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Attachment in Romantic Relationships and Somatization

Neumann, Eva PhD*; Sattel, Heribert Dipl-Psych; Gündel, Harald MD; Henningsen, Peter MD; Kruse, Johannes MD§∥

Journal of Nervous & Mental Disease: February 2015 - Volume 203 - Issue 2 - p 101–106
doi: 10.1097/NMD.0000000000000241
Original Articles

Abstract: Adult attachment representations have been considered to play a role in the development and treatment of somatizing behavior. In this study, the associations between the two attachment dimensions avoidance and anxiety and dimensions of psychopathology (somatization, depression, and general anxiety) were explored. The sample consists of 202 outpatients diagnosed with a somatoform disorder. Data were collected via self-report measures. A path analysis shows that the two attachment dimensions are not directly associated with somatization. There are, however, significant indirect associations between attachment and somatization mediated by depression and general anxiety, which are more pronounced for attachment anxiety than for attachment avoidance. The findings reveal that a low level of attachment security in romantic relationships, especially an anxious stance toward the partner, comes along with poor mental health, which in turn is related to a preoccupation with somatic complaints. Implications for the treatment of somatizing patients are discussed.

*Heinrich-Heine-University, Düsseldorf; †Technische Universität, Munich; ‡Ulm University, Ulm; §Justus-Liebig University, Giessen; and ∥Philipps-University, Marburg, Germany.

Send reprint requests to Eva Neumann, PhD, Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Bergische Landstraße 2, D - 40629 Düsseldorf, Germany. E-mail:

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