), a comparison of HRV estimates for certain subphases might be helpful to further justify deriving average scores between individuals with different attachment patterns. Furthermore, recent developments in virtual reality (VR) technology provided the applicability of this technological platform to confront study participants with an environmental stressor, the Trier Social Stress Test (TSST) being a prominent example for virtually experienced stress (Kirschbaum et al, 1993).…”

“…Recently published studies measure autonomic imbalance during attachment-related stressful situations using indices of heart-rate variability (HRV) ( Bryant and Hutanamon, 2018 ; Farina et al, 2015 ) which is considered to be important for the psychophysiological regulation of emotions in humans. HRV reflects the rhythmic oscillations of heart rate (HR) and is involved in the regulation of fight-or-flight responses.…”

“…On a physiological level, adults with a secure-autonomous attachment demonstrated a lower increase in cardiovascular reactivity from baseline to questions during the AAI related to a threat, rejection, and separation compared to the insecure groups ( Dozier and Kobak, 1992 ; Roisman et al, 2004 ; Roisman et al, 2007 ; Holland and Roisman, 2010 ). Farina et al (2015) focused on the unresolved attachment group in adult patients with dissociative disorder. This attachment group is characterized by a breakdown of defensive and coping strategies in response to stressful attachment situations which might be reflected in higher physiological arousal during attachment-related stressors compared to the other three attachment groups.…”

The Role of Attachment Trauma and Disintegrative Pathogenic Processes in the Traumatic-Dissociative Dimension

“…First, the long-lasting stressful and powerless experience of DA activates a chronic stress neurobiological response that interferes with brain development (De Bellis and Zisk, 2014; Teicher et al., 2016). Second, the inescapable threatening condition created by the simultaneous and conflicting activation of attachment and survival defense systems triggers an autonomic parasympathetic detachment response (Porges, 2007; Farina et al., 2015). Finally, the simultaneous tendencies to get close to and flee from the parent cannot be assimilated into the same framework of meaning, because a one-year old child’s limited consciousness-memory skills cannot integrate them into a single act of mental synthesis (Liotti, 2004, 2009).…”

A brief report on the status of theJournal of Trauma & Dissociation

“…Bethany Brand once again generously served as chair of the awards committee. The Richard P. Kluft Award for the Journal of Trauma & Dissociation 2015 Best Article went to Farina, Speranza, Imperatori, Quintiliani, and Della Marca (2015) for their article "Change in Heart Rate Variability After the Adult Attachment Interview in Dissociative Patients." The awards committee noted about this winning paper, "This small but important study contributes to our understanding of dissociation by validating with a psycho-physiological experiment that attachment trauma is associated with differences or adaptations in biological stress regulation.…”