Examining the Connection Between Attachment and Risk for Psychopathology in Adolescents : A Comprehensive Review

Abstract

The foundation of attachment theory is the notion that early relationships – such as the one between a child and primary caregiver – play a crucial role in patterns of emotional regulation, interpersonal behaviors and adult functioning. This review explores how attachment styles are associated with psychopathology in adolescents by systematically assessing research studies up to May 2024. Studies have shown that insecure attachment styles are risk factors for adaptation and psychopathology in adolescence, including anxiety disorders, dissociative disorders, borderline personality disorder, conduct disorder and substance use. Securely attached adolescents have better mental health outcomes. Longitudinal studies have also confirmed that early attachment affects later psychopathology. Insecure infant attachment is linked to depression, suicidality, substance use and dissociation in adolescents. Emerging attachment-based interventions – including, for example, Attachment-Based Family Therapy (ABFT) – have demonstrated promise in treating adolescent mental health by targeting attachment disorganization level. Ultimately, working on reflective functioning, parental sensitivity and emotion regulation skills can help adolescents repair their attachments. Even in light of these findings, attachment does not appear as straightforwardly explanatory as one might expect, given the developmental importance of attachment entering a new stage. Attachment researchers should consider participants’ experiences of early attachment, in light of patterns of change during individual development, as well as in light of a family systems perspective – for instance, understanding that some adolescents who become disaffected from their families have parents who tend to be dismissive of their emotional needs. All of these could help in effective prevention and treatment of adolescent psychopathology.