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Although many studies indicate that people in low quality relationships are less healthy, precisely how relationships influence health remains unclear. We focus on one physiological pathway that may provide clues to understanding the link between relationships and health: the hypothalamic-pituitary-adrenal (HPA) axis. Evidence indicates that attachment processes in adult romantic relationships are associated with HPA responses to stress (assessed via cortisol levels). Specifically, attachment insecurity predicts different cortisol patterns than does attachment security, especially when the stressor potentially threatens the relationship. Thus, attachment may get under the skin through biological responses to attachment-relevant stressors, but further work is needed to pinpoint the complete physiological and behavioral pathways through which attachment may influence health and disease outcomes.

Does Attachment Get Under the Skin? Adult Romantic Attachment and Cortisol Responses to Stress