title: Attachment representation and cortisol response to the adult attachment interview in idiopathic spasmodic torticollis.
abstract: OBJECTIVE
  The study investigates individual differences in the mental representation of attachment and their impact on the cortisol response to psychosocial stress in idiopathic spasmodic torticollis (IST). It was hypothesized (a) that in IST insecure attachment is more prevalent than in a non-clinical control group and (b) that subjects with dismissing attachment respond with higher physiological arousal to a specific stimulus activating the attachment behavioural system than subjects with secure attachment.
  
  
  METHODS
  20 patients with IST and 20 healthy controls matched for age and sex underwent the Adult Attachment Interview, an hour-long, semiclinical interview on attachment experiences. During the interview salivary cortisol levels were monitored. The subjects' mental state with regard to attachment was classified using the attachment Q-sort method. Anxiety and depression were measured as potential covariates of the adrenocortical stress response.
  
  
  RESULTS
  Compared to the non-clinical group, dismissing attachment was strongly overrepresented in IST. In IST, but not in the healthy control group, dismissing attachment correlated with an elevated cortisol response to the interview.
  
  
  CONCLUSIONS
  In clinical, but not in non-clinical samples dismissing attachment may be associated with increased vulnerability to psychosocial stress. The factors contributing to this interaction are not yet fully elucidated.
authors.affiliation: Abteilung für Psychosomatik und Psychotherapeutische Medizin, Universitätsklinik Freiburg, Deutschland. ces@pss1.ukl.uni-freiburg.de
authors.forename: C E
authors.initials: CE
authors.lastname: Scheidt
authors.forename: E
authors.initials: E
authors.lastname: Waller
authors.forename: H
authors.initials: H
authors.lastname: Malchow
authors.forename: U
authors.initials: U
authors.lastname: Ehlert
authors.forename: F
authors.initials: F
authors.lastname: Becker-Stoll
authors.forename: J
authors.initials: J
authors.lastname: Schulte-Mönting
authors.forename: C H
authors.initials: CH
authors.lastname: Lücking
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D011779:Q-Sort; D012803:Sick Role; D012917:Social Adjustment; D014103:Torticollis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*
chemical_list: D006854:Hydrocortisone