#THE SKIN DEEP COUPLES QUESTIONS SKIN#
Studying the effects of psychosocial factors on skin repair provides a clinically relevant health outcome that can be measured in a short amount of time in healthy individuals. For example, immediately after skin barrier disruption, pre-formed proinflammatory cytokines are released in the upper epidermal layer( Hauser et al., 1986 Tsai et al., 1994 Wood et al., 1997), and proinflammatory cytokines are synthesized in the hours following disruption ( Nickoloff and Naidu, 1994). Even minor damage to the skin, such as the removal of cells in the upper layer of the epidermis through a carpet burn, initiates a cascade of immune-mediated events involved in repairing the skin barrier, and these events occur immediately following damage to the skin. In addition, chemical messengers in the immune system (cytokines), play significant roles in the barrier function of the skin, particularly restoration of the barrier following damage through physical injury ( Nickoloff and Naidu, 1994). The skin is highly innervated by the central nervous system and is a target for neuroendocrine factors involved in the stress response ( Arck et al., 2006).
The primary function of skin is to provide a protective barrier for internal tissues against the outside world through physical, chemical, and biological means ( Elias, 2005). The skin is an ideal organ system in which to study the interplay between close relationship functioning and health. Thus, determining whether the physiological changes associated with close relationship events have meaningful consequences for health is a key direction for the field ( Pietromonaco et al., in press). However, much like research on physiological responses to acute stress ( Kiecolt-Glaser et al., 1992), many of the observed changes in cardiovascular, endocrine, and immune function in response to interpersonal interactions are well within the normal ranges, and their clinical significance is unclear. The physiological changes associated with support and strain in relationships are frequently cited as key mechanisms explaining how the quality of close relationships can “get under the skin” and impact physical health ( Loving et al., 2006 Robles and Kiecolt-Glaser, 2003 Slatcher, 2010). Within our intimate relationships, conflict is often related to physiological changes characteristic of the fight-or-flight response ( Robles and Kiecolt-Glaser, 2003), which can be dampened by supportive behaviors ( Robles et al., 2006). Relationships are central to human life, and the quality of one's social connections has a strong influence on health ( Uchino, 2004). These findings are the first to demonstrate associations between individual differences in attachment style and restorative biological processes in the skin, even in a sample of young dating couples in satisfied relationships. Cortisol changes, self-reported emotions, stress appraisals, and supportiveness ratings were tested as potential mediators, and none explained the relationships between attachment and skin barrier recovery. The observed effects remained significant after controlling for transepidermal water loss in undisturbed skin, suggesting that the relationship between attachment security and skin barrier recovery was not due to other skin-related factors like sweating. Among men, greater attachment anxiety predicted slower skin barrier recovery during the personal concern discussion only. Among women, greater attachment anxiety predicted faster skin barrier recovery across the two visits, while greater attachment avoidance predicted slower skin barrier recovery.
Multilevel modeling showed that skin barrier recovery did not differ between the personal concern or relationship problem discussions. Skin barrier recovery was assessed by measuring transepidermal water loss up to 2 h after skin disruption. Dating couples ( N = 34) completed a self-report measure of attachment anxiety and avoidance, and during two separate laboratory visits, normal skin barrier function was disrupted using a tape-stripping procedure, followed by a 20 min discussion of personal concerns in one visit and relationship problems in the other, counterbalanced randomly across visits.
This study examined the relationship between individual differences in adult attachment and skin barrier recovery.
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