Sonfelianu Alexandra, González-Sala Francisco, Lacomba-Trejo Laura
Faculty of Psychology and Speech Therapy, Universitat de València, 46010 València, Spain.
Developmental and Educational Psychology Department, Faculty of Psychology and Speech Therapy, Universitat de València, 46010 València, Spain.
Actas Esp Psiquiatr. 2025 Aug;53(4):813-838. doi: 10.62641/aep.v53i4.1928.
Attachment styles may exert an influence on emotional regulation, specifically, secure attachment has been associated with more adaptative emotion regulation strategies and enhanced adult well-being. Despite the recognized importance of secure attachment in promoting mental health and well-being, little is known about how attachment styles manifest and evolve in adults with autism spectrum disorder (ASD). This systematic review examines "What is the connection between attachment styles and psychological, relational, and clinical variables in individuals with ASD or autistic traits, according to scientific research?".
A literature search, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed across PubMed, Web of Science and ProQuest Central databases. Using HubMeta, 12 studies were selected based on set criteria. Two independent reviewers conducted the entire process, from searching and selecting studies to extracting data and assessing quality. Inter-rater agreement was high, with kappa values ranging from 0.94 to 1.
The sample included 91,078 (98.99%) women and 346 (0.38%) men. Studies assessed attachment, ASD or autistic traits (Broader Autism Phenotype, BAP), intelligence quotient (IQ), depression, anxiety, stress, marital and relationship satisfaction, emotional availability and intelligence, empathy, ASD difficulties, personality traits and motivational processes, and gaming disorder. Individuals with ASD show higher rates of insecure attachment than general population and this could have an impact on their mental health and well-being. Parents with ASD also show difficulties when establishing the bond with their children.
This review highlights the importance of developing interventions with adults with ASD with the aim to establish better bonding and reaching greater well-being and mental health. The PROSPERO Registration: CRD42024628086, (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024628086).
依恋风格可能会对情绪调节产生影响，具体而言，安全型依恋与更具适应性的情绪调节策略以及更高的成人幸福感相关。尽管安全型依恋在促进心理健康和幸福感方面的重要性已得到认可，但对于自闭症谱系障碍（ASD）成年人中依恋风格如何表现和演变却知之甚少。本系统评价探讨了“根据科学研究，ASD或具有自闭症特征的个体的依恋风格与心理、人际关系和临床变量之间有何联系？”
按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，在PubMed、科学网和ProQuest Central数据库中进行文献检索。使用HubMeta，根据既定标准选择了12项研究。两名独立评审员进行了从检索和选择研究到提取数据和评估质量的整个过程。评分者间一致性很高，kappa值在0.94至1之间。
样本包括91,078名女性（98.99%）和346名男性（0.38%）。研究评估了依恋、ASD或自闭症特征（广义自闭症表型，BAP）、智商（IQ）、抑郁、焦虑、压力、婚姻和关系满意度、情感可用性和智力、同理心、ASD困难、人格特质和动机过程以及游戏障碍。与一般人群相比，ASD个体不安全依恋的发生率更高，这可能会对他们的心理健康和幸福感产生影响。患有ASD的父母在与孩子建立亲密关系时也存在困难。
本评价强调了针对ASD成年人开展干预措施的重要性，目的是建立更好的亲密关系，实现更高的幸福感和心理健康。PROSPERO注册号：CRD42024628086，（https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024628086）
