This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Waldinger, R. J. Articles by Ahern, D. K. Search for Related Content PubMed PubMed Citation Articles by Waldinger, R. J. Articles by Ahern, D. K. Related Collections Social Support Pediatrics Somatoform Stress and Coping

Mapping the Road From Childhood Trauma to Adult Somatization: The Role of Attachment

From the Brigham and Women's Hospital and Harvard Medical School, Boston, MA (R.J.W., A.J.B., D.K.A.); and Bryn Mawr College, Bryn Mawr, PA (M.S.S.).

Address correspondence and reprint requests to Robert J. Waldinger, MD, Department of Psychiatry, Brigham and Women's Hospital, 1249 Boylston Street, Boston, MA 02215. E-mail: rwaldinger{at}partners.org

Objective: This study tested whether insecure attachment mediates the link between childhood trauma and adult somatization.

Methods: A community sample of 101 couples completed self-report measures, including the Relationship Scales Questionnaire, the Childhood Trauma Questionnaire, the Somatic Symptom Inventory, the Beck Depression Inventory, and the Conflict Tactics Scale.

Results: Childhood trauma was associated with higher levels of somatization and insecure attachment. Insecure attachment style was also associated with higher levels of somatization. Controlling for age, income, and recent intimate partner violence, analyses showed that fearful attachment fully mediated the link between childhood trauma and somatization for women. For men, there was no such mediation, but both childhood trauma and insecure attachment styles made independent contributions to predicting levels of somatization.

Conclusions: Findings are consistent with the hypothesis that, for women, childhood trauma influences adult levels of somatization by fostering insecure adult attachment. For men, findings suggest that trauma and attachment are both important independent predictors of adult somatization. Study results support the idea that childhood trauma shapes patients' styles of relating to others in times of need, and these styles, in turn, influence the somatization process and how patients respond to providers. Screening for attachment style may provide information that could allow health care providers to tailor treatment more effectively.

Key Words: attachment style • somatization • childhood trauma • interpersonal models

Abbreviations: CTQ = Childhood Trauma Questionnaire; CTS2 = Conflict Tactics Scale version 2; SSI = Somatic Symptom Inventory; RSQ = Relationship Scales Questionnaire; BDI = Beck Depression Inventory.

This article has been cited by other articles:

				R. Noyes Jr., S. P. Stuart, and D. B. Watson A Reconceptualization of the Somatoform Disorders Psychosomatics, February 1, 2008; 49(1): 14 - 22. [Abstract] [Full Text] [PDF]

				C. Bass and G. Adshead Fabrication and induction of illness in children: the psychopathology of abuse Advan. Psychiatr. Treat., May 1, 2007; 13(3): 169 - 177. [Abstract] [Full Text] [PDF]