Cited by 638Attachment and Relationship DynamicsChild and Adolescent Psychosocial and Emotional DevelopmentPsychoanalysis and Psychopathology Research

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The significance of insecure and disorganized attachment for children's internalizing symptoms: a meta-analytic study

Groh, Ashley M, Roisman, Glenn I, van IJzendoorn, Marinus H, Bakermans-Kranenburg, Marian J, Fearon, R Pasco·2012·Child Development

DOI 10.1111/j.1467-8624.2011.01711.x

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Abstract

This meta-analytic review examines the association between attachment and internalizing symptomatology during childhood, and compares the strength of this association with that for externalizing symptomatology. Based on 42 independent samples (N = 4,614), the association between insecurity and internalizing symptoms was small, yet significant (d = 0.15, CI 0.06∼0.25) and not moderated by assessment age of internalizing problems. Avoidance, but not resistance (d = 0.03, CI −0.11∼0.17) or disorganization (d = 0.08, CI −0.06∼0.22), was significantly associated with internalizing symptoms (d = 0.17, CI 0.03∼0.31). Insecurity and disorganization were more strongly associated with externalizing than internalizing symptoms. Discussion focuses on the significance of attachment for the development of internalizing versus externalizing symptomatology.

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“…meta-analysis examining attachment and internalizing behaviors (including anxiety disorders) reported that such issues had little effect on internalizing outcomes (Groh et al., 2012), as opposed to externalizing behaviors (Fearon, Bakermans-Kranenburg, van IJzendoorn, Lapsley, & Roisman, 2010).”
Background
Impact of preschool attendance, parental stress, and parental mental health on internalizing and externalizing problems during COVID-19 lockdown measures in preschool children
Jarvers, I., Ecker, A., Schleicher, D., Brunner, R. M., & Kandsperger, S. (2023) · PLoS ONE · doi:10.1371/journal.pone.0281627 · Cited by 34
“The impact of insecure attachment on internalizing problems in early childhood has been investigated and identified previously [32, 33], however, the role of attachment in relation to lockdown measures due to the COVID-19 pandemic has not been examined as of now.”
Background
The longitudinal and concurrent relationship between caregiver sensitivity and preschool attachment: A systematic review and meta-analysis
O’Neill, M. C., Badovinac, S. D., Riddell, R. P., Bureau, J., Rumeo, C., & Costa, S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0245061 · Cited by 29
“For example, insecure attachments are associated with internalizing symptomatology, while insecure and disorganized attachments are associated with externalizing symptomatology [3].”
Background
Routinely used interventions to improve attachment in infants and young children: a national survey and two systematic reviews
Wright, B., Fearon, P. R. M., Garside, M., Tsappis, E., Amoah, E., Glaser, D., Allgar, V. L., Minnis, H., Woolgar, M., Churchill, R. C., et al. (2023) · Health Technology Assessment · doi:10.3310/ivcn8847 · Cited by 37
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The Cambridge Handbook of Infant Development
Lockman, J. J., Hertz, D., Tamis-LeMonda, C. S., Brain, B. C., Context..........................................., Rey, J., Falck-Ytter, T., Jones, E., Maurer, D., Cirelli, L., et al. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108351959 · Cited by 31
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Akezhuoli, H., Lu, J., Zhao, G., Xu, J., Wang, M., Wang, F., Li, L., & Zhou, X. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.894741 · Cited by 29
Heterotypic and homotypic continuity in psychopathology: a narrative review
Speranza, A. M., Liotti, M., Spoletini, I., & Fortunato, A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1194249 · Cited by 32
“Yet other studies (Groh et al., 2012; Madigan et al., 2013) found the opposite trend: avoidant attachment correlated significantly, however moderately, with internalizing problems, while resistant attachment did not.”
Background
Children’s mental representations with respect to caregivers and post-traumatic symptomatology in Somatic Symptom Disorders and Disruptive Behavior Disorders
Bizzi, F., Cavanna, D., Castellano, R., & Pace, C. S. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01125 · Cited by 34
“Studies on attachment during middle childhood and early adolescence confirm that secure attachment is associated with greater resilience and lower levels of internalizing and externalizing problems (Fearon and Belsky, 2011; Groh et al., 2012).”
Background
Investigating Direct and Indirect Effects of Attachment on Internalizing and Externalizing Problems through Emotion Regulation in a Cross-Sectional Study
Ștefan, C. A., & Avram, J. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0723-7 · Cited by 30
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Grumi, S., Cappagli, G., Aprile, G., Mascherpa, E., Gori, M., Provenzi, L., & Signorini, S. G. (2021) · Infant Behavior and Development · doi:10.1016/j.infbeh.2021.101590 · Cited by 28
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Effect of a parenting intervention on decreasing adolescents’ behavioral problems via reduction in attachment insecurity: A longitudinal, multicenter, randomized controlled trial
Barone, L., Carone, N., Costantino, M. A., Genschow, J., Merelli, S., Milone, A., Polidori, L., Ruglioni, L., & Moretti, M. M. (2021) · Journal of Adolescence · doi:10.1016/j.adolescence.2021.07.008 · Cited by 39
Attachment security in young foster children: continuity from 2 to 3 years of age
Jacobsen, H., Ivarsson, T., Wentzel‐Larsen, T., Smith, L., & Moe, V. (2013) · Attachment & Human Development · doi:10.1080/14616734.2013.850102 · Cited by 33
Substance‐dependent women becoming mothers: breaking the cycle of adverse childhood experiences
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Effects of Father and Mother Attachment on Depressive Symptoms in Middle Childhood and Adolescence: The Mediating Role of Emotion Regulation
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Prospective Bidirectional Associations between Attachment and Depressive Symptoms from Middle Childhood to Adolescence
Cortés‐García, L., Wichstrøm, L., Viddal, K. R., & Senra, C. (2019) · Journal of Youth and Adolescence · doi:10.1007/s10964-019-01081-4 · Cited by 26
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Concepts travel faster than thought: an empirical study of the use of attachment classifications in child protection investigations
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“Moreover, insecure or disorganized child attachment have been linked to an array of negative developmental outcomes, including higher levels of internalizing (Groh et al., 2012) and externalizing (Fearon et al., 2010) behavior problems, and lower social competence (e.g. Groh et al., 2014).”
Background
Behavior problems in sexually abused preschoolers over a 1-year period: The mediating role of attachment representations
Charest, F., Hébert, M., Bernier, A., Langevin, R., & Miljkovitch, R. (2019) · Development and Psychopathology · doi:10.1017/s0954579418000226 · Cited by 26
Exploring Perinatal Indicators of Infant Social-Emotional Development: A Review of the Replicated Evidence
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Insecure attachment is associated with math anxiety in middle childhood
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Developmental cascade effects of interpersonal psychotherapy for depressed mothers: Longitudinal associations with toddler attachment, temperament, and maternal parenting efficacy
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The Development of Multisensory Attention Skills
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Attachment and affect between mothers with depression and their children: Longitudinal outcomes of Child Parent Psychotherapy
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Attention and Executive Functions as Mediators of Attachment and Behavior Problems
Low, J. A., & Webster, L. L. (2015) · Social Development · doi:10.1111/sode.12166 · Cited by 24
Attachment Style and the Association of Spanking and Child Externalizing Behavior
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Positive parenting in foster care: Testing the effectiveness of a video-feedback intervention program on foster parents’ behavior and attitudes
Schoemaker, N. K., Juffer, F., Rippe, R. C. A., Vermeer, H. J., Stoltenborgh, M., Jagersma, G., Maras, A., & Alink, L. R. A. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.104779 · Cited by 31
“…attachment are at higher risk for developing behavior problems and psychopathology later in life (Fearon, Bakermans-Kranenburg, Van IJzendoorn, Lapsley, & Roisman, 2010; Groh, Roisman, Van IJzendoorn, Bakermans-Kranenburg, & Fearon, 2012; Van IJzendoorn, Schuengel, & Bakermans-Kranenburg, 1999).”
Background
Improving Parent–Child Interactions in Maltreating Families with the Attachment Video-feedback Intervention: Parental Childhood Trauma as a Moderator of Treatment Effects
van der Asdonk, S., Cyr, C., & Alink, L. (2021) · Attachment & Human Development · doi:10.1080/14616734.2020.1799047 · Cited by 23
“…to child signals in an adequate and prompt manner (Ainsworth et al., 1978), children are able to develop a secure attachment (De Wolff & Van IJzendoorn, 1997), which is an important indicator of their future development (Fearon et al., 2010; Groh et al., 2014, 2017, 2012; Sroufe et al., 2005).”
Background
Infant crying problems and symptoms of sleeping problems predict attachment disorganization at 18 months
Bilgin, A., & Dieter Wolke, C. (2019) · Attachment & Human Development · doi:10.1080/14616734.2019.1618882 · Cited by 28
Developmental pathways from maternal history of childhood maltreatment and maternal depression to toddler attachment and early childhood behavioral outcomes
Alto, M. E., Warmingham, J. M., Handley, E. D., Rogosch, F. A., Cicchetti, D., & Toth, S. L. (2020) · Attachment & Human Development · doi:10.1080/14616734.2020.1734642 · Cited by 25
“…differences in the association between attachment and internalizing and externalizing behavior based on socioeconomic status (Fearon et al., 2010; Groh et al., 2012), these studies did not examine the impact of multiple risk factors, such as the effect of maternal history of childhood…”
BackgroundResult
Longitudinal links among parent-child attachment, emotion parenting, and problem behaviors of preadolescents
Wang, J., Yang, Y., Tang, Y., Wu, M., Jiang, S., & Zou, H. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105797 · Cited by 23
Parent Emotion Regulation, Mindful Parenting, and Youth Attachment: Direct and Indirect Associations with Internalizing and Externalizing Problems
Vernon, J. R. G., & Moretti, M. M. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01446-0 · Cited by 23
Early Childhood Precursors and School age Correlates of Different Internalising Problem Trajectories Among Young Children
Parkes, A., Sweeting, H. N., & Wight, D. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-015-0116-6 · Cited by 27
“Our finding for low mother-child warmth could reflect earlier attachment problems (Groh et al. 2012).”
Background

Authors: Groh, A. M., Roisman, G. I., van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., & Fearon, R. P.
Affiliations: University of Illinois Urbana-Champaign (US)
University of Leiden
University of Reading
Corresponding author: Groh, Ashley M
ORCID: Groh, Ashley M
Roisman, Glenn I
Venue: Child Development
Publisher: Oxford University Press (OUP)
Published: 2012-03-01
Volume: 83
Issue: 2
Pages: 591-610
ISSN: 0009-3920 (ISSN-L)
1467-8624
DOI: 10.1111/j.1467-8624.2011.01711.x
OpenAlex: W2118748762
Semantic Scholar: 1aaa3cc6768aac1af795b29740f57ac8c88a734e
Cited by: 638
References: 96
Citations by year: 2026: 27 · 2025: 28 · 2024: 40 · 2023: 34 · 2022: 48 · 2021: 74 · 2020: 80 · 2019: 56 · 2018: 40 · 2017: 55 · 2016: 54 · 2015: 43 · 2014: 33 · 2013: 14 · 2012: 11
FWCI: 4.61
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Child Development (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
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 › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: insecure attachment, disorganized attachment, internalizing problems, externalizing problems, childhood, attachment avoidance, child psychopathology
MeSH terms: Adaptation, Psychological, Age Factors, Anxiety Disorders, Child, Child Behavior Disorders, Child, Preschool, Defense Mechanisms, Depressive Disorder, Female, Humans, Internal-External Control, Male, Personality Assessment, Personality Disorders, Social Behavior Disorders, Somatoform Disorders, Statistics as Topic, Reactive Attachment Disorder

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The significance of insecure and disorganized attachment for children's internalizing symptoms: a meta-analytic study

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