Insecure Attachment Research Articles

From childhood adversity to interpersonal problems: The mediating role of attachment insecurity and perfectionism

Attachment theory offers an important clinical framework for understanding and treating negative effects of early life adversity. Attachment styles emerge during critical periods of development in response to caregivers' ability to consistently meet their offspring's needs. Attachment styles are classified as secure or insecure (anxious, avoidant, or disorganized), with rates of insecure attachment rising in high-risk populations and correlating with a plethora of negative health outcomes throughout life. Despite its importance, little is known about the neural basis of attachment. Work in rats has demonstrated that limited bedding and nesting (LB) impairs maternal care and produces abnormal maternal attachment linked to increased pup corticosterone. However, the effects of LB on attachment-like behavior have not been investigated in mice where additional genetic and molecular tools are available. Furthermore, no group has utilized home-cage monitoring to link abnormal maternal care with deficits in attachment-like behavior. Using home-cage monitoring, we confirmed a robust increase in maternal fragmentation among LB dams. Abnormal maternal care was correlated with elevated corticosterone levels on post-natal day seven (P7) and a stunted growth trajectory that persisted later in life. LB did not alter maternal buffering at P8 or maternal preference at P18, indicating that certain attachment-like behaviors remain unaffected despite exposure to high levels of erratic maternal care. However, LB male and female pups vocalized less in response to maternal separation at P8, did not readily approach their dam at P13, and exhibited higher anxiety-like behavior at P18, suggesting that LB induces avoidant-like attachment deficits in mice.Significance Statement The impoverished conditions of limited bedding and nesting (LB) cause erratic maternal care and elevated corticosterone levels in rat and mouse pups. The increase in corticosterone levels causes attachment-like deficits in rat pups; however, it remains unclear whether similar deficits are observed in mice, where additional genomic and molecular tools are available. Using continuous home-cage monitoring, we confirmed a substantial increase in erratic maternal care and elevated corticosterone levels in 7-day-old mouse pups. LB mouse pups exhibited attachment-like deficits in some, but not all, tests, underscoring the robustness of this evolutionarily conserved bond. Despite some similarities, the attachment abnormalities observed in mice differed from previous reports in rats, paving the way for in-depth mechanistic studies in mice.

Opioids are suggested to serve as an emotional substitute for social attachments, why patients with persistent back pain and high levels of attachment-avoidance may be vulnerable to long-term opioid treatment (LTOT). The primary aim was to assess the association between attachment insecurity and LTOT and secondary to assess the associations between attachment insecurity, pain, and disability. A 5-year follow-up study of patients with persistent back pain. Questionnaire data on attachment insecurity, psychological distress, pain intensity, and disability were collected and combined with longitudinal register data on prescriptions of opioids. A total of 3,102 patients was included. Patients in LTOT (9.3%) were significantly more avoidantly attached compared to non-opioid users. For every one-point increase on attachment-avoidance, the odds of LTOT increased by 4%. When adjusting for covariates, only age, pain, and depression were significantly associated with LTOT. Both attachment-avoidance and attachment-anxiety were significantly associated with pain intensity and disability. Attachment insecurity may be associated with an increased risk of LTOT, pain, and disability. Acknowledging that unmet attachment needs and emotional distress can be linked to an increased risk of LTOT highlights the importance of considering these factors before prescribing the first opioid.

ABSTRACT This article provides an alternative avenue for guiding research on the exploration of the connection between childhood maltreatment and adult spirituality. Grounded theory, a qualitative and inductive methodology which relies on rich participant narratives, would allow researchers to map how survivors describe spiritual ruptures and repairs across the lifespan. Prior research and anecdotal clinical observation suggest that there are negative impacts of childhood maltreatment to spirituality in adulthood. Researchers typically draw from attachment theory to interpret data on spirituality in adults with childhood maltreatment histories. The dominance of attachment theory as an explanatory theory for a connection between spirituality and childhood maltreatment creates multiple problems, including: (1) model ambiguity in regard to conscious and subconscious process; (2) limited comparability between insecure attachment and childhood maltreatment; (3) lack of participant direction to organize findings; and (4) attachment theory’s focus on primary caregivers that overlooks other perpetrators. The current article outlines these limitations as they relate to the connection between childhood maltreatment and adult spirituality and demonstrates how a grounded theory approach with more attention to perpetrator characteristics could create a deeper, survivor-informed understanding of the topic area.

Eating disorders pose a significant risk to physical health and have a negative impact on an individual's daily functioning and are widely regarded as the most dangerous mental disorder. Usually, eating disorders occur in adolescents and young adults. From 2000 to 2018, the prevalence of eating disorders worldwide more than doubled, with an increase in reported cases from 3.5% to 7.8%. ED’s occur when several interactions come together in a person's life. Attachment theory has become one of the most important theoretical frameworks for general understanding, as in the case of the psychopathology of eating. In recent decades, insecure attachment styles have linked it to eating disorders. Another factor that also affects eating disorders and comes from within a person is self-compassion. According to several previous research results, the self-compassion variable has been shown to act as a "protector" in the area of body image and eating behavior. Research on eating disorders participants also shows that patients who develop self-compassion do better in the recovery process.Through this study, researcher wants to show how the relationship between these variables, and whether the self-compassion variable can play a role in influencing the relationship between attachment styles and eating disorders in women aged 18-40 years. This study used cross-sectional quantitative research methods and was conducted on women aged 18-40 years. The results of the study found that the self-compassion variable significantly moderated the relationship between fearful attachment style and AN with a value of B=0.285, significance t=2.240, Sig.(p<0.05); dismissive attachment style to AN with a value of B=0.300, significance t=2.019, Sig.(p<0.05); and dismissive attachment style to BN with a value of B=0.356, significance t=2.208, Sig.(p<0.05).

ABSTRACT Objective: Emotion regulation (ER) is increasingly recognized as a key mechanism in couple therapy. However, little is known about how ER changes across treatment or how early adverse events and current attachment experiences shape this process. Methods: Using a sample of 308 married individuals in couple therapy, this study examined changes in ER difficulties across a total of 24 sessions. We also tested whether adverse childhood experiences (ACEs) and current attachment insecurity (anxiety, avoidance) predicted baseline levels and changes in ER. Results: Multilevel modelling showed a small but significant decline in ER difficulties across sessions. Both ACEs and insecure attachment were associated with higher baseline ER difficulties. However, only avoidant attachment predicted greater improvement over time. ACEs and attachment anxiety were unrelated to change. Variance analysis revealed that most variation in ER occurred between individuals (70%) and within individuals over time (23%), with minimal variance at the couple (5%) and therapist (2%) levels. Conclusion: Findings support ER as a dynamic treatment target and underscore the importance of assessing developmental history and current attachment insecurity to guide intervention.

This bibliometric analysis examined 625 publications (1980-2024) on how parent-child relationships affect children’s social-emotional development. Interest surged post-2000, peaking in the 2020s. Research indicates that democratic parenting and secure attachment foster positive growth, while authoritarian, permissive, neglectful styles, and insecure attachment are linked to adverse outcomes. The USA, China, Australia, and Canada lead this research. The study offers a comprehensive overview to guide future work. In this context, the study aims to understand the impact of parent-child relationships on social-emotional development, directing future research and providing valuable insights for Behavior Therapy (BT) and Cognitive Behavioral Therapy (CBT) practitioners.

ABSTRACT Accumulating evidence shows that psychological trauma can impact subsequent generations, though the mechanisms are unclear. Attachment has been proposed as a central factor in the transmission of parental trauma. This review examined 26 studies on attachment’s role in intergenerational trauma transmission, covering both large-scale traumas (e.g. wars, genocide) and individual traumas (e.g. childhood trauma). Of these studies, 20 out of 26 supported the link between attachment and intergenerational trauma transmission. The consensus is that trauma negatively affects parental attachment, leading to behaviors that foster attachment insecurity in children, which in turn results in adverse psychological and behavioral outcomes. However, some studies found that while parental trauma impacted attachment and behavior, it did not significantly affect the offspring’s mental health. Although findings were consistent across different trauma contexts, the review noted limitations due to diverse data collection methods, such as relying on parental reports. Further longitudinal research is needed to collect self-report data from trauma survivors’ offspring to confirm the link between attachment insecurity and psychological or behavioral outcomes in the context of intergenerational trauma.

ABSTRACT One pathway to children’s antisocial orientations implicates a longitudinal sequence from parents’ attachment insecurity to their hostile representations of the child (Internal Working Models, IWMs) to negative parenting. The relevant research, however, is subject to limitations. One, although parts of that path have been robustly supported, few studies have formally examined the entire longitudinal cascade. Two, the pertinent studies have rarely considered child temperament. In a study of 200 families (mothers, fathers, and children), we examined whether the path from parental insecurity in infancy, to parental hostile IWMs of the child, to negative parenting, both at toddler age, to children’s antisocial orientation at preschool age was moderated by children’s toddler-age temperament. For mothers and children, the path was found only for children with highly difficult temperaments. Research bridging frameworks informed by attachment theory, social cognitive representations, parenting, and temperament can enhance our understanding of early origins of antisocial outcomes.

The prevalence of adolescent depressive symptoms has been rising, and maternal depression is a key predictor. This review synthesizes evidence on mechanisms of influence and on intervention research. The intergenerational transmission of risk from maternal depression appears more pronounced than that associated with paternal depression. At the biological level, genetic susceptibility and neurodevelopmental alterations underpin intergenerational transmission; at the social level, negative parenting practices and stressful family environments create a vicious cycle; at the psychological level, deficits in emotion regulation and insecure attachment amplify vulnerability to depression. Family-based interventions, including cognitive-behavioral therapy and family systems therapy, can mitigate intergenerational transmission. However, more longitudinal research is needed, and future work may integrate digital technologies to develop structured intervention protocols.

Despite its central role in fostering effective social support, support-seeking behavior has received limited empirical attention—particularly among older adults, who have heightened needs for support due to age-related cognitive and physical decline. This study identified and examined key predictors of four types of support-seeking behaviors—direct and indirect instrumental and emotional support-seeking. Long-term married couples, with at least one partner aged 65 or older, participated in a laboratory-based discussion about a personal life stressor, during which support-seeking behaviors were coded. We examined both the support-seeker’s and support-provider’s attachment orientation, as well as the support-seeker’s stress level and relationship quality (e.g., satisfaction, commitment, and trust), as predictors of observed support-seeking behaviors. Results indicated that greater stress and higher relationship quality were associated with more direct instrumental support-seeking, while lower relationship quality and greater attachment insecurity in both partners predicted more indirect instrumental and emotional support-seeking. However, support-seekers also showed more direct emotional support-seeking with avoidantly attached partners, possibly as a compensatory effort to elicit needed support. This study contributes to the limited literature focusing on support-seeking behaviors, particularly in older adulthood, and has implications for interventions aimed at promoting effective communication and support-seeking.

Research exploring the connection between pet ownership and mental health has expanded substantially in recent years, yet scientific evidence remains inconclusive. Existing studies have oversimplified this relationship by focusing primarily on pet ownership itself, without accounting for crucial factors such as species of the pet, or important relationship dynamics such as owner-pet attachment orientations. This study sought to investigate whether the relationship between owner-pet attachment and owner mental health could be better understood through the lens of owner-perceived pet compatibility, perceived pet welfare, and pet behavioral issues. These under researched aspects are believed to play crucial roles in shaping owner-pet relationships and owner mental well-being. This study surveyed emerging adults (ages 18–26) who owned dogs and/or cats from the United Kingdom (N = 600) who self-identified as experiencing difficulties with anxiety and/or low mood, of whom some reported clinical diagnoses. Our findings revealed that dog owners exhibited more secure pet attachments than cat owners. Anxious attachment was associated with poorer mental health among dog owners, while avoidant attachment was associated with better mental health in both dog and cat owners. Insecure attachment related to poorer perceived pet quality of life, increased reports of pet behavioral problems, and poorer owner-pet compatibility, regardless of pet species. Additionally, poorer welfare and more behavioral problems were associated with poorer mental health for dog owners; these findings were not replicated for cat owners. Notably, a dog’s mental state (such as appearing depressed), as well as fear and anxiety, mediated the relationship between owner-pet attachment and owner mental health. Owner-dog compatibility, particularly in the affection domain, positively mediated the relationship between anxious attachment and poorer mental health, while negatively mediating the relationship between avoidant attachment and better mental health. These findings suggest that a simplistic view of pet ownership fails to capture the complexity of the factors that shape the mental health of pet owners and underscores the need to consider important owner-pet factors to fully understand how the human-pet relationship can impact the well-being of both people and their pets.

Research exploring the connection between pet ownership and mental health has expanded substantially in recent years, yet scientific evidence remains inconclusive. Existing studies have oversimplified this relationship by focusing primarily on pet ownership itself, without accounting for crucial factors such as species of the pet, or important relationship dynamics such as owner-pet attachment orientations. This study sought to investigate whether the relationship between owner-pet attachment and owner mental health could be better understood through the lens of owner-perceived pet compatibility, perceived pet welfare, and pet behavioral issues. These under researched aspects are believed to play crucial roles in shaping owner-pet relationships and owner mental well-being. This study surveyed emerging adults (ages 18-26) who owned dogs and/or cats from the United Kingdom (N = 600) who self-identified as experiencing difficulties with anxiety and/or low mood, of whom some reported clinical diagnoses. Our findings revealed that dog owners exhibited more secure pet attachments than cat owners. Anxious attachment was associated with poorer mental health among dog owners, while avoidant attachment was associated with better mental health in both dog and cat owners. Insecure attachment related to poorer perceived pet quality of life, increased reports of pet behavioral problems, and poorer owner-pet compatibility, regardless of pet species. Additionally, poorer welfare and more behavioral problems were associated with poorer mental health for dog owners; these findings were not replicated for cat owners. Notably, a dog's mental state (such as appearing depressed), as well as fear and anxiety, mediated the relationship between owner-pet attachment and owner mental health. Owner-dog compatibility, particularly in the affection domain, positively mediated the relationship between anxious attachment and poorer mental health, while negatively mediating the relationship between avoidant attachment and better mental health. These findings suggest that a simplistic view of pet ownership fails to capture the complexity of the factors that shape the mental health of pet owners and underscores the need to consider important owner-pet factors to fully understand how the human-pet relationship can impact the well-being of both people and their pets.

ABSTRACT Millions of children around the globe experience abuse every year, with over a thousand children dying within the United States in 2020 alone as a result of child abuse. Child abuse can take different shapes, such as physical abuse, emotional abuse, sexual abuse, and neglect, all of which can leave a lasting impact on the victim which can alter their childhood as well as their adulthood. Two aspects of adulthood that can be impacted by childhood abuse that are addressed within this article are attachment style and sexual satisfaction. The purpose of this study was to examine the associations between childhood physical abuse, childhood sexual abuse, adult attachment, and adult sexual satisfaction. This study has accomplished this by using a mediating model with adult attachment as the mediator in a sample of 30,507 partnered adults from a cohort study. Results from the mediation analysis illustrated significant, albeit modest in size, negative links between childhood physical abuse and adult sexual satisfaction through levels of adult attachment insecurity. These results are important as they encourage clinicians to consider the indirect impact events can have on individuals, the importance of considering contextual factors, and thinking systemically when examining the connection between events and concerns our clients present us with. Analyzing and understanding these dynamics can allow clinicians to better support their clients when addressing the impacts of child abuse, insecure adult attachment, and sexual dissatisfaction in adulthood.

HighlightsWhat are the main findings?In youth with Functional Abdominal Pain Disorders (FAPDs), less secure parental attachment is associated with more severe gastrointestinal symptoms, greater depressive symptoms, and more functional impairment.To varying degrees, pain catastrophizing mediated these relationships.What is the implication of the main finding?Results support an attachment-diathesis model of pediatric FAPDs.Parent–child attachment and catastrophizing may be important treatment targets in children with FAPDs.Background and Objectives: The attachment-diathesis model of chronic pain, which associates insecure attachment with pain catastrophizing and worse pain-related outcomes, is well-supported in adults. Although Functional Abdominal Pain Disorders (FAPDs) are common in youth, with symptoms influenced by the parent–child dynamic, an attachment-diathesis model of FAPDs is unexplored. The aim of this study was to investigate if insecure parental attachment is associated with pain catastrophizing and pain-related variables in youth with FAPDs. Methods: Baseline questionnaire data from an RCT of cognitive behavioral therapy for children with FAPDs (n = 200, 73% girls, 93% White, and a mean age of 11.2 years old) were used to examine relationships between parental attachment (subscales include Alienation, Trust, and Communication), catastrophizing, and pain-related variables (depression, disability, and gastrointestinal (GI) symptom severity). Results: Alienation was significantly correlated with depression (r = 0.39), GI symptom severity (r = 0.30), and disability (r = 0.22; ps < 0.05). Trust was also correlated with depression (r = −0.39), GI symptom severity (r = −0.19), and disability (r = −0.19; ps < 0.05). Communication was associated with depression (r = −0.30, p < 0.01). Catastrophizing mediated these associations, accounting for 22–89% of the relationship between attachment and pain-related variables. Conclusions: Children who report a less secure attachment to their parents report more physical and psychological symptomatology than children who describe their attachment as more secure. This association is partly explained by child catastrophizing. Results suggest that parent–child attachment and catastrophizing may be important treatment targets in children with FAPDs.

ABSTRACT Parenting children with behavioral and emotional difficulties often involves significant stress and emotional challenges, requiring targeted interventions to support parental well-being. This study examines how attachment styles (anxious and avoidant) influence emotion regulation (ER) difficulties in parents, focusing on the mediating roles of self-compassion and parental feelings. Data were collected from 662 parents of children receiving care in a psychiatric center. Path analysis revealed that insecure attachment styles are directly linked to increased ER difficulties. Self-compassion emerged as a protective mediator, while parental anger uniquely mediated the relationship between anxious attachment and ER challenges. These findings underscore the need for social work interventions that enhance self-compassion and address parental emotions, particularly in high-stress caregiving contexts. This study highlights actionable pathways for improving parental ER capacities, which can strengthen family resilience and enhance outcomes for children receiving mental health care.

Infidelity has negative consequences on both partners’ mental health and romantic relationship quality. Recent studies demonstrated that adult attachment insecurity is linked to Turkish emerging adults’ infidelity intentions. However, the associations of infidelity intentions with perceived emotional and sexual intimacy and parental infidelity experience need further investigation. In order to address this gap in the literature, the current study explored the associations between parental infidelity, adult attachment anxiety and avoidance, emotional and sexual intimacy, and infidelity intentions among Turkish emerging adults. The sample included 280 participants who were 18­–30 years old, unmarried, childless, and in an ongoing romantic relationship for at least a year. Participants who were deemed eligible completed an online survey through Qualtrics. Findings suggested that a history of cheating on a prior romantic partner, parental infidelity, and the level of adult attachment avoidance were positively related to infidelity intentions, while perceived emotional and sexual intimacy were negatively associated with infidelity intentions. There was no significant relationship between adult attachment anxiety and infidelity intentions. These findings shed light on the importance of addressing parental infidelity, adult attachment avoidance, and intimacy problems in couples therapy, given the risk of engaging in infidelity.

The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is a brief measure for personality functioning based on the Alternative Model for Personality Disorders. Despite a strong emerging research base in support of the measure, most studies have been conducted in North America or Europe, and few studies have explored its association with theoretically relevant correlates such as mentalizing and attachment. The current study examined its factor structure, reliability, measurement invariance, and validity in Iranian samples using Exploratory Structural Equation Modeling. Two Iranian samples participated, composed of community-dwelling adults (N = 579, 58.9% female, Mage = 33.47) and university students (N = 390, 70.8% female, Mage = 27.09). Participants completed the LPFS-BF 2.0 alongside measures of categorical personality pathology, mentalizing, and attachment. Competing measurement models were contrasted, and invariance was tested across samples, sexes, age groups, and diagnostic status. A two-factor Exploratory Structural Equation Modeling model representing self and interpersonal functioning demonstrated optimal fit with good reliability and measurement invariance across all groups. Both domains showed strong associations with attachment insecurities, mentalizing deficits, and personality pathology. The mean score of self dysfunction was significantly higher in students, females, emerging adults, and diagnosed participants, while the interpersonal domain showed no significant group differences. The LPFS-BF 2.0 showed robust psychometric properties in Iranian samples, supporting its cross-cultural utility. Given that self dysfunction varied significantly by sample type, sex, age, and diagnostic status while interpersonal dysfunction did not, the self domain appears to better distinguish between demographic and clinical groups. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Past research shows strong links between object attachment and hoarding but has relied on poorly validated measures of object attachment. The Object Attachment Security Measure (OASM; David & Norberg, 2022b) was developed to address this limitation. This study evaluates the construct validity and measurement invariance of the OASM across age groups, genders, and hoarding severity. Participants were 777 individuals recruited via Prolific. Confirmatory factor analysis confirmed the correlated two-factor structure with two subscales: secure object attachment (SOA) and insecure object attachment (IOA). Measurement invariance testing showed strict invariance across age, gender, and hoarding severity. SOA and IOA had moderate to strong correlations with hoarding, and weaker associations with other psychopathology. IOA showed stronger correlations with hoarding than SOA, and the relationship between SOA and hoarding was no longer significant after accounting for IOA. These findings support the construct validity of OASM and reaffirm the central role of insecure object attachment in hoarding.

Adverse childhood experiences (ACEs) refer to any stressful or potentially traumatic events that happen before age 18 years. Early neglect and an early high–emotional environment seem to impair the normal acquisition of the understanding of the self and others (mentalization) and have an impact on the attachment relationship that persists into adulthood. Few studies have evaluated the associations between ACEs, attachment and mentalization in adult community samples. The present study aims to evaluate the associations among ACEs, adult attachment style in peer relationships and mentalization in a sample of 403 community–dwelling adults. Participants were administered the Childhood Abuse and Trauma Scale, the Attachment Style Questionnaire, and the Mentalization Questionnaire. The results showed significant associations between ACEs, mentalization, and adult insecure attachment style. Moreover, the insecure attachment styles Discomfort with Closeness and Need for Approval fully mediated the observed associations between ACEs and mentalization deficit. These data suggested that ACEs impact on mentalization via its effect on avoidant and preoccupied attachment style and that an adult insecure attachment style in individuals who experienced early adverse events could impair mentalization ability. Furthermore, they seem to present relevant clinical implications highlighting the importance of the development of a secure attachment relationship in the therapeutic context.