The exploration of family member state adult attachment and neurological activation when viewing images of an AUD loved one: An fMRI study

Abstract

Alcohol Use Disorder (AUD) has negative impacts on family member relational dynamics and attachment. Increased stress and fear imposed on family members creates emotional distress resulting in unmet attachment needs, possibly shifting in family members Internal Working Model (IWM) and subsequent attachment style. Attachment theory posits that IWMs for attachment styles stay stable over time, however, they can be impacted by major life events like those experienced by family members of a loved-one with AUD. Activation of reward brain regions in response to images of an AUD loved-one may be representative of or associated with family members’ current state of their attachment style. This study utilized Functional Magnetic Resonance Imaging (fMRI) to collect blood-oxygen-level-dependent (BOLD) responses of family members when viewing images of an AUD loved-one, among other affective images. A General Linear Model with mixed effects was conducted to examine the association between BOLD activation responses and attachment anxiety, avoidance, and security among both a family member of AUD and control group. Attachment anxiety was positively associated with increase activation in the Insular Cortex and Orbitofrontal Cortex while attachment security was negatively associated with activation in the Anterior Cingulate Gyrus. Clinical implications for such findings are discussed.