title: Attachment and the metabolic syndrome in midlife: the role of interview-based discourse patterns.
abstract: OBJECTIVE
  Adult attachment discourse patterns and current family relationship quality were examined as correlates of health behaviors and number of metabolic syndrome (MetS) criteria met, and as mediators of the link between childhood adversity and these health outcomes.
  
  
  METHODS
  A sample of 215 white/European American and black/African American adults aged 35 to 55 years were examined using a cross-sectional study design. Discourse was assessed with the Adult Attachment Interview, using coherence (a marker of attachment security), unresolved trauma/loss (a marker of disorganized cognitions related to trauma or loss), and idealization (minimizing stressful experiences and their impact) scores. Relationship quality, adverse childhood experiences, and current depressive symptoms were assessed, as were health behaviors of diet, exercise, and smoking. MetS includes obesity, elevated blood pressure, elevated fasting glucose, high triglycerides, and low high-density lipoprotein cholesterol.
  
  
  RESULTS
  Using path analysis and including childhood adversity severity and depressive symptoms in the model, both Adult Attachment Interview coherence and unresolved trauma/loss were directly linked to the number of MetS criteria (r = 0.186 and r = 0.170, respectively). Idealization was indirectly linked to MetS through poor diet (r = 0.183). The final model explained 21% of the variance in scores for the number of MetS criteria met.
  
  
  CONCLUSIONS
  Insecure adult attachment is associated with increased risk of MetS.
authors.affiliation: From Judge Baker Children's Center (C.R.D., N.U., C.C-D., J.A.C.), Boston, Massachusetts; Boston College (E.D.), Boston, Massachusetts; Department of Psychiatry, Cambridge Health Alliance (A.R.B.), Cambridge, Massachusetts; Department of Psychology (S.D.N.), North Carolina State University, Raleigh, North Carolina; Division of Endocrinology (C.S.M.), Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, Massachusetts (C.S.M.); Department of Psychiatry (J.A.C.), Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Davis
authors.forename: Nicole
authors.initials: N
authors.lastname: Usher
authors.forename: Eric
authors.initials: E
authors.lastname: Dearing
authors.forename: Ayelet R
authors.initials: AR
authors.lastname: Barkai
authors.forename: Cynthia
authors.initials: C
authors.lastname: Crowell-Doom
authors.forename: Shevaun D
authors.initials: SD
authors.lastname: Neupert
authors.forename: Christos S
authors.initials: CS
authors.lastname: Mantzoros
authors.forename: Judith A
authors.initials: JA
authors.lastname: Crowell
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004032:Diet / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008016:Life Change Events; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000523:psychology*; D008875:Middle Aged; D009769:Object Attachment