A functional neuro-anatomical model of human attachment (NAMA): Insights from first- and second-person social neuroscience

Attachment theory, developed by Mary Ainsworth and John Bowlby about seventy years ago, has become one of the most influential and comprehensive contemporary psychology theories. It predicts that early social interactions with significant others shape the emergence of distinct self- and other-representations, the latter affecting how we initiate and maintain social relationships across the lifespan. A person's attachment history will therefore associate with inter-individual differences in emotional and cognitive mechanisms sustaining representations, modeling, and understanding of others on the biological and brain level. This review aims at summarizing the currently available social neuroscience data in healthy participants on how inter-individual differences in attachment associate with brain anatomy and activity across the lifespan, and to integrate these data into an extended and refined functional neuro-anatomical model of human attachment (NAMA). We first propose a new prototypical initial attachment pathway and its derivatives as a function of attachment security, avoidance, and anxiety. Based on these pathways, we suggest a neural attachment system composed of two emotional mentalization modules (aversion and approach) and two cognitive mentalization modules (emotion regulation and mental state representation) and provide evidence on their functionality depending on inter-individual differences in attachment. We subsequently expand this first-person social neuroscience account by also considering a second-person social neuroscience perspective comprising the concepts of bio-behavioral synchrony and particularly inter-brain coherence. We hope that such extended and refined NAMA can inform attachment theory and ultimately help devising new prevention and intervention strategies for individuals and families at risk for attachment-related psychopathology

Epigenetic modification of the oxytocin and glucocorticoid receptor genes is linked to attachment avoidance in young adults

Attachment in the context of intimate pair bonds is most frequently studied in terms of the universal strategy to draw near, or away, from significant others at moments of personal distress. However, important interindividual differences in the quality of attachment exist, usually captured through secure versus insecure – anxious and/or avoidant – attachment orientations. Since Bowlby’s pioneering writings on the theory of attachment, it has been assumed that attachment orientations are influenced by both genetic and social factors – what we would today describe and measure as gene by environment interaction mediated by epigenetic DNA modification – but research in humans on this topic remains extremely limited. We for the first time examined relations between intra-individual differences in attachment and epigenetic modification of the oxytocin receptor (OXTR) and glucocorticoid receptor (NR3C1) gene promoter in 109 young adult human participants. Our results revealed that attachment avoidance was significantly and specifically associated with increased OXTR and NR3C1 promoter methylation. These findings offer first tentative clues on the possible etiology of attachment avoidance in humans by showing epigenetic modification in genes related to both social stress regulation and HPA axis functioning

Exploring the effect of attachment styles and winning or losing a status contest on testosterone levels

A person's ability to form relationships and seek and attain social status affects their chances of survival. We study how anxious and avoidant-attachment styles and subsequent winning or losing affects the testosterone (T) levels of team members playing two status contests. The first is a management game played by teams striving to earn the most profits. Winners and losers emerge due to the cognitive endeavor of the players, which provokes intense status dynamics. Avoidant-attached winners do not show higher T levels whereas anxious-attached winners do. The second is an economic game which is rigged and favors some teams to become richer than others; teams have the option though to trade with each other and reduce the self-perpetuating rich-poor dynamics embedded in the game. Besides attachment styles, we here also explore how authentic pride as a self-conscious emotion affects team members' T levels as players trade with others to create more fairness. As in the first status contest, players' T levels are not significantly affected by their avoidant attachment style, neither as a main effect nor in interaction with winning or losing the game. However, similar to the first game, players' anxious attachment style affects their T levels: anxious-attached players generate significantly higher T levels when winning the game, but only when experiencing high authentic pride during the game. In short, the moderating effects of attachment style on winners' T levels are partly replicated in both status games which allows us to better understand the functioning of working models of attachment styles during and after status contests and gives us a better understanding of working models of attachment styles in general

Differences in Cortisol Response to Trauma Activation in Individuals with and without Comorbid PTSD and Depression

Background: Although depression symptoms are often experienced by individuals who develop posttraumatic stress disorder (PTSD) following trauma exposure, little is know about the biological correlates associated with PTSD and depression co-morbidity vs. those associated with PTSD symptoms alone. Methods: Here we examined salivary cortisol responses to trauma activation in a sample of 60 survivors of the World Trade Center attacks on September 11, 2001. Participants recalled the escape from the attacks 7 months post 9/11. Salivary cortisol levels were measured before and after their recollection of the trauma. PTSD, depression, and somatic symptoms were also assessed. From the behavioral assessment scales, the participants were grouped into three conditions: those with comorbid PTSD and depressive symptoms, PTSD alone symptoms, or no-pathology. Results: Baseline and cortisol response levels differed between the comorbid, PTSD alone, and no-pathology groups. Individuals endorsing co-morbid symptoms had higher PTSD and somatic symptom severity and their cortisol response decreased following their trauma reminder while a trend of an elevated response to the trauma was found in the PTSD alone group. Our findings show distinct psychological and biological correlates related to the endorsement of PTSD with and without depression comorbidity. Conclusions: The findings suggest that comorbidity symptoms manifestation entails a separate trauma induced condition from PTSD. Future research on biological correlates of comorbid PTSD and depression is warranted

Early Environments Shape Neuropeptide Function: The Case of Oxytocin and Vasopressin

Oxytocin (OT) and vasopressin (AVP) are neuropeptides that govern the social-emotional functioning of humans. We contend that to fully understand their function, research should consider how they are flexibly fitted to maximize survival and reproduction given the variety of human experience. In a series of two studies, we show that early life stress is associated with change in the core function of OT and AVP in evolutionary predictable ways: Under high early life stress, AVP promotes threat-detection capabilities, whereas OT motivates non-selective proximity seeking to others. Conversely, under low early life stress these neuropeptides have an opposite, yet adaptive response: AVP promotes low vigilance and preservation of energy, whereas OT increases detection of interpersonal flaws. Our results demonstrate the plasticity of neuropeptide functioning that mirrors the variance in human social-emotional functioning

Sugarcoated isolation: Evidence that social avoidance is linked to higher basal glucose levels and higher consumption of glucose

Objective: The human brain adjusts its level of effort in coping with various life stressors as a partial function of perceived access to social resources. We examined whether people who avoid social ties maintain a higher fasting basal level of glucose in their bloodstream, reflecting a strategy to draw more on personal resources when threatened.Methods: For Study 1, we obtained fasting blood glucose and adult attachment orientations data from 60 undergraduate women at the University of Virginia. For Study 2, we collected measures of fasting blood glucose, self-reported trait anxiety, DHEA-cortisol, hypertension, and adult attachment orientations from 285 older adults of mixed gender, using a measure of attachment style different from study 1.Results: In study 1, fasting blood glucose levels corresponded with higher attachment avoidance scores after statistically adjusting for interpersonal anxiety. For study 2, fasting blood glucose continued to correspond with higher adult attachment avoidance even after statistically adjusting for interpersonal anxiety, trait anxiety, DHEA-cortisol and hypertension. Conclusions: Results suggest socially avoidant individuals upwardly adjust their basal glucose levels with the expectation of increased personal effort because of limited access to social resources

The dynamic course of peripartum depression across pregnancy and childbirth

Objective Peripartum depression (PPD) pertaining to depression in pregnancy and postpartum is one of the most common complications around childbirth with enduring adverse effects on mother and child health. Although psychiatric symptoms may improve or worsen over time, relatively little is known about the course of PPD symptoms and possible fluctuations Methods We applied a person-centered approach to examine PPD symptom patterns across pregnancy and childbirth. 824 women were assessed at three time points: first trimester (T1), third trimester (T2), and again at eight weeks (T3) postpartum. We assessed PPD symptoms, maternal mental health history, and childbirth variables Results Growth mixture modeling (GMM) analysis revealed four discrete PPD symptom trajectory classes including chronic PPD (1.1%), delayed (10.2%), recovered (7.2%), and resilient (81.5%). Delivery complications were associated with chronic PPD but also with the recovered PPD trajectory class. History of mental health disorders was associated with chronic PPD and the delayed PPD class Conclusion The findings underscore that significant changes in a woman’s depression level can occur across pregnancy and childbirth. While a minority of women experience chronic PDD, for others depression symptoms appear to significantly alleviate over time, suggesting a form of recovery. Our findings support a personalized medicine approach based on the woman’s symptom trajectory. Future research is warranted to identify the mechanisms underlying modifications in PPD symptoms severity and those implicated in recovery.Peer reviewe

A unified model of the biology of peripartum depression

Abstract Peripartum depression (PPD) is a prevalent and debilitating disorder that adversely affects the development of mothers and infants. Recently, there has been a plea for increased mental health screening during the peripartum period; however, currently, there is no accurate screening tool to identify women at risk of PPD. In addition, some women do not respond to current treatment schemes and develop treatment-resistant depression. The current perspective aims to propose a unified understanding of the biological underpinnings of PPD (UmPPD) that considers the heterogeneity in the onset, symptoms cluster, and severity of PPD. Such a model could promote basic and applied research on PPD and suggest new treatment avenues. The central hub of the model is the kynurenine pathway (KP) and the KP-serotonin ratio. The forces and specific processes at play that cause an imbalance within the KP and between KP and serotonin are inflammation, stress, reproductive hormones (especially estradiol and progesterone), and oxytocin. UmPPD predicts that the most severe PPD would comprise prolonged inflammation, ongoing or multiple stressors, excessive estrogen, progesterone resistance, and avoidance of breastfeeding, skin-to-skin contact, and social proximity. These factors would be associated with a higher likelihood of developing PPD, early onset, and more significant symptom severity. In addition, subtypes of PPD would consist of different compositions and expressions of these components, with one central common factor. UmPPD could aid in directing future research and possibly detecting critical processes that could help discover, develop, and utilize novel treatments for PPD