Associations between early childhood parent-child attachment and internalizing/externalizing symptoms: A systematic review and narrative synthesis

• In Event: Poster Session 11
  In Poster Session: PS 11 Topic - Parenting & Parent-Child Relationships

Abstract

Introduction: Bowlby’s (1969/1982; 1980) attachment theory proposes that the quality of early parent-child relationships has important implications for children’s social, emotional, and psychological development. In the decades since these hypotheses were put forth, a substantial amount of research has focused on uncovering the links between attachment relationships in early life and the development of symptoms of psychopathology. Three meta-analyses published within the last decade have summarized this research (Fearon et al., 2010; Groh et al., 2012; Madigan et al., 2013), and have identified small positive associations between insecure early childhood attachment and both internalizing (Madigan et al., 2013) and externalizing (Fearon et al., 2010) symptoms. Since the publication of these reviews, new evidence has accumulated, offering an opportunity to build on the findings of the previous reviews in important ways: 1) by examining how subtypes of the disorganized-controlling category may confer different risk for psychological outcomes; 2) by including the first published reports of associations between father-child attachment and internalizing and externalizing symptoms; and 3) by focusing specifically on investigations of early childhood attachment behavior assessed by the attachment classification systems developed by Cassidy and Marvin (1992) and Main and Cassidy (1988), thereby overcoming limitations of previous reviews that combined information across developmental periods and assessments of attachment.

Aim: This systematic review aimed to provide a narrative synthesis of associations between the early childhood (i.e., preschool and early school age) attachment classification systems (Cassidy & Marvin, 1992; Main & Cassidy, 1988) and internalizing and externalizing symptoms measured from preschool age through adolescence.

Methods: The review was pre-registered with PROSPERO (International Prospective Register of Systematic Reviews) and was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 9,312 records were screened and 34 articles were deemed as eligible for inclusion in the review. Study quality was evaluated and findings were reviewed using narrative synthesis techniques.

Results: Findings across studies suggest consistent associations between insecure early childhood attachment and both internalizing and externalizing symptoms during the preschool and school-age/middle childhood periods. Children classified as disorganized/controlling tended to be at heightened risk for internalizing and externalizing symptoms, and the association between disorganized/controlling attachment and internalizing (but not externalizing) symptoms tended to strengthen across development. There is insufficient evidence to confirm associations between early childhood parent-child attachment and preadolescent or adolescent internalizing or externalizing symptoms.

Discussion: Insecure early childhood attachment generally and disorganized/controlling attachment specifically were consistently associated with increased internalizing and externalizing symptoms across the preschool and school-age periods. Findings also identified significant methodological shortcomings within the extant literature, highlighting the need for replication of findings using larger samples, more transparent methodologies, consideration of the father-child attachment relationship, as well as movement towards more sophisticated statistical methods such as individual participant data (IPD) meta-analysis or continuous (vs. categorical) operationalizations of attachment subtypes.

Authors

• Shaylea Badovinac, York University
  Presenting Author

• Rebecca Rita Pillai Riddell, York University
  Non-Presenting Author

• Audrey-Ann Deneault, University of Calgary (U of C)
  Non-Presenting Author

• Jodi Martin, York University
  Non-Presenting Author

• Jean-Francois Bureau, University of Ottawa
  Non-Presenting Author

• Monica O'Neill, York University
  Non-Presenting Author