Loneliness-Mediated Long-term Associations Between Preoccupied Attachment and General Health

Joseph S. Tan, Jessica Kansky, Elenda T. Hessel, Megan M. Schad, & Joseph P. Allen

University of Virginia.

We would like to thank the National Institute of Child Health & Human Development for funding awarded to Joseph P. Allen, Principal Investigator, (R01 HD058305 & R01-MH58066) for funding to conduct this study as well as for the write-up of this study.

Introduction• Research has shown that aspects of adult social functioning,

such as social support and loneliness, carry implications for health outcomes such as cardiovascular disease and mortality (Hawkley & Cacioppo, 2010; Uchino, 2004).

• Therefore, developing close relationships and the sense of connectedness that comes with them is an important task.

• Research on adolescent antecedents to these adult processes may help to identify risk factors for poorer adult social functioning and in turn, poorer adult health outcomes.

• Attachment theory may explain individual variation in success at developing close relationships, as it postulates that an individual’s early experience drawing support and comfort from caregivers in times of distress sets expectations for future close relationships.

• Individuals with a preoccupied attachment (characterized by an inability to separate themselves from past attachment experiences) have been shown to be especially at risk for difficulties in social functioning (Paley et al, 1999).

• In this study, we investigated the long-term associations between adolescent preoccupied attachment and adult health, as well as the role of loneliness in mediating these associations.

Method

Results

Participants•Participants were 184 individuals assessed at age 14 and annually from ages 25 to 27.•The sample was 63% European-American, 27% African-American, and 14% mixed race or other race/ethnicities. •Baseline median family income was in the $40,000 to $59,000 range

ProcedureTime 1 – At age 14, participants completed a modified version of Adult Attachment Interview.Time 2 – Between ages 25 and 27, participants reported on their loneliness and their general health annually. Composites were created for both measures, averaging across the 3-year timespan.

MeasuresPreoccupied attachment state of mind was assessed using a modified version of the Adult Attachment Interview and the Kobak Q-sort coding system.

Loneliness was assessed with the self-report UCLA Loneliness Scale (Russell, 1996). Loneliness was measured with 20 items on which participants rated their loneliness on a 4-point Likert scale (Cronbach’s α = .97). Example items include “I lack companionship,” and “I feel completely alone.”

Participants reported on their general health using a health outcomes questionnaire (Ware & Sherbourne, 1992). General health was measured with five items (Cronbach’s α = .82 - .86). Example items include “I get sick easily,” and “I expect my health to get worse.”

Conclusions• The results suggest that adolescents with a preoccupied

attachment state of mind self-report poorer general health as adults than less preoccupied individuals because preoccupied adolescents also experience more loneliness as adults.

• This may be due to a lack of social skills for preoccupied individuals, inhibiting them from establishing supportive close relationships with others that may reduce loneliness and reduce negative health impacts.

• Alternatively, preoccupied individuals may be establishing maladaptive close relationships with others that do not provide support.

Future Directions• Are there differences between how preoccupied individuals

perceive adult relationships and the actual qualities of these relationships?

• What are the qualities of preoccupied individual relationships that might be leading to more loneliness and poorer health?

• What relationships (e.g. romantic, close friendships) are implicated?

• What adolescent antecedents exist for the development of loneliness?

Analyses using a Full Information Maximum Likelihood approach for handling missing data suggested that adolescent preoccupied attachment state of mind predicted adult general health, with this association mediated by adult loneliness (see Figure 1).

Controlling for gender and income, preoccupied attachment state of mind at age 14 predicted general health at ages 25 through 27. Reported loneliness at ages 25 through 27 also predicted general health at ages 25 through 27. Loneliness mediated the association between preoccupied attachment state of mind and general health.