Attachment and Health
John Bowlby and Mary Ainsworth developed attachment theory in the 1960s while investigating the effects of maternal separation on infant development. The development of the Strange Situation task in 1965 by Ainsworth and Wittig allowed researchers to systematically investigate the attachment system operating between children and their parents. The Strange Situation involves separating infant-parent dyads and observing infant behaviours upon reunion. Infant behaviour tended to follow patterns, leading to the development of three attachment categories: Secure, Anxious-Avoidant, and Anxious-Resistant. In 1990, Ainsworth added a new category, championed by Mary Main, called Disorganized/Disoriented attachment, characterized by its less reliable pattern of behaviour.
Attachment and Health
While strong social support has been linked to greater resilience to stress and lower medical morbidity and mortality, the mechanism behind this association is poorly understood. In the late 1990s, Paul Ciechanowski investigated the role of attachment styles in patients managing diabetes, finding that individuals with an avoidant-dismissive style were less likely to be compliant with treatment recommendations and had less well-controlled disease as measured by glycosylated hemoglobin. Larger scale evidence comes from a large American survey of self-reported attachment styles and physical illness conducted by McWilliams and Bailey. They found that those with insecure attachment reported more physical illness than securely attached individuals. Specifically, they found preoccupied individuals reported more heart disease, and dismissive individuals more pain conditions. A prospective study followed children until the age of 32 and found a similar pattern of results. They found that people with anxious-resistant (dismissive) styles of attachment reported vague, non-specific symptoms more often, and those with anxious-preoccupied classification had a higher rate of inflammation-based illnesses. This prospective study was particularly important because of the difficulty assigning causation in the often observed relationship between chronic pain and insecure attachment. Further support is derived from experimental pain studies that have demonstrated numerous risk factors for the development of a chronic pain disorder associated with insecure adult attachment including lower perceived control of pain, higher pain catastrophizing and higher perceived pain intensity.