Attachment impacts cortisol awakening response in chronically depressed individuals

A two-generation study: The transmission of attachment and young adults’ depression, anxiety, and social media addiction

Artificial intelligence (AI) has increasingly transitioned from a functional technological tool to a psychologically meaningful presence in the daily lives of college students. Beyond academic assistance, AI systems are now frequently used for emotional expression, companionship, and non-judgmental support, raising important questions regarding emotional bonding and attachment-like relationships with non-human agents. Drawing on attachment theory, the present study aims to examine how attachment styles—specifically attachment anxiety and attachment avoidance—are associated with emotional bonding, trust, and reliance on AI among college students. The study adopts a quantitative research design with a sample of 60 undergraduate students aged 18–23 years from a university in Mohali, India. Data will be collected using an adapted version of the Experiences in Close Relationships (ECR) Scale to assess attachment anxiety and avoidance toward AI, along with selected subscales of the Godspeed Questionnaire Series measuring anthropomorphism, likeability, and trust. Responses will be obtained through online questionnaires, and descriptive and correlational analyses will be conducted to explore relationships between attachment dimensions and emotional engagement with AI. It is anticipated that students with higher attachment anxiety will report stronger emotional bonds, greater trust, and increased reliance on AI for emotional support, whereas attachment avoidance may be associated with more instrumental and emotionally distant patterns of use. The expected findings aim to position AI not merely as a technological tool but as an emerging relational entity in students’ psychological lives. This study contributes to the growing literature on human–AI interaction by applying attachment theory to understand evolving emotional dynamics, while also highlighting implications for mental health practice, ethical AI design, and the prevention of over-reliance on artificial agents.

Transgender women are disproportionately affected by HIV and experience high rates of depression and anxiety. The importance of secure attachment in buffering against negative sexual and mental health outcomes is well established. However, few studies have examined attachment among transgender women. We recruited a community-based convenience sample of 213 transgender women in New York City (Mage =34.3; SD = 11.7). The majority were women of color (75.6%), almost half identified as heterosexual (47.4%), and 34.7% were HIV-positive. Preliminary analyses examined the sample distribution across attachment categories using the Revised Experiences in Close Relationships scale. Specifically, Brennan, Clark and Shaver’s guidelines were used for categorization (43.19% fearful, 22.5% preoccupied, 21.6% dismissive, and 12.7% secure). Regression analyses examined the association of dimensional attachment anxiety, attachment avoidance, and their interaction with depression, anxiety, self-efficacy for condom use, temptations for condomless sex, and condomless sex acts. Results indicated a positive association between attachment anxiety and depression, anxiety, temptations and probability for condomless sex; and also between attachment avoidance and condomless sex probability. A significant interaction indicated that individuals with low attachment anxiety and attachment avoidance (i.e., secure) had the greatest condom use self-efficacy and the lowest probability of engaging in condomless sex.

ABSTRACTWe compared each individual group member’s attachment fit with the attachment of the other group members. Participants were 201 members of 20 therapy groups who sought treatment because they were overweight or obese. Group members completed the Attachment Style Questionnaire before commencing treatment and the Group Questionnaire at three points during group treatment. Multilevel polynomial regression followed by response surface analysis was used to examine how the attachment anxiety and avoidance of the individual group member and the aggregated attachment anxiety and avoidance of the group members were related to individual group members’ perceptions of the positive bonding, positive working relationships, and negative relationships in the group. The findings suggested that attachment heterogeneity in group is related to the perception of members’ stronger bonding relationships and lower negative relationships. In addition, positive bonding can be increased when a patient high in attachment avoidance is added to a group whose patients are low in attachment avoidance; however, group members reported weaker negative relationships when their attachment anxiety or avoidance became increasingly higher or lower than other group members’ attachment anxiety or avoidance.

Daily variations in attachment anxiety and avoidance: A density distributions approach

The purpose of this study was to explore whether maladaptive affect regulation(particularly brooding which is a type of rumination and emotion suppression) contributes as a mediator between attachment dimensions(attachment anxiety and attachment avoidance) and depression. 200 undergraduate students participated in this study and were asked to complete the Experience in Close Relationship Scale(ECRS), Ruminative Response Scale(RRS), Emotion Regulation Questionnaire(ERQ), The center for Epidemiological Studies-Depression(CES-D). The data were analyzed using Structural equation modeling. The result showed that (1) brooding significantly mediated the relationship between the attachment anxiety and depression and (2) the significant relationship between attachment avoidance and depression was not mediated by emotion suppression. The implications and limitations of this study, and directions for future study were discussed.

Hippocampal volume and parahippocampal cingulum alterations are associated with avoidant attachment in patients with depression

Recent research suggests that individuals with attachment difficulties are at increased risk for experiencing intimate partner violence (IPV) victimization. However, most studies conducted on this topic have been cross-sectional, leaving it unclear whether attachment difficulties actually precede this type of violence. The current 6-month prospective study examined the relation between adult attachment and subsequent IPV victimization in a sample of 133 college women. At Time 1, participants completed the Experiences in Close Relationships (ECR) questionnaire to assess the two underlying orthogonal dimensions of adult attachment (anxiety and avoidance) and the Traumatic Life Events Questionnaire (TLEQ) to assess prior exposure to interpersonal traumatic events. At follow-up, participants completed a modified version of the Revised Conflict Tactics Scale (CTS-2) to assess IPV victimization. Results indicated that attachment anxiety was associated with an increased risk for experiencing physical assault during the 6-month follow-up period, even after statistically adjusting for prior interpersonal trauma. In contrast, attachment avoidance was unrelated to subsequent IPV victimization.

Attachment insecurity can interfere with the experience, expression, and benefits of positive emotions, including happiness and life satisfaction (LS). However, both the pattern and effects of insecure attachment orientations on LS vary across cultures. Considering that attachment anxiety is higher in collectivist cultures and attachment avoidance is relatively high in individualistic cultures, the present chapter elaborates on the idea that anxious and avoidant attachment would have varying effects on LS in individualistic and collectivistic cultural contexts. Study 1 (N = 2456) involved a community sample of married couples in Turkey and demonstrated that attachment avoidance was a stronger predictor of LS than attachment anxiety in Turkish collectivist context. Study 2 tested the hypothesis that the roles of attachment anxiety and avoidance in predicting LS would vary between collectivistic and individualistic cultures. Mothers’ adult attachment dimensions and LS in Turkey (N = 89) and the United States (N = 91) were measured. As expected, results indicated that LS was predicted only by attachment avoidance in Turkey and by attachment anxiety in the United States. These findings are in line with the cultural fit hypothesis, suggesting that culturally incongruent attachment orientations have a stronger negative impact on individuals’ LS.

Research has found that childhood adversity is associated with numerous maladaptive outcomes, including insecure attachment, mental health challenges, and problematic media use. As attachment is a primary developmental process that can be affected by childhood adversity, insecure attachment may be one psychological mechanism through which childhood adversity is associated with problematic media use. Further, disturbances in the attachment relationship resulting from childhood adversity may be associated with increased impulsivity, a construct that has been connected with problematic media use. Using a sample of adults (n = 616), this study examined whether the relationship between adverse childhood experiences and problematic media use was mediated through (i) attachment anxiety, (ii) attachment avoidance, or (iii) both attachment dimensions operating in series with impulsivity. Results revealed that a history of adverse childhood experiences was significantly associated with more problematic media use. Both anxious and avoidant attachment dimensions independently mediated the relationship between adverse childhood experiences and problematic media use. Specifically, avoidant attachment was associated with less problematic media use, and anxious attachment was associated with more problematic media use. Avoidant attachment and impulsivity in series, as well as anxious attachment and impulsivity in series, both accounted for part of the relationship between adverse childhood experiences and problematic media use. Results suggest that attachment may influence media use both directly and indirectly. Implications are discussed.

Attachment style and salivary cortisol awakening response in eating disorders

The purpose of this study was to examine whether anxious and avoidant attachment styles improve during guided internet-based cognitive behavioral treatment (ICBT) for panic disorder, and if so, to identify potential theoretically driven mechanisms related to the change. We examined changes in anxious and avoidant attachment and their time-lagged (1 week), longitudinal relationship with panic-related constructs in patients participating in ICBT (n = 79) in an open trial. Anxious attachment scores improved significantly with a medium effect during ICBT, d = 0.76 [0.45, 1.08]. According to benchmark analyses, changes were similar to the magnitude of change in face-to-face CBT and final scores to values of a nonclinical sample. Additionally, similar to findings in face-to-face CBT for panic disorder, longitudinal time analyses revealed that anxiety sensitivity scores predicted later improvement in anxious attachment scores, but not vice versa. Counter to our hypothesis, avoidant attachment did not significantly change during treatment, d = 0.15 [0.02, 0.46]; however, pretreatment level of avoidant attachment in ICBT was similar to the nonclinical sample. Also counter to our hypotheses, agoraphobic avoidant behaviors when alone did not predict changes in anxious attachment. These results suggest that anxious attachment can improve in ICBT for panic disorder even though the focus of the treatment is not on interpersonal relationships. These changes appear to follow changes in anxiety sensitivity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The cortisol awakening response in amyotrophic lateral sclerosis is blunted and correlates with clinical status and depressive mood

e24002 Background: In research, how people act in close relationships is described as “attachment styles” which are composed of multiple attachment style dimensions (ASDs). Attachment avoidance is characterized by the need to isolate from the relationship (i.e. withdrawing and increased independence) while attachment anxiety is defined as needing reassurance and higher dependence. These two insecure ASDs are correlated with reduced quality of life for cancer patients (PT) and the family caregivers (CG). In ovarian cancer, PT and CG ASDs were correlated to dyadic coping, however 27% of PTs were disease-free. Attachment insecurity may be exacerbated by active treatment and uncertain prognosis. Therefore, we investigated the relationship between ASDs, and CG and PT reported dyadic coping and illness-specific communication. Methods: Metastatic sarcoma PTs and their CGs were recruited prospectively for a longitudinal, survey study investigating dyadic coping at Fred Hutchinson Cancer Center from Feb. 2022 – Dec. 2022. Participation rate for eligible PTs was 42% and 68% for CGs. Results are of participants who identified as intimate partners (individuals and dyads were allowed to participate). Attachment avoidance and attachment anxiety were measured via Relationship Structures Questionnaire. Dyadic coping and communication were measured via Dyadic Coping Inventory and Illness-Specific Relationship Talk (ISRT), respectively. Results: Sixty-nine participants enrolled: 43 PTs and 26 CGs (25 dyads). Participants were primarily non-Hispanic and white (91% PTs; 85% CG) with mean age 64 years ( SD= 13.1; range = 26-89). 61% of PTs identified as men; 60% of CGs identified as women. CGs with attachment anxiety were more likely to report worse coping and less ISRT, while PTs with attachment anxiety were more likely to report only worse coping (See Table 1). However, PTs with attachment avoidance were more likely to report both worse coping and ISRT. Conclusions: Advance cancer PTs and their CGs with insecure ASDs report worse coping and communication. Screening for insecure ASDs may identify PTs and CGs who would benefit from supportive care, including psychotherapy. Future research should investigate this in a larger, more heterogenous population at earlier in the rare cancer trajectory and the effect of ASDs on PT, CG, and clinician communication. [Table: see text]

Individuals with chronic pain are both more likely to have an insecure adult attachment style and impaired conditioned pain modulation (CPM) than pain-free individuals. This study investigated whether impaired CPM is seen in pain-free individuals and determined associations with attachment. A CPM test paradigm was used to determine the differences in the measures of pain across attachment anxiety and avoidance dimensions in pain-free females in a neutral social context. First, static (heat pain threshold, heat pain tolerance, and cold pain intensity) and dynamic (cumulative pain load) measures of pain were explored. One hundred and three females were recruited (median [IQR] age: 21 [20-23] years). We found no associations between attachment dimensions and static measures of pain (ps > 0.05). Higher attachment anxiety, but not avoidance, was associated with an increase in pain intensity over time (Estimate [95% CI] = 0.15 [0.06-0.25], p-value = 0.002), and increased average test stimulus pain intensity rating both before (Estimate [95% CI] = 0.15 [0.07-0.23], p-value < 0.001) and during (Estimate [95% CI] = 0.36 [0.23-0.48], p-value < 0.001) conditioning. In the 78% (80/103) who completed the full CPM procedure, there was no association between CPM effect and attachment anxiety (Estimate [95% CI] = -3.79 [-8.62 to 1.03], p = 0.122) or avoidance (Estimate [95% CI] = 0.25 [-4.88 to 5.38], p = 0.923). Effective CPM was seen in 90% (72/80). Impaired CPM was not seen in pain-free individuals suggesting that impaired endogenous analgesia may develop from chronic pain, rather than cause chronic pain. Individuals with chronic pain are both more likely to have an insecure adult attachment style and impaired conditioned pain modulation (CPM) than pain-free individuals. This is the first study to investigate a link between attachment and experimental pain using a conditioned pain modulation (CPM) paradigm in a neutral social context. Impaired CPM was not seen in pain-free individuals, suggesting that impaired endogenous analgesia may develop from chronic pain, rather than cause chronic pain.