ABSTRACT

Researchers have long discussed the rich clinical applications of attachment theory. Specifically, clinicians have been compelled by the idea that insecure attachment, broadly speaking, may bring about stressful (real or perceived) interpersonal experiences that increases risk for internalizing symptoms. However, recent meta-analyses examining the links between attachment representations and internalizing symptoms have challenged this assumption, highlighting the importance of considering insecure attachment subtypes in understanding one’s vulnerability for internalizing symptoms. Here we expand on this special issue’s target papers and propose that, despite an increase in citation impact of clinically relevant attachment research, there are still core theoretical and methodological questions left unanswered. We highlight three clinical conundrums: (1) hyperactivating, but not deactivating, attachment is linked to increased internalizing symptoms in adolescence and adulthood; (2) the magnitude of the associations between insecure attachment subtypes and internalizing symptoms varies depending on the developmental period; and (3) self-reported, but not narrative-based, deactivating attachment is associated with increased internalizing symptoms. We call for engagement with adjunct academic disciplines to elucidate these issues. These clinical conundrums have important ethical implications regarding how we understand insecure attachment and necessitate close theoretical and empirical attention before attachment findings can truly inform clinical practice.

摘要

长期以来，研究人员一直在讨论依恋理论丰富的临床应用。具体而言，临床医生一直认为不安全的依恋，从广义上讲，可能会带来压力（真实的或感知的）人际关系体验，从而增加内化症状的风险。然而，最近研究依恋表征和内化症状之间联系的元分析对这一假设提出了挑战，强调了考虑不安全依恋亚型的重要性了解一个人对内化症状的脆弱性。在这里，我们扩展了本期特刊的目标论文，并提出，尽管临床相关依恋研究的引用影响有所增加，但仍有一些核心理论和方法论问题没有得到解答。我们强调了三个临床难题：(1) 过度激活而非失活的依恋与青春期和成年期内化症状的增加有关；(2) 不安全依恋亚型与内化症状之间的关联程度因发育时期而异；(3) 自我报告的，但不是基于叙述的，停用依恋与内化症状的增加有关。我们呼吁与附属学科合作来阐明这些问题。