Abstract
Attachment disturbance such as, infant-mother separation causes prolonged depressed behavior and sympathetic withdrawal plus vagal activation(i.e.vagal bias).Vagal neural pathways mediate airway constriction in asthma. Miller’s ANS Dysregulation Model posits that depression, accompanied by ANS vagal bias potentiates airway instability. Purpose: Our study tests the hypothesis that insecure attachment is linked to child depression, which potentiates vagal bias and pulmonary compromise under stress. Method: 171 child asthmatics watched the film “E.T.” The ET death scene elicited separation/loss-related emotions. Self-report indexed insecure attachment (IS), and the CDI indexed depression (D). Asthma disease activity (ADA) was assessed using NHLBI criteria. Children viewed the film while ECG and impedance measures indexed sympathetic activation (pre-ejection period,PEP) and vagal activation(RSA). ANS vagal bias was measured: Zrsa-Zpep (i.e.,RSA minus PEP standardized scores). Respiratory resistance (Rint) indexed pulmonary function. Results: Children with IA had higher D (t=3.6,p=.001), greater vagal bias in the death scene (t=1.9,p=.06) and greater ADA (t=2.1,p=.04) When stratified by D score, D versus non-D children had greater vagal bias in response to ET death scene (t=2.25,p=.03), and greater ADA(t=3.2,p=.002). Finally both D and vagal bias were correlated with post-movie Rint (r=.43,p =.001;r=.39, p=.004). Conclusion: These findings suggest that insecure attachment may contribute to depression, stress vulnerability, and ANS dysregulation which potentiate pulmonary compromise in child asthma under stressful conditions.
- © 2013 ERS
