ARTICLE IN PRESS

Psychoneuroendocrinology (2008) 33, 581590

Available at www.sciencedirect.com

journal homepage: www.elsevier.com/locate/psyneuen

HPA system regulation and adult attachment anxiety:

Individual differences in reactive and
awakening cortisol
Markus Quirina,, Jens C. Pruessnerb, Julius Kuhla

a
Institute of Psychology, University of Osnabrueck, Seminarstrae 20, 49069 Osnabruck, Germany
b
Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada

Received 4 July 2007; received in revised form 22 January 2008; accepted 30 January 2008

KEYWORDS Summary
HPA; Early life experiences can influence hypothalamuspituitaryadrenal (HPA) axis regulation
Cortisol responsivity; in adulthood, in both animals and humans. In humans, they have also been shown to
Cortisol response to influence adult attachment styles. However, the relationship between adult attachment
awakening; styles and HPA axis regulation is largely unexplored. The present study investigated the
Stress; relationship among varying levels of attachment anxiety and avoidance with both the
Adult attachment cortisol response to acute stress (CRS) and the cortisol response to awakening (CRA) in 48
anxiety; adult women. Attachment-unrelated stress was induced by a laboratory stress task. Saliva
Hypocortisolism; for free cortisol assessment was sampled before and after the stress task in the laboratory
Personality and at home on 2 consecutive days in the morning after awakening. We found that
development; attachment anxiety but not attachment avoidance was associated with cortisol measures.
PSI theory Attachment anxiety was positively correlated with CRS and negatively with CRA. Finally,
the two cortisol parameters were negatively associated with one another. The results are
discussed with respect to (1) recent findings suggesting that the HPA system and
hippocampus are programmed during critical development periods, establishing a certain
trajectory of physiological responsiveness throughout life, and (2) a model that links
development of the hippocampus with self development.
& 2008 Elsevier Ltd. All rights reserved.

1. Introduction

Corresponding author. Tel.: +49 541 969 4729;
fax: +49 541 969 4788.
E-mail addresses: mquirin@uos.de (M. Quirin),
jens.pruessner@mcgill.ca (J.C. Pruessner), j.kuhl@gmx.net
(J. Kuhl).
Frequent early life stress like, for example, inadequate
parental care, can have enduring effects on stress reactivity,
hypothalamuspituitaryadrenal (HPA) system regulation, and
neurodevelopment as evidenced by studies on rodents (e.g.,
Sapolsky, 1996; Sapolsky and Meaney, 1986; Meaney et al.,

0306-4530/$ - see front matter & 2008 Elsevier Ltd. All rights reserved.
doi:10.1016/j.psyneuen.2008.01.013
 ARTICLE IN PRESS
582
1988), monkeys (e.g., Coplan et al., 1996), and humans (e.g.,
Heim and Nemeroff, 1999; Heim et al., 2001; Buss et al.,
2007). In humans, quality of parental caretaking is considered
to be particularly crucial while brain systems critically
involved in the regulation of the HPA axis such as the
hippocampus or the prefrontal cortex are developing (Sanchez
et al., 2001; Teicher et al., 2003). Accordingly, while high
parental responsiveness and sensitivity during this period
attenuates HPA reactivity throughout the life span (Spangler
et al., 1994; Gunnar, 1998) and promotes adequate biobeha-
vioral regulation and well-being of the offspring in general
(Gunnar, 2003, 2005; Gunnar and Donzella, 2002), adverse
early rearing conditions such as insensitive and unresponsive
care (e.g., De Wolff and van IJzendoorn, 1997), have been
linked to increased HPA reactivity, increased risk for substance
abuse and psychopathology, and poor biobehavioral regulation
throughout the life span.
Interestingly, attachment insecurity, which refers to
inappropriate behavior and expectations in the context of
close relationships (Bowlby, 1973; see also Ainsworth et al.,
1978), has been associated with adverse early rearing
conditions as well. Attachment insecurity can be described
along two dimensions, attachment anxiety and attachment
avoidance (Brennan et al., 1998; Shaver and Mikulincer,
2002) and shows relative stability from infancy to adulthood
(Fraley, 2002; Simpson et al., 2007). A high level of
attachment anxiety is characterized by worries about
relationships, strong need for closeness, and fear of being
abandoned. By contrast, a high level of attachment
avoidance is characterized by self-reliance and emotional
distance from close relationships. Because both HPA axis
regulation and attachment styles are influenced by early
rearing conditions, we wanted to investigate whether HPA
axis regulation is associated with variations in attachment
styles as well.
It has previously been shown that adult attachment
insecurity is associated with impairments in stress regulation
(Shaver and Mikulincer, 2007). Specifically, attachment
anxiety is linked to hyperreactivity to threats and cata-
strophic beliefs about potentially aversive situations
(Bartholomew and Horowitz, 1991; Mikulincer and Florian,
1998). Moreover, individuals high in attachment anxiety
report higher subjective levels of psychological stress in
response to stressful events, and a stronger tendency to
ruminate about them (see Mikulincer and Florian, 1998, for
a review). Attachment avoiders, on the other hand, use
defensive regulation mechanisms (e.g., repression of un-
pleasant emotions) that allow them to control emotional
stressful situations (e.g., Mikulincer et al., 1990; Dozier and
Kobak, 1992; Mikulincer and Orbach, 1995; Fraley and
Shaver, 1997; Mikulincer and Horesh, 1999). Therefore, it
is interesting to investigate whether adult attachment
insecurity, particularly attachment anxiety, is related to
HPA regulation.
When investigating HPA axis regulation, the circadian
rhythm (baseline regulation) needs to be differentiated
from the response of the system to acute stimulation, e.g.,
stress. Over the course of the past decade, the cortisol
response to awakening (CRA) as part of the circadian rhythm
has extensively been investigated. The CRA typically
constitutes the circadian peak of cortisol secretion and has
been identified as a reliable marker for studying individual
M. Quirin et al.
differences (Pruessner et al., 1997b). Although the CRA has
been found to be related to a number of factors such as age,
time of awakening, sleep quality, and genetic differences,
the determinants of CRA have not been fully explained yet.
Importantly, recent work suggests that the integrity of the
hippocampus is essential for the CRA (Buchanan et al., 2004;
Pruessner et al., 2005; Wolf et al., 2005).
There is considerable evidence that the cortisol increase
after awakening is reduced in individuals scoring high on
personality dimensions that have been associated with high
levels of attachment security such as self-esteem, internal
locus of control (Pruessner et al., 1999a), life satisfaction,
autonomous control (Brandtstadter et al., 1991), and
emotional stability (Gilbert et al., 1996; Westrin et al.,
1998). One study has directly related reduced morning
cortisol in individuals with high attachment insecurity (Adam
and Gunnar, 2001).
Regarding the HPA axis response to stress, there is
considerable evidence suggesting that an elevated cortisol
response to acute stress (CRS) is related to attachment
insecurity in children (Spangler and Grossmann, 1993;
Hertsgaard et al., 1995; Nachmias et al., 1996; Gunnar
et al., 1996; Spangler and Schieche, 1998; van Bakel and
Riksen-Walraven, 2004). However, little research has been
conducted on the relationship between attachment styles in
adults and the CRS. In a recent study investigating cortisol
responses to an interpersonal conflict situation in young
adult participants, Powers et al. (2006) found that attach-
ment insecurity was associated with increased HPA reactiv-
ity. Specifically, attachment avoidance in female
participants was related to increased HPA reactivity,
whereas a combination of attachment avoidance and
attachment anxiety predicted HPA reactivity in male
participants. In a similar vein, an elevated CRS has also
been observed in psychological dispositions that have
typically been associated with attachment insecurity such
as low self-esteem (Pruessner et al., 1999b) or low
subjective autonomous control (Pruessner et al., 1997a).
Likewise, Luecken (1998) found that adults who reported
poor early relationships to their parents, which is a typical
finding for insecurely attached individuals, showed heigh-
tened cortisol as a response to a video clip that showed the
death of a parent. Similarly, individuals with early loss of a
parent showed pronounced cortisol elevations as a reaction
to a stressful speech task only when they reported poor early
family relationships (Luecken, 2000).
In sum, the relationship between cortisol and adult
attachment dimensions has not been explored extensively.
Further, there are only few studies available that have
investigated the CRA together with the CRS, and none of
these studies have assessed individual differences in adult
attachment styles. Thus, we wanted to investigate the
mutual relationships between adult attachment styles, CRA
and CRS.
2. Methods
2.1. Participants and study design
Forty-eight adult working women (mean age 33.978.4
years) were recruited via advertisements and invited to
 ARTICLE IN PRESS
HPA regulation and adult attachment anxiety
the laboratory for three sessions. First, participants took
part in an information session where the study and its
procedures were explained to them. If individuals consented
to participate, they were invited to a second session where
psychological questionnaires were completed and saliva
home sampling was explained to them. Within 2 weeks, the
participants brought their saliva samples back to the
laboratory and performed the laboratory stress task.
Participants were compensated for their time and incon-
venience with a total of 20h. All procedures were carried
out with the adequate understanding and written consent of
the participants.
To control for gender differences (Kirschbaum et al.,
1999), only women were recruited for this study. To
minimize the influence of variables known to affect HPA
system regulation, we excluded smoking, cortisone or
psychotropic medications, psychiatric disorders or alcohol
abuse, or symptoms of a common cold. In order to minimize
the effects of age on HPA system regulation (e.g., Bremner
and Vermetten, 2001; Seeman et al., 2001; Kudielka et al.,
2004), we restricted the age range to young adulthood, from
20 to 45 years. Because the CRS is influenced by the
menstrual cycle (Kirschbaum et al., 1999), we assessed the
number of days since the last menstruation and categorized
subjects into follicular versus luteal phase accordingly.
Moreover, in order to further control for possible influences
on HPA axis regulation, we only recruited non-menopausal
women on oral contraceptives.
2.2. Morning saliva sampling
Sampling was performed by participants themselves (cf.
Smyth et al., 1997) by using the sampling device Salivette of the stress task (peak).
(Sarstedt, Rommelsdorf, Germany). To ensure validity
of the time points, sampling time was monitored by an
electronic drug exposure monitor (Aardex, Zug, Switzerland)
and participants were informed that their activities
would be recorded. Previous research has demonstrated
that use of this monitor makes participants more compliant
with respect to the timing instructions (Kudielka et al.,
2003).
Participants were instructed to sample saliva for 2
consecutive days at the time of awakening (in bed), as well
as 30, 45, 60, and 75 min after awakening. Subjects were
instructed to chew on the salivettes for at least 30 s, to
ensure saturation with saliva. Because all participants had
regular working hours during the sampling days, the
sampling period ranged from 04:45 to 07:30 h. The electro-
nic monitor revealed that no participant deviated from the
required sampling times for more than 5 min, which
indicates high compliance with the instructions. Moreover,
participants were asked not to have breakfast during the
sampling period in order to avoid contamination of the saliva
with food or drinks. However, if it was not possible to
postpone the breakfast, participants were asked to thor-
oughly rinse their mouth after eating or drinking, and wait
5 min before taking the sample. Further, to avoid contam-
ination with blood from microinjuries in the oral cavity,
participants were asked not to brush their teeth before the
end of the sampling period. Participants were asked to store
the samples in a refrigerator until returning them to the
instructor.
583
2.3. Laboratory stress procedure
Participants were invited to the laboratory to perform a
stress task in front of a computer situated in a cubicle. To
control for circadian cortisol fluctuations, each session
started at 14:00 h. Stress was induced by the following
procedure: participants were exposed to a repeatedly
presented uncontrollable and unpredictable aversive noise
(auditory startle probe) of 500 ms duration and 102 decibel
via headphones while performing a visual classification task
of about 8 min. The startle probe consisted of a sound
recording of an electric shock, presented pseudo-randomly
36 times over the course of the procedure (mean inter-
stimulus interval 13 s). Participants neither knew when or
how often the stressor would appear nor had they any
control over the stressor once it occurred. Uncontrollability
and unpredictability are situational aspects that have been
shown to stimulate HPA system activity in previous research
(Mason, 1968; Dickerson and Kemeny, 2004). Noise in
particular has been linked to HPA system activation in
previous studies in both rats (Windle et al., 1997; Burow
et al., 2005) and humans (Brandenberger, 1980; Wittersheim
et al., 1985; Bollini et al., 2004). The classification task as
such, which required pattern recognition, was not designed
to influence HPA activity.
We chose uncontrollable noise over typical stress tasks
such as public speaking or mental arithmetic (Kirschbaum
et al., 1993; Dickerson and Kemeny, 2004) because of
limitations in manpower. The here implemented task was
fully computerized and thus did not require a panel of
observers. Saliva samples were taken 20 min before the
experimental session (baseline) and 25 min after the onset
2.4. Cortisol analysis and parameterization
Cortisol was analyzed by a time-resolved immunoassay with
fluorescence detection (Dressendorfer et al., 1992). CRA
was parameterized through the maximum individual cortisol
increase during the first hour after awakening, that is the
cortisol level at awakening (time 1) to the individual cortisol
peak (e.g., Pruessner et al., 1997b). To obtain the average
CRA, awakening level and maximum level from the first
assessment day were aggregated with corresponding vari-
ables from the second day, respectively. CRS was operatio-
nalized through the net increase in cortisol concentration
(post-measurement minus baseline).
2.5. Psychological assessment
Attachment Security versus Insecurity was measured by the
Experiences in Close Relationships Scale (Brennan et al.,
1998; German version by Neumann et al., 2007), which is a
dimensional self-report measure comprising the scales
anxiety (about abandonment; e.g., I worry a fair amount
about losing my partner) and avoidance (of closeness;
e.g., I get uncomfortable when a romantic partner wants
to be very close), each based on 18 items. Response
options vary from (1) Disagree strongly to (7) Agree
strongly. Thus, high values in each scale indicate high
levels of insecure attachment. In the present sample,
 ARTICLE IN PRESS
584 M. Quirin et al.

Cronbachs alpha was .84 for anxiety and .81 for avoidance. 3. Results
As described by the authors, if required, both scales can be
combined to make up the four attachment categories In three individuals, laboratory cortisol samples were
secure (low anxiety, low avoidance), fearful (high incomplete. Therefore, analyses referring to the CRS were
anxiety, high avoidance), preoccupied (high anxiety, low based on the remaining sample of 45 participants.
avoidance), and dismissing (low anxiety, high avoidance)
(cf. Main and Goldwyn, 1994).
3.1. Cortisol response to stress
Moreover, we controlled for autonomous control, self-
esteem, neuroticism and chronic levels of social stress.
To investigate changes in cortisol levels in response to
Autonomous control was measured with a four-item short
stress, we conducted a one-way (time) repeated-measures
version of the self-determination scale (Kuhl and Fuhrmann,
ANOVA with the cortisol levels before and after stress as the
2001) taken from the Volitional Components Inventory (Kuhl
dependent variables. There was no significant change over
and Fuhrmann, 1998). This scale measures the degree to
time for the whole group, F(1,44) .61, ns, with a mean
which a person feels self-involvement across daily actions
(S.D.) of 5.4 (3.1) nmol/l at time 1 and a mean (S.D.) of 5.7
and expects to manage a situation even if difficult to do so.
(3.1) nmol/l at time 2. Computing a two-way (group  time)
Response options vary from (1) not at all to (4)
mixed-design ANOVA with menstrual cycle phase as the
absolutely. Self-esteem was measured by the Rosenberg
independent, and the cortisol levels as dependent variable,
Self-Esteem Scale (see Ferring and Filipp, 1996, for a
failed to show a significant effect of cycle phase on the
German version; Rosenberg, 1965). This scale draws on 10
cortisol levels, F(1,43) .36, ns.
items to ascertain the extent to which a person feels
content with himself and likes his own person the way he is.
Response options vary from (0) not at all to (3) 3.2. Cortisol response to awakening
absolutely. In order to control for general forms of
anxiety, we assessed neuroticism via the corresponding 12- Consistent with the literature, morning cortisol levels increased
item scale from the NEO Five-Factor Inventory (Costa and significantly as a response to awakening, F(1,47) 60.9,
McCrae, 1992; for the German version, see Borkenau and po.001 for the first day (awakening level: M 12.26,
Ostendorf, 1993), with response options ranging from (1) S.D. 8.13; individual maximum of second to fifth assessment:
not at all to (5) absolutely. M 23.90; S.D. 11.15), and F(1,47) 57.6, po.001 for the
Social stress, which has previously been related to cortisol second day (awakening level: M 11.86, S.D. 7.70; indivi-
(Dickerson and Kemeny, 2004) and which may also be related dual maximum of second to fifth assessment: M 23.87;
to attachment anxiety, was assessed by the Trier Inventory S.D. 11.07). The course of cortisol concentrations was similar
for the Assessment of Chronic Stress (Schulz and Schlotz, for each day, with peak levels 30 min after awakening.
1999). This scale uses seven items to assess the frequency Replicating the findings by Pruessner et al. (1997b), CRA
with which individuals have been making negative experi- showed relatively high intraindividual stability from 1 day to
ences or stressful experiences during the past 12 months the next, rp(44) .65, po.001. To increase the reliability of
(e.g., being criticized by others). CRA for further analyses, individual cortisol measures were
averaged across the 2 days for each subject.

2.6. Statistical analyses

3.3. Relationships of adult attachment with other
personality variables and chronic social stress
As revealed by preliminary KolmogorovSmirnov tests, all
variables were sufficiently normally distributed. To investi-
Attachment anxiety was marginally correlated with attach-
gate the degree to which cortisol changed in response to
ment avoidance, r(46) .26, po.10, supporting the relative
awakening and acute stress, we performed repeated-
independence of these two dimensions (Brennan et al., 1998).
measures analyses of variance (ANOVA). To investigate
Moreover, attachment anxiety was significantly inversely
relationships between attachment dimensions with other
related to self-esteem, r(46) .51, po.001, and to
psychometric variables, we used Pearson correlations. To
autonomous control, r(46) .57, po.001, positively related
investigate whether attachment dimensions and other
to neuroticism, r(46) .48, po.001, as well as marginally
psychometric variables were significantly related with
related to social stress, r(46) .26, po.10. Attachment
CRA and CRS, we correlated attachment dimensions (and
avoidance was moderately inversely related to self-esteem,
other psychometric variables) with CRA peak and CRS,
r(46) .31, po.05, and autonomous control, r(46) .29,
with baseline cortisol levels partialed out. We also used
po.05, positively to neuroticism, r(46) .39, po.01, and
this approach to correlate both CRA and CRS with one
marginally to social stress, r(46) .25, po.10. Therefore, it
another. We decided to use this approach in order to
seemed appropriate to control whether potential relation-
keep the full range of information given by the conti-
ships between attachment styles and cortisol can be
nuous psychometric variables (e.g., Cohen and Cohen,
attributed to the role of any of these variables.
1983). In addition, we built groups of high and low
attachment by performing a median-split of the attachment
variables, and compared cortisol levels in the two groups 3.4. Adult attachment and cortisol responses
using a two factor (group  time) mixed design ANOVA with
the cortisol levels (separate for CRA and CRS) as dependent Table 1 lists partial correlations of attachment and alter-
variables. native personality traits with cortisol before (baseline) and
 ARTICLE IN PRESS
HPA regulation and adult attachment anxiety 585

after stress induction (columns 1 and 2, respectively) as well 25

Cortisol (nmol/l)
as individual baseline and maximum cortisol levels in the 20
morning (columns 3 and 4, respectively), both baseline-
15
corrected. As expected, attachment anxiety was signifi-
cantly related to CRS, rp(42) .39, po.01. The correspond- 10
low attachment anxiety
ing two-factor (group  time) mixed-design ANOVA was 5 high attachment anxiety
significant as well, F(1,43) 7.5, po.01 (see Figure 1,
0
for the course of cortisol in the morning as a function of 0 30 45 60 75
high versus low attachment anxiety). Moreover, attachment
Time after awakening (min)
anxiety was significantly and negatively related to CRA,
rp(45) .40, po.01. The corresponding ANOVA was Figure 2 Mean salivary cortisol levels (7S.E.) averaged across
significant as well, F(1,46) 5.5, po.05 (see Figure 2, 2 days at 0, 30, 45, 60, and 75 min after awakening as a function
for cortisol changes as a function of high versus low of high versus low attachment anxiety (median split).
attachment anxiety). Additionally, a paired t-test confirmed
that cortisol significantly increased in the subgroup of 3.5. Relationship between CRS and CRA
individuals with high attachment anxiety, t(23) 2.14,
po.05. By contrast, neither attachment avoidance, The relationship between CRA and CRS was examined
self-esteem, self-determination, nor social stress were by correlating the individual maximum cortisol level during
significantly related to any of the cortisol measures: the first hour after awakening (CRAmax) with post-stress
.22orps(45)o.22, ps4.10 (Table 1). Moreover, the two cortisol levels after partialing out both CRA and CRS baseline
cortisol measures were not predicted by the interaction levels. The partial correlation model revealed a significant
between attachment anxiety and avoidance, suggesting that negative relationship between maximum cortisol concentra-
cortisol is not associated specifically with one of the four tion in the morning and post-stress cortisol concentration,
attachment categories described by Main and Goldwyn rp(41) .35, po.05.
(1994).

4. Discussion
Table 1 Correlations of psychological variables with
cortisol baseline (bivariate) and increase (baseline The present study aimed at investigating the degree to
partialed out) at awakening (N 48) and at acute stress which individual differences in adult attachment security/
(N 45). insecurity predict both the CRA and the CRS. First and most
importantly, we found that attachment anxiety was posi-
Awakening Acute stress tively related to CRS and inversely to CRA. In contrast,
neither attachment avoidance nor self-esteem, autonomous
Baseline Increase Baseline Increase
control, social stress, or neuroticism were significantly
Awakening increase .35 related to either CRA or CRS. A lack of those relationships
Attachment anxiety .07 .40 .12 .39 suggests that the association of attachment anxiety with
Attachment avoidance .16 .05 .11 .03 CRS and CRA cannot be attributed to these variables, which
Self-esteem .06 .21 .05 .01 have been found to be associated with HPA activity in
Autonomous control .27 .19 .11 .06 previous research. Additionally, CRS and CRA were inversely
Neuroticism .17 .23 .13 .15 related to each other.
Social stress .13 .22 .22 .09
 po.05. 4.1. Adult attachment and cortisol response to
 po.01.
acute stress

While there was no main effect of our stress paradigm on

cortisol levels, the two cortisol samples before and after our
experimental condition were nonetheless significantly and
8 positively related to individual differences in attachment
7 anxiety. The direction of this relationship was positive, i.e.,
cortisol (nmol/l)

6 higher cortisol responses to the stressor were associated

5
with higher levels of attachment anxiety. The size of the
4
effect suggested that approximately 16% of the variability of
3
low attachment anxiety CRS was explained by individual variations in attachment
2
high attachment anxiety anxiety (r2 .16).
1
Previous research has found elevated cortisol secretion in
0
before 25 min after
insecurely attached infants as a response to attachment
threat. Recently, this has also been shown for adult
Figure 1 Cortisol changes (7S.E.) as a reaction to the stress attachment insecurity (Powers et al., 2006). The present
procedure as a function of low versus high attachment anxiety findings are new in that no study has yet investigated how
(median split). adult attachment is related to cortisol reactions to a stressor
 ARTICLE IN PRESS
586
that is not directly associated with attachment stress. The
present study extends this research by showing that
attachment anxiety is positively related to cortisol release
to a stressor based on uncontrollable and unpredictable
aversive noise stimuli. Indeed, previous research has
demonstrated that individuals high in attachment anxiety
suffer increased psychological reactivity to attachment-
unrelated stressors (see Shaver and Mikulincer, 2007). The
present study extends this research to the field of HPA axis
reactivity. Increased psychological stress reactivity in
attachment anxiety can be attributed to a tendency to
engage in increased anticipatory cognitive appraisal of,
rumination or even catastrophic beliefs about forthcoming
events (see Shaver and Mikulincer, 2007). Notably, Gaab
et al. (2005) have revealed that the CRS varies as a function
of anticipatory cognitive appraisal of the stressor. There-
fore, it is possible that cortisol is elevated in anxiously
attached individuals because of increased employment of
anticipatory cognitive appraisals. Moreover, the finding of
increased HPA reactivity to stress is in line with the
assumption that having experienced a secure attachment
to ones caregivers contributes to the development of affect
regulation capabilities not only relevant for attachment-
related but also attachment-unrelated stressors (Bowlby,
1969; Thompson, 1988; Kuhl, 2000; Mikulincer and Shaver,
2005).
4.2. Adult attachment and cortisol response to
awakening
We found that the direction of the relationship between
attachment anxiety and CRA was negative, i.e., higher
cortisol responses to awakening were associated with lower
levels of attachment anxiety. The size of the effect
suggested that approximately 16% of the variability of CRA
was explained by individual variations in attachment anxiety
(r2 .16). Previous studies have shown that morning cortisol
levels are associated with individual differences in adult
personality such as autonomy (Brandtstadter et al., 1991) or
self-esteem (Pruessner et al., 2005). To our knowledge, only
the study by Adam and Gunnar (2001) has yet explored the
relationships between circadian cortisol variations and
dimensions of adult attachment, revealing a negative
relationship between attachment anxiety and baseline
cortisol levels but not increase after awakening. Notably,
most of past studies regarding personality and cortisol
regulation did not distinguish between level and increase of
cortisol in the morning. As such, the present study adds to
the literature by showing that attachment anxiety is related
to cortisol increase to awakening rather than absolute
cortisol levels.
Which mechanisms could explain the simultaneous reduc-
tion in CRA and elevation in CRS in individuals with high
attachment anxiety? According to the allostatic load model
(e.g., McEwen, 1998), prolonged periods of stress, particu-
larly during the first years of life (Gunnar and Vazquez,
2001), can lead to persistent reduction in basal HPA activity,
for example through largely irreversible changes in receptor
density at either structure of the HPA system (Hellhammer
and Wade, 1993; McEwen, 1998; Heim et al., 2000) or
through underdevelopment of neural structures that have an
M. Quirin et al.
inhibitory influence on HPA activity such as the hippocampus
(Jacobson and Sapolsky, 1991) or the prefrontal cortex
(Lupien and Lepage, 2001). Such findings, along with
evidence of reduced parental care in insecurely attached
infants (De Wolff and van IJzendoorn, 1997; Carter et al.,
2006), leave us to assume that, on average, adults with high
attachment anxiety may have suffered more from past
life stress than those with low attachment anxiety, result-
ing in long-lasting HPA attenuation and neurotoxical
processes. The finding of deviant HPA activity in anxiously
attached individuals also converges with a broad animal
literature on adverse and long-lasting influences of early life
stress and inadequate nursing on each HPA regulation,
hippocampus development, stress-related behavior, health,
and mortality of the grown-up animal (for a review, see
Meaney, 2001).
The finding of reduced rather than increased baseline
cortisol in attachment anxiety is congruent with more
recent insights in the role of the hippocampus in HPA system
regulation. Despite an inhibitory influence of the hippo-
campus on stress-contingent cortisol secretion (Jacobson
and Sapolsky, 1991; Herman et al., 2005), the hippocampus
may exert an excitatory influence on the CRA (Buchanan
et al., 2004; Pruessner et al., 2005; Wolf et al., 2005). This
seemingly opposing role of the hippocampus is not fully
explained yet, but our finding of an inverse relationship
between CRS and CRA is in line with this model as well:
individuals with a stronger HPA reactivity to acute stress
showed reduced HPA activity after awakening.
To our knowledge, this study is the first to report a
relationship between CRS and CRA. Schmidt-Reinwald et al.
(1999) also examined the CRS and CRA in combination but
failed to find a relationship. In that study, the Trier Social
Stress Test (TSST) was used to stimulate a CRS. It is plausible
to assume that the milder form of acute stress might have
produced individual differences that the more powerful
TSST might have masked because of reduced variance in
cortisol measures due to ceiling effects. In line with this
notion, it has previously been shown that associations
between the cortisol stress response to the TSST and
personality differences are not shown upon first exposure
to this task, but that it takes repeated TSST trials to reveal
the link to interindividual differences (Kirschbaum et al.,
1995; Pruessner et al., 1997a, Schommer et al., 1999; see
also Gerra et al., 2001).
A theoretical approach that may have the potential to
integrate the present findings with the existing literature is
Personality Systems Interactions (PSI) Theory (Kuhl, 2000,
2001). PSI theory bridges research on personality and
neurobiology by relating psychological functions to activa-
tion levels of and interactions between particular neuronal
systems. Specifically, an affect-regulatory role is postulated
for structures that facilitate access to self-referential
knowledge (autonoetic access, cf. Wheeler et al., 1997)
such as the hippocampus (e.g., Maguire and Mummery, 1999)
and the right prefrontal cortex (e.g., Nyberg et al., 1996),
which are at the same time implicated in HPA regulation
(Herman et al., 2005). Beneficial development of these
self-relevant neural structures are thus considered to
contribute to adequate emotional and personality develop-
ment (e.g., Kuhl, 2001, Chapter 11) as found in securely-
attached individuals.
 ARTICLE IN PRESS
HPA regulation and adult attachment anxiety
Several limitations of the present study need to be
addressed. First, it became apparent that our stress
induction did not lead to a significant rise in cortisol levels
across the whole group. However, the finding of a significant
relationship between attachment anxiety and cortisol stress
levels indicates that at least for some individuals, namely
those with high levels of attachment anxiety, the situation
was stressful. As reported above, previous studies capitaliz-
ing on intense stressors such as the TSST have shown
interindividual differences in reactive cortisol secretion
with groups of responders and non-responders only after
repeated exposure to the stressor but not after a single
exposure. Therefore, for studying relationships between
personality and HPA system responses to a single exposure,
moderate stressors, as the one used in this research, appear
to be appropriate even if they do not lead to significant main
effects.
Second, the data are cross-sectional in nature. Therefore,
the data did not allow for a direct investigation of the
developmental processes that are assumed to underlie the
establishing of the relationships as found between person-
ality and HPA system activity. In this context, the present
focus on the role of personality in HPA activity does not belie
the influence of other factors, such as hereditary factors on
cortisol regulation, which has been evidenced by a great
number of studies (Meikle et al., 1988; Linkowski et al.,
1993; Wust et al., 2000; Bartels et al., 2003). Thus, early
attachment stress is not the only explanation for a deviating
functioning of the HPA system. In the same way, it cannot be
excluded that attachment security and self-development
themselves are influenced by hereditary factors, or even by
cortisol regulation itself. Finally, the present study only
included women. Although we know of no evidence that
relationships between personality differences and cortisol
regulation are qualified by gender, the present findings need
to be generalized to male samples by future research.
Taken together, the present study indicates a significant
role of adult attachment anxiety in the regulation of
cortisol. The present study contributes to the literature in
several ways: first, by uncovering direct relationships
between attachment, CRS and CRA, the relationship
between personality and HPA axis could be further sub-
stantiated. Second, it has been proposed that hyperactivity
of the HPA stress system can have detrimental effects on a
variety of organ systems (McEwen, 1998). In line with this
notion, a large literature refers to relationships between
deviant cortisol regulation in diverse psychopathologies such
as depression (Yehuda et al., 1996; Gold et al., 2002), post-
traumatic stress disorder (Yehuda, 2002), and psychosomatic
symptoms (Heim et al., 2000). If personality plays a key role
in non-clinical cortisol regulation, relationships between
psychopathology and cortisol regulation may be at least in
part be attributed to individual differences in personality
(for example mediated through cognitive appraisal and
affect regulation processes).
Role of the funding sources
This research was facilitated by the Graduate School
Integrative Competences and Well-Being funded by
Deutsche Forschungsgemeinschaft (DFG, Grant 772/3); the
587
DFG had no further role in study design; in the collection,
analysis and interpretation of data; in the writing of the
report; and in the decision to submit the paper for
publication.
Conflict of interest
All authors declare that they have no conflicts of interest.
Acknowledgment
The authors would like to thank Thomas Kunne for his
assistance in data collection and preparation.
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