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David Sloma. Flying Dutchman of the Spacelanes. Children of Jad Omnibus. The Art of Negotiation. IPT focusses on current interpersonal relationships, and intervenes in the social dysfunction associated with depression. All in all, there is growing evidence that interventions for depression should be informed by attachment theory.

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The current study also offers implications for future studies. We found a significant correlation between attachment and depression in longitudinal studies, and thus, that attachment insecurity is a risk factor for depression. However, we did not test whether attachment insecurity is also a causal risk factor Kraemer et al. Although several attachment-based interventions have shown to be effective in reducing internalizing problems e.

Therefore, future studies should examine whether treating attachment insecurity can prevent depression later on in life. Second, some hypotheses on the relation between attachment security and depression could not be tested. For example, an in-depth exploration of cultural differences that may moderate the association between attachment and depression was not conducted, due to the limited number of non-Western studies.

In line with Mesman et al. Further, the current study gave some indication that disorganized attachment has the strongest association with depression. However, this needs to be further explored. Finally, it is recommended to assess potential interactions between moderators in future meta-analyses. For example, some studies showed that the unique influence of mothers and fathers on depression could be different for boys and girls Liu ; De Minzi Assessing interactions between moderators on a meta-analytic level could lead to further understanding of the association between attachment and depression in youth.

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Attachment insecurity and depressive symptoms in youth are associated in both longitudinal and cross-sectional studies, and therefore we argue that attachment problems and depressive symptoms co-occur and that attachment insecurity is a risk factor for depression. The association between attachment security and depression in youth can be explained at different levels, including genetic factors through shared genetic vulnerability for attachment problems and depression , cognitive factors in which the internal working model of the child is the base of dysfunctional cognitions , socio-emotional factors including emotion regulation and social skills , and factors at the level of culture and society for example, though a shared socio-ecological risk environment.

In addition, the current meta-analytic study provided insights into the moderators of the association between attachment and depression. Larger effect sizes were found in cross-sectional and non-Western studies, in female samples, in questionnaires, and in broad insecure attachment measures. Clinical practice should incorporate attachment theory to increase the effectiveness of depression interventions. It is recommended to further explore the relation between attachment security and depression in future studies, for example, by conducting studies in non-Western countries, applying longitudinal mediation models, and by testing interactions between potential moderators.

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This article does not contain any studies with human participants or animals performed by any of the authors. Skip to main content Skip to sections.

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Advertisement Hide. Download PDF. Open Access. First Online: 07 August Introduction From early infancy on, children seek the proximity of a sensitive and responsive caregiver for protection and security Bowlby , The Relation Between Attachment and Depression Secure attachment is a protective mechanism that prevents the development of psychopathology, while insecure attachment is correlated with child psychopathology, in particular, internalizing problems, including depression Colonnesi et al. The Current Study We sought to investigate the association between attachment and depression in youth and to examine which moderators influence the relation between attachment and depression.

Inclusion Criteria All studies available from until June addressing the relation between attachment and depression from infancy to adolescence were included in the current meta-analysis. Selection of Studies and Limiting Publication Bias According to the recommendations by Lipsey and Wilson , the following search strategy was conducted to find qualified studies.

Coding the Studies The first author and a research assistant coded the included studies according to the suggestions of Lipsey and Wilson Calculations and Analyses Effect sizes were reflected in correlation coefficients. The meta-analysis included studies, with independent samples s , effect sizes k , and a total of 54, participants.

The overall association between attachment and depression can be found in this table, as well as the results of the moderator analyses. We examined the unique contribution of the significant moderators to the variance in effect sizes by applying a multivariate model.

We included all moderators that were significant in the bivariate models, except for the variables time between the attachment and depression and the categorical age variable, because of overlap with the other constructs. Overall Association Between Attachment and Depression The current multilevel meta-analysis aimed to test the association between attachment security and depression in youth using a multilevel approach, and to examine potential moderators of this association.

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Moderators of the Attachment—Depression Association In the current meta-analysis, we found significant variance both at the between and at the within-study level, indicating that the effect size distribution was heterogeneous, and that moderating variables may explain differences in the strength of the overall effect size. Limitations There are several limitations that need to be mentioned. Implications for Research and Clinical Practice The current meta-analytic review offers several implications for clinical practice. Compliance with Ethical Standards Conflict of interest The authors declare that they have no conflict of interest.

Ainsworth, M. Patterns of attachment. Hillsdale, NJ: Erlbaum. Google Scholar. Allen, B. Parent-child interaction therapy as an attachment-based intervention: Theoretical rationale and pilot data with adopted children.

Children and Youth Services Review, 47, — CrossRef Google Scholar. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed.

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Armsden, G. The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16, — Assink, M. Risk factors for persistent delinquent behavior among juveniles: A meta-analytic review. Clinical Psychology Review, 42, 47— Fitting three-level meta-analytic models in R: A step-by-step tutorial. The Quantitative Methods for Psychology, 12, — Banasr, M. Characterization of GABAergic marker expression in the chronic unpredictable stress model of depression. Chronic Stress, 1, Baumeister, R. Bad is stronger than good.

Review of General Psychology, 5, Beck, A. Depression: Clinical, experimental and theoretical aspects. New York: Hoeber. Black, S. American Economic Review, 95, — Bosmans, G. A cognitive perspective on attachment: The functioning of the internal working model and connections with the cognitive schema theory. Doctoral Dissertation. Ghent: Ghent University.