Substance Use and Change in Attachment Insecurity Among Adolescents in Residential Care

ABSTRACT Objective We examined whether adolescent attachment insecurity to parents/caregivers changed over the course of psychiatric residential care, and if changes differ depending on substance use reported at intake, as well as the gender of the caregiver and adolescent. Background Studies have shown a link between substance misuse and insecure attachment, particularly in adolescents. While attachment in/security is increasingly stable as an individual ages, it remains influenced by factors related to the family environment. Method Adolescents ( n = 3831 for paternal‐figure, n = 3916 for maternal‐figure) reported on past 30‐day alcohol, marijuana, and nicotine use at intake, and attachment insecurity to a maternal‐figure and paternal‐figure at intake, Day 21, and every 2 weeks until discharge while in residential treatment. Results Results from growth curve models suggested that over the course of treatment, attachment insecurity to maternal and paternal figures declined on average. In addition, substance use at intake was associated with both intake level attachment and change in attachment insecurity over time, which differed by substance, gender of the adolescent, and gender of the parent. Conclusion and Implications Our findings highlight the importance of considering potential associations between substance use and attachment insecurity for youth in residential treatment, and how they may differ by adolescent and parent gender.