Insecure attachment to primary caregivers is associated with the development of depression symptoms in children and youth. This association has been shown by individual studies testing the relation between attachment and depression and by meta-analyses focusing on broad internalizing problems instead of depression or adult samples only. We therefore meta-analytically examined the associations between attachment security and depression in children and adolescents, using a multilevel approach. In total, 643 effect sizes were extracted from 123 independent samples. A significant moderate overall effect size was found (r = .31), indicating that insecure attachment to primary caregivers is associated with depression. Multivariate analysis of the significant moderators that impacted on the strength of the association between attachment security and depression showed that country of the study, study design, gender, the type of attachment, and the type of instrument to assess attachment uniquely contributed to the explanation of variance. This study suggests that insecure attachment may be a predictor of the development of depression in children and adolescents. When treating depression in children, attachment should therefore be addressed.

Attachment theory suggests that children's attachment insecurity plays a key role in the development of anxiety. In the present study we evaluated the empirical evidence for the link between insecure attachment and anxiety from early childhood to adolescence. A meta-analysis of 46 studies, from 1984 to 2010, including 8,907 children, was conducted. The results show an overall effect size of r = .30, indicating that attachment is moderately related to anxiety. Moderator analyses indicated that ambivalent attachment showed the strongest association with anxiety. Further, the relation was stronger during adolescence, when attachment and anxiety were measured through questionnaires, when the informant was the child, when attachment was measured as internal working model, in cross-sectional studies, and in studies conducted in Europe. No difference was found between studies that measured anxiety as symptoms or as a disorder, and when different kinds of anxiety were considered.

Children’s early onset of social anxiety may be associated with their social understanding, and their ability to express emotions adaptively. We examined whether social anxiety in 48-month-old children (N = 110; 54 boys) was related to: a) a lower level of theory of mind (ToM); b) a lower proclivity to express shyness in a positive way (adaptive); and c) a higher tendency to express shyness in a negative way (non-adaptive). In addition, we investigated to what extent children’s level of social anxiety was predicted by the interaction between ToM and expressions of shyness. Children’s positive and negative expressions of shyness were observed during a performance task. ToM was measured with a validated battery, and social anxiety was assessed using both parents’ reports on questionnaires. Socially anxious children had a lower level of ToM, and displayed more negative and less positive shy expressions. However, children with a lower level of ToM who expressed more positive shyness were less socially anxious. Additional results show that children who displayed shyness only in a negative manner were more socially anxious than children who expressed shyness only in a positive way and children who did not display any shyness. Moreover, children who displayed both positive and negative expressions of shyness were more socially anxious than children who displayed shyness only in a positive way. These findings highlight the importance of ToM development and socio-emotional strategies, and their interaction, on the early development of social anxiety.

Parental mind-mindedness, the parent’s propensity to treat the child as an intentional agent, has repeatedly shown to promote children’s development of social understanding and secure attachment. Less is known about whether the impact of maternal and paternal mind-mindedness extends to children’s social and behavior problems. We investigated the combined effect of mothers’ and fathers’ (N = 104) mind-mindedness at 4, 12, and 30 months on children’s social competence and externalizing and internalizing behavior problems at 4.5 years. Besides, we examined the stability, continuity, parental concordance, and inter-parental differences in the use of mind-related comments. Appropriate mind-mindedness (i.e., correct interpretations of the child’s mental states) and nonattuned mind-mindedness (i.e., misinterpretations of the child’s mental states) were observed during parent-child free-play interactions. Social competence, internalizing and externalizing behavior problems were assessed using both parents’ reports. Hierarchical multiple regression analyses showed that, at 30 months, infrequent use of appropriate mind-related comments of both parents predicted children’s externalizing problems, while their frequent use of nonattuned comments predicted children’s low social competence. Furthermore, mothers’ frequent use of nonattuned comments at 12 and 30 months and fathers’ nonattuned comments at 30 months predicted children’s externalizing behavior. The findings suggest that both parents’ low use of mind-related comments, and frequent misinterpretations of their child’s mind, may act as risk factors for later social and behavior problems of their child.