Keywords
broader autism phenotype
attachment styles
social functioning
communication
How to Cite
Abstract
Autistic traits such as social skill and communication difficulties are linked to increased risk of depression and anxiety. Attachment theory offers a useful framework for understanding these associations, as insecure attachment styles are known to affect emotion regulation and mental health. This study examined whether adult attachment styles (secure, avoidant, anxious-ambivalent) mediate the relationship between autistic traits and psychological distress. A sample of 130 adults completed measures of autistic traits, attachment, and psychological functioning. Mediation analyses revealed that social difficulties – but not communication deficits – consistently mediated the link between attachment styles and psychological symptoms. Secure attachment was protective, while avoidant and especially anxious-ambivalent styles predicted greater distress. These findings highlight the importance of addressing attachment-related processes and social functioning in interventions for individuals with elevated autistic traits.
References
Adar, T., Davidof, M., & Elkana, O. (2022). Social Support Mediates the Association between Attachment Style and Psychological Distress during COVID-19 in Israel. Viruses, 14. https://doi.org/10.3390/v14040693
Ainsworth, M.D.S. (1982). Attachment: Retrospect and Prospect. (In:) C.M. Parkes, & J. Stevenson-Hinde (eds.), The Place of Attachment in Human Behavior, 3-30. New York: Basic Books.
Anders, S., & Tucker, J. (2000). Adult attachment style, interpersonal communication competence, and social support. Personal Relationships, 7, 379-389. https://doi.org/10.1111/J.1475-6811.2000.TB00023.X
Başal, F., Onur, S., Yamaç, D., Karaçin, C., Zengin, G., Bilgetekin, I., Demirci, U., & Oksuzoglu, B. (2020). Does a Secure Attachment Style Predict High Psychological Resilience in Patients With Cancer Receiving Chemotherapy? Cureus, 12. https://doi.org/10.7759/cureus.10954
Beffel, J., Cary, K., Nuttall, A., Chopik, W., & Maas, M. (2021). Associations between the broad autism phenotype, adult attachment, and relationship satisfaction among emerging adults. Personality and Individual Differences, 168, 110409. https://doi.org/10.1016/J.PAID.2020.110409
Birnbaum, G., Orr, I., Mikulincer, M., & Florian, V. (1997). When Marriage Breaks Up-Does Attachment Style Contribute to Coping and Mental Health?. Journal of Social and Personal Relationships, 14, 643-654. https://doi.org/10.1177/0265407597145004
Bosmans, G., Bakermans-Kranenburg, M., Vervliet, B., Verhees, M., & Van IJzendoorn, M. (2020). A learning theory of attachment: Unraveling the black box of attachment development. Neuroscience & Biobehavioral Reviews, 113, 287-298. https://doi.org/10.1016/j.neubiorev.2020.03.014
Cooley, E., Buren, A., & Cole, S. (2010). Attachment Styles, Social Skills, and Depression in College Women. Journal of College Counseling, 13, 50-62. https://doi.org/10.1002/J.2161-1882.2010.TB00047.X
Couteur, A., Bailey, A., Goode, S., Pickles, A., Gottesman, I., Robertson, S., & Rutter, M. (1996). A broader phenotype of autism: the clinical spectrum in twins. Journal of Child Psychology and Psychiatry, 37(7), 785-801. https://doi.org/10.1111/J.1469-7610.1996.TB01475.X
Dagan, O., Facompré, C., & Bernard, K. (2018). Adult attachment representations and depressive symptoms: A meta-analysis. Journal of Affective Disorders, 236, 274-290. https://doi.org/10.1016/j.jad.2018.04.091
Dark-Freudeman, A., Pond, R., Paschall, R., & Greskovich, L. (2020). Attachment style in adulthood: Attachment style moderates the impact of social support on depressive symptoms. Journal of Social and Personal Relationships, 37, 2871-2889. https://doi.org/10.1177/0265407520941091
Dawson, G., Webb, S., Schellenberg, G., Dager, S., Friedman, S., Aylward, E., & Richards, T. (2002). Defining the broader phenotype of autism: Genetic, brain, and behavioral perspectives. Development and Psychopathology, 14, 581-611. https://doi.org/10.1017/S0954579402003103
Dykas, M., & Cassidy, J. (2011). Attachment and the processing of social information across the life span: theory and evidence. Psychological Bulletin, 137 (1), 19-46. https://doi.org/10.1037/a0021367
El-Bouhali-Abdellaoui, F., Voltas, N., Morales-Hidalgo, P., & Canals, J. (2025). Examining the Relationship Between Parental Broader Autism Phenotype Traits, Offspring Autism, and Parental Mental Health. Autism research, 18(2), 387-401. https://doi.org/10.1002/aur.3295
Ginalska, K., & Cichopek, A. (2024). Exploring links between attachment and mental health. Quarterly Journal Fides et Ratio, 59(3):73-83. https://doi.org/10.34766/fer.v59i3.1299
Havdahl, A., Niarchou, M., Starnawska, A., Uddin, M., Van Der Merwe, C., & Warrier, V. (2021). Genetic contributions to autism spectrum disorder. Psychological Medicine, 51, 2260-2273. https://doi.org/10.1017/S0033291721000192
Hirota, T., & King, B. (2023). Autism Spectrum Disorder: A Review. JAMA, 329(2), 157-168. https://doi.org/10.1001/jama.2022.23661
Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9, S55-S65. https://doi.org/10.21037/tp.2019.09.09
Hyman, S., Levy, S., & Myers, S. (2019). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145. https://doi.org/10.1542/peds.2019-3447
Ingersoll, B., & Wainer, A. (2014). The broader autism phenotype. (In:) F.R. Volkmar, S.J. Rogers, R. Paul, & K.A. Pelphrey (eds.). Handbook of autism and pervasive developmental disorders: Diagnosis, development, and brain mechanisms (4th ed.), 28-56. John Wiley & Sons, Inc.. https://doi.org/10.1002/9781118911389.hautc02
Jennissen, S., Volz, M., Schauenburg, H., & Dinger, U. (2024). State and trait characteristics of attachment as predictors of outcome in inpatient psychotherapy. Psychotherapy, 61(3), 212 – 221. https://doi.org/10.1037/pst0000529
Karreman, A., & Vingerhoets, A. (2012). Attachment and well-being: The mediating role of emotion regulation and resilience. Personality and Individual Differences, 53, 821-826. https://doi.org/10.1016/J.PAID.2012.06.014
Keller, H. (2013). Attachment and Culture. Journal of Cross-Cultural Psychology, 44, 175-194. https://doi.org/10.1177/0022022112472253
Kulasinghe, K., Whittingham, K., & Mitchell, A. (2021). Mental health, broad autism phenotype and psychological inflexibility in mothers of young children with autism spectrum disorder in Australia: A cross-sectional survey. Autism, 25, 1187-1202. https://doi.org/10.1177/1362361320984625
Lamport, D., & Turner, L. (2014). Romantic attachment, empathy, and the broader autism phenotype among college students. The Journal of Genetic Psychology, 175, 202-213. https://doi.org/10.1080/00221325.2013.856838
Landry, O., & Chouinard, P. (2016). Why We Should Study the Broader Autism Phenotype in Typically Developing Populations. Journal of Cognition and Development, 17, 584-595. https://doi.org/10.1080/15248372.2016.1200046
Levy, K., Johnson, B., Clouthier, T., Scala, J., & Temes, C. (2015). An Attachment Theoretical Framework for Personality Disorders. Canadian Psychology, 56, 197-207. https://doi.org/10.1037/CAP0000025
Lord, C., Brugha, T., Charman, T., Cusack, J., Dumas, G., Frazier, T., Jones, E., Jones, R., Pickles, A., State, M., Taylor, J., & Veenstra-VanderWeele, J. (2020). Autism Spectrum Disorder. Nature Reviews Disease Primers, 6, 1-23. https://doi.org/10.1038/s41572-019-0138-4
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-VanderWeele, J. (2018). Autism spectrum disorder. The Lancet, 392, 508-520. https://doi.org/10.1016/S0140-6736(18)31129-2
Malik, S., Wells, A., & Wittkowski, A. (2015). Emotion regulation as a mediator in the relationship between attachment and depressive symptomatology: A systematic review. Journal of Affective Disorders, 172, 428-44. https://doi.org/10.1016/j.jad.2014.10.007
Mallinckrodt, B., & Wei, M. (2005). Attachment, Social Competencies, Social Support, and Psychological Distress. Journal of Counseling Psychology, 52, 358-367. https://doi.org/10.1037/0022-0167.52.3.358
Manes, S., Nodop, S., Altmann, U., Gawlytta, R., Dinger, U., Dymel, W., Ehrenthal, J., Joraschky, P., Nolting, B., Petrowski, K., Ritter, V., Schauenburg, H., Stangier, U., Willutzki, U., & Strauss, B. (2016). Social anxiety as a potential mediator of the association between attachment and depression.. Journal of Affective Disorders, 205, 264-268. https://doi.org/10.1016/j.jad.2016.06.060
Manning, R., Dickson, J., Palmier-Claus, J., Cunliffe, A., & Taylor, P. (2017). A systematic review of adult attachment and social anxiety. Journal of Affective Disorders, 211, 44-59. https://doi.org/10.1016/j.jad.2016.12.020
Mikulincer, M. (1995). Attachment style and the mental representation of the self. Journal of Personality and Social Psychology, 69, 1203-1215. https://doi.org/10.1037/0022-3514.69.6.1203
Mikulincer, M. (1998). Adult attachment style and affect regulation: strategic variations in self-appraisals. Journal of Personality And Social Psychology, 75(2), 420-35. https://doi.org/10.1037/0022-3514.75.2.420
Mikulincer, M., & Orbach, I. (1995). Attachment styles and repressive defensiveness: the accessibility and architecture of affective memories. Journal of Personality and Social Psychology, 68(5), 917-925 https://doi.org/10.1037/0022-3514.68.5.917
Parada-Fernández, P., Herrero-Fernández, D., Oliva-Macías, M., & Rohwer, H. (2021). Analysis of the mediating effect of mentalization on the relationship between attachment styles and emotion dysregulation. Scandinavian Journal of Psychology, 62(3), 312-320. https://doi.org/10.1111/sjop.12717
Pickles, A., Starr, E., Kazak, S., Bolton, P., Papanikolaou, K., Bailey, A., Goodman, R., & Rutter, M. (2000). Variable expression of the autism broader phenotype: findings from extended pedigrees. Journal of Child Psychology and Psychiatry, 41(4), 491-502. https://doi.org/10.1111/1469-7610.00634
Pisula, E., Danielewicz, D., Kawa, R., & Pisula, W. (2015). Autism spectrum quotient, coping with stress and quality of life in a non-clinical sample – an exploratory report. Health and Quality of Life Outcomes, 13, 1-9. https://doi.org/10.1186/s12955-015-0370-x
Pisula, E., & Ziegart-Sadowska, K. (2015). Broader Autism Phenotype in Siblings of Children with ASD – A Review. International Journal of Molecular Sciences, 16, 13217-13258. https://doi.org/10.3390/ijms160613217
Piven, J., Palmer, P., Jacobi, D., Childress, D., & Arndt, S. (1997). Broader autism phenotype: evidence from a family history study of multiple-incidence autism families. The American Journal of Psychiatry, 154(2), 185-90. https://doi.org/10.1176/AJP.154.2.185
Priel, B., & Shamai, D. (1995). Attachment style and perceived social support: Effects on affect regulation. Personality and Individual Differences, 19, 235-241. https://doi.org/10.1016/0191-8869(95)91936-T
Pruitt, M., Rhoden, M., & Ekas, N. (2018). Relationship between the broad autism phenotype, social relationships and mental health for mothers of children with autism spectrum disorder. Autism, 22, 171-180. https://doi.org/10.1177/1362361316669621
Rasmussen, P., Storebø, O., Løkkeholt, T., Voss, L., Shmueli-Goetz, Y., Bojesen, A., Simonsen, E., & Bilenberg, N. (2018). Attachment as a core feature of resilience: A systematic review and meta-analysis. Psychological Reports, 122, 1259-1296. https://doi.org/10.1177/0033294118785577
Rivers, A., Bosmans, G., Rivera, I., Ruan-Iu, L., & Diamond, G. (2022). Maternal and paternal attachment in high-risk adolescents: Unique and interactive associations with anxiety and depressive symptoms.Journal of Family Psychology, 36(6), 954-963. https://doi.org/10.1037/fam0000989
Ruzich, E., Allison, C., Smith, P., Watson, P., Auyeung, B., Ring, H., & Baron-Cohen, S. (2015). Subgrouping siblings of people with autism: Identifying the broader autism phenotype. Autism Research, 9, 658-665. https://doi.org/10.1002/aur.1544
Schuman, D., Whitworth, J., Galusha, J., Carbajal, J., Ponder, W., Shahan, K., & Jetelina, K. (2023). Differences in resilience and mental health symptoms among us first responders with secure and insecure attachment. Journal of Occupational and Environmental Medicine, 65, 378-386. https://doi.org/10.1097/JOM.0000000000002799
Sechi, C., Vismara, L., & Lucarelli, L. (2020). Attachment to parents and peers and adolescent mental health: The mediating role of alexithymia. Community Mental Health Journal, 56, 894-905. https://doi.org/10.1007/s10597-020-00553-3
Sharma, S., Gonda, X., & Tarazi, F. (2018). Autism Spectrum Disorder: Classification, diagnosis and therapy. Pharmacology & Therapeutics, 190, 91-104. https://doi.org/10.1016/j.pharmthera.2018.05.007
Svanberg, P. (1998). Attachment, resilience and prevention. Journal of Mental Health, 7, 543-578. https://doi.org/10.1080/09638239817716
Stimpson, N.J., Hull, L., & Mandy, W. (2021). The association between autistic traits and mental well-being. Journal of Happiness Studies, 22(1), 287-304. https://doi.org/10.1007/s10902-020-00229-5
Taylor, E., Target, M., & Charman, T. (2008). Attachment in adults with high-functioning autism. Attachment & Human Development, 10, 143-163. https://doi.org/10.1080/14616730802113687
Tidwell, M., Reis, H., & Shaver, P. (1996). Attachment, attractiveness, and social interaction: a diary study. Journal of Personality and Social Psychology, 71(4), 729-45. https://doi.org/10.1037/0022-3514.71.4.729
Wang, H. (2023). Impact of attachment relationships on anxiety and depression. SHS Web of Conferences, 180(6). https://doi.org/10.1051/shsconf/202318002028
Watt, J. (2023). Mental health, resilience and attachment theory. Mental Health & Human Resilience International Journal, 7(1). https://doi.org/10.23880/mhrij-16000225
Widom, C., Czaja, S., Kozakowski, S., & Chauhan, P. (2018). Does adult attachment style mediate the relationship between childhood maltreatment and mental and physical health outcomes? Child Abuse & Neglect, 76, 533-545. https://doi.org/10.1016/j.chiabu.2017.05.002
Yoon, S., Choi, J., Lee, W., & T., J. (2020). Genetic and epigenetic etiology underlying autism spectrum disorder. Journal of Clinical Medicine, 9. https://doi.org/10.3390/jcm9040966
Zhang, X., Li, J., Xie, F., Chen, X., Xu, W., & Hudson, N. (2022). The relationship between adult attachment and mental health: A meta-analysis. Journal of Personality And Social Psychology, 123(5), 1089-1137. https://doi.org/10.1037/pspp0000437
Zheng, L., Luo, Y., & Chen, X. (2020). Different effects of attachment anxiety and attachment avoidance on depressive symptoms: A meta-analysis. Journal of Social and Personal Relationships, 37, 3028-3050. https://doi.org/10.1177/0265407520946482