Annals of Behavioral Medicine

, Volume 51, Issue 2, pp 189–198 | Cite as

Attachment Orientations, Respiratory Sinus Arrhythmia, and Stress Are Important for Understanding the Link Between Childhood Socioeconomic Status and Adult Self-Reported Health

Original Article



Low childhood socioeconomic status (SES) is reliably associated with poor adult health. Social environments early in life and physiological stress responses are theorized to underlie this link; however, the role of attachment orientations is relatively unknown.


In this study, we examined whether attachment orientations (i.e., attachment anxiety and attachment avoidance) and self-reported stress were mediators of the association between childhood SES and self-reported health in adulthood. Furthermore, we examined whether parasympathetic nervous system functioning was a moderator of associations between attachment orientations and self-reported stress.


Participants (N = 213) provided self-reports of childhood SES, attachment orientations, general stress, and self-rated health. Respiratory sinus arrhythmia (RSA) was measured at rest, as well as during an acute social stressor.


Low childhood SES was associated with poor self-reported health via the serial pathway from attachment anxiety to general stress. Moreover, attachment avoidance was associated with self-reported health via general stress, but only among those with high stress-induced RSA. Findings were independent of participant age, sex, race, body mass index, baseline RSA, and adult SES.


Attachment theory is useful for understanding why those from low SES backgrounds are at greater risk of negative health outcomes in adulthood. Findings extend our knowledge of how interpersonal relationships in childhood can shape emotional and physical health outcomes in adulthood.


Attachment theory Respiratory sinus arrhythmia Stress Self-rated health Child development 


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© The Society of Behavioral Medicine 2016

Authors and Affiliations

  1. 1.Department of PsychologyRice UniversityHoustonUSA
  2. 2.Department of Symptom ResearchThe University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.Department of PsychiatryBaylor College of MedicineHoustonUSA

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