Anxious attachment style predicts an enhanced cortisol response to group psychosocial stress

Insecure attachment style is associated with poor health outcomes. A proposed pathway implicates the hypothalamic-pituitary-adrenal axis (HPA-axis), dysregulation of which is associated with a wide range of mental and physical ill-health. However, data on stress reactivity in relation to attachment style is contradictory. This relationship was examined using the novel Trier Social Stress Test for groups (TSST-G): a group-based acute psychosocial stressor. Each participant, in the presence of other group members, individually performed public speaking and mental arithmetic tasks. Seventy-eight healthy young females (20.2 ± 3.2 years), in groups of up to six participants completed demographic information and the Vulnerable Attachment Style Questionnaire (VASQ), and were then exposed to the TSST-G. Physiological stress reactivity was assessed using salivary cortisol concentrations, measured on seven occasions at 10-min intervals. Vulnerable attachment predicted greater cortisol reactivity independent of age, smoking status, menstrual phase and body mass index. Supplementary analysis indicated that insecure anxious attachment style (high scores on the insecurity and proximity-seeking sub-scales of the VASQ) showed greater cortisol reactivity than participants with secure attachment style. Avoidant attachment style (high scores for insecurity and low scores for proximity seeking) was not significantly different from the secure attachment style. Attachment style was not associated with the timing of the cortisol peak or post-stress recovery in cortisol concentrations. These findings in healthy young females indicate subtle underlying changes in HPA axis function in relation to attachment style and may be important for future mental health and well-being.