Does Preoccupied Attachment in Adolescence Have Long-term Implications for Physical Health in Adulthood – and How? Leah Grande, Joseph S. Tan, Joseph P. Allen, Lauren Cannavo, & Sarah Coe-Odess University of Virginia. For more information, please go to: We would like to thank the National Institute of Child Health & Human Development for funding awarded to Joseph P. Allen, Principal Investigator, (R01 HD & R01-MH58066) for funding to conduct this study as well as for the write-up of this study. Introduction Premises Preoccupied attachment state of mind is characterized by anxiety over the availability of attachment figures; when describing relationships with attachment figures these individuals often appear angrily confused or overwhelmed by emotion (Main, 2002). Self-reported preoccupied attachment style is associated with higher trait anxiety, pain severity, and pain catastrophizing (Dilmac et al., 2009; Tremblay & Sullivan, 2010). Anxiety is associated with chronic inflammation and can impair overall health as severely as some chronic physical conditions (Kiecolt-Glaser et al., 2002; Stein et al., 2005). It remains unclear how observational measures of attachment state of mind relate to anxiety and health development over time. Hypotheses 1.Preoccupied adolescent attachment will significantly predict poorer adult general health. 2.This relationship will be mediated by adult trait anxiety. Methods Results Participants 175 individuals, with mean age of 14.81, were assessed via the Adult Attachment Interview (AAI). Demographics: 58% European-American, 29% African- American, and 13% mixed race or other race/ethnicities. Baseline median family income was in the $40,000 to $59,000 range Procedure Time 1 – At ~age 14, participants completed the AAI. Time 2 – At ages 25-27, participants reported on their general health and trait anxiety. Measures Preoccupied attachment state of mind was assessed using a modified version of the Adult Attachment Interview and the Kobak Q-sort coding system (George, Kaplan, & Main, 1996; Kobak et al., 1993). General health was assessed via participants’ reports on a health outcomes questionnaire at ages (Ware & Sherbourne, 1992). Sample items: “I get sick easily”, “I expect my health to get worse” Anxiety was measured via the State-Trait Anxiety Inventory’s Trait Anxiety subscale at ages (Spielberger et al., 1970). Sample items: “I worry too much over something that doesn’t really matter”, “I am ‘cool, calm, and collected’” (reverse- scored) Conclusions The results suggest that preoccupied attachment style in adolescence is associated with anxiety in adulthood. This is supported by previous literature suggesting that the adult attachment interview may be assessing broader aspects of affect regulation (Allen & Manning, 2007). Anxiety is associated with chronic inflammation and dysregulated immune functioning, which could be contributing to poorer health outcomes even at this early stage in adulthood (Kiecolt-Glaser et al., 2002). Alternatively, a preoccupied, anxious individual may be more likely to catastrophize health concerns and report lower physical health. This could lead to increased doctors visits and associated individual and health system costs. In sum, these findings suggest that anxiety about the availability of one’s attachment figure may predict anxiety about the stability of one’s emotional and physical health later in life. This process is likely sustained by patterns of thinking and relating in relationships, which could be targets for intervention. Future Directions Is there discrepancy or consistency between preoccupied individuals’ self-reports of health and observational reports? Is preoccupied attachment state of mind associated with inflammation and immune functioning? What qualities of preoccupied individuals’ cognitions, behavior, and relationships may contribute to increased anxiety and poorer health? Analyses, conducted using a Full Information Maximum Likelihood approach for handling missing data, yielded significant results consistent with our hypotheses (see Figure 1). Adolescent preoccupied attachment was a significant predictor of general health in adulthood after accounting for gender and income. This relationship was fully mediated by adult trait anxiety. Thoughts? Questions? Ideas? Leah Grande