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Attachment Security and Immunity in Healthy Women

Picardi, Angelo MD; Battisti, Francesca MD; Tarsitani, Lorenzo MD; Baldassari, Maurizio MD; Copertaro, Alfredo MD; Mocchegiani, Eugenio MD; Biondi, Massimo MD

doi: 10.1097/PSY.0b013e31802dd777
Original Articles

Background: Attachment security is associated with health and possibly autonomic and endocrine reactivity to stress, however the relationship between attachment style and immune function has not yet been investigated.

Methods: A random sample of 61 female nurses provided a blood sample and completed the Perceived Stress Scale, the Multidimensional Scale of Perceived Social Support, the 20-item Toronto Alexithymia Scale, and the Experiences in Close Relationships questionnaire. Immune measures included immunophenotypic analysis, lymphocyte proliferative response to Phytohemagglutinin, and NK cell cytotoxicity (NKCC). Statistical analysis focused on the relationship between attachment-related anxiety or avoidance and immune measures. Multiple regression was used to control for perceived stress and support, alexithymia, health-related behaviors possibly influencing immunity, and use of anti-inflammatory drugs, tobacco or alcohol.

Results: Attachment-related anxiety was not associated with any immune parameter. Attachment-related avoidance was associated with lower NKCC. This association was independent from the number of circulating NK cells, which suggests a change in cell functionality. Perceived stress was also associated with lower NKCC.

Conclusions: This study suggests a link between attachment security and immunity. While our findings should be interpreted with great caution and need replication, they are consistent with previous work suggesting that insecure attachment may be a risk factor for health and may relate to biological processes relevant to health.

PSS = Perceived Stress Scale; MSPSS = Multidimensional Scale of Perceived Social Support; TAS-20 = 20-item Toronto Alexithymia Scale; ECR = Experiences in Close Relationships questionnaire; PHA = Phytohemagglutinin; NKCC = Natural Killer Cell Cytotoxicity; BMI = body mass index.

From the Center of Epidemiology and Health Surveillance & Promotion (A.P.), Italian National Institute of Health, Rome, Italy; Department of Psychiatric Science and Psychological Medicine (F.B., L.T., M.Biondi), University “La Sapienza” of Rome, Italy; Occupational Health Unit (M.Baldassari), United Hospitals of Ancona and Politechnic University of Marche, Ancona, Italy; Healthcare Workers Service (A.C.), Regional Health Administration, Ancona, Italy; Immunology Center, Section Nutrition, Immunity and Aging, Research Department (E.M.), Istituto Nazionale Riposo e Cura Anziani, Ancona, Italy.

Address correspondence and reprint requests to Angelo Picardi, Italian National Institute of Health, Center of Epidemiology and Health Surveillance & Promotion, Mental Health Unit, Viale Regina Elena, 299-00161 Rome, Italy. E-mail:

Received for publication December 23, 2005; revision received July 26, 2006.

Copyright © 2007 by American Psychosomatic Society
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