Attachment as a Health Determinant

Maria Isabel Loureiro and Teresa Maia

in Public Health

ISBN: 9780199756797
Published online February 2011 | | DOI:
Attachment as a Health Determinant


Attachment theory was first formulated by John Bowlby. This theory is about how relationships are established between humans early in life, and has multiple evolutionary and ethological implications. Its importance today to public health relates to the growing recognition of the extreme importance of early-infant and child development to the lifetime trajectory of health, and it is strongly associated with other social determinants of population health. One fundamental aspect of this theory is the focus on the biological bases of attachment behavior. This behavior has the predictable outcome of increasing the child’s proximity to the attachment figure. The infant’s repertoire of proximity-promoting behaviors (vocalizing and cries, approaching and clinging) becomes organized into a behavior system (the attachment system) focused on a specific caregiver, usually the mother. The attachment system includes the form of attachment itself, the exploratory system, the social system, and the caregiver system. The caregiver system is the complementary system developed by the attachment figure. Each individual experiences emotional ties to the other and forms an internal representation—what Bowlby called an “internal working model”—of the relationship and its participants. This will influence the child’s later development and his future relationships. Mary Ainsworth had a relevant contribution to the development of methodological aspects, creating a standardized interview to assess the quality of attachment in infancy: the “Strange Situation.” Other relevant contributions to the development of this theory were the longitudinal studies that allowed researchers to understand the implications of attachment, the deprivations of care, or foster situations in development and future relationships and attachment. multiple evolutions in the development of evaluation procedures on babies, caregivers, and the type of relationship have emerged. Biological research brought new inputs and opened an area of understanding. All this information allowed researchers and clinicians to design and implement multiple intervention programs that have been evaluated. Attachment theory is today a complex and rich field of knowledge with multiple scientific and clinical implications.

Article.  10392 words. 

Subjects: Public Health and Epidemiology

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