What are the potential impacts of insecure (unhealthy) attachment?
One particular pattern of insecure attachment, insecure disorganised/disorientated attachment, is associated with aggression in childhood. Violent children are significantly more likely to become violent adults[i].
There is good evidence that difficulties in early parent-child relationships are associated with a range of mental health problems throughout the lifespan. The costs to both the community and the individual are substantial[ii]. Early intervention however appears to enhance the likelihood of successful outcomes[iii].
Difficulties in school
There is evidence that children who have not experienced early sensitive care struggle to achieve literacy in the early years. Children who have not learned to trust adults and peers are less likely to flourish in an educational environment. Children who have not had necessary motor or sensory experiences may not be school ready. Nurture groups are attempting to address this in the early primary years with some success. However, if this moment of opportunity is missed, learning can become increasingly more difficult. Opportunities to learn basic skills can become less available as children become more alienated from the educational process. For children with attachment problems, transitions can be difficult. The transition to secondary school, where children have to deal with many relationships with teachers, can be a particular problem[iv].
For over 6,000 children in the Republic of Ireland[v] and 2,890 children in Northern Ireland[vi] it has been necessary to care for them outside of the context of their biological families. Although there are multiple reasons why this may occur, including bereavement and disability, in the majority of the cases there has been a fundamental failure in the quality of the attachment relationships with primary caregivers. The impact of the early adverse experiences can be so profound that difficulties may persist after admission to care. Children in care are also more likely to have experienced trauma of a physical, sexual or emotional nature. Multiple moves within the care system are associated with persistent attachment and emotional difficulties[vii].
There is a substantial cohort of children who are not taken into the care of the state but are living in situations that are characterised by a lack of parental attunement to the degree that child protective services are involved in a supportive non-custodial role. Other children may reach adolescence, or leave care, without the nature of their attachment difficulties ever being understood. It is important that services are sufficiently resourced in terms of funding and training so as to address such problems as early as possible.
Impact on future parenting.
Psychological well-being in adolescence and adulthood is dependent on remaining connected to nurturing and supportive parents / caregivers. As young people move into a parenting role, their own experiences of being parented and cared for are re-evoked in order to create the template for patterns of caregiving with the next generation. As mentioned earlier, the work of George, Kaplan and Main published in 1985 on the adult attachment interview suggests that although experiences shape attachment, it is the manner in which the individual has processed and integrated his / her past that is most significant in shaping emotional security in adulthood[viii]. The support of trained professionals may be required in order to achieve resolution.
In terms of supportive public health policy, relationships between children and their caregivers need to be seen as the fundamental building blocks of a healthy society. It is important that problems are understood in the context of relational difficulties, rather than being ascribed to personal failures, pathology or chemical imbalances. There is a need to recognize relationships between people as the target for intervention and to develop services that are grounded in a recognition that most mental health problems are associated with and often resultant from significant interpersonal problems. Intervention into problematic relationships, as soon as difficulties are identified, is crucial in the prevention and amelioration of a whole range of social and health problems. This requires the identification and anticipation of the conditions within which relationship difficulties often emerge.
IAIA asserts as a policy position that attachment theory should provide one of the key theoretical foundations underpinning policy formation within relevant governmental departments. Services that are planned and developed so that they incorporate a theoretical framework that understands the causes and aetiology of mental health difficulties are more likely to be successful in preventing them. Attachment theory provides an understanding of mechanisms of both successful and problematic parenting, as well as the effects of early trauma. It can also inform policy planners in relation to mental and emotional health throughout the lifespan.
[i] Steele H, Steele M and Fonagy P (1996) Associations among attachment classifications of mothers, fathers, and their infants. Child Development. Vol 67 pp 541-555
[ii] WHO Health Statistics and Information Systems 2000 – 2012 DALY scale (disability adjusted life years) Available at: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index2.html
Accessed 24th October 2016
[iii] Injury Research: Theories, Methods, and Approaches (2012) edited by Guohua Li, Susan P. Baker New York: Springer.
[iv] Roy P & Rutter M (2006) Institutional care: Associations between inattention and early reading performance. Journal of Child Psychology & Psychiatry. Vol 47 pp 480-7.
[v] Department of Children and Youth Affairs, (2015). Available at: http://www.dcya.gov.ie/viewdoc.asp?fn=/documents/Children_In_Care/FosterCare.htm
Accessed 23rd October, 2016
[vi] Children’s Social Care Statistics for Northern Ireland 2015/16, Department of Health (NI) Available at:
Accessed 23rd October, 2016
[vii] Dozier, M. & Rutter, M. (2008) Challenges to the Development of Attachment Relationships Faced by Young Children in Foster and Adoptive Care.
[viii] Van Ijzendoorn M H, Schuengel C and Bakermans-Kranenburgh M J (1999) Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology Vol 11 pp 225-49.