1. Andrea Oskis Neuroendocrine correlates of insecure attachment in adolescents Psychophysiology and Stress Research Group

3. Attachment theory as a stress theory Bowlby’s original theory: a biobehavioural safety- regulating system  Activated in times of threat or stress Internal working model

4. Activates our body’s ‘stress hormone hotline’ The Hypothalamic-Pituitary- Adrenal (HPA) axis  Secretes the hormone cortisol STRESS!

5. Cortisol is not just a stress hormone... Based on Genuth (2008) Bone formation and resorption Decrease connective tissue Maintain muscle function; decrease muscle mass Maintain cardiac output Modulate emotional tone, wakefulness Support glucose synthesis Inhibit inflammatory and immune responses Increase glomerular filtration and free water clearance Cortisol

6. An excellent way to measure cortisol

7. The diurnal cortisol rhythm Oskis et al. (2009) Cortisol Awakening Response (CAR)

8. Especially post-awakening... In women with early life attachment adversity... and also with anxious insecure attachment style Meinlschmidt and Heim (2005) Quirin et al. (2008) Cortisol rhythms matter...

9. ...especially immediately post-awakening Kudielka & Kirschbaum (2003) Shirtcliff and Essex (2008)...especially in adolescence...

10. General methods Participants: 60 healthy female adolescents aged 9-18 yrs, mean age 14.16 (± 2.63) years +0 mins +15 mins +30 mins +45 mins +3 hrs +6 hrs +9 hrs +12 hrs x 2 consecutive weekdays Key measures: Attachment Style Interview (ASI) Saliva samples

11. The importance of adherence Participant 35C, 28/02/07, age 17 Morning Andrea! Woke up 0702, sample 1 done @ 0702. All going well! Its 12:35 so I’ve just done tube 6. I’ll b ready 4 tube 7 at 3:35. Thanx 4 messages, hope ur havin a good day! xXx Participant 26C, 28/02/07, age 17 Personalised text message prompts for each saliva sample sent over the day

12. The Attachment Style Interview Assesses current relationship behaviour & attitudes Insecurely attached AnxiousAvoidant vs. Securely attached Mild Moderate Marked Mild Moderate Marked

13. The Attachment Style Interview Assesses current relationship behaviour & attitudes Insecurely attached AnxiousAvoidant vs. Securely attached Mild Moderate Marked Mild Moderate Marked

14. Results

15. Securely attached Attachment style Insecure Anxious Insecure Avoidant

16. Secure (n = 30) Anxious (n = 13) Avoidant (n = 17) Age in years14.70 (± 2.56)13.39 (± 2.72)13.12 (± 2.55) Eating disorder risk (EDI-3) 27.93 (± 6.21)26.92 (± 7.75)25.18 (± 4.56) General psychological maladjustment 34.80 (± 4.66)37.23 (± 6.00)36.65 (± 6.14) STAI trait33.50 (± 6.16)33.62 (± 9.93)35.65 (± 7.58) STAI state am † 29.42 (± 6.74)29.23 (± 7.21)30.85 (± 6.60) STAI state pm † 28.50 (± 7.34)27.42 (± 7.11)29.32 (± 6.06) Participant characteristics

17. Secure (n = 30) Anxious (n = 13) Avoidant (n = 17) Age in years14.70 (± 2.56)13.39 (± 2.72)13.12 (± 2.55) Eating disorder risk (EDI-3) 27.93 (± 6.21)26.92 (± 7.75)25.18 (± 4.56) General psychological maladjustment 34.80 (± 4.66)37.23 (± 6.00)36.65 (± 6.14) STAI trait33.50 (± 6.16)33.62 (± 9.93)35.65 (± 7.58) STAI state am † 29.42 (± 6.74)29.23 (± 7.21)30.85 (± 6.60) STAI state pm † 28.50 (± 7.34)27.42 (± 7.11)29.32 (± 6.06) Participant characteristics All within age-appropriate normative range All within age-appropriate normative range No significant differences between attachment style groups No significant differences between attachment style groups

18. CAR and attachment style Oskis et al. (2012)

19. Daytime cortisol and attachment style Oskis et al. (2012)

20. Attachment style groups differed in the dynamic of the CAR  Anxious insecure:  awakening  45 min post-awakening No significant difference in subsequent daytime cortisol secretion The CAR as a distinct and especially sensitive part of the diurnal cortisol cycle? Summary and implications: Cortisol and attachment style

21. A prognostic ‘non-healthy’ CAR? Kudielka & Kirschbaum (2003) Similarity to anxious insecure adolescent profile

22. Thank you for listening Andrea.Oskis@uwl.ac.uk