Attachment and Psychopathology
MARK T. GREENBERG
This chapter reviews what is currently known about the relations between attachment and psychopathology in childhood. Given the existence of excellent recent reviews on this topic by others (Carlson & Sroufe, 1995; Cicchetti, Toth, & Lynch, 1995; Lyons-Ruth, Zeanah, & Benoit, 1996; Rutter, 1997), this review focuses on the more common externalizing and internalizing disorders of childhood and does not cover developmental disabilities. The chapter begins with general comments on the role of attachment in the development of psychopathology. It then addresses two fundamental questions. First, how has the study of attachment contributed to the understanding of childhood disorders? The answer includes a review of how attachment has been linked to childhood difficulties, a discussion of modes of transmission and differential pathways of influence, and the presentation of a heuristic model for understanding the role of attachment relations. The second question is this: How can the field of childhood psychopathology enrich the further study of attachment? The chapter closes with suggestions for future research.
The nature of the parent–child relationship during infancy and toddlerhood is believed to be one of the central causal factors in the child’s personality (Bowlby, 1969/1982; Bronfenbrenner, 1979; Erikson, 1963; Freud, 1965; Greenspan, 1981). Numerous empirical findings indicate that the development of a secure attachment with caregiver(s) in the first 2 years of life is related to higher sociability with other adults and children, higher compliance with parents, and more effective emotional regulation (Ainsworth, Blehar, Waters, & Wall, 1978; Bretherton, 1985; Richters & Waters, 1991). Moreover, insecure attachment prior to age 2 has been related to lower sociability, poorer peer relations, symptoms of anger, and poorer behavioral self-control during the preschool years and beyond (Carlson & Sroufe, 1995; see Thompson, Chapter 13, this volume).
The idea that social relationships both affect and are affected by developing psychopathology in childhood is fundamental to most modern theories of development. Furthermore, object relations theorists (Mahler, Pine, & Bergman, 1975; Winnicott, 1965) and ego psychologists (Freud, 1965) have hypothesized that a child’s earliest and closest relationships have the greatest impact on the development of mental health and illness. Yet it was not until John Bowlby (1969/1982, 1973) focused the fields of child development and child psychiatry on the study of infant and child attachment relationships that researchers truly began to study the associations between the child’s closest relationships and the development of various forms of behavioral disorder. In spite of Bowlby’s original focus, attachment research focused almost entirely during its early stages on infant development in normal