Is there a link between childhood adversity, attachment style and Scotland's excess mortality? Evidence, challenges and potential research

Smith, M., Williamson, A.E. , Walsh, D. and McCartney, G. (2016) Is there a link between childhood adversity, attachment style and Scotland's excess mortality? Evidence, challenges and potential research. BMC Public Health, 16, 655. (doi: 10.1186/s12889-016-3201-z) (PMID:27465498) (PMCID:PMC4964073)

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Publisher's URL: http://dx.doi.org/10.1186/s12889-016-3201-z

Abstract

<b>Background</b> Scotland has a persistently high mortality rate that is not solely due to the effects of socio-economic deprivation. This "excess" mortality is observed across the entire country, but is greatest in and around the post-industrial conurbation of West Central Scotland. Despite systematic investigation, the causes of the excess mortality remain the subject of ongoing debate.<p></p> <b>Discussion</b> Attachment processes are a fundamental part of human development, and have a profound influence on adult personality and behaviour, especially in response to stressors. Many studies have also shown that childhood adversity is correlated with adult morbidity and mortality. The interplay between childhood adversity and attachment is complex and not fully elucidated, but will include socio-economic, intergenerational and psychological factors. Importantly, some adverse health outcomes for parents (such as problem substance use or suicide) will simultaneously act as risk factors for their children. Data show that some forms of "household dysfunction" relating to childhood adversity are more prevalent in Scotland: such problems include parental problem substance use, rates of imprisonment, rates of suicide and rates of children being taken into care. However other measures of childhood or family wellbeing have not been found to be substantially different in Scotland compared to England.<p></p> <b>Summary</b> We suggest in this paper that the role of childhood adversity and attachment experience merits further investigation as a plausible mechanism influencing health in Scotland. A model is proposed which sets out some of the interactions between the factors of interest, and we propose parameters for the types of study which would be required to evaluate the validity of the model.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Williamson, Professor Andrea and Smith, Dr Michael and Walsh, Dr David
Authors: Smith, M., Williamson, A.E., Walsh, D., and McCartney, G.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN:1471-2458
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in BMC Public Health 16:655
Publisher Policy:Reproduced under a Creative Commons License

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