In recent years, correlations have been demonstrated between various forms of neglect in adolescence and later mental disorders. Long-term studies indicate a connection between insecure attachment in childhood and personality disorders in adolescents and adults. 

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This is stated in an article on the Norwegian Medical Association's website. 

The article in the Norwegian Medical Association tells in more detail about what the connection is:

The attachment system can be described as people's innate tendency to forge lasting emotional bonds with their closest caregivers. According to the creator of attachment theory, John Bowlby, we are born with a need to connect with someone bigger and / or stronger, in order to receive protection and care.


Early attachment leads to expectations about what is possible in interaction with others

It is emphasized that early attachment is important for what inner perceptions the person gets in relation to how my relationship is with other people, and that this is important for the extent to which one is able to have good relationships with other people or not.

According to attachment theory, the first year's experiences from interaction with those closest to them form both the basis for the development of internal work models and attachment strategies or attachment patterns. Internal working models are about expectations with regard to oneself, others and what is possible in interaction.


Attachment patterns

Various forms of attachment patterns have been uncovered, ie certain ways in which children relate to their caregiver (s), and which later become a way in which they also relate to other people.

Attachment patterns are about strategies for achieving the greatest possible security within the framework of the interaction. Four different patterns of attachment behavior are described: security, anxious avoidance, anxious ambivalence and disorganized attachment.

Most children (approx. 65%) develop a secure attachment to their caregivers, but at the same time a large proportion of children do not receive a secure attachment (approx. 35%).  


Secure attachment

Secure attachment seems to develop based on a sensitive, predictable and loving care for the child's need for protection and comfort from those closest to him.

People with a secure attachment show openness in relation to the meaning of emotions, and they are able to regulate and adapt their own emotions to the situation and to their own and others' needs. People with secure attachments also show greater sociability, better ability to cooperate, to tolerate stress and to recover after greater stress, compared to people with insecure forms of attachment.


Anxious avoidant attachment

Anxiously evasive attachment pattern means that emotions are covered, inhibited and withdrawn. This is believed to be related to rejection and emotional distance from the child's need for protection and comfort from those closest to him.

People with anxious evasive attachments show varying degrees of reservation, avoidance and rejection in relation to the expression and meaning of emotions. This becomes especially evident in close relationships and when the person is restless or scared.


Anxious ambivalent attachment

Anxiously ambivalent pattern revolves around an amplification / exaggeration of emotions, and an emotional and behavioral unpredictability. It is assumed that such aattachment is developed in the face of care that is inconsistent and that provides too little predictability in the way those closest to them react to the child's need for protection and comfort.

People with anxious ambivalent attachments often show a lot of anxiety and lack of emotional stability. They are unable to regulate and adapt their own emotions, have a tendency to emotional outbursts and to respond directly to impulses and have a low tolerance for stress and strain.


Disorganized attachment

Disorganized affiliation is the most worrying form of affiliation. This involves a high degree of emotional and behavioral chaos and confusion. It is assumed to develop in the face of long-term neglect, abuse and mistreatment of the child by those closest to them - and thus has a close connection with neglect. Instead of being a source of protection and comfort, many of these children experience that those closest to them pose the greatest danger and threat. They are thus in an extremely difficult situation, where they are both drawn towards proximity and driven towards fleeing from the most important people in their lives.

People with disorganized attachments may both have tendencies to withdraw and try to isolate themselves from others and / or go in and out of a number of conditions, e.g. characterized by aggression and violence.

Children with disorganized attachment have the greatest risk of developing serious mental disorders.


Neglect increases the risk of personality disorders

Personality disorders can be defined as lasting (personality) patterns that create problems to such an extent that it leads to significantly reduced social or occupational ability and / or subjective disorder. The diagnosis of personality disorder is usually made on the basis of the duration and strength of dysfunctional personality traits, and it is assumed that the disorder occurs and develops through childhood and adolescence.

The article describes a study that showed that there is a fourfold chance of getting a personality disorder if you are exposed to neglect.

Malnutrition gave the greatest risk. Emotional neglect increased the risk of symptoms of evasive, paranoid and a variant of antisocial personality disorder. Physical malpractice increased the symptoms of schizotypal and antisocial personality disorder, and malnutrition increased the risk of paranoid symptoms.

Mothers' emotional abuse of the child tripled the risk of developing symptoms of emotionally unstable and narcissistic personality disorder.

Reference is also made to another study that shows a close connection between childhood trauma, post-traumatic stress disorder and personality disorders.

Emotional abuse in childhood was associated with symptoms of all types of personality disorders, while sexual abuse was particularly associated with symptoms of the emotionally unstable form. The most common prior trauma with symptoms of personality disorders was forced unwanted sexual contact as well as physical abuse to injure or kill.


Insecure attachment increases the chance of later mental health problems

The article also presents other research findings, which show that:


  1. childhood abuse increased the risk of developing personality disorders; that adolescence stories with neglect were very high, especially in those with the emotionally unstable form of personality disorder
  2. there are strong links between behavioral problems at the age of 7-9 and later crime, substance abuse, mental disorders and deviant sexual behavior
  3. there are strong links between antisocial personality disorder, physical abuse and prolonged separations from loved ones in childhood; 
  4. antisocial and schizoid personality disorders were typical of sexual abusers
  5. people with personality disorders reported both that the fathers were less caring and that they allowed greater freedom than in the comparison group
  6. Insecure forms of attachment were pervasive for the whole group of abusers, and problematic attachment seems to play a role in the development of pedophile behavior.
  7. Aggression and antisocial behavior in childhood later predict antisocial behavior in a number of areas. This includes crime, partner abuse, traffic crimes, substance abuse and physical aggression.
  8. People with emotionally unstable personality disorder reported a high incidence of physical abuse and sexual abuse growing up. At the same time, these people had very low scores on reflection capacity, which is a measure of mentalization, ie the ability to understand mental states such as intentions and emotions in oneself and others.
  9. there is a definite development in men who end up abusing their partners: fear and anger - desperation, withdrawal and depression - distancing, indifference and violence. The perpetrators are described as emotionally immature, ie they have a delayed emotional development.
  10. rejection and punishment from fathers seemed to be particularly predictive of later partner violence and abuse.
  11. insecure attachment occurred especially in those who had experienced prolonged negative life circumstances, e.g. divorce, life-threatening illness, violence, substance abuse, financial stress and parental mental illness.

The author concludes that secure attachment should be considered a risk factor for a number of psychological problems and life challenges and secure attachment as a protective factor with a view to further psychosocial development.


The ability to open and clear communication is crucial

The article summarizes: 

Bowlby believed that the most important criterion for mental health is whether the individual's communication is open and whether it is clear and coherent or unclear and contradictory. In descriptions of the various personality disorders, we can e.g. see a general and growing tendency for unclear, contradictory, closed or lack of communication between the patient and the outside world.

It is emphasized how this can be related to attachment patterns, and the degree of trust one has in other people to offer me comfort and help when I am having difficulty.

A particular problem (in the case of insecure attachment) seems to lie in the tendency for self-fulfilling prophecies embedded in the inner working models. The pain and fear in children who experience neglect and do not receive help will most likely lead to generalized expectations of more pain and more fear.

At the same time, it is emphasized in the article that there is no simple connection between insecure attachment in childhood and later mental disorders. The affiliation system also seems, for better or worse, to be relatively open and flexible right up to adulthood. This means that you can have a secure attachment style in adulthood, even if you as a child were insecurely attached. Unfortunately, this also means that you can have an insecure attachment style in adulthood, even if you were safe as a child. This can, for example, happen in the case of abuse, trauma and painful fractures / losses in adulthood.


Relationship trauma must be prevented!

The article concludes with the following considerations:

An ever-increasing amount of empirical data is in the process of deepening and clarifying connections between attachment-related trauma in childhood and various mental disorders. The existing findings should already be strong wake-up calls regarding the importance of preventing and offering help to children and young people who experience care failure.

By focusing on support for vulnerable children and families, we can both help children who are suffering and most likely contribute to preventing serious psychosocial disorders, including personality disorders.

It emphasizes here the importance of openness about the care situation, the possibility of processing trauma and access to comfort and protection as absolutely crucial.