Cited by 235Child Abuse and TraumaAttachment and Relationship DynamicsChild Welfare and Adoption

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Does adult attachment style mediate the relationship between childhood maltreatment and mental and physical health outcomes

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Widom, Cathy Spatz, Czaja, Sally J., Kozakowski, Sandra Sepulveda, Chauhan, Preeti·2018·Child Abuse & Neglect

DOI 10.1016/j.chiabu.2017.05.002PMC PMC5685930

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Abstract

Attachment theory has been proposed as one explanation for the relationship between childhood maltreatment and problematic mental and physical health outcomes in adulthood. This study seeks to determine whether: (1) childhood physical abuse and neglect lead to different attachment styles in adulthood, (2) adult attachment styles predict subsequent mental and physical health outcomes, and (3) adult attachment styles mediate the relationship between childhood physical abuse and neglect and mental and physical health outcomes. Children with documented cases of physical abuse and neglect (ages 0-11) were matched with children without these histories and followed up in adulthood. Adult attachment style was assessed at mean age 39.5 and outcomes at 41.1. Separate path models examined mental and physical health outcomes. Individuals with histories of childhood neglect and physical abuse had higher levels of anxious attachment style in adulthood, whereas neglect predicted avoidant attachment as well. Both adult attachment styles (anxious and avoidant) predicted mental health outcomes (higher levels of anxiety and depression and lower levels of self-esteem), whereas only anxious adult attachment style predicted higher levels of allostatic load. Path analyses revealed that anxious attachment style in adulthood in part explained the relationship between childhood neglect and physical abuse to depression, anxiety, and self-esteem, but not the relationship to allostatic load. Childhood neglect and physical abuse have lasting effects on adult attachment styles and anxious and avoidant adult attachment styles contribute to understanding the negative mental health consequences of childhood neglect and physical abuse 30 years later in adulthood.

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Authors: Widom, C. S., Czaja, S. J., Kozakowski, S. S., & Chauhan, P.
Affiliations: City University of New York (US)
The College of New Jersey (US)
Corresponding author: Widom, Cathy Spatz
ORCID: Widom, Cathy Spatz
Chauhan, Preeti
Venue: Child Abuse & Neglect
Publisher: Elsevier BV
Published: 2018-02
Volume: 76
Pages: 533-545
ISSN: 0145-2134 (ISSN-L)
DOI: 10.1016/j.chiabu.2017.05.002
PMC: PMC5685930
OpenAlex: W2616818484
Cited by: 235
References: 97
Citations by year: 2026: 22 · 2025: 31 · 2024: 30 · 2023: 33 · 2022: 32 · 2021: 29 · 2020: 26 · 2019: 23 · 2018: 8
FWCI: 19.62
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Child Abuse & Neglect (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Eunice Kennedy Shriver NICHD (HD40774)
NIMH (MH49467, MH58386)
NIJ (86-IJ-CX-0033, 89-IJ-CX-0007)
NIDA (DA17842, DA10060)
NIAAA (AA09238, AA11108)
Doris Duke Charitable Foundation
Topics: Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
Social Sciences › Sociology and Political Science › Child Welfare and Adoption
Keywords: adult attachment styles, child abuse, child physical abuse, child neglect, attachment anxiety, attachment avoidance, mediation, mental health outcomes, depression, anxiety, self-esteem, allostatic load, physical health outcomes
MeSH terms: Physical Abuse, Adult, Anxiety, Anxiety Disorders, Child, Child Abuse, Child, Preschool, Depression, Depressive Disorder, Female, Health Status, Humans, Infant, Infant, Newborn, Male, Mental Health, Object Attachment, Self Concept, Allostasis

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Does adult attachment style mediate the relationship between childhood maltreatment and mental and physical health outcomes

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