Implications of attachment style for patterns of health and illness.

There is substantial evidence that health status and health outcomes are related to the availability and quality of personal relationships. The proposition that attachment relationships in childhood and adolescence have health-related implications fits within this research tradition, and has guided recent attempts to develop models linking attachment style with emotional regulation, coping mechanisms, and illness behaviours. The present paper discusses these theoretical models, together with relevant empirical findings. It is argued that measures of attachment security are related to symptom-reporting, health-care utilization, and restriction of normal activities, and that these links can be explained, in part, by individual differences in emotional and behavioural responses to stress. It is further noted that researchers have proposed physiological and biochemical pathways which may explain some of the effects of attachment style on physical health. The quality of parent-child attachment also predicts family responses to children's illness, as reflected in parents' visitation rates and in family participation in studies of health and illness. The implications of the findings for research and for practice in the health professions are briefly discussed.

Attachment style as a piedictor of sexual attitudes and behavior in late Adolescence.

Abstract This research applied attachment theory to the study of sexual attitudes and behaviors in a sample of late adolescents. Four hundred and seventy heterosexual undergraduate students completed questionnaires assessing attachment (discomfort with closeness; anxiety over relationships). relationship history, communication about sex. sexual self-efficacy and locus of control, and attitudes to condoms. Eight weeks later, participants reported on sexual behaviors occurring during the eight-week interval. and perceived risk of these activities. Both discomfort with closeness and anxiety over relationships were associated with external locus of control for sexual outcomes, and with use of drugs before sexual contact. Anxiety over relationships was linked to unsafe sex and to negative attitudes to condoms, but discomfort with closeness was associated with a more cautious approach to sexual risk-taking. Some results were qualified by gender differences. and by differences between the full sample and those who were sexually active. The findings arc discussed in terms of attachment style and its links with communication and affect regulation. SUMMARY AND CONCLUSIONS This study indicates that attachment dimensions are reliably related to many aspects of sexual attitudes and behaviors among late adolescents. Insecure attachment was linked to increased drug use before sexual contact. Anxiety over relationships was also linked to less safe sexual practice, but discomfort with closeness was associated with a tendency for males to be cautious about sexual risk-taking. The results support the utility of the attachment perspective on adolescent sexuality, but also highlight the complex relations between attachment dimensions and sexual outcomes. Future research would benefit from more detailed investigations of the attitudes, emotions, and cognitions which may mediate the link between attachment style and sexual behavior. For example, those who are highly anxious about their relationships may engage in more risky sexual practices because they fear that non-compliance with partners' wishes will jeopardize their relationship; the tendency to engage in drug use before sexual cpntact may reflect their attempts to boost self-confidence or to manage negative mood states. Research into these issues has the potential to explain how attachment insecurity is played out in patterns of sexual activity.

Relationship history and relationship attitudes in gay males and lesbians: attachment style and gender differences.

OBJECTIVE: The objective of the present study was to assess the applicability of attachment theory to the relationships of gay males and lesbians, with particular emphasis on parental relationships, relationship satisfaction, sexual attitudes and 'coming out' as being homosexual. METHODS: Gay males (n = 77) and lesbians (n = 100) completed questionnaires assessing attachment style, working models of attachment, early relationships with parents and relationship history, status and functioning. A comparison sample of heterosexual participants completed measures of attachment style and relationship history. RESULTS: Relative frequencies of attachment styles were similar for homosexual and heterosexual samples. Contrary to previous research using largely heterosexual respondents, no link between early parenting and attachment style was found. However, homosexual males reported more positive early relationships with mothers than did females. Associations of attachment style with working models, relationship variables and sexual attitudes largely supported those based on heterosexual samples. Gender and attachment style differences were found in reported effects of 'coming out' on relationships with parents. CONCLUSIONS: Overall, the results suggest that insecure attachment may not be over-represented in gay and lesbian samples, but that insecurity is associated with less relationship satisfaction and with problems related to the disclosure of sexual orientation. The implications of these findings for research and clinical practice are addressed.

Attachment style and affect regulation: relationships with health behavior and family experiences of illness in a student sample.

Questionnaire measures of attachment style and health behavior were completed by 287 university students on 2 occasions, 10 weeks apart. At Time 1, Ss also provided reports of emotionality and early family experiences of illness. Reports of early family illness showed theoretically meaningful relationships with attachment style. Symptom reporting was predicted most strongly by anxious/ambivalent attachment and negative emotionality, with the link between anxious/ambivalent attachment and symptom reporting partially mediated by negative emotionality. Visits to health professionals at Time 2 were directly related to reports of chronic illness in the family but inversely related to paternal illness and avoidant attachment, controlling for symptom reporting. The results are discussed in terms of theories of attachment and affect regulation.

Adolescents' interactions with the opposite sex: influence of attachment style and gender.

The present research assessed attachment style and gender differences in adolescents' relationships with the opposite sex, using questionnaire and diary methodologies. In Study 1, 193 unmarried undergraduate subjects completed questionnaire measures of attachment style, relationship history and attitudes to sex. Relationship history data supported previous findings: avoidant subjects reported fewer and less intense love experiences; anxious/ambivalent subjects reported frequent but less enduring love relationships; secure subjects reported more loving and satisfying relationships. As hypothesized, avoidant subjects were more accepting of casual (uncommitted) sex than other attachment groups. In Study 2, 85 subjects from the previous study used a diary format to record their interactions with members of the opposite sex, classifying each interaction according to intimacy level and partner type. Avoidant subjects engaged in fewer interactions overall, fewer chats, and interacted with a smaller number of friends. Anxious/ambivalent subjects engaged in fewer interactions with strangers than did secure subjects. Female avoidants and male anxious/ambivalents were the least likely to report engaging in sexual intercourse during the course of the study, suggesting that attachment style and gender role expectations jointly influence relationship development.

Adult attachments and sexuality: implications for understanding risk behaviours for HIV infection.

In response to the AIDS epidemic, there has been an intensification of interest in human sexuality research in general and "safe sex" practices in particular. Most research models have been somewhat mechanistic in focus, however, with little recognition of the significance of affectional needs in the formation and maintenance of sexual relationships. In this paper we propose that relationship issues are central to an understanding of the expression of sexuality, and that attachment theory provides a useful perspective on human sexual bonds. It is suggested that future research could usefully extend the conceptualisation of adult attachment styles by exploring the meaning of attachment relationships for gay and heterosexual couples, and the implications of attachment style for the behaviours associated with sexual relationships, including the negotiation of safe sex practices. Such research would have direct relevance for prevention programs relevant to HIV/AIDS.