Attachment theory as a framework for understanding sequelae of severe adolescent psychopathology: an 11-year follow-up study.

This study examined long-term sequelae of severe adolescent psychopathology from the perspective of adult attachment theory. The study compared 66 upper-middle-class adolescents who were psychiatrically hospitalized at age 14 for problems other than thought or organic disorders, to 76 sociodemographically similar high school students. When reinterviewed at age 25, virtually all of the previously hospitalized adolescents displayed insecure attachment organizations, in contrast to a more typical mixture of security and insecurity in the former high school sample. Lack of resolution of previous trauma with attachment figures accounted for much of this insecurity. Insecurity in adult attachment organization at age 25 was also linked to self-reported criminal behavior and use of hard drugs in young adulthood. These findings are discussed as reflecting a substantial and enduring connection between attachment organization and severe adolescent psychopathology and a possible role of attachment organization in mediating some of the long-term sequelae of such psychopathology.