Attachment theory: a model for health care utilization and somatization

Area of Science:

• Psychology
• Medical Sociology
• Health Services Research

Background:

• Attachment theory posits that early caregiver experiences shape interpersonal relationship schemas.
• Insecure attachment styles, specifically preoccupied and fearful, may influence health perceptions and behaviors.

Purpose of the Study:

• To investigate the association between attachment styles (preoccupied, fearful) and physical symptom reporting in primary care patients.
• To examine the relationship between attachment styles and primary care utilization and costs.

Main Methods:

• A study of 701 adult female primary care patients utilized analysis of covariance and Poisson regressions.
• Attachment style was assessed to determine its association with symptom reporting (somatization) and healthcare utilization/costs.

Main Results:

• Patients with preoccupied and fearful attachment reported significantly more physical symptoms compared to secure attachment.
• Attachment style significantly correlated with primary care visits and costs: preoccupied attachment showed highest utilization, fearful the lowest.
• No significant differences in medical comorbidity were observed across attachment groups.

Conclusions:

• Attachment style is a crucial factor in understanding symptom perception and healthcare utilization patterns.
• Preoccupied and fearful attachment are linked to heightened symptom reporting, challenging the uniform association between symptoms and utilization.
• These findings highlight the need to consider attachment in clinical assessments of symptom reporting and healthcare resource use.