A systematic review of the lived experiences of attachment in relationships for adults with learning disabilities

Abstract

BackgroundResearch has shown that people with learning disabilities are vulnerable to attachment difficulties, have smaller networks, and experience high levels of isolation and marginalisation. The need for a review gaining people’s subjective perspectives was indicated to offer insight into the lived experience of how attachment develops and what challenges are faced. Objectives: This paper aimed to systematically review and synthesise qualitative studies exploring people with learning disabilities’ experiences of attachment in relationships. Methods: Three databases were accessed to retrieve articles by using relevant search terms. Thematic synthesis was conducted to synthesis the findings across 25 papers using Thomas and Harden’s (2008) three-stage method. Results: In total, 25 studies met the inclusion criteria, with data from 456 people with learning disabilities, with a diverse range of background and levels of functioning. All the studies were classified as moderate to high quality using the Critical Appraisal Skills Programme (CASP, 2018) criteria. Thematic synthesis generated four themes: (1) ‘I feel safe’: Attachment safety and significance of relationships (2) Challenges and constraints to attachment, (3) Experiencing loss of attachment and (4) Hopes and desires of attachments within relationships. Conclusions: The findings indicate how caregivers and services could use trauma-informed and attachment-focused approaches. Further research on adult attachment representations is required to build the evidence-base for adults with learning disabilities.