Research Article
The Relationship Between Adult Attachment Styles and Social Anxiety Disorder: The Role of Parental Bonding in Outpatient Adults
Abstract
Purpose: This study aimed to explore the connection between attachment styles and social anxiety disorder (SAD) in patients receiving psychiatric outpatient treatment.
Methods: The research included 85 participants, comprising 45 individuals diagnosed with SAD and 40 healthy controls. The participants completed assessments on social anxiety, parental bonding, and attachment styles.
Results: Participants with SAD showed significantly lower maternal care scores (16.31 ± 2.30) compared to the healthy control group (28.77 ± 6.77, p < .001) and notably lower paternal care scores (16.84 ± 3.14 vs. 25.28 ± 9.28, p < .001). They also exhibited higher avoidant (25.88 ± 7.39 vs. 22.47 ± 6.23, p = .034) and anxious attachment scores (23.65 ± 7.66 vs. 16.80 ± 6.98, p < .001). The Liebowitz Social Phobia Scale scores were positively correlated with avoidant (r = .433, p < .001) and anxious attachment (r = .458, p < .001), while negatively correlated with maternal (r = -.566, p<.001) and paternal care (r=-.384,p<.001).
Conclusion: The study demonstrates that insecure attachment styles and inadequate parental care are closely linked to elevated levels of social anxiety. These results underscore the need for considering attachment-based interventions when treating social anxiety disorder.
References
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- 26. Parker G, Tupling H, Brown LB. A parental bonding instrument. British Journal of Medical Psychology. 1979;52(1):1-10. DOI:10.1111/j.2044-8341.1979.tb02487.x
- 27. Warren SL, Huston L, Egeland B, Sroufe LA. Child and adolescent anxiety disorders and early attachment. Journal of the American Academy of Child & Adolescent Psychiatry. 1997;36(5):637-44. DOI:10.1097/00004583-199705000-00014
- 28. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change (2nd ed.). The Guilford Press; 2019.
- 29. Rapee RM. Potential role of childrearing practices in the development of anxiety and depression. Clinical Psychology Review. 1997;17(1):47-67. DOI:10.1016/S0272-7358(96)00040-2
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Year 2025,
, 246 - 254, 10.04.2025
Abstract
References
- 1. Memik ÇN, Yıldız Ö, Tural U, Ağaoğlu B. Sosyal fobinin yaygınlığı: Bir gözden geçirme. Nöropsikiyatri Arşivi. 2011;48:4-10.
- 2. Bowlby J. A secure base: Parent-child attachment and healthy human development. New York: Basic Books; 1988.
- 3. Hazan C, Shaver P. Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology. 1987;52(3):511-24. DOI:10.1037/0022-3514.52.3.511
- 4. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. Guilford Press; 2007.
- 5. Bifulco A, Kwon J, Jacobs C, Moran PM, Bunn A, Beer N. Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety. Social Psychiatry and Psychiatric Epidemiology. 2006;41:796-805. DOI:10.1007/s00127-006-0101-z
- 6. Parker G, Tupling H, Brown LB. A parental bonding instrument. British Journal of Medical Psychology. 1979;52(1):1-10. DOI:10.1111/j.2044-8341.1979.tb02487.x
- 7. Bögels SM, Brechman-Toussaint ML. Family issues in child anxiety: Attachment, family functioning, parental rearing and beliefs. Clinical Psychology Review. 2006;26(7):834-56. DOI:10.1016/j.cpr.2005.08.001
- 8. Bowlby J. Attachment and loss: Volume III: Loss, sadness and depression. Basic Books; 1980.
- 9. Muris P, Meesters C, van Melick M. The self-report version of the Strengths and Difficulties Questionnaire: Its psychometric properties in 8- to 13-year-old non-clinical children. British Journal of Clinical Psychology. 2003;42(4):431-7. DOI:10.1348/014466503322528734
- 10. Öztürk Y, Özyurt G, Turan S, et al. Relationships between Theory of Mind (ToM) and attachment properties in adolescent with social anxiety disorder. Nöro Psikiyatri Arşivi. 2020;57:65-70.
- 11. Read DL, Clark GI, Rock AJ, Sheffield J. Adult attachment and social anxiety: The mediating role of emotion regulation strategies. PLOS ONE. 2018;13.
- 12. Nielsen SK, de Graaf A, Lichtenstein MB, Kessing LV. Adult attachment style and anxiety: The mediating role of emotion regulation. Journal of Anxiety Disorders. 2017;50:55-62.
- 13. Fattouh N, Haddad C, Salameh P, Sacre H, Hallit R, Soufia M, Hallit S, Obeid S. A national study of the association of attachment styles with depression, social anxiety, and suicidal ideation among Lebanese adolescents. Frontiers in Psychology. 2022;13:251.
- 14. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing; 2013.
- 15. Liebowitz MR. Social phobia. Modern Problems of Pharmacopsychiatry. 1987;22:141-73. DOI:10.1159/000414022
- 16. Soykan C, Özgüven HD, Gençöz T. Liebowitz sosyal kaygı ölçeği'nin Türkçe çevirisinin geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi. 2003;14:29-37.
- 17. Hazan C, Shaver P. Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology. 1987;52(3):511-24. DOI:10.1037/0022-3514.52.3.511
- 18. Mikulincer M, Florian V, Tolmacz R. Attachment styles and fear of personal death: A case study of affect regulation. Journal of Personality and Social Psychology. 1990;58(2):273-80. DOI:10.1037/
- 19. Sabuncuoğlu O, Berkem M. Türk erişkin bağlanma stilleri envanteri: Uyarlama çalışması. Türk Psikiyatri Dergisi. 2006;17:286-95.
- 20. Kesebir S, Kökçü F, Dereboy F. Erişkin Bağlanma Biçimi Ölçeği: Geçerlilik ve güvenilirlik çalışması. Yeni Symposium. 2012;50(2):96-103.
- 21. Bowlby J. A secure base: Parent-child attachment and healthy human development. Basic Books; 1988.
- 22. Kapçı EG, Küçüker S. Ana Babaya Bağlanma Ölçeği: Türk üniversite öğrencilerinde psikometrik özelliklerinin değerlendirilmesi. Türk Psikiyatri Dergisi. 2006;17(4):286-95.
- 23. Rapee RM, Schniering CA, Hudson JL. Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology. 2013;9:205-235. DOI:10.1146/annurev-clinpsy-050212-185637
- 24. McLeod BD, Wood JJ, Weisz JR. Examining the association between parenting and childhood anxiety: A meta-analysis. Clinical Psychology Review. 2007;27(2):155-72. DOI:10.1016/j.cpr.2006.09.002
- 25. Lieb R, Wittchen HU, Höfler M, Fuetsch M, Stein MB, Merikangas KR. Parental psychopathology, parenting styles, and the risk of social phobia in offspring: A prospective-longitudinal community study. Archives of General Psychiatry. 2000;57(9):859-66. DOI:10.1001/archpsyc.57.9.859
- 26. Parker G, Tupling H, Brown LB. A parental bonding instrument. British Journal of Medical Psychology. 1979;52(1):1-10. DOI:10.1111/j.2044-8341.1979.tb02487.x
- 27. Warren SL, Huston L, Egeland B, Sroufe LA. Child and adolescent anxiety disorders and early attachment. Journal of the American Academy of Child & Adolescent Psychiatry. 1997;36(5):637-44. DOI:10.1097/00004583-199705000-00014
- 28. Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change (2nd ed.). The Guilford Press; 2019.
- 29. Rapee RM. Potential role of childrearing practices in the development of anxiety and depression. Clinical Psychology Review. 1997;17(1):47-67. DOI:10.1016/S0272-7358(96)00040-2
- 30. Cassidy J, Shaver PR. Handbook of attachment: Theory, research, and clinical applications (3rd ed.). The Guilford Press; 2016.
There are 30 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Psychiatry |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | March 24, 2025 |
| Publication Date | April 10, 2025 |
| Submission Date | August 11, 2024 |
| Acceptance Date | October 19, 2024 |
| Published in Issue | Year 2025 |