The association between attachment insecurity and negative symptoms in clinical and non-clinical populations: A systematic review and meta-analysis.
Aiden Duffy, David Carmichael, Zsofia K Takacs et al.
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In 30 seconds
This systematic review and meta-analysis examined associations between attachment insecurity and negative symptoms of psychosis, including symptom domains, in clinical and non-clinical populations. Twenty-two studies included 6,507 participants; 14 studies involved clinical samples and nine involved non-clinical samples. Attachment anxiety showed a small, significant average association with negative symptoms in both populations. Attachment avoidance was also associated with negative symptoms, with a small association in clinical samples and a moderate-sized association in non-clinical samples. Associations varied across negative symptom domains.
Key findings
- Across clinical and non-clinical samples, attachment anxiety had a small, significant average association with negative symptoms.
- Attachment avoidance had a small, significant association with negative symptoms in clinical samples and a moderate-sized, significant association in non-clinical samples.
- The strength of associations differed between attachment dimensions and individual negative symptom domains.
- Five of the 22 included studies achieved a low risk-of-bias score.
Why it matters
The findings suggest that attachment insecurity is related to negative symptoms, but the pattern differs by attachment dimension, population and symptom domain. This may help frame research into factors associated with negative symptoms while underscoring the need to distinguish individual symptoms and use measures aligned with the NIMH consensus definition.
What to keep in mind
Only five included studies achieved a low risk-of-bias score, and the review reports associations rather than evidence that attachment insecurity causes negative symptoms.