title: Attachment representation and illness behavior in somatoform disorders.
abstract: Somatoform disorders are characterized by high health care utilization and conflictual interactions with health care providers. The aim of the present study was to explore whether patterns of insecure attachment are a prominent feature of somatoform disorder. In addition, the links between insecure attachment and health care utilization were evaluated. Thirty-seven patients with an International Classification of Diseases, 10th Revision diagnosis of somatoform disorders and 20 healthy control subjects matched for age, sex, and education were administered the Adult Attachment Interview. Psychological symptoms and health care utilization were assessed using various self-report measures. There was a clearly higher incidence of insecure attachment in the somatoform group compared with the nonclinical control subjects. In the somatoform group, dismissing attachment occurred approximately twice as frequently as the preoccupied pattern of attachment. The results provide evidence for an association between health care utilization and insecure attachment. Insecure attachment in somatoform disorder may underlie problems in interpersonal functioning and in health care behavior.
authors.affiliation: Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital of Freiburg, Freiburg, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Waller
authors.forename: Carl Eduard
authors.initials: CE
authors.lastname: Scheidt
authors.forename: Armin
authors.initials: A
authors.lastname: Hartmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D009769:Object Attachment; D012720:Severity of Illness Index; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy