Abstract
An increasing amount of evidence indicates the significance of attachment in the etiology of poly-drug use disorder (PUD). The aim of this study was to investigate associations between PUD and adult attachment in particular, with a focus on white matter (WM) fiber tract integrity. For this purpose, we selected several regions-of-interest based on previous findings which were examined for their role in PUD and estimated whole-brain associations between adult attachment and WM integrity. A total sample of 144 right-handed males were investigated (Age: M = 27; SD = 4.66). This included a group of patients diagnosed with PUD (n = 70) and a group of healthy controls (HC; n = 74). The Adult Attachment Scales (AAS) was applied to assess attachment attitudes in participants. Diffusion Tensor Imaging was used to investigate differences in WM integrity. The findings suggest substantially less attachment security in PUD patients compared to HC. Furthermore, PUD patients exhibited reduced integrity in WM fiber tracts, most pronounced in the bilateral corticospinal tract, the fronto-occipital fasciculus, and the right inferior longitudinal fasciculus. However, these results were not controlled for comorbid depressiveness. With regard to associations between adult attachment and WM integrity, the results for PUD patients indicate a negative relationship between “Comfort with Closeness” and the structural integrity of a cluster comprising parts of the right anterior thalamic radiation, the inferior fronto-occipital fasciculus and the uncinate fasciculus. Despite being limited by the cross-sectional design of this study, the results emphasize the significance of attachment in PUD etiology, both at a behavioral and a neurological level. Largely in line with previous research, the findings revealed tentative links between adult attachment and WM fiber tracts related to cognitive and affective functions in PUD patients.
Highlights
Attachment theory emphasizes the significance of early dyadic relationship experiences with the primary caregiver regarding the development of functional representations of the self and others (Bowlby, 1969; Mikulincer and Shaver, 2003)
Based on an extensive sample, this study investigated differences between healthy adults and patients suffering from poly-drug use disorder (PUD) regarding attachment security and white matter (WM) integrity, as well as associations between WM integrity and adult attachment security
The integrity of parts of the right anterior thalamic radiation (ATR), inferior fronto-occipital fasciculus (IFOF), and uncinate fasciculus (UF) were negatively associated with comfort with closeness in PUD patients
Summary
Attachment theory emphasizes the significance of early dyadic relationship experiences with the primary caregiver regarding the development of functional representations of the self and others (Bowlby, 1969; Mikulincer and Shaver, 2003). Based on these representations or “working models,” the individual develops secure or insecure attachment patterns which constitute rather stable traits, Neural Correlates of Attachment in Poly-Drug Use still traceable in adulthood (Waters et al, 2000a; Fraley, 2002). That this relationship might rely especially on the strong association between insecure attachment and increased sadness disposition (Fuchshuber et al, 2019b), as increased sadness was repeatedly observed as a typical vulnerability factor in substance use disorder (SUD; Unterrainer et al, 2017a; Fuchshuber et al, 2019a)
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