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Attachment Strategies and Neuroendocrine Biomarkers in Obese Children
Inês Pinto1, Simon Wilkinson2, Daniel Virella3
1Department of Child and Adolescent Psychiatry. Hospital Beatriz Ângelo. Loures. Department of Psychiatry and Mental Health. Faculty of Medicine. University of Porto. Porto. Hospital Dona Estefânea. Centro Hospitalar Lisboa Central. Lisboa.
Insights
Parent-infant relationship quality impacts child stress regulation. In obese children, attachment styles like avoidant (Type A) and secure (Type B) are linked to thyroid stimulating hormone and cortisol levels, influencing metabolic profiles.
Area of Science:
- Pediatric endocrinology
- Developmental psychology
- Childhood obesity research
Background:
- Parent-child relationship quality is crucial for physiological stress regulation development in children.
- Obesity in children is associated with altered stress response mechanisms.
- Attachment strategies may mediate or influence the mother-child relationship's impact on metabolic biomarkers.
Purpose of the Study:
- To investigate the associations between different attachment strategies and levels of cortisol and thyroid stimulating hormone in obese children.
- To explore cortisol as a potential mediator and thyroid stimulating hormone as a potential intervening variable in the context of the mother-child relationship in pediatric obesity.
Main Methods:
- Recruited 83 obese children (mean age 10.9 years) from a pediatric obesity clinic.
- Assessed attachment strategies using self and parent-report questionnaires.
- Measured metabolic biomarkers (cortisol, thyroid stimulating hormone) and family functioning; employed multivariate linear regression analysis.
Main Results:
- Avoidant (Type A) attachment showed positive association with thyroid stimulating hormone and negative association with cortisol (R2 = 0.352).
- Secure (Type B) attachment demonstrated positive associations with hypothyroidism and body mass index percentile (R2 = 0.541).
- Insecure attachment (Types A and C) showed a positive association with thyroid stimulating hormone (R2 = 0.250).
Conclusions:
- Findings suggest potential commonalities in the regulation of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-thyroid axes.
- Development of Type A attachment strategy appears linked to effects on the hypothalamic-pituitary-adrenal axis regulatory mechanisms.
- Diverse attachment strategies in obese children correlate with varied metabolic profiles, suggesting avenues for differentiated treatment approaches.
Introduction:
Quality of the parent-infant relationship influences the mechanisms of development of the child's physiological stress regulation. This study explored associations between attachment strategies and both cortisol and thyroid stimulating hormone, hypothesized to be respectively a potential mediator and a potential intervening variable of the mother-child relationship in obese children.
Material And Methods:
A sample of 83 obese children (46 boys), aged 10.9 (1.8) years was recruited from a child obesity clinic. Obesity was defined by body mass index percentile adjusted for age and sex. Metabolic biomarkers were measured by routine methods. Attachment strategies were assessed with self and parent-report questionnaires. Family functioning was assessed with parent-reported questionnaires (FACES-III). Multivariate linear regression analyses were performed.
Results:
Type A, avoidant attachment strategies, had significant positive association with thyroid stimulating hormone levels and negative association with cortisol levels (R2 = 0.352). Type B, secure attachment strategies, had significant positive associations with both hypothyroidism and body mass index percentile (R2 = 0.541). 'Insecure attachment' (types A and C combined) strategies showed some evidence of positive association with thyroid stimulating hormone (R2 = 0.250).
Discussion:
These findings suggest that there may be commonalities in the regulation of hypothalamic-pituitary-adrenal and hypothalamic-pituitary-thyroid axes. Processes involved in development of the type A attachment strategy appear to be associated with effects on the regulatory mechanisms of the hypothalamic-pituitary-adrenal axis.
Conclusions:
In obese children, different attachment strategies are associated with diverse metabolic profiles. How this may contribute to developing differentiated treatment approaches remains to be explored.
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