A meta-analysis of longitudinal associations between substance use and interpersonal attachment security.

Abstract

Substance use has long been associated with close relationship distress. While the direction of influence for this association has not been established, it has often been assumed that substance use is the causal agent and that close relationship distress is the effect. But research seeking to establish temporal precedence in this link has produced mixed findings. Further, theoretical models of substance use and close relationship processes present the plausibility of the inverse pathway—that insecure close relationships may serve as a vulnerability factor for the development of later substance problems. The current review applies an attachment-theoretical framework to the association between close social bonds and substance use and substance-related problems. Targeting longitudinal studies of attachment and substance use, we examined 665 effect sizes drawn from 34 samples (total N=56,721) spanning time frames ranging from 1 month to 20 years (M=3.8 years). Results revealed a significant prospective correlation between earlier attachment and later substance use (r =−.11, 95%CI=−.14 to −0.08). Further, cross-lagged coefficients were calculated which parsed auto-regressive effects, indicating that lower attachment security temporally preceded increases in substance use (r=−.05, 95%CI=−.06 to −.04). Analyses further indicated that the pathway from earlier attachment to later substance use was significantly stronger than that from earlier substance use to later attachment. Results also revealed several moderators of the attachment-substance use link. These findings suggest that insecure attachment may be a vulnerability factor for substance use, and indicate close relationship quality as a promising line of inquiry in research on substance use disorder risk.

Parent-adolescent relationship characteristics and adolescent cannabis use: A growth curve analysis

“…Contrary to hypotheses and prior research, we did not find an association between cannabis misuse and discipline or attachment (16,28). Discipline is similar to the construct of parental control which, in the absence of a supportive relationship, is related to adolescent problem behavior (7,18).…”

“…Treatments that include a parenting or family component to support the adolescent, reduce family conflict, and increase adaptive behaviors like rule-setting and monitoring show potential for reducing impairment (10,(13)(14)(15). Specifically, characteristics of the parent-adolescent relationship, including warmth, attachment, control, and discipline have been linked to adolescent psychopathology and problem behavior, including substance use (16)(17)(18)(19)(20)(21)(22)(23). In the context of psychiatric disorders, parent-youth relationships can be complicated and a source of frustration and stress (24,25).…”

Patient-Level Predictors of Psychiatric Readmission in Substance Use Disorders

“…Studies on psychotic patients showed that being single increases the risk of readmission, while others found that a divorce increases the likelihood of readmission (23). There is a large evidence that SUDs are generally associated with dysfunctional attachment (24). Relational difficulties in SUD are underscored by the fact that divorces are seven times more likely in patients with alcohol addiction than in others (25).…”

Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems

“…The psychological and developmental literature already contains several excellent reviews that have examined the empirical findings showing the relationship between a variety of measures of attachment and different kinds of addiction (53,54). While it is well accepted that addiction results in the deterioration of the quality of close relationships, Fairbairn's review showed that longitudinal studies have established that attachment insecurity prospectively predicts the development of later substance problems irrespective of the type of measure used.…”