Influence of Parental Attachment Style on Parent vs. Child Somatization in Families with Children with Asthma

Abstract

Background: Insecure attachment is a factor in an individual's physical and psychological well being (Berant, Mikulincer, & Shaver, 2008; Wood, Klebba, & Miller, 2000). Previous literature indicates an intergenerational transmission of somatization involving maternal modeling and reinforcement of illness behaviors (Craig, Cox, & Klein, 2002; Crane & Martin, 2004; Marshall, Jones, Ramchandani, Stein, & Bass, 2007; Walker, Garber, & Greene, 1993). This study investigates the role of parental attachment style on parent somatization, and the influence of parental modeling on child somatization in children with asthma. Gender, ethnicity, and family income were examined for differences in attachment style and somatization. Methods: One hundred and three pediatric asthma patients aged 7--15 and their primary caregivers were recruited from outpatient clinics in hospital settings in Bronx, New York. Primary caregivers completed the Relationship Questionnaire, a measure of attachment style, and the Patient Health Questionnaire-15 (PHQ-15), a self-report measure of somatization. Children completed the Children's Somatization Inventory (CSI), a self report measure of somatization. Results: Between group differences were found in family income by parental attachment style [chi2 (2) =8.42, p &le; .02] such that an income below the median ({dollar}18,000) was significantly more prevalent in those with fearful attachment as compared with dismissing attachment [chi 2 (1)=7.94, p &le; .017]. There were no between group differences in somatization by attachment style, child gender, ethnicity, and family income. A Pearson correlation found a weak positive relationship between parent and child somatization (r=.21, p <.05, n=103) however a hierarchical regression analysis revealed no evidence of a relationship between parent and child somatization controlling for family income. Conclusion: Findings were inconsistent with literature on somatization and likely due to the overall minimal levels of somatization in our sample. This may speak to high levels of resilience in our sample of inner city families. Future studies should consider the methodological complexities of assessment across cultures. Further, research should include alternate measures of attachment, somatization, and negative affect which may shed some light on risk factors for negative health outcomes for chronically ill children.