eprintid: 10205614 rev_number: 9 eprint_status: archive userid: 699 dir: disk0/10/20/56/14 datestamp: 2025-03-05 08:49:51 lastmod: 2025-03-05 08:49:51 status_changed: 2025-03-05 08:49:51 type: article metadata_visibility: show sword_depositor: 699 creators_name: Van Leeuwen, W creators_name: Van der Straten, A creators_name: Bögemann, S creators_name: Luyten, P creators_name: Denys, D creators_name: Van Wingen, G creators_name: Van Marle, H title: Attachment insecurity modulates neural responses to psychological distress in OCD and healthy individuals ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: D05 divisions: F66 keywords: Obsessive compulsive disorder; Psychological distress; Attachment insecurity; Hippocampus; Emotion regulation note: Copyright © 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). abstract: Background: Insecure attachment style has been associated with obsessive-compulsive disorder (OCD). Psychological stress is known to aggravate OCD symptoms and activate the attachment system. Here, we investigated reactivity of attachment-related neurocircuitry under psychological distress in OCD patients. // Methods: Twenty-two patients with OCD and twenty-three healthy controls underwent fMRI scanning after psychological stress induction and a control condition in a cross-over design. Neural responses were measured during presentation of negative emotional faces. Attachment insecurity was measured using the self-report experiences in close relationships scale (ECR) and the adult attachment interview (AAI). // Results: OCD participants showed higher scores on ECR attachment anxiety compared to controls. Stress was successfully induced as shown by subjective stress measurements and physiological parameters. OCD participants showed a blunted cortisol response to the stressor. However, no group differences were found in neural stress responses. Across participants, psychological distress decreased hippocampal responses. This effect was dependent on attachment style, with participants scoring high on attachment anxiety showing increased rather than decreased hippocampal activity when distressed. Participants scoring high on attachment insecurity as measured with the AAI showed increased activity in multiple attachment-related brain regions. // Conclusions: Attachment style, but not OCD status, modulated neural responses to emotionally salient information under psychological distress. These findings provide further support for the assumption that attachment insecurity may be an important transdiagnostic vulnerability factor. date: 2025-05-15 date_type: published publisher: Elsevier BV official_url: https://doi.org/10.1016/j.jad.2025.02.055 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2364156 doi: 10.1016/j.jad.2025.02.055 medium: Print-Electronic pii: S0165-0327(25)00262-9 lyricists_name: Luyten, Patrick lyricists_id: PLUYT39 actors_name: Luyten, Patrick actors_name: Farrar, Clare actors_id: PLUYT39 actors_id: CFARR38 actors_role: owner actors_role: impersonator full_text_status: public publication: Journal of Affective Disorders volume: 377 pagerange: 157-167 event_location: Netherlands issn: 0165-0327 citation: Van Leeuwen, W; Van der Straten, A; Bögemann, S; Luyten, P; Denys, D; Van Wingen, G; Van Marle, H; (2025) Attachment insecurity modulates neural responses to psychological distress in OCD and healthy individuals. Journal of Affective Disorders , 377 pp. 157-167. 10.1016/j.jad.2025.02.055 <https://doi.org/10.1016/j.jad.2025.02.055>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10205614/1/Luyten_1-s2.0-S0165032725002629-main.pdf