Experiential Avoidance Mediates the Link between Maternal Attachment Style and Theory of Mind
Abstract
Theoretical and empirical models suggest a relation between attachment style and theory of mind (ToM) in childhood and adulthood; however, this link has not been evaluated to the same extent in adolescence. Additionally, these models typically fail to consider mechanisms by which attachment style affects ToM abilities. The present study sought to test a mediational model in which experiential avoidance mediates the relation between maternal attachment style and ToM. A sample of 282 adolescents (Mage=15.42years, SD=1.44, 62.8% female) was recruited from an inpatient psychiatric hospital. Findings revealed that maternal attachment style in females was related to ToM, through experiential avoidance. Specifically, those with a disorganized maternal attachment were most likely to engage in experiential avoidant cognitive and emotional strategies, which in turn related to lower levels of ToM ability. Implications and areas for future research are discussed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Attachment insecurity is correlated with higher levels of experiential avoidance.
“Attachment insecurity is indeed correlated with higher levels of experiential avoidance [76,77]”
Cites
SPSS and SAS procedures for estimating indirect effects in simple mediation models
Preacher, K. J., & Hayes, A. F. (2004) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03206553 · Cited by 17,383 · see citing works
Does the chimpanzee have a theory of mind?
Premack, D., & Woodruff, G. (1978) · Behavioral and Brain Sciences · doi:10.1017/s0140525x00076512 · Cited by 8,743 · see citing works
The Interpersonal World of the Infant
Stern, D. N. (2018) · Routledge eBooks · doi:10.4324/9780429482137 · Cited by 5,348 · see citing works
Security in Infancy, Childhood, and Adulthood: A Move to the Level of Representation
Main, M., Kaplan, N., & Cassidy, J. (1985) · Monographs of the Society for Research in Child Development · doi:10.2307/3333827 · Cited by 4,567 · see citing works
Meeting of minds: the medial frontal cortex and social cognition
Amodio, D. M., & Frith, C. D. (2006) · Nature Reviews Neuroscience · doi:10.1038/nrn1884 · Cited by 3,782 · see citing works
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1152 · Cited by 3,595 · see citing works
Statistical mediation analysis with a multicategorical independent variable
Hayes, A. F., & Preacher, K. J. (2014) · British Journal of Mathematical and Statistical Psychology · doi:10.1111/bmsp.12028 · Cited by 3,403 · see citing works
Steinberg, L., & Morris, A. S. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.83 · Cited by 2,517 · see citing works
Social Cognitive Neuroscience: A Review of Core Processes
Lieberman, M. D. (2007) · Annual Review of Psychology · doi:10.1146/annurev.psych.58.110405.085654 · Cited by 2,010 · see citing works
The social brain in adolescence
Blakemore, S.-J. (2008) · Nature Reviews Neuroscience · doi:10.1038/nrn2353 · Cited by 1,896 · see citing works
Fonagy, P., & Luyten, P. (2009) · Development and Psychopathology · doi:10.1017/s0954579409990198 · Cited by 1,146 · cited 1× · see citing works
“While research in adolescence exists supporting the theory that insecure attachment is associated with limited attention to and memory for social information [42–44], no research has”
BackgroundCOGNITIVE DEVELOPMENT: Children's Knowledge About the Mind
Flavell, J. H. (1999) · Annual Review of Psychology · doi:10.1146/annurev.psych.50.1.21 · Cited by 959 · see citing works
Introducing MASC: A Movie for the Assessment of Social Cognition
Dziobek, I., Fleck, S., Kalbe, E., Rogers, K., Hassenstab, J., Brand, M., Kessler, J., Woike, J. K., Wolf, O. T., & Convit, A. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0107-0 · Cited by 926 · see citing works
Cutting, A. L., & Dunn, J. (1999) · Child Development · doi:10.1111/1467-8624.00061 · Cited by 817 · see citing works
Attachment and the processing of social information across the life span: Theory and evidence.
Dykas, M. J., & Cassidy, J. A. (2011) · Psychological Bulletin · doi:10.1037/a0021367 · Cited by 690 · see citing works
The parent–infant dyad and the construction of the subjective self
Fonagy, P., Gergely, G., & Target, M. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2007.01727.x · Cited by 555 · see citing works
Theory of Mind and Self‐Consciousness: What Is It Like to Be Autistic?
Frith, U., & Happé, F. (1999) · Mind & Language · doi:10.1111/1468-0017.00100 · Cited by 527 · see citing works
Greco, L. A., Lambert, W., & Baer, R. A. (2008) · Psychological Assessment · doi:10.1037/1040-3590.20.2.93 · Cited by 514 · see citing works
Theory of mind and emotion regulation difficulties in adolescents with borderline traits
Sharp, C., Pane, H., Ha, C., Venta, A., Patel, A. B., Sturek, J., & Fonagy, P. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.01.017 · Cited by 492 · see citing works
Are children with autism blind to the mentalistic significance of the eyes?
Baron‐Cohen, S., Campbell, R., Karmiloff‐Smith, A., Grant, J., & Walker, J. (1995) · British Journal of Developmental Psychology · doi:10.1111/j.2044-835x.1995.tb00687.x · Cited by 470 · see citing works
Impaired “Affective Theory of Mind” Is Associated with Right Ventromedial Prefrontal Damage
Shamay-Tsoory, S. G., Tomer, R., Berger, B. D., Goldsher, D., & Aharon-Peretz, J. (2005) · Cognitive and Behavioral Neurology · doi:10.1097/01.wnn.0000152228.90129.99 · Cited by 445 · see citing works
Social Cognition: Understanding Self and Others
Moskowitz, G. B. (2005) · Medical Entomology and Zoology · Cited by 385 · see citing works
Parents of Children with Asperger Syndrome: What is the Cognitive Phenotype?
Baron‐Cohen, S., & Hammer, J. (1997) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.1997.9.4.548 · Cited by 365 · see citing works
Walker, S. (2005) · The Journal of Genetic Psychology · doi:10.3200/gntp.166.3.297-312 · Cited by 347 · see citing works
Precursors to a theory of mind: Understanding attention in others.
Baron‐Cohen, S. (1991) · Cited by 344 · see citing works
Fraley, R. C., Niedenthal, P., Marks, M. J., Brumbaugh, C., & Vicary, A. M. (2006) · Journal of Personality · doi:10.1111/j.1467-6494.2006.00406.x · Cited by 330 · see citing works
Theory of Mind in Preadolescence: Relations Between Social Understanding and Social Competence
Bosacki, S., & Astington, J. W. (1999) · Social Development · doi:10.1111/1467-9507.00093 · Cited by 294 · see citing works
BUITELAAR, J. K., VAN DER WEES, M., SWAAB–BARNEVELD, H., & VAN DER GAAG, R. J. (1999) · Development and Psychopathology · doi:10.1017/s0954579499001947 · Cited by 250 · see citing works
Encoding-Specific Effects of Social Cognition on the Neural Correlates of Subsequent Memory
Mitchell, J. P., Macrae, C. N., & Banaji, M. R. (2004) · The Journal of Neuroscience · doi:10.1523/jneurosci.0481-04.2004 · Cited by 248 · see citing works
Functional differences among those high and low on a trait measure of psychopathy
Gordon, H. L., Baird, A. A., & End, A. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.06.030 · Cited by 218 · see citing works
The neural basis of primate social communication
Brothers, L. (1990) · Motivation and Emotion · doi:10.1007/bf00991637 · Cited by 216 · see citing works
Labels and explanations in mother–child emotion talk: Age and gender differentiation.
Cervantes, C. A., & Callanan, M. A. (1998) · Developmental Psychology · doi:10.1037/0012-1649.34.1.88 · Cited by 189 · see citing works
Adult attachment and the perception of facial expression of emotion.
Niedenthal, P. M., Bräuer, M., Robin, L., & Innes-Ker, Å. H. (2002) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.82.3.419 · Cited by 180 · see citing works
Smeets, T., Dziobek, I., & Wolf, O. T. (2009) · Hormones and Behavior · doi:10.1016/j.yhbeh.2009.01.011 · Cited by 176 · see citing works
Kashdan, T. B., Farmer, A. S., Adams, L. M., Ferssizidis, P., McKnight, P. E., & Nezlek, J. B. (2013) · Journal of Abnormal Psychology · doi:10.1037/a0032733 · Cited by 162 · see citing works
Attachment in adolescence: overlap with parenting and unique prediction of behavioural adjustment
Scott, S., Briskman, J., Woolgar, M., Humayun, S., & O’Connor, T. G. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02453.x · Cited by 154 · see citing works
Iverson, K. M., Follette, V. M., Pistorello, J., & Fruzzetti, A. E. (2012) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/a0023703 · Cited by 133 · see citing works
Cassidy, J., Ziv, Y., Mehta, T. G., & Feeney, B. C. (2003) · Child Development · doi:10.1111/1467-8624.7402019 · Cited by 121 · see citing works
Repetitive Nonsuicidal Self‐Injury as Experiential Avoidance Among a Community Sample of Adolescents
Howe‐Martin, L. S., Murrell, A. R., & Guarnaccia, C. A. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21868 · Cited by 113 · see citing works
Obsuth, I., Hennighausen, K., Brumariu, L. E., & Lyons-Ruth, K. (2014) · Child Development · doi:10.1111/cdev.12113 · Cited by 103 · see citing works
Old Friends, New Friends: Predictors of Children’s Perspective on Their Friends at School
Dunn, J., Cutting, A. L., & Fisher, N. (2002) · Child Development · doi:10.1111/1467-8624.00427 · Cited by 101 · see citing works
Assessing attachment in adolescence: A psychometric study of the Child Attachment Interview.
Venta, A. C., Shmueli‐Goetz, Y., & Sharp, C. (2013) · Psychological Assessment · doi:10.1037/a0034712 · Cited by 96 · see citing works
Feeney, B. C., & Cassidy, J. A. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.85.5.945 · Cited by 84 · see citing works
Reading other people's mind: Insights from neuropsychology
Samson, D. (2008) · Journal of Neuropsychology · doi:10.1348/174866408x377883 · Cited by 54 · see citing works
Mentalization in borderline personality disorder: From bench to bedside.
Sharp, C., & Kalpakci, A. H. (2015) · Personality Disorders Theory Research and Treatment · doi:10.1037/per0000106 · Cited by 41 · see citing works
Dykas, M. J., Woodhouse, S. S., Ehrlich, K. B., & Cassidy, J. A. (2010) · Child Development · doi:10.1111/j.1467-8624.2010.01484.x · Cited by 29 · see citing works
Mentalizing Mediates the Relation Between Attachment and Peer Problems Among Inpatient Adolescents
Venta, A. C., & Sharp, C. (2015) · Journal of Infant Child and Adolescent Psychotherapy · doi:10.1080/15289168.2015.1071997 · Cited by 24 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Early life experiences and social cognition in major psychiatric disorders: A systematic review
Rokita, K., Dauvermann, M. R., & Donohoe, G. J. (2018) · European Psychiatry · doi:10.1016/j.eurpsy.2018.06.006 · Cited by 122 · see citing works
“As a result of this selective or ‘biased’ information processing an individual also lacks integrated memories of negative states, which in turn may impact their Theory of Mind (ToM) development [33].”
Know Thy Selves: Learning to Understand Oneself Increases the Ability to Understand Others
Böckler, A., Herrmann, L., Trautwein, F., Holmes, T., & Singer, T. (2017) · Journal of Cognitive Enhancement · doi:10.1007/s41465-017-0023-6 · Cited by 61 · see citing works
Fact or fiction? A longitudinal study of play and the development of reflective functioning
Tessier, V. P., Normandin, L., Ensink, K., & Fonagy, P. (2016) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2016.80.1.60 · Cited by 55 · see citing works
Psychological Flexibility under Fire: Testing the Incremental Validity of Experiential Avoidance
Vaughan-Johnston, T. I., Quickert, R. E., & MacDonald, T. K. (2017) · Personality and Individual Differences · doi:10.1016/j.paid.2016.10.011 · Cited by 39 · see citing works
Miller, S. A. (2022) · doi:10.1093/oso/9780197573174.001.0001 · Cited by 36 · see citing works
Castilho, P., Martins, M. J., Pinto, A. M., Viegas, R., Carvalho, S., & Madeira, N. (2017) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2016.11.007 · Cited by 31 · see citing works
Tan, X. F., Yang, Y., & Yu, M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.07.069 · Cited by 28 · see citing works
Linking attachment to empathy in childhood and adolescence: A multilevel meta-analysis
Li, S., Ran, G., & Chen, X. (2021) · Journal of Social and Personal Relationships · doi:10.1177/02654075211031006 · Cited by 23 · see citing works
“…have shown that insecure attachment is negatively related to empathy (e.g., Diamond et al., 2012; Repacholi & Trapolini, 2004), others have failed to detect a significant association between these two variables in childhood and adolescence (e.g., Delhaye et al., 2013; Vanwoerden et al., 2015).”
BackgroundExperiential avoidance in the vulnerability to depression among adolescent females
Mellick, W., Vanwoerden, S., & Sharp, C. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.10.034 · Cited by 25 · see citing works
Be(com)ing social: Daily-life social interactions and parental bonding.
Achterhof, R., Schneider, M., Kirtley, O. J., Wampers, M., Decoster, J., Derom, C. A., Binder, M. D., Gülöksüz, S., Jacobs, N., Menne‐Lothmann, C., et al. (2022) · Developmental Psychology · doi:10.1037/dev0001315 · Cited by 15 · see citing works
Quickert, R. E., & MacDonald, T. K. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17186472 · Cited by 14 · see citing works
“Attachment insecurity is indeed correlated with higher levels of experiential avoidance [76,77], and lower levels of distress tolerance [75], suggesting that present-moment awareness of negative thoughts and feelings would be especially challenging.”
BackgroundZakiei, A., Ghasemi, S. R., Gilan, N. R., Reshadat, S., Sharifi, K., & Mohammadi, O. (2017) · Eastern Mediterranean Health Journal · doi:10.26719/2017.23.5.335 · Cited by 15 · see citing works
“It has been shown that experiential avoidance has the potential to act as a mediating factor among different psychological variables (19).”
Background石津, 憲., Shimoda, Y., & Ohtsuki, T. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188368 · Cited by 12 · see citing works
Christodoulou, A., Michaelides, M. P., & Karekla, M. (2017) · Journal of Psychoeducational Assessment · doi:10.1177/0734282917713500 · Cited by 14 · see citing works
“(2015) and other studies that had used manifest scores from the AFQ-Y (Sharp et al., 2014; Vanwoerden et al., 2015).”
ResultMydani, F. N., Vand, H. D. A., Abasi, I., & Noori, M. (2022) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.28.3.4175.1 · Cited by 5 · see citing works
Understanding motivations for sexual communication from a regulatory focus perspective
Simpson, K. S. W., & Rehman, U. S. (2024) · Journal of Social and Personal Relationships · doi:10.1177/02654075241289832 · Cited by 5 · see citing works
“…linked to attachment and the development of experiential avoidance (as an emotion regulation strategy) is viewed as being in fl uenced by attachment processes (e.g. Ross et al., 2016; Vanwoerden et al., 2015), it may have been dif fi culty to detect unique variance related to experiential avoidance.”
Mackey, M., Dunne, E., & Ahern, E. (2025) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-025-00724-y · Cited by 2 · see citing works
Consequences: Social Development
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0007 · Cited by 1 · see citing works
Trucharte, A., López, R. E., Valiente, C., Contreras, A., & Peinado, V. (2019) · Edupsykhé Revista de Psicología y Educación · doi:10.57087/edupsykhe.v16i1.4081
Early life adversities and social cognition in schizophrenia
Rokita, K. (2020) · ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) · doi:10.13025/17136
Time to Get Social: Adaptive Social Processes in the Daily Lives of Youth (Full PhD thesis)Preprint
Achterhof, R. (2022) · doi:10.31234/osf.io/knzms
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0009
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0004
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0001
Understanding of Cognitive States
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0002
Consequences: Cognitive Development
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0006
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0010
Variations of First-Order Paradigms
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0005
Understanding of Affective States
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0003
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.003.0008
Vargas, D. E. A. (2023) · Ciencia Latina Revista Científica Multidisciplinar · doi:10.37811/cl_rcm.v7i6.8730
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.002.0006
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.002.0003
Miller, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197573174.002.0004
Parchami, Z., Najafi, M., & Khosravani, V. (2025) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-025-00610-4
“Consequently, this lack of emotional awareness and understanding can increase the tendency among patients with OCD to avoid their internal states, particularly for those with significant deficits in identifying feelings (Vanwoerden et al., 2015).”
Gerdan, G., Akgül, Ö., & Gürlük, Y. O. (2025) · Addictive Behaviors · doi:10.1016/j.addbeh.2025.108509
From attachment to emotion regulation: the mediating role of epistemic trust
Greiner, C., Besch, V., Prada, P., & Debbané, M. (2026) · Current Psychology · doi:10.1007/s12144-026-09968-9
“…and/ or intrusive caregiving, may undermine the development of ET, leading the individual to shift between epistemic stances dominated either by hypervigilant rejection of social communication (EM) or overreliance on others’ input (EC) (Mikulincer & Shaver, 2016; Vanwoerden et al., 2015).”
Intervention Programs Implemented for Adoptive Families
Kunt, M., & Avcı, N. (2026) · IGI Global eBooks · doi:10.4018/979-8-2600-0031-1.ch011
- Authors
- Vanwoerden, S., Kalpakci, A. H., & Sharp, C.
- Affiliations
- University of Houston (US)
- Menninger Clinic (US)
- Corresponding author
- Sharp, Carla
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 57
- Pages
- 117-124
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2032978982
- Cited by
- 39
- References
- 47
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 17 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 4
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Menninger Clinic
- Topics
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- experiential avoidance, maternal attachment style, theory of mind, disorganized attachment, adolescents, mediation, psychiatric inpatients
- MeSH terms
- Adolescent, Child, Cognition, Female, Humans, Inpatients, Male, Maternal Behavior, Models, Psychological, Mothers, Neuropsychological Tests, Object Attachment, Social Behavior, Social Perception, Young Adult, Theory of Mind
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
