The role of attachment relationships in the pathogenesis of dissociative symptoms – literature review

Objective: The objective of this paper is to review the literature on the role of the attachment relationship in the pathogenesis of dissociative symptoms. The paper integrates the knowledge of environmental and genetic factors as well as neurobiological processes mediating the development of dissociative symptoms in a holistic way. Material and method: The literature review was performed with the use of the following databases: EBSCO, PsycINFO, PubMed, Google Scholar. The databases were searched using the following keywords: “attachment style”, “dissociation”, “trauma”. These terms were combined with the words ‘secure’, ‘disorganised’, ‘epigenetic’, ‘genetic’ and the term ‘monoaminergic system’. Results: Literature analysis suggests that the pathomechanism linking traumatic experiences in the attachment relationship with dissociative symptoms is mediated by neurobiological factors. These include: dysregulation within monoaminergic systems and atrophy of neuronal structures that play a role in affective regulation. Discussion and conclusions: Research suggests that traumatic experiences in the attachment relationship are a risk factor for the development of dissociative symptoms in the future. There is still a lack of research verifying the relationship between attachment experiences and epigenetic changes in genes regulating the activity of monoaminergic systems. These processes may play an important role in the aetiology of many nosological units, the development of which is mediated by dissociative symptoms. Future research should evaluate dissociation from the perspective of a transdiagnostic risk factor for the development of a broad spectrum of psychopathology. attachment style; dissociation; neurobiology