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This study examined the associations between maternal depression and oxytocin in pregnancy, caregiving sensitivity and adult attachment style, and infant temperament. One hundred and six women recruited from a public hospital antenatal clinic in Australia, and their infants completed assessments at three time points (Time 1: pregnancy; Time 2: 3-month postpartum; Time 3: 12-month postpartum). Mothers completed self-report questionnaires assessing maternal depression symptom severity at Time 1-3, adult attachment style at Time 2, and infant temperament at Time 3. At Time 1, they also provided a blood sample to assess peripheral oxytocin levels, and at Time 2, participated in a parent-child interaction session, which was later coded for caregiving behavior (sensitivity). Neither maternal depression nor lower levels of oxytocin during pregnancy predicted difficult infant temperament; rather, it was predicted by non-Caucasian ethnicity. When all other variables were free to vary, adult attachment avoidance mediated an association between maternal depression during pregnancy and difficult infant temperament. Results highlight the potential value of interventions focusing on adult attachment insecurity for pregnant women and raise questions about associations between culture/ethnicity and infant temperament.

Cette étude a examiné les liens entre la dépression maternelle et l'oxytocine durant la grossesse, la sensibilité de la personne prenant soin de l'enfant, le style d'attachement adulte et le tempérament du nourrisson. Cent six femmes recrutées dans une clinique prénatale d'un hôpital public et leurs nourrissons ont rempli des évaluations à trois moments (Moment 1 : la grossesse; Moment 2 : 3 mois postpartum; Moment 3 12 mois postpartum). Les mères ont rempli des questionnaires d'auto­évaluation évaluant la sévérité du symptôme de dépression maternelle aux Moments 1, 2, et 3, le style d'attachement adulte au Moment 2, et le tempérament du nourrisson au Moment 3. Au Moment 1 elles ont aussi donné un échantillon de sang afin d'évaluer les niveaux périphériques d'oxytocine, et au Moment 2 elles ont participé à une séance d'interaction parent­enfant qui fut plus tard codée pour le comportement de soin (sensibilité). Ni la dépression maternelle ni des niveaux plus bas d'oxytocine durant la grossesse ont prédit un tempérament difficile du nourrisson. En fait ce dernier s'est avéré prédit par une ethnicité non blanche. Lorsque toutes les autres variables étaient libres de varier le fait d'éviter l'attachement adulte a servi de médiation dans le lien entre la dépression maternelle durant la grossesse et le tempérament difficile du nourrisson. Les résultats mettent en lumière la valeur potentielle des interventions qui mettent l'accent sur l'insécurité de l'attachement adulte pour les femmes enceintes et soulèvent des questions quant aux liens entre la culture/l'ethnicité et le tempérament du nourrisson.

Este estudio examinó las asociaciones entre depresión materna y oxitocina en el embarazo, la sensibilidad acerca de la prestación de cuidado y el estilo de afectividad adulta, así como el temperamento del infante. Ciento seis mujeres, reclutadas de la clínica antenatal de un hospital público, y sus infantes, completaron un instrumento evaluativo en 3 momentos (Momento 1: embarazo; Momento 2: 2­3 meses después del parto; Momento 3: 12 meses después del parto). Las madres completaron cuestionarios de autoinforme en los que evaluaban la severidad de los síntomas de depresión materna en los Momentos 1, 2 y 3, el estilo de afectividad adulta al Momento 2, así como el temperamento del infante al Momento 3. Al Momento 1, ellas también aportaron una muestra de sangre para evaluar los niveles perimetrales de oxitocina, y al Momento 2, participaron en una sesión de interacción progenitor­infante que luego fue codificada en cuanto al comportamiento de prestación de cuidado (sensibilidad). Ni la depresión materna ni los bajos niveles de oxitocina durante el embarazo predijeron el temperamento difícil del infante; más bien, eso lo predijo la etnicidad no caucásica. Cuando todas las otras variables estaban libres para variar, la evasión de la afectividad adulta sirvió de mediadora en una asociación entre depresión materna durante el embarazo y temperamento difícil del infante. Los resultados subrayan el valor potencial de intervenciones que se enfoquen en la inseguridad de la afectividad adulta para mujeres embarazadas y plantean preguntas acerca de las asociaciones entre cultura/etnicidad y el temperamento del infante.

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This study aimed to analyze the impact of the lockdown period due to COVID-19 pandemic on the mental health status of healthcare workers and identify the related risk factors of psychosomatic distress. We conducted an online questionnaire survey to investigate the general demographic characteristics, perceived stress level, adult attachment style (AAS), family cohesion and adaptability, social support, sleep state, emotional state, and physical health of healthcare workers during the lockdown period due to the pandemic in 2022. We compared the mental health status between doctors and nurses, and further analyzed the factors influencing sleep, emotions, physical symptoms, and severe psychosomatic distress separately. For factors that showed statistical significance in the univariate analysis, forward stepwise regression was used for logistic regression analysis to identify risk factors for the corresponding issues. A total of 622 healthcare workers participated in the survey. Among the participants, 121 (19.5%) reported sleep problems, 209 (33.6%) had negative emotional states, and 147 (23.6%) reported physical health problems. There were 48 (7.7%) healthcare workers with severe psychosomatic distress. Compared to the group of nurses, the group of doctors exhibit a higher prevalence of emotional issues, physical health problems and psychosomatic distress. Perceived stress was identified as a risk factor for sleep disturbance, while living with others during quarantine and family adaptability were identified as protective factors. Higher educational background and perceived stress were identified as risk factors for negative emotion, while subjective support was identified as a protective factor. Perceived stress and coming from a rural area were also identified as risk factors for physical health. Overall, for the comparison between the no psychosomatic distress and severe psychosomatic distress groups, perceived stress was identified as a risk factor for severe psychosomatic distress, while subjective support was identified as a protective factor. Healthcare workers' potential mental and physical health problems are related to their educational background, family cohesion and adaptability, perceived stress and social support. This makes it clearer on how to deal with and prevent adverse consequences when facing stressful situations.

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Background: To determine the relationships between attachment style, social support, and mental health states, as well as the mediation mechanism within this relationship, we conducted a survey among healthcare workers during the coronavirus disease 2019 (COVID-19) epidemic quarantine. Methods: The survey assessed their mental health states, adult attachment style, social support, and some other relevant information. Mental health states were represented by the overall state of sleep, physical and emotional assessment. A multiple mediator model was used to explain how social support could mediate the relationship between attachment and mental health states during COVID-19 quarantine. Results: Our findings revealed that 33.3% of the participants experienced emotional issues, 8.5% had sleep problems, and 24.9% reported physical discomfort. The direct effect of adult attachment styles on mental health states during COVID-19 quarantine was significant (c' = -0.3172; p < 0.01). The total indirect effect also showed statistical significance (ab = -0.1857; p < 0.01). Moreover, the total effect of adult attachment styles on mental health states was -0.5029 (c = -0.5029; p < 0.01). Subjective social support and utilization of social support play mediating roles in the relationship between attachment style and mental health states, respectively (ab1 = -0.1287, 95% CI: -0.9120 to -0.3341, ab2 = 0.0570, 95% CI: -0.4635 to -0.1132). Conclusion: These findings highlight social support played a mediation role between attachment style and mental health states. Thus, offering social support during a crisis might be useful for those individuals with an insecure attachment.

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The mothers of children with a specific clinical situation such as type 1 diabetes mellitus may have a higher level of stress, causing a worse perception of their quality of life, greater anxiety, and greater avoidance (adult attachment factors). The objective of this research was to verify if there is a relationship between the adult attachment factors of mothers of children with and without type 1 diabetes mellitus and the perception of the quality of life of these mothers. This survey was carried out from July to September 2022, with mothers of children aged 5 to 10 years, with and without diabetes. The data were collected through an online questionnaire, with socioeconomic data from the attachment scale Experience in Close Relationship-(Reduced), and the questionnaire on the quality of life, the WHOQOL-abbreviated questionnaire. For statistical analysis, the Statistical Package for Social Science 24 was used. A total of 45 mothers of children with DM1 and 55 mothers of healthy children were evaluated. The mothers of children with DM1 had a worse perception of their quality of life when compared to the mothers of healthy children (p < 0.05), with no difference in terms of the attachment style. Therefore, it is understood that actions aimed at improving the quality of life of these mothers are necessary.

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PURPOSE: The primary purpose of this cross-sectional study was to delve into the connections among adult attachment styles, communication patterns, and caregiver burden within the sample of parents caring for children diagnosed with solid tumors. METHODS: A sample of 456 parents responsible for the care of children with solid tumors was conveniently recruited from a pediatric oncology ward at a tertiary hospital from September 2021 to September 2022. The data collection process included a questionnaire on general information, the Caregiver Burden Inventory, the Adult Attachment Questionnaire Short Form, and the Communication Pattern Questionnaire. RESULTS: The findings demonstrated a strong and positive connection between caregiver burden and attachment avoidance, whereas no considerable association was observed for attachment anxiety. Attachment avoidance exhibited a positive link with communication patterns and caregiver burden, and a noteworthy inverse correlation with attachment anxiety. Additionally, communication patterns were uncovered as a mediator in the association between attachment avoidance and caregiver burden. CONCLUSIONS: This study underscores the role of communication patterns as mediators between attachment avoidance and caregiver burden among parents of children with solid tumors. These outcomes emphasize the significance of considering attachment styles and communication patterns when comprehending caregiver burden, and can guide the development of targeted interventions to provide support for parents within this challenging context.

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Objective This study aimed to explore whether behavioral synchrony (BS) and inter-brain synchrony (IBS) could serve as potential biomarkers for alliance quality or outcomes among clients with different adult attachment styles. Method: We assessed the clients' self-report working alliance and clinical outcomes as well as simultaneously measured BS using motion energy analysis (MEA) and IBS with functional near-infrared spectroscopy (fNIRS) among 37 secure (N = 21) or dismissing (N = 16) clients with their counselors during the first psychological counseling meeting. Results: Dismissing dyads manifested significantly higher late-stage counselor-led and client-led IBS (p = .018) than secure dyads. Adult attachment style served as the moderators in the correlation of both whole-stage client-led BS with bond dimension of alliance (p = .015) as well as in the correlation of both whole-stage no-lag IBS with CORE-10 score changes (p = .022). Moreover, increases in the whole-stage client-led BS were significantly associated with decreases in early-stage, late-stage and whole-stage no-lag IBS (all ps ≤ 0.01). Conclusion: These findings revealed the potentially impeding role of interpersonal synchrony in alliance quality for dismissing clients, at least during the first psychological counseling meetings. They also might partially validate the relationship between different modalities of interpersonal synchrony.

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How expectant fathers think and feel about the unborn child (prenatal representations), has shown associations with fathers' postnatal parenting behaviors, observed father-infant interactional quality and child cognitive development. There is limited knowledge about fathers' prenatal representations. The present study examined if fathers' partner-related attachment styles were related to their prenatal representations of the unborn child. In the "Little in Norway Study", an ongoing prospective, longitudinal population-based study, 396 expectant fathers completed the Experiences in Close Relationships Scale at enrollment (mean gestational week = 23.76, SD = 4.93), and in gestational weeks 27-35 completed three questions assessing prenatal representations. Correlations of attachment style and prenatal representations were reported using logistic regression analyses. We found that an avoidant attachment style by fathers were predicted to have absent or negative representations on all three items (1) "strongest feeling about the unborn child" (Cl = 1.19-2.73), (2) "thoughts about child personality" (Cl = 1.16-1.87), and (3) "experiences of relationship with the child" (Cl = 1.14-1.75). Father anxious attachment style was not significantly associated with absent or negative prenatal representations. Results suggest that expectant fathers with a partner related avoidant attachment style have an increased risk of having absent or negative prenatal representations of the unborn child.

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To date, there is increasing evidence to suggest that age and adult attachment styles, such as secure, anxious and avoidant attachment are predictive or protective for psychological distress. The study aimed to investigate the extent to which age and adult attachment style, measured by the Attachment Style Questionnaire, predicted psychological distress, measured by the Kessler 10 Psychological Distress Scale, in the Singapore general population during COVID-19. Ninety-nine residents of Singapore (44 females, 52 males, 3 prefer not to state their gender) aged between 18 and 66 completed an online survey, which collected information on age, adult attachment styles and levels of psychological distress. Multiple regression analysis was performed to study the influence of predictive factors on psychological distress. The study identified 20.2%, 13.1% and 14.1% of participants reporting psychological distress at the mild, moderate and severe levels, respectively. The study also reported that age and psychological distress were negatively correlated, and that psychological distress was negatively correlated with both anxious and avoidant attachment styles. It was concluded that age and adult attachment style significantly predicted psychological distress in the Singapore general population during COVID-19. Further studies exploring other variables and risk factors are required to further consolidate these results. At the global level, these findings may help countries predict residents' reactions to future outbreaks and help them prepare strategies and approaches to address these situations.

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The Adult Attachment Scale-Revised (Collins and Read in J Person Soc Psychol 58(4):644, 1990. https://doi.org/10.1037/0022-3514.58.4.644) measures the dimensions of the attachment style of adults through the degree to which the individual feels comfortable in intimacy and closeness with the partner (Close), with dependence on the partner (Depend) and worrying about being rejected or unloved (Anxiety). Dimensions measured by the AAS can capture the core of the structure that determines adults' differences in attachment styles. This study aimed to evaluate the factorial structure of the AAS-R among a sample of Italian adults. The Italian translation of AAS-R was administered to the sample of 1546 Italian adults (M = 27.4; SD 9.35). Exploratory factor analysis and confirmatory factor analysis were performed to examine the validity of the Italian version of the AAS-R measure. The present study showed that the Italian version of the AAS-R has a clear factorial structure and good psychometric properties. Clinical and research implications were discussed.

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Introduction: Why are women (not) romantically attracted to dark personalities or villains, which might be a risk factor for intimate partner violence (IPV) victimization? In the current study, it is opted to investigate how adult attachment, maladaptive personality traits, and acceptance of couple violence in women predict romantic attraction to heroic/villainous characters using structural equation modeling (SEM). Method: First, a pilot study was conducted in 122 heterosexual women (aged 16-25) to select male TV characters. This resulted in the selection of six villains and 10 heroes for the main study, in which 194 other heterosexual women (aged 16-25) were asked to rate the pictures of TV characters through an online questionnaire. This was combined with self-report measures of maladaptive personality traits, acceptance of couple violence, and adult attachment. These variables were entered into a SEM model to assess model fit. Results: Overall, women rated heroes higher on physical appearance (pilot study) and romantic attraction (main study) compared to villains. We found different direct effects of avoidant (negative) and anxious (positive) attachment styles on romantic attraction to heroes. Moreover, maladaptive personality traits fully mediated the positive effect of avoidant attachment style on romantic attraction to villains. Discussion: Despite the limitations of the study design (e.g., low N, low notoriety of the TV characters), this study emphasizes that women are generally more romantically attracted to heroes (vs. villains). Besides, there are different predictors of romantic attraction to heroes and villains, which requires further investigation, especially in the context of IPV.

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BACKGROUND: Recent views posited that negative parenting and attachment insecurity can be considered as general environmental factors of vulnerability for psychosis, specifically for individuals diagnosed with psychosis (PSY). Furthermore, evidence highlighted a tight relationship between attachment style and social cognition abilities, a key PSY behavioral phenotype. The aim of this study is to generate a machine learning algorithm based on the perceived quality of parenting and attachment style-related features to discriminate between PSY and healthy controls (HC) and to investigate its ability to track PSY early stages and risk conditions, as well as its association with social cognition performance. METHODS: Perceived maternal and paternal parenting, as well as attachment anxiety and avoidance scores, were trained to separate 71 HC from 34 PSY (20 individuals diagnosed with schizophrenia + 14 diagnosed with bipolar disorder with psychotic manifestations) using support vector classification and repeated nested cross-validation. We then validated this model on independent datasets including individuals at the early stages of disease (ESD, i.e. first episode of psychosis or depression, or at-risk mental state for psychosis) and with familial high risk for PSY (FHR, i.e. having a first-degree relative suffering from psychosis). Then, we performed factorial analyses to test the group x classification rate interaction on emotion perception, social inference and managing of emotions abilities. RESULTS: The perceived parenting and attachment-based machine learning model discriminated PSY from HC with a Balanced Accuracy (BAC) of 72.2%. Slightly lower classification performance was measured in the ESD sample (HC-ESD BAC = 63.5%), while the model could not discriminate between FHR and HC (BAC = 44.2%). We observed a significant group x classification interaction in PSY and HC from the discovery sample on emotion perception and on the ability to manage emotions (both p = 0.02). The interaction on managing of emotion abilities was replicated in the ESD and HC validation sample (p = 0.03). CONCLUSION: Our results suggest that parenting and attachment-related variables bear significant classification power when applied to both PSY and its early stages and are associated with variability in emotion processing. These variables could therefore be useful in psychosis early recognition programs aimed at softening the psychosis-associated disability.

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Adult attachment style has consequences for mental health, interpersonal functioning and emotion regulation. This occurs partly deliberately, also referred to as explicit, and partly on an automatic level outside of conscious awareness, also referred to as implicit. Whereas explicit adult attachment can be assessed with self-report instruments, measurement of implicit adult attachment requires indirect methods. This paper describes the psychometric properties of two Implicit Association Tests measuring general adult attachment in a population sample. The study evaluated the reliability and the validity of the Avoidant Attachment IAT (ANX-IAT) and the Anxious Attachment IAT (AVOID-IAT). Validity was evaluated against self-report measures of adult attachment style (RQ), psychopathology (SQ-48), and well-being (MHC-SF). The split-half reliabilities of both IATs were good; the test-retest reliability of the ANX-IAT was adequate; however the AVOID-IAT had low test-retest reliability. Both IATs did not explain variance in psychopathology additional to explicit measures. The AVOID-IAT showed added value over explicit measurement of avoidant attachment in explaining variance in well-being, particularly regarding emotional and psychological well-being. The ANX-IAT did not explain variance in any measure of well-being additional to the explicit measure of anxious attachment. Our findings provide a basis from which more valid IATs measuring general adult attachment can be developed. Furthermore, they suggest that implicit avoidant attachment might be related to well-being, particularly emotional and psychological well-being. However, further research is needed to investigate the role of implicit general adult attachment in mental health and to optimize the two IATs in terms of validity before clinical use is recommended.

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While there is substantial evidence that emotion regulation plays a role in the maintenance of substance and behavior addiction, its role in addiction to social networking sites (SNS) remains unclear. Drawing on attachment theory, we explore whether emotion regulation mediates the relationship between insecure attachment and SNS addiction among 463 college students. The participants completed the short version of the Experience in Close Relationships Scale, Difficulties in Emotion Regulation Scale, and Chinese Social Media Addiction Scale. The results indicated that attachment anxiety positively predicted SNS addiction and that emotion regulation mediated this link. These findings suggest that individuals' affective regulation capability should be a target of future interventions and treatments.

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Attachment scale is constructed from two components (anxiety and avoidance) effectively treated as providing salient measures in previous studies. Recent studies have suggested associations between sensitivities to physical warmth and anxiety scores of attachment scale. Some researchers also suggest that the degree of one's comfort with physical proximity depends on attachment styles, attributing differences to the number of oxytocin (a neuropeptide released by physical touch) receptors. Lateral preference is an important aspect of physical proximity, coupled with the lateralization of visual, emotional, and other cognitive systems. However, there are few studies investigating the relationship between attachment scale scores and one's lateral preferences in physical proximity. Here we surveyed the preferences of subjects regarding positional relations with their romantic partner in some daily situations, and examined the association with attachment scale score. Our results show that the existence or absence of partner correlates with different relations between attachment styles and subjects' awareness of lateral preferences. Lateral preferences in physical proximity may play an important role in attachment in adulthood.

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OBJECTIVES: The aim of this study was to measure the effect of a group-based parent education program on parenting stress and attitude and comparing the same according to adult attachment styles. METHODS: Twenty-two mothers who enrolled in the parent education program participated in our study. The participants filled in the Korean version of the Experience in Close Relationship Revised (ECR-R), Korean-Parenting Stress Index-Short Form (K-PSI-SF), Maternal Behavior Research Instrument (MBRI), and Symptom Checklist-90-Revised (SCL-90-R) before and after the program. We compared the pre-and post-scores of the groups and compared the differences in effect according to adult attachment styles. RESULTS: For all study participants, the Parent Distress (p=0.023) and Total Parenting Stress (p=0.018) significantly declined after the parent education program. There were no differences in other variables. Within the secure attachment group, the Total Parenting Stress (p= 0.008), Parent Distress (p=0.015), and Difficult Child (p=0.011) scores in the K-PSI-SF significantly decreased after participating in the program. The Difficult Child scores (p=0.040) significantly dropped in the K-PSI-SF post program within the secure attachment group, compared to the insecure attachment group. CONCLUSION: The group-based parent education program impacted parenting stress. Depending on the adult attachment styles, the effect of the program varied.

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OBJECTIVES: The aim of this study was to measure the effect of a group-based parent education program on parenting stress and attitude and comparing the same according to adult attachment styles.

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The neuropeptide oxytocin plays an essential role in regulating social behavior and has been implicated in a variety of human cognitive processes in the social domain, including memory processes. The present study investigates the influence of oxytocin on human memory encoding, taking into account social context and personality, which have previously been neglected as moderators for how oxytocin affects memory encoding. To examine the role of social context of encoding, we employed an established experimental paradigm in which participants perform a word-categorization task in either a joint (social) or individual (non-social) setting. To investigate the role of socially relevant personality factors, participants' adult attachment style (AAS) was assessed. Previous research has identified attachment style as a potent moderator of oxytocin effects in the social-cognitive domain, but here we investigated for the first time its role in memory encoding. Participants were invited in pairs and received either placebo or oxytocin intranasally. Forty-five minutes later, they were instructed to react to different word categories within a list of successively presented words. This task was performed individually in the non-social condition and simultaneously with the partner in the social condition. After a 24-h delay, memory for all words was tested individually in a surprise recognition memory test. Oxytocin effects on memory accuracy depended on participants' AAS. Specifically, oxytocin positively affected memory for participants who scored low on attachment dependence (who find dependence on others uncomfortable), but negatively affected memory for high scorers (who are comfortable depending on others). Oxytocin effects were not moderated by social vs. non-social context at encoding, and we discuss reasons for this outcome. Regardless of encoding condition or personality, oxytocin led to more liberal responding in the recognition memory test, which was also reflected in significantly higher false alarm rates (FARs) and a trend towards higher hit rates (HRs) compared to placebo. Overall, our results are consistent with an interactionist view on oxytocin effects on human cognitive functioning. Future research should further examine how oxytocin affects response biases via previous encoding and the ways in which biological dispositions linked to attachment style affect the process of memory encoding.

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The successful recovery from affective loss (i.e., bereavement, relationship breakup) has been linked to adult attachment style (AAS), a personality trait. Up to now, the association between AAS, affective loss experiences and brain gray matter volume is unclear. In 192 healthy subjects we investigated the association between MRI brain gray matter volume, applying voxel based morphometry, AAS (Relationship Scales Questionnaire (RSQ), subscales "avoidance" (AV) and "anxiety" (ANX)), and number of affective losses within the last 5 years (AL; List of Threatening Experiences Questionnaire). In a whole-brain analysis (p < 0.05 FWE-corrected) ANX compared to AV was significantly more positively associated with brain gray matter volume in the left insula and in the pars opercularis of left inferior frontal gyrus. In additional region-of-interest (ROI) analyses (p < 0.05 FWE-corrected), based on previously reported findings, no significant associations were observed. ANX and AV differently correlate with local volumes of the left insula and pars opercularis of the left inferior frontal gyrus, which are implicated in emotion processing, empathy and emotion regulation among other functions. Our results support the notion that individual attachment styles, which develop in the interplay of genes and social environment, differ in their correlation with brain structure.

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Internalised stigma is associated with a range of negative outcomes, yet little is known about what determines the internalisation of stigma. In this study we examined the potential role of adult attachment style in the internalisation process in a transdiagnostic sample of adults with experience of recent mental health service use (n = 122), using an online survey. Associations between internalised stigma and perceived public stigma were tested. We also examined whether anxious and avoidant (insecure) attachment styles were positively associated with a significant amount of variance in internalised stigma when controlling for other variables, and whether the relationship between perceived public stigma and internalised stigma was moderated by anxious and avoidant attachment. We found that internalised stigma, perceived public stigma and insecure attachment were commonly reported and that internalised stigma was positively associated with perceived public stigma. However, neither anxious or avoidant attachment were associated with a significant amount of variance in internalised stigma and we found no moderating effect on the relationship between perceived public stigma and internalised stigma for insecure attachment. Despite mixed results, the strength of association between anxious attachment and internalised stigma suggests further research, which addresses some limitations of the current study, is warranted.

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Attachment theory has been proposed as one explanation for the relationship between childhood maltreatment and problematic mental and physical health outcomes in adulthood. This study seeks to determine whether: (1) childhood physical abuse and neglect lead to different attachment styles in adulthood, (2) adult attachment styles predict subsequent mental and physical health outcomes, and (3) adult attachment styles mediate the relationship between childhood physical abuse and neglect and mental and physical health outcomes. Children with documented cases of physical abuse and neglect (ages 0-11) were matched with children without these histories and followed up in adulthood. Adult attachment style was assessed at mean age 39.5 and outcomes at 41.1. Separate path models examined mental and physical health outcomes. Individuals with histories of childhood neglect and physical abuse had higher levels of anxious attachment style in adulthood, whereas neglect predicted avoidant attachment as well. Both adult attachment styles (anxious and avoidant) predicted mental health outcomes (higher levels of anxiety and depression and lower levels of self-esteem), whereas only anxious adult attachment style predicted higher levels of allostatic load. Path analyses revealed that anxious attachment style in adulthood in part explained the relationship between childhood neglect and physical abuse to depression, anxiety, and self-esteem, but not the relationship to allostatic load. Childhood neglect and physical abuse have lasting effects on adult attachment styles and anxious and avoidant adult attachment styles contribute to understanding the negative mental health consequences of childhood neglect and physical abuse 30 years later in adulthood.

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