The relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical adolescents

Abstract

Título: Relación entre los estilos de apego y los síntomas externalizantes e internalizantes en adolescentes clínicos y no clínicos. Resumen: Los estudios sobre la relación entre apego y psicopatología durante la adolescencia, se han realizado separadamente en muestras clínicas y no clínicas de adolescentes y han utilizado instrumentos de evaluación diferentes, lo que en conjunto ha podido dar lugar a un sesgo metodológico que ha incrementado la asociación entre apego y psicopatología. Con objeto de evitar este sesgo, en el presente estudio se utilizaron las mismas medidas para explorar la relación entre estilos de apego y síntomas internalizantes y externalizantes en grupos clínicos y no clínicos de adolescentes. La muestra estuvo formada por 248 adolescentes, entre 14 y 18 años de edad. Los adolescentes de cada grupo se emparejaron en edad, sexo y nivel socioeconó-mico. El apego se valoró con el cuestionario CaMir y los síntomas psicopatológicos con el Youth Self Report. Las relaciones entre apego y psicopatología fueron similares en adolescentes clínicos y no clínicos. El estilo de apego preocupado predijo síntomas internalizantes y externalizantes, quejas somáticas, conducta fóbico-ansiosa, agresividad verbal, conducta de bús-queda de atención y problemas de pensamiento. En comparación con estudios previos, esta investigación ha permitido identificar asociaciones más amplias, más fuertes y más específicas entre el estilo de apego preocupado y los síntomas psicopatológicos en adolescentes. Palabras clave: Estilo de apego; adolescencia; síntomas internalizantes; síntomas externalizantes.Abstract: Studies regarding the relationship between attachment and psychopathology during adolescence have been performed separately for clinical and nonclinical adolescents and have used different assessment measures, which together might produce a methodological bias that increases the association between attachment and psychopathology. With the aim of avoiding this bias, the present study used identical measures to explore the relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical samples of adolescents. The sample consisted of 258 adolescents, 129 clinical and 129 nonclinical, aged between 14 and 18 years. The adolescents in each sample were matched for age, gender, and socioeconomic status. Attachment was assessed using the CaMir Q-sort, and psychopathological symptoms were assessed by means of the Youth Self Report (YSR). The relationships between attachment and psychopathology were similar for clinical and nonclinical adolescents. A preoccupied attachment style predicted internalizing and externalizing symptoms, somatic complaints, anxious-fearful behavior, verbal aggression, attention-seeking behavior, and thinking problems. Compared to previous studies, this research has made it possible to identify broader, stronger, and more specific associations between preoccupied attachment style and psychopathological symptoms in adolescents.

The relationship between attachment styles and internalizing/externalizing problems: The mediating role of self-criticism

“…This would be consistent with Muris et al's (2003) suggestion that avoidantly attached youth may be disposed to ex -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 ternalizing problems because they adopt strategies to minimize their distress such as being hostile and defensive towards others in order to avoid close attachment relationships. These results are also consistent with prior research that has found significant associations of avoidant attachment with externalizing behaviors (Ramos et al, 2016;Nishikawa et al, 2010), although other studies have not found such an association (Brumariu & Kerns, 2010;Lacasa et al, 2015). Thus, further research is likely needed into the associations between attachment avoidance and externalizing symptoms.…”

“…Furthermore, gender might also be a factor in the development of attachment styles and psychopathology. For example, in both clinical and non-clinical samples, female gender has been associated with an anxious attachment style, and male gender has been associated with an avoidant attachment style during adolescence (see Lacasa, Mitjavila, Ochoa, & Balluerka, 2015). Moreover, in the large majority of studies (e.g.…”

“…The empirical evidence on the relationship between attachment styles and internalizing versus externalizing problems therefore remains unclear. For example, while some studies found that anxious and avoidant attachment predicted internalizing problems in adolescents, with a weak or non-significant relationship between avoidant attachment and externalizing problems (Brumariu & Kerns, 2010;Lacasa et al, 2015), other studies found significant associations between an avoidant attachment style and externalizing problems (Ramos, Canta, de Castro, & Leal, 2016;Nishikawa et al, 2010). Muris et al (2003) provide further conflicting evidence in that they found that insecurely attached girls displayed higher levels of internalizing symptoms than insecurely attached boys.…”

Delivering evidence based services for all vulnerable families

“…Another challenge is that, despite the potential for family services to address disparities in outcomes for vulnerable families, they remain underutilised in practice because they fail to address not only the economic but also the cultural obstacles to families' access and use of services (Kumpfer, Magalhães and Xie, 2017 [95]). The challenge is then to identify good practices and effective initiatives for the "hard-to-reach" families.…”

The Factor Structure of the CA-MIR as Evaluated Using Confirmatory Factor Analysis

“… 1 In terms of convergent validity, Roskam et al ( 2011 ) found a relationship between secure attachment as evaluated using the CA-MIR in both mothers and fathers and secure attachment in children referred for externalizing behavior problems at 4 years, as assessed using the French version of Attachment Q-Sort (Pierrehumbert et al, 1995a , b ). The instrument also showed discriminant validity with respect to measures of a range of psychopathological constructs in studies with clinical samples: psychotic patients (Benony et al, 2001 ), adolescents with eating disorders and substance abuse (Pierrehumbert et al, 2002 ; Miljkovitch et al, 2005 ), and groups with a range of different disorders (Lacasa et al, 2015 ). …”