Dagan Or, Groh Ashley M, Madigan Sheri, Bernard Kristin
Department of Psychology, Stony Brook University, Stony Brook, NY 11794, USA.
Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO 65211, USA.
Brain Sci. 2021 Sep 16;11(9):1226. doi: 10.3390/brainsci11091226.
Attachment scholars have long argued that insecure attachment patterns are associated with vulnerability to internalizing symptoms, such as depression and anxiety symptoms. However, accumulating evidence from the past four decades, summarized in four large meta-analyses evaluating the link between insecure attachment and internalizing symptoms, provide divergent evidence for this claim. This divergent evidence may be accounted for, at least in part, by the developmental period under examination. Specifically, children with histories of deactivating (i.e., insecure/avoidant) but not hyperactivating (i.e., insecure/resistant) attachment patterns in infancy and early childhood showed elevated internalizing symptoms. In contrast, adolescents and adults with hyperactivating (i.e., insecure/preoccupied) but not deactivating (i.e., insecure/dismissing) attachment classifications showed elevated internalizing symptoms. In this paper, we summarize findings from four large meta-analyses and highlight the divergent meta-analytic findings that emerge across different developmental periods. We first present several potential methodological issues that may have contributed to these divergent findings. Then, we leverage clinical, developmental, and evolutionary perspectives to propose a testable lifespan development theory of attachment and internalizing symptoms that integrates findings across meta-analyses. According to this theory, subtypes of insecure attachment patterns may be differentially linked to internalizing symptoms depending on their mis/match with the developmentally appropriate orientation tendency toward caregivers (in childhood) or away from them (i.e., toward greater independence in post-childhood). Lastly, we offer future research directions to test this theory.
依恋理论学者长期以来一直认为，不安全的依恋模式与内化症状的易感性有关，比如抑郁和焦虑症状。然而，过去四十年来积累的证据——这一证据在四项评估不安全依恋与内化症状之间联系的大型元分析中得到了总结——为这一说法提供了不同的证据。这种不同的证据至少部分可以通过所研究的发育阶段来解释。具体而言，在婴儿期和幼儿期具有去激活型（即不安全/回避型）而非过度激活型（即不安全/抗拒型）依恋模式的儿童表现出更高的内化症状。相比之下，具有过度激活型（即不安全/痴迷型）而非去激活型（即不安全/忽视型）依恋分类的青少年和成年人表现出更高的内化症状。在本文中，我们总结了四项大型元分析的结果，并强调了在不同发育阶段出现的不同元分析结果。我们首先提出几个可能导致这些不同结果的潜在方法学问题。然后，我们利用临床、发展和进化的观点，提出一个可检验的依恋与内化症状的毕生发展理论，该理论整合了各项元分析的结果。根据这一理论，不安全依恋模式的亚型可能因其与童年期对照顾者（或童年后远离照顾者，即走向更大独立性）的发展适当的定向倾向的错配/匹配，而与内化症状存在不同的关联。最后，我们提供了未来研究方向以检验这一理论。
