Insecure attachment to primary caregivers is associated with the development of depression symptoms in children and youth. This association has been shown by individual studies testing the relation between attachment and depression and by meta-analyses focusing on broad internalizing problems instead of depression or adult samples only. We therefore meta-analytically examined the associations between attachment security and depression in children and adolescents, using a multilevel approach. In total, 643 effect sizes were extracted from 123 independent samples. A significant moderate overall effect size was found (r = .31), indicating that insecure attachment to primary caregivers is associated with depression. Multivariate analysis of the significant moderators that impacted on the strength of the association between attachment security and depression showed that country of the study, study design, gender, the type of attachment, and the type of instrument to assess attachment uniquely contributed to the explanation of variance. This study suggests that insecure attachment may be a predictor of the development of depression in children and adolescents. When treating depression in children, attachment should therefore be addressed.

中文翻译：

---

儿童和青少年依恋与抑郁之间的关系：多层次荟萃分析。

对主要照顾者的不安全依恋与儿童和青少年抑郁症状的发展有关。这种关联已通过测试依恋与抑郁之间关系的个人研究以及侧重于广泛的内在化问题的荟萃分析显示出来，而不仅仅是抑郁症或成人样本。因此，我们采用多层次方法对儿童和青少年的依恋安全性与抑郁症之间的关联进行了荟萃分析。总共从123个独立样本中提取了643个效果大小。发现显着的总体效果中等大小（r = 0.31），表明与主要看护人的不安全依恋与抑郁症有关。对影响依恋安全与抑郁之间关联强度的重要主持人进行多变量分析，结果表明，所研究的国家/地区，研究设计，性别，依恋类型以及评估依恋的工具类型独特地解释了方差。这项研究表明，不安全的依恋可能是儿童和青少年抑郁症发展的预测指标。因此，在治疗儿童抑郁症时，应注意依恋。