Insecure attachment in a subgroup with ulcerative colitis defined by ANCA status

This study is the first test of the novel hypothesis that perinuclear anti- neutrophil cytoplasmic antibody (p-ANCA) marks an etiological division betw een stress-susceptible and stress-neutral ulcerative colitis. Subjects were 47 UC patients with known p-ANCA status (19 p-ANCA-positive, 28 p-ANCA-abs ent). Controls were 77 university students. Subjects and controls completed the Reciprocal Attachment Questionnaire. Subjects were categorized as avoi dant/nonavoidant and anxious/nonanxious based on scores for compulsive self -reliance and compulsive care seeking, respectively. A higher prevalence of avoidant attachment was present in p-ANCA-absent (58.6%) than p-ANCA-posit ive subjects (22.2%, chi-square = 5.95, P < 0.02). There was no difference in the prevalence of anxious attachment between p-ANCA-absent and p-ANCA-po sitive subjects. There was no difference in clinical and psychiatric variab les between groups. This finding provides support for a psychobiological co ntribution to UC in a subgroup identified by the absence of p-ANCA.