The Role of Attachment Style in Predicting Repetition of Adolescent Self-Harm: A Longitudinal Study

This study investigated whether insecure attachment is associated with poorer outcomes at 6-month follow-up in adolescents who self-harm. At baseline the Child Attachment Interview was administered to 52 adolescents (13-17 years) referred to specialist child and adolescent mental health services and with a recent history of self-harm. Participants also completed self-report measures of self-harm, peer attachment, anxiety, and depression and were administered the means end problem-solving task. Self-harm behavior and problem-solving skills were assessed again at 6-month follow-up. At baseline, 14 (27%) were securely attached to their mothers. In the 49 (94%) adolescents followed-up, those with insecure maternal attachment and insecure peer attachment were more likely to have repeated self-harm. In addition, securely attached adolescents showed greater improvement in problem-solving skills. These findings indicate that secure maternal and peer attachments may help recovery from self-harm, possibly by supporting the acquisition of problem-solving skills, and highlights the importance of social connections and attachments for youth with a history of self-harm.