The Significance of Insecure and Disorganized Attachment for Children's Internalizing Symptoms: A Meta-Analytic Study

Department, University of Illinois at Urbana-Champaign, 603 E. Daniel Street, Champaign, IL 61820, USA.
Child Development (Impact Factor: 4.92). 01/2012; 83(2):591-610. DOI: 10.1111/j.1467-8624.2011.01711.x
Source: PubMed


This meta-analytic review examines the association between attachment and internalizing symptomatology during childhood, and compares the strength of this association with that for externalizing symptomatology. Based on 42 independent samples (N = 4,614), the association between insecurity and internalizing symptoms was small, yet significant (d = 0.15, CI 0.06~0.25) and not moderated by assessment age of internalizing problems. Avoidance, but not resistance (d = 0.03, CI -0.11~0.17) or disorganization (d = 0.08, CI -0.06~0.22), was significantly associated with internalizing symptoms (d = 0.17, CI 0.03~0.31). Insecurity and disorganization were more strongly associated with externalizing than internalizing symptoms. Discussion focuses on the significance of attachment for the development of internalizing versus externalizing symptomatology.

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    • "The greatest frustration of attachment needs was seen in this group, and this frustration was hypothesized to lead to the highest levels of anger and the lowest levels of selfregulation . Consistent with this theory, meta-analytic evidence indicates that disorganized attachment behavior in the infancy period increases the risk for externalizing behavior (Fearon et al., 2010), but not internalizing problems (Groh et al., 2012; Madigan et al., 2013). However, similar to avoidant and ambivalent attachment , little is known about the association between disorganized attachment assessed at later ages and behavioral problems. "
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    ABSTRACT: Although the quality of the attachment relationship is often cited as an important determinant of development, the extent of impact of this environmental influence in shaping behavioral outcomes has been a matter of considerable debate. This may, in part, be because of the variability in methodologies used for assessing attachment across infancy, childhood, and adolescence, including behavioral, representational, and questionnaire measures of attachment. Previous meta-analyses of the relations between attachment and internalizing and externalizing problems have focused on the behavioral measures of attachment used primarily in infancy. The current meta-analysis is a comprehensive examination of the literature on attachment and behavioral problems in children aged 3-18 years, focusing on the representational and questionnaire measures most commonly used in this age range. When secure attachment was compared with insecure attachment, modest associations with internalizing behavior (165 studies; 48,224 families; d = .58; 95% confidence interval [CI] [.52-.64]) were found. Multivariate moderator analyses were used to disentangle the unique influence of each significant univariate moderator more precisely, and results revealed that effect sizes decreased as the child aged, and were larger in studies in which the participants were ethnically White, where the child was the problem informant, and when the internalizing measure was depressive symptoms. Attachment and externalizing behavior were also associated (116 studies; 24,689 families; d = .49; 95% CI [42-.56]), and effect sizes were larger in ethnically White samples, and in those where the child was the problem informant. Avoidant, ambivalent, and disorganized attachment classifications were associated with internalizing behavior, but only disorganized attachment was associated with externalizing behavior. (PsycINFO Database Record
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    • "Bates and Dozier (2002) found proportions of attachment states of mind comparable to that in the general population, although there was a trend showing fewer secure-autonomous and preoccupied foster mothers, and more dismissing and unresolved foster mothers. When children are placed with insecure foster mothers, they are more likely to show disorganized attachment behaviors (Dozier, Stoval, Albus, & Bates, 2001) – a form of attachment that is a significant risk factor for child maladjustment in the short-and long-term (Fearon et al., 2010; Groh et al., 2012). In line with these results, a recent study showed that foster caregivers' insecure states of mind were associated with increased atypical parenting while interacting with the foster child (Ballen et al., 2010). "
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    • "A meta-analysis reported on the causes of infant-mother attachment disorganization in 851 families (Madigan et al., 2006), with robust findings linking infant-mother disorganization to frightened or frightening caregiving and/or abusive behavior (Cyr et al., 2010; Hesse & Main, 1990), to unresolved states of mind concerning past loss or trauma, and dissociative symptoms during adolescence, assessed via self-, peer-, and teacher-report (Carlson, 1998). More recent reports show via longitudinal research that disorganized attachments to mother in infancy predict children's externalizing problems (Fearon et al., 2010; Fearon & Belsky, 2011), internalizing symptoms (Groh et al., 2012), and Borderline Personality Disorder features in young adults (Lyons-Ruth & Jacobvitz, 2008) . Coincident in time with the introduction of the Disorganized Attachment Classification in Infancy, Main, Kaplan, & Cassidy (1985) introduced the Adult Attachment Interview, which signaled a paradigmatic shift in the field of developmental attachment research captured by the title of the 1985 paper, that is, " a move to the level of representation, " beyond an exclusive focus on the behavior of preverbal infants with their caregivers (at home or in the Strange Situation Procedure). "
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