ArticleClinical neuropsychiatry2026
Examining Attachment Styles and Internal Working Models in Relation to Physical and Mental Health in an Italian Sample.
Article in Clinical neuropsychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: this study, grounded in attachment theory and situated within the debate between categorical and dimensional approaches to attachment, aims to pursue two complementary objectives: firstly, to examine the differences in physical and mental health across different attachment styles; secondly, to analyze the specific contribution of internal working models (IWMs) in explaining these variations, allowing for an integrated interpretation of the results. Method: a total of 548 Italian adults participated in the study by completing self-report questionnaires assessing the aforementioned study variables. For the first aim, univariate analyses of variance (ANOVAs) were conducted to test differences in physical and mental health according to different attachment styles; for the second aim, multiple linear regression analyses were performed by including physical and mental health as dependent variables and IWMs of the self and IWMs of others as potential explanatory variables. Results: the findings suggest that individuals with secure and dismissing attachment styles, both characterized by positive IWMs of the self, report better mental health when compared to those with preoccupied and fearful patterns, who are characterized by negative IWMs of the self. As for the second aim, IWMs of the self emerged as a substantially stronger predictor of mental health than IWMs of others. No associations were found with physical health. Conclusions: overall, the findings highlight the central role of attachment in adult mental health from an integrative perspective. While the categorical approach reveals clear differences in mental health across attachment styles, the dimensional analyses indicate that IWMs of the self constitute the primary mechanism underlying these differences. These results support the value of combining categorical and dimensional approaches to achieve a more comprehensive understanding of the relationship between attachment and health.
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