Attachment Theory: Novel Clinical and Molecular Insights

Early-life adversity (ELA) disrupts brain development and is linked to poor health outcomes across species, including humans and rodents. A growing body of work suggests that impaired attachment to a caregiver-arising from erratic, neglectful, or abusive parenting-mediates a substantial portion of ELA's long-term effects. Despite the conceptual and clinical appeal of this idea, the neural mechanisms by which ELA disrupts attachment and how altered attachment in turn produces diverse psychiatric and medical sequelae remain incompletely understood. In this review, we synthesize recent randomized controlled trials showing that strengthening caregiver-child attachment can ameliorate a broad range of ELA-related outcomes. We also highlight key animal studies that illuminate the biology of attachment and outline critical priorities for future research.