Longitudinal Associations between Attachment Quality, C-Reactive Protein, and BMI: Preliminary Evidence from a CPS-Referred Sample

• In Event: 3-128 - Close Relationships and Physical Health: A Lifespan Developmental Perspective

Integrative Statement

BACKGROUND: Childhood adversity, such as exposure to maltreatment and poverty, is associated with increased risk for physical health problems across the lifespan, such as obesity and cardiovascular disease (Anderson et al., 2018; Felitti et al., 1998). Chronic low-grade inflammation is one mechanism by which childhood adversity “gets under the skin” to influence adulthood health outcomes (Miller, Chen, & Parker, 2011). Insecure or disorganized attachment, which occurs at elevated rates among children exposed to maltreatment and high sociodemographic risk (Cyr, Euser, Bakermans-Kranenburg, & van Ijzendoorn, 2010), has been proposed as a possible risk factor for chronic inflammation (Ehrlich, Miller, Jones, & Cassidy, 2016). The current study leveraged pilot data collected within the context of an ongoing longitudinal study of children with histories of child protective services (CPS) involvement. We predicted that CPS-referred children with insecure or disorganized attachments would have higher CRP levels than children with secure attachments. We also explored associations among attachment quality, CRP, and body mass index (BMI), predicting that early childhood CRP would mediate the association between secure attachment in infancy and BMI in middle childhood.
METHOD: Participants included 84 children and their mothers: 45 with histories of CPS involvement, and 39 with no CPS involvement. When children were 4–6 years old (M= 4.9 years, SD = 0.6), blood spot samples were collected that were assayed for CRP levels. For children in the CPS group, attachment was assessed using the gold standard Strange Situation procedure (Ainsworth, Blehar, Waters, & Wall, 1978) during infancy, and BMI was assessed when children were 4 and 8 years old. To control for sociodemographic risk factors, a composite parental risk score was computed by summing four dichotomized risk factors: low income, low education, single parenthood, and being a young mother.
RESULTS: Hierarchical multiple regression demonstrated that attachment quality significantly predicted early childhood CRP among CPS-referred children (see Table 1). An ANCOVA comparing CPS-referred children with secure attachments, CPS-referred children with insecure/disorganized attachments, and low-risk comparison children demonstrated a significant effect of group on CRP, F(1, 75) = 3.98, p = .023 (see Figure 1). In pairwise comparisons, CPS-referred children with insecure/disorganized attachments had significantly higher CRP levels than both low-risk children (p = .010) and CPS-referred children with secure attachments (p = .026); CPS-referred children with secure attachments did not differ significantly from low-risk children (p = .705). Early childhood CRP levels significantly predicted BMI at age 8, B = 1.94, p = .006, controlling for BMI at age 4, suggesting that elevated CRP in early childhood was associated with increases in BMI over time. Finally, mediation analyses demonstrated a significant indirect effect from insecure/disorganized attachment to age 8 BMI via early childhood CRP [B = .43, 95% CI: 0.04, 1.11].
DISCUSSION: These findings offer novel support for an association between attachment quality and early chronic inflammation, which in turn may have implications for later physical health. Such research into the developmental origins of disease vulnerability may identify novel opportunities for the prevention of pervasive physical health conditions later in life.

Authors

• Kristin Bernard, Stony Brook University
  Presenting Author

• Camelia E. Hostinar, University of California-Davis
  Non-Presenting Author

• Mary Dozier, University of Delaware
  Non-Presenting Author