Attachment and parenting in adult patients with anxiety disorders

Angelo Picardi, Emanuele Caroppo, Elisa Fabi, Serena Proietti, Giancarlo Di Gennaro, Giulio Nicolò Meldolesi, Giovanni Martinotti

Research output: Contribution to journalArticlepeer-review


Background: The literature suggests that dysfunctional parenting and insecure attachment may increase risk of anxiety-related psychopathology. This study aimed at testing the association between anxiety disorders, attachment insecurity and dysfunctional parenting while controlling for factors usually not controlled for in previous studies, such as gender, age, and being ill. Methods: A sample of 32 non-psychotic inpatients with SCID-I diagnosis of an anxiety disorder, either alone or in comorbidity, was compared with two age- and sex-matched control groups consisting of 32 non-clinical participants and 32 inpatients with drug-resistant epilepsy. Study measures included the Experience in Close Relationships questionnaire (ECR) and the Parental Bonding Instrument (PBI). Results: The patients with anxiety disorders scored significantly higher on attachment-related anxiety and avoidance than patients with drug-resistant epilepsy and non-clinical participants. These findings were independent of comorbidity for mood disorders. ECR scores did not differ among diagnostic subgroups (generalized anxiety disorder, panic disorder, other anxiety disorders). Patients with anxiety disorders scored significantly lower on PBI mother's care and borderline significantly lower on PBI fathers care than patients with drug-resistant epilepsy. Conclusions: Although limitations such as the relatively small sample size and the cross-sectional nature suggest caution in interpreting these findings, they are consistent with the few previous adult studies performed on this topic and corroborate Bowlbys seminal hypothesis of a link between negative attachment-related experiences, attachment insecurity, and clinical anxiety. Attachment theory provides a useful theoretical framework for integrating research findings from several fields concerning the development of anxiety disorders and for planning therapeutic interventions.

Original languageEnglish
Pages (from-to)157-163
Number of pages7
JournalClinical Practice and Epidemiology in Mental Health
Publication statusPublished - Nov 2013


  • Anxiety
  • Attachment
  • Emotion regulation
  • Epilepsy
  • Parenting
  • Stress

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Epidemiology


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