Adult attachment, alexithymia, symptom reporting, and health-related coping

J Psychosom Res. 2003 Oct;55(4):341-7. doi: 10.1016/s0022-3999(02)00635-9.


Objective: The objective of this study was to test a hypothesised model of associations between adult attachment style and two health-related outcomes, symptom reporting and coping with health problems. Alexithymia, a construct involving a deficit in the ability to identify and describe emotions, is thought to develop as a result of childhood interactions with caregivers. We wished to determine whether alexithymia acted as a mediating variable between attachment and health outcomes.

Method: Two hundred and one female undergraduates, aged 18-34, completed questionnaire measures of attachment style, alexithymia, positive and negative affectivity, symptom reporting, and coping with health problems.

Results: Insecure attachment (both avoidant and anxious), alexithymia, and negative affectivity were all weakly intercorrelated. However, insecure attachment was associated with alexithymia independent of its association with negative affectivity. Avoidant attachment was weakly predictive of symptom reporting and emotional preoccupation as a way of coping with health problems. Regression analyses showed that the association between avoidant attachment and these health-related outcomes was mediated by alexithymia and negative affectivity, both of which made significant independent contributions to the health outcomes.

Conclusions: Our results are consistent with the proposition that alexithymia develops in response to interactions with primary caregivers that also influence infant and adult attachment. Associations between adult attachment and health outcomes may be due in part to disturbances in affect regulation.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Affect
  • Affective Symptoms
  • Caregivers
  • Female
  • Health Status*
  • Humans
  • Interpersonal Relations*
  • Models, Psychological*