Insecure Attachment, Dysfunctional Attitudes, and Low Self-Esteem Predicting Prospective Symptoms of Depression and Anxiety During Adolescence
Open accessAbstract
This study extends the existing adult literature on insecure attachment as a predictor of depression and anxiety by examining these pathways in a sample of adolescents. In addition, dysfunctional attitudes and low self-esteem were tested as mediators of the association between insecure attachment and symptoms of depression and anxiety. Youth (N = 350; 6th-10th graders) completed self-report measures of attachment, dysfunctional attitudes, self-esteem, and symptoms of depression and anxiety in a 4-wave prospective study. Results indicate that anxious and avoidant attachment each predicted changes in both depression and anxiety (after controlling for initial symptom levels). The association between anxious attachment, but not avoidant attachment, and later internalizing symptoms was mediated by dysfunctional attitudes and low self-esteem. Effects remained even after controlling for initial co-occurring symptoms.
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The self-esteem mediation pathway is insufficient to explain the relationship between insecure attachment and paranoia; additional factors are required.
“However, based on the observation that the mediating role of self‐esteem is also present in the association between attachment anxiety and depression symptoms (Lee & Hankin, 2009; Roberts, Gotlib, & Kassel, 1996), the relationship between insecure attachment and paranoia would seem to require the involvement of additional factors.”
From Mistrust and negative self‐esteem: Two paths from attachment styles to paranoia. (2021) · cites this paper as Lee & Hankin, 2009
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“Adolescents and adults with aversive early life experiences and insecure attachment tend to have low self-esteem and often report symptoms of depression and hopelessness, 11 social anxiety, 12 or dissociation.”
Background
- Authors
- Lee, A., & Hankin, B. L.
- Affiliations
- University of Illinois Chicago (US)
- University of Denver (US)
- Corresponding author
- Lee, Adabel
- ORCID
- Hankin, Benjamin L.
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2009-03-12
- Volume
- 38
- Issue
- 2
- Pages
- 219-231
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC2741157
- OpenAlex
- W2163988201
- Cited by
- 434
- References
- 11
- Citations by year
- 2026: 13 · 2025: 23 · 2024: 27 · 2023: 28 · 2022: 25 · 2021: 47 · 2020: 71 · 2019: 29 · 2018: 19 · 2017: 23 · 2016: 18 · 2015: 24 · 2014: 17 · 2013: 28 · 2012: 15
- FWCI
- 18.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R03MH066845)
- Topics
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- insecure attachment, attachment anxiety, attachment avoidance, dysfunctional attitudes, low self-esteem, depression, anxiety, internalizing problems, adolescents, mediation, prospective development
- MeSH terms
- Adolescent, Anxiety Disorders, Attitude, Child, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Object Attachment, Prospective Studies, Surveys and Questionnaires, Self Concept, Severity of Illness Index
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