Neuroendocrine correlates of
insecure attachment in adolescents
Andrea Oskis
Psychophysiology
and Stress
Research Group
Attachment theory as a stress theory
Bowlby’s original theory:
a biobehavioural safetyregulating system
 Activated in times of
threat or stress
Internal working
model
STRESS!
Activates our body’s
‘stress hormone hotline’
The Hypothalamic-PituitaryAdrenal (HPA) axis
 Secretes the hormone
cortisol
Cortisol is not just a stress hormone...
Bone formation and
resorption
Maintain muscle
function; decrease
muscle mass
Decrease
connective
tissue
Cortisol
Inhibit
inflammatory and
immune
responses
Support glucose
synthesis
Increase glomerular
filtration and free
water clearance
Maintain cardiac
output
Modulate
emotional tone,
wakefulness
Based on Genuth (2008)
An excellent way to measure cortisol
The diurnal cortisol rhythm
Cortisol
Awakening
Response
(CAR)
30
Cortisol (nmol/l)
25
20
15
10
5
0
wake-up
0
3
6
9
12
Hours post-awakening
Oskis et al. (2009)
Cortisol rhythms matter...
Especially post-awakening
Quirin et al. (2008)
... In women with early life
attachment adversity
... and also with anxious
insecure attachment style
Meinlschmidt and Heim (2005)
...especially in adolescence...
...especially immediately
post-awakening
Kudielka & Kirschbaum (2003)
Shirtcliff and Essex (2008)
General methods
Participants: 60 healthy female adolescents aged 9-18 yrs,
mean age 14.16 (± 2.63) years
Key measures:
• Attachment Style Interview (ASI)
• Saliva samples
+0
mins
+15
mins
+30
mins
+45
mins
+3
hrs
+6
hrs
+9
hrs
+12
hrs
x 2 consecutive weekdays
The importance of adherence
• Personalised text message
prompts for each saliva
sample sent over the day
Morning Andrea!
Woke up 0702,
sample 1 done @
0702. All going well!

Participant 35C,
28/02/07, age 17
Its 12:35 so I’ve just done
tube 6. I’ll b ready 4 tube 7
at 3:35. Thanx 4
messages, hope ur havin
a good day! xXx
Participant 26C,
28/02/07, age 17
The Attachment Style Interview
Assesses current relationship behaviour & attitudes
Securely
attached
vs.
Insecurely
attached
Anxious
Avoidant
Mild
Moderate
Marked
Mild
Moderate
Marked
The Attachment Style Interview
Assesses current relationship behaviour & attitudes
Securely
attached
vs.
Insecurely
attached
Anxious
Avoidant
Mild
Moderate
Marked
Mild
Moderate
Marked
Results
Attachment style
Insecure
Anxious
Securely
attached
Insecure
Avoidant
Participant characteristics
Secure
(n = 30)
Anxious
(n = 13)
Avoidant
(n = 17)
Age in years
14.70 (± 2.56) 13.39 (± 2.72)
13.12 (± 2.55)
Eating disorder
risk (EDI-3)
27.93 (± 6.21) 26.92 (± 7.75)
25.18 (± 4.56)
General
psychological
maladjustment
34.80 (± 4.66) 37.23 (± 6.00)
36.65 (± 6.14)
STAI trait
33.50 (± 6.16) 33.62 (± 9.93)
35.65 (± 7.58)
STAI state am†
29.42 (± 6.74) 29.23 (± 7.21)
30.85 (± 6.60)
STAI state pm†
28.50 (± 7.34) 27.42 (± 7.11)
29.32 (± 6.06)
Participant characteristics
Secure
(n = 30)
Age in years
Eating disorder
risk (EDI-3)
General
psychological
maladjustment
STAI trait
Anxious
(n = 13)
14.70 (± 2.56) 13.39 (± 2.72)
All within age-appropriate
27.93 (± 6.21) 26.92 (± 7.75)
normative range
34.80 (± 4.66) 37.23 (± 6.00)
No significant differences
between attachment style
33.50 (± 6.16) 33.62 (± 9.93)
groups
Avoidant
(n = 17)
13.12 (± 2.55)
25.18 (± 4.56)
36.65 (± 6.14)
35.65 (± 7.58)
STAI state am†
29.42 (± 6.74) 29.23 (± 7.21)
30.85 (± 6.60)
STAI state pm†
28.50 (± 7.34) 27.42 (± 7.11)
29.32 (± 6.06)
CAR and attachment style
25
Cortisol (nmol/l)
*
20
Anxious insecurely attached
Avoidant insecurely attached
Securely attached
15
*
10
5
0
15
30
45
Minutes post-awakening
Oskis et al. (2012)
Daytime cortisol and attachment style
10
Secure
Cortisol (nmol/l)
8
Anxious
Avoidant
6
4
2
0
3
6
9
12
Hours post-awakening
Oskis et al. (2012)
Summary and implications:
Cortisol and attachment style
Attachment style groups differed in the dynamic of the
CAR
 Anxious insecure: h awakening
i 45 min post-awakening
No significant difference in subsequent daytime
cortisol secretion
The CAR as a distinct and especially sensitive part of
the diurnal cortisol cycle?
A prognostic ‘non-healthy’ CAR?
Kudielka & Kirschbaum (2003)
Similarity to
anxious
insecure
adolescent
profile
Thank you for listening
Andrea.Oskis@uwl.ac.uk