Attachment and psychosomatic medicine: Developmental contributions to stress and disease
Attachment and psychosomatic medicine: Developmental contributions to stress and disease
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DOI：
10.1097/00006842-200107000-00006
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发表时间：
2001-07-01
影响因子：
3.3
通讯作者：
Hunter, JJ
中科院分区：
文献类型：
--
作者：
Maunder, RG;Hunter, JJ
目的：本研究的目的是评估连接依恋不安全感与疾病的证据。依恋理论描述了婴儿在与其主要照顾者的互动中习得的对威胁的终身反应模式。尽管依恋理论属于生物心理社会领域，但它直到最近才被应用于心身医学。方法：检索MEDLINE和PsychInfo数据库1966 ~ 2000年的英文文献，检索词为“依恋”和“客体关系”。“如果论文及其引用的参考文献与身体疾病，症状或生理学直接相关，则对其进行审查。一个假设的因果关系模型。结果：调查研究的直接和间接证据支持依恋不安全感和疾病之间的关联。动物研究和人类实验表明，依恋有助于生理应激反应的个体差异。也有不太强的支持，不安全的依恋导致症状报告和更频繁的健康风险行为，特别是物质使用和治疗不依从性。证据支持依恋理论的预测，即社会支持的好处更多地来自依恋关系而不是非依恋关系。结论：虽然现有的数据是提示性的，而不是结论性的，数据可以组织成一个模型，描述通过三种机制导致疾病风险的附件不安全。这些是增加对压力的敏感性，增加使用外部调节器的影响，以及改变寻求帮助的行为。该模型值得进一步的前瞻性研究。
Objective: The object of this study was to evaluate the evidence linking attachment insecurity to illness. Attachment theory describes lifelong patterns of response to threat that are learned in the interaction between an infant and his or her primary caregiver. Despite its biopsychosocial domain, attachment theory has only recently been applied to psychosomatic medicine. Method: MEDLINE and PsychInfo databases were searched from 1966 to 2000 for English language papers with key words "attachment" and "object relations." Papers and their cited references were reviewed if they were directly related to physical illness, symptoms, or physiology. A hypothetical causal model was developed. Results: Direct and indirect evidence from survey studies supports an association between attachment insecurity and disease. Animal studies and human experiments suggest that attachment contributes to individual differences in physiological stress response. There is also less robust support for insecure attachment leading to symptom reporting and to more frequent health risk behaviors, especially substance use and treatment nonadherence. Evidence supports the prediction from attachment theory that the benefits of social support derive more from attachment relationships than nonattachment relationships. Conclusions: Although the available data are suggestive rather than conclusive, the data can be organized into a model that describe attachment insecurity leading to disease risk through three mechanisms. These are increased susceptibility to stress, increased use of external regulators of affect, and altered help-seeking behavior. This model warrants further prospective investigation.