British Jonrnal of Medical Psychology zyxwvutsrqp (1994), 67, zyxwvut 237-245 zyxwvut 0 1994 The zyxwvutsrq British Psychological Society Printed in Great Britain 237 Avoidant attachment as a risk factor for health Tamara Kotler,* Simone Buzwell, Yolanda Romeo and Jocelyn Bowland Department of Psychology, University of Melbourne, ParkviIIe, Victoria 3052, Australia A style of coping with stress is described which has been observed in cancer patients and in highly dependent, insecurely attached individuals. This coping style includes the suppression of negative emotions and avoidance of support seeking. It is suggested that this pattern of responses is potentially dysfunctional insofar as it tends to perpetuate distress and may increase vulnerability to a broad range of illnesses. These considerations provide the basis for a provisional conceptual model, which links avoidant attachment style to the regulation of negative affect and to symptoms of psychological and physical ill-health. This is tested on a sample of young adults under stress and predictions from the model are largely supported. Central to psychosomatic medicine is the view that emotions, and particularly emotional suppression, can have adverse physiological effects which increase the risk of ill-health (Anderson, 1981). This belief is supported by a significant body of empirical evidence which indicates that excessive control of anger, hostility or anxiety is associated with various types of somatic disorders such as asthma (Malatesta, Jones 8c hard, 1987), rheumatoid arthritis (Crawford, 1981) and migraines (Passchier, Gaudswaard, Orlebeke zyxw & Verhage, 1988). Suppression of negative emotions, such as anger and anxiety, has also been reported in cancer patients, together with interpersonal characteristics such as stoicism, compliance, cooperativeness and unassertiveness (BrCmond, Kune 8c Bahnson, 1986; Greer & Morris, 1975; Gross, 1989). Taken as a whole, this pattern of responses or ‘cancer-prone’ coping style (Greer & Morris, 1975) has been interpreted as a strategy for social interaction which is directed at avoiding interpersonal conflict and stress (Temoshok, 1987). Although this may be an effective means of managing stress in the short term, there are likely to be physiological and psychologial costs insofar as the person’s needs are not addressed. Distress may therefore be prolonged and could include feelings of depression and helplessness about the likelihood that emotional and/or physical needs may be satisfied (Temoshok, 1987). Although this coping style has been most fully described in the context of cancer research, there is not yet any strong evidence that it has biological effects which are *Requests for reprints.