A Prediction Model for Separation Anxiety: The Role of Attachment Styles and Internalizing Symptoms in Italian Young Adults

  • Diana MabiliaEmail author
  • Daniela Di Riso
  • Adriana Lis
  • Andrea Bobbio


Following recent literature, which stresses the importance of broadening the conceptualization of mental functioning in youth, this paper investigated the relations between indicators of attachment styles, internalizing symptoms, and separation anxiety in 379 non-referred Italian university students, as captured by the relationship questionnaire, the experiences in close relationships-revised, the Personality Assessment Inventory (PAI), and the adult separation anxiety-27. Psychometric properties of all measures were scrutinized and a confirmatory factor analysis was conducted to support the soundness of a one-factor model representing indicators of all PAI internalizing symptoms: Anxiety, Anxiety-related disorders, Depression, Somatization, and Suicidal ideation. Then, a multivariate analysis was performed in order to test a model of relation linking attachment styles, internalizing symptoms, and separation anxiety scores. Results supported the mediation role of Internalizing symptoms in the association between preoccupied attachment and separation anxiety scores. Preoccupied attachment towards the romantic partner, as compared to attachment towards family and friends, played a more relevant role in predicting internalizing symptoms and separation anxiety scores. Findings corroborate the combined use of the over-mentioned indicators as a screening battery for the dimensional assessment of the interplay among these variables in young adults. Implications and limitations of the study are presented and discussed.


Young adulthood Internalizing symptoms Attachment style Separation anxiety Personality Assessment Inventory 



  1. Achenbach, T. M., Dumenci, L., & Rescorla, L. A. (2003). Are American children’s problems still getting worse? A 23-year comparison. Journal of Abnormal Child Psychology, 31(1), 1–11.Google Scholar
  2. Alloy, L. B., Abramson, L. Y., Whitehouse, W. G., Hogan, M. E., Panzarella, C., & Rose, D. T. (2006). Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression. Journal of Abnormal Psychology, 115(1), 145.Google Scholar
  3. American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing,. Edizione italiana: Manuale diagnostico e statistico dei disturbi mentali. Milano: Raffaello Cortina, 2014.Google Scholar
  4. American Psychiatric Association (APA). (2014). Diagnostic and Statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  5. Arnett, J. J. (2006). Emerging adulthood in Europe: A response to Bynner. Journal of Youth Studies, 9(1), 111–123.Google Scholar
  6. Arnett, J. J. (2007). Emerging adulthood: What is it, and what is it good for? Child Development Perspectives, 1(2), 68–73.Google Scholar
  7. Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61(2), 226.Google Scholar
  8. Bitsika, V., Sharpley, C. F., Aroutzidis, A. S., & Smith, D. (2011). The impact of students’ ‘internally’ versus ‘externally’ oriented coping strategies upon anxiety and depression: Implications for counselling processes. Asia Pacific Journal of Counselling and Psychotherapy, 2 (1), 71–81.Google Scholar
  9. Bittner, A., Egger, H. L., Erkanli, A., Jane Costello, E., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry, 48(12), 1174–1183.Google Scholar
  10. Bögels, S. M., Knappe, S., & Clark, L. A. (2013). Adult separation anxiety disorder in DSM-5. Clinical Psychology Review, 33(5), 663–674.Google Scholar
  11. Bonab, B. G., & Koohsar, A. A. H. (2011). Relation between quality of attachment and psychological symptoms in college students. Procedia-Social and Behavioral Sciences, 30, 197–201.Google Scholar
  12. Busonera, A., San Martini, P., Zavattini, G. C., & Santona, A. (2014). Psychometric properties of an italian version of the experiences in close relationships-revised (ECR-R) scale. Psychological Reports, 114(3), 785–801.Google Scholar
  13. Carli, L. (1995). Attaccamento E Rapporto Di Coppia. Milano: Cortina.Google Scholar
  14. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd edn.). New York: Academic Press.Google Scholar
  15. Costello, E. J., Egger, H. L., & Angold, A. (2005). The developmental epidemiology of anxiety disorders: Phenomenology, prevalence, and comorbidity. Child and Adolescent Psychiatric Clinics, 14(4), 631–648.Google Scholar
  16. Costello, E. J., Copeland, W., & Angold, A. (2011). Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? Journal of Child Psychology and Psychiatry, 52(10), 1015–1025.Google Scholar
  17. Dell’Osso, L., Carmassi, C., Corsi, M., Pergentini, I., Socci, C., Maremmani, A. G., & Perugi, G. (2011). Adult separation anxiety in patients with complicated grief versus healthy control subjects: Relationships with lifetime depressive and hypomanic symptoms. Annals of General Psychiatry, 10(1), 1.Google Scholar
  18. Di Riso, D., Bobbio, A., Chessa, D., Lis, A., & Mazzeschi, C. (2014). Analysis of the interplay between depression, anxiety, and psychological resources in adolescence using self-report measures. International Journal of Psychiatry in Clinical Practice, 18(2), 103–111.Google Scholar
  19. Djoric, J. Z., & Medjedovic, J. (2011). Romantic adult attachment and basic personality structure. Psihološka Obzorja, 20(4), 9–22.Google Scholar
  20. Edens, J. F., & Ruiz, M. A. (2008). Identification of mental disorders in an in-patient prison psychiatric unit: Examining the criterion-related validity of the personality assessment inventory. Psychological Services, 5(2), 108.Google Scholar
  21. EUROSTAT (2014), Information society statistics.Google Scholar
  22. Evans, G. W., Kim, P., Ting, A. H., Tesher, H. B., & Shannis, D. (2007). Cumulative risk, maternal responsiveness, and allostatic load among young adolescents. Developmental Psychology, 43(2), 341.Google Scholar
  23. Fraley, R. C., & Shaver, P. R. (2000). Adult romantic attachment: Theoretical developments, emerging controversies, and unanswered questions. Review of General Psychology, 4(2), 132.Google Scholar
  24. Froiland, J. M. (2018). Promoting gratitude and positive feelings about learning among young adults. Journal of Adult Development, 25(4), 251–258.Google Scholar
  25. Galambos, N. L., Barker, E. T., & Krahn, H. J. (2006). Depression, self-esteem, and anger in emerging adulthood: Seven-year trajectories. Developmental Psychology, 42(2), 350.Google Scholar
  26. Hill, R. M., Castellanos, D., & Pettit, J. W. (2011). Suicide-related behaviors and anxiety in children and adolescents: A review. Clinical Psychology Review, 31(7), 1133–1144.Google Scholar
  27. Jones, G. (2005). The thinking and behaviour of young adults (aged 16–25). Literature review for the social exclusion unit, London: SEU.Google Scholar
  28. Keenan, K., Feng, X., Hipwell, A., & Klostermann, S. (2009). Depression begets depression: Comparing the predictive utility of depression and anxiety symptoms to later depression. Journal of Child Psychology and Psychiatry, 50(9), 1167–1175.Google Scholar
  29. Kiecolt-Glaser, J. K., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127(4), 472.Google Scholar
  30. Lehnart, J., & Neyer, F. J. (2006). Should I stay or should I go? Attachment and personality in stable and instable romantic relationships. European Journal of Personality, 20(6), 475–495.Google Scholar
  31. Lehnart, J., Neyer, F. J., & Eccles, J. (2010). Long-term effects of social investment: The case of partnering in young adulthood. Journal of Personality, 78(2), 639–670.Google Scholar
  32. Lewinsohn, P. M., Rohde, P., Seeley, J. R., Klein, D. N., & Gotlib, I. H. (2003). Psychosocial functioning of young adults who have experienced and recovered from major depressive disorder during adolescence. Journal of Abnormal Psychology, 112(3), 353.Google Scholar
  33. Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: Exploring the question, weighing the merits. Structural Equation Modeling, 9(2), 151–173.Google Scholar
  34. Lizardi, D., Grunebaum, M. F., Burke, A., Stanley, B., Mann, J. J., Harkavy-Friedman, J., & Oquendo, M. (2011). The effect of social adjustment and attachment style on suicidal behaviour. Acta Psychiatrica Scandinavica, 124(4), 295–300.Google Scholar
  35. Manicavasagar, V., & Silove, D. (1997). Is there an adult form of separation anxiety disorder? A brief clinical report. Australian and New Zealand Journal of Psychiatry, 31(2), 299–303.Google Scholar
  36. Manicavasagar, V., Silove, D., Curtis, J., & Wagner, R. (2000). Continuities of separation anxiety from early life into adulthood. Journal of anxiety disorders, 14(1), 1–18.Google Scholar
  37. Manicavasagar, V., Silove, D., Marnane, C., & Wagner, R. (2009). Adult attachment styles in panic disorder with and without comorbid adult separation anxiety disorder. Australian and New Zealand Journal of Psychiatry, 43, 167–172.Google Scholar
  38. Manicavasagar, V., Silove, D., Wagner, R., & Drobny, J. (2003). A self-report questionnaire for measuring separation anxiety in adulthood. Comprehensive Psychiatry, 44, 146–153.Google Scholar
  39. Markey, C. N., Markey, P. M., Ericksen, A. J., & Tinsley, B. J. (2006). Children’s behavioral patterns, the five-factor model of personality, and risk behaviors. Personality and Individual Differences, 41(8), 1503–1513. Scholar
  40. Maybury, K. K. (2013). The influence of a positive psychology course on student well-being. Teaching of Psychology, 40(1), 62–65.Google Scholar
  41. McNally, A. M., Palfai, T. P., Levine, R. V., & Moore, B. M. (2003). Attachment dimensions and drinking-related problems among young adults: The mediational role of coping motives. Addictive Behaviors, 28(6), 1115–1127.Google Scholar
  42. Meyers, S. A., & Landsberger, S. A. (2002). Direct and indirect pathways between adult attachment style and marital satisfaction. Personal Relationships, 9(2), 159–172.Google Scholar
  43. Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford.Google Scholar
  44. National Collaborating Centre for Mental Health (Great Britain). (2011). Common mental health disorders: Identification and pathways to care (No. 123). RCPsych Publications.Google Scholar
  45. Negovan, V. (2010). Dimensions of students’ psychosocial well-being and their measurement: Validation of a students’ psychosocial well being inventory. Europe’s Journal of Psychology, 6(2), 85–104.Google Scholar
  46. Nelson, L. J., & Barry, C. M. (2005). Distinguishing features of emerging adulthood the role of self-classification as an adult. Journal of Adolescent Research, 20(2), 242–262.Google Scholar
  47. Neyer, F. J., & Asendorpf, J. B. (2001). Personality–relationship transaction in young adulthood. Journal of Personality and Social Psychology, 81(6), 1190.Google Scholar
  48. Neyer, F. J., & Lehnart, J. (2007). Relationships matter in personality development: Evidence from an 8-year longitudinal study across young adulthood. Journal of Personality, 75(3), 535–568.Google Scholar
  49. Pascuzzo, K., Cyr, C., & Moss, E. (2013). Longitudinal association between adolescent attachment, adult romantic attachment, and emotion regulation strategies. Attachment and Human Development, 15(1), 83–103.Google Scholar
  50. Pini, S., Abelli, M., Shear, K. M., Cardini, A., Lari, L., Gesi, C., Pini, S., et al. (2010). Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders. Acta Psychiatrica Scandinavica, 122(1), 40–46.Google Scholar
  51. Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879.Google Scholar
  52. Ponizovsky, A. M., Nechamkin, Y., & Rosca, P. (2007). Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients. American Journal of Orthopsychiatry, 77(2), 324–331.Google Scholar
  53. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. Scholar
  54. Roberts, B. W., & Mroczek, D. (2008). Personality trait change in adulthood. Current Directions in Psychological Science, 17(1), 31–35.Google Scholar
  55. Roberts, B. W., & Wood, D. (2006). Personality Development in the Context of the Neo-Socioanalytic Model of Personality. In D. K. Mroczek & T. D. Little (Eds.), Handbook of personality development (pp. 11–39). Mahwah: Lawrence Erlbaum Associates Publishers.Google Scholar
  56. Roelofs, J., Meesters, C., ter Huurne, M., Bamelis, L., & Muris, P. (2006). On the links between attachment style, parental rearing behaviors, and internalizing and externalizing problems in non-clinical children. Journal of Child and Family Studies, 15(3), 319.Google Scholar
  57. Schad, M. M., Szwedo, D. E., Antonishak, J., Hare, A., & Allen, J. P. (2008). The broader context of relational aggression in adolescent romantic relationships: Predictions from peer pressure and links to psychosocial functioning. Journal of Youth and Adolescence, 37(3), 346–358.Google Scholar
  58. Scharfe, E., & Bartholomew, K. I. (1994). Reliability and stability of adult attachment patterns. Personal Relationships, 1(1), 23–43.Google Scholar
  59. Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23–74.Google Scholar
  60. Schulenberg, J., & Schoon, I. (2012). The transition to adulthood across time and space: Overview of special section. Longitudinal and Life Course Studies, 3(2), 164.Google Scholar
  61. Schulenberg, J. E., Bryant, A. L., & O’Malley, P. M. (2004). Taking hold of some kind of life: How developmental tasks relate to trajectories of well-being during the transition to adulthood. Development and Psychopathology, 16(04), 1119–1140.Google Scholar
  62. Seligman, L. D., & Wuyek, L. A. (2007). Correlates of separation anxiety symptoms among first-semester college students: An exploratory study. The Journal of Psychology, 141(2), 135–145.Google Scholar
  63. Settersten, R. A. Jr., & Ray, B. (2010). What’s going on with young people today? The long and twisting path to adulthood. The Future of Children, 20(1), 19–41.Google Scholar
  64. Shear, K., Jin, R., Ruscio, A. M., Walters, E. E., & Kessler, R. C. (2006). Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the National Comorbidity Survey Replication. Am J Psychiatry, 163(6), 1074–1083. Scholar
  65. Sibley, C. G., Fischer, R., & Liu, J. H. (2005). Reliability and validity of the revised experiences in close relationships (ECR-R) self-report measure of adult romantic attachment. Personality and Social Psychology Bulletin, 31(11), 1524–1536.Google Scholar
  66. Silove, D., Manicavasagar, V., O’connell, D., Blaszczynski, A., Wagner, R., & Henry, J. (1993). The development of the separation anxiety symptom inventory (SASI). Australian and New Zealand Journal of Psychiatry, 27(3), 477–488.Google Scholar
  67. Silove, D., Slade, T., Marnane, C., Wagner, R., Brooks, R., & Manicavasagar, V. (2007). Separation anxiety in adulthood: Dimensional or categorical? Comprehensive Psychiatry, 48, 546–553.Google Scholar
  68. Silove, D. M., Marnane, C. L., Wagner, R., Manicavasagar, V. L., & Rees, S. (2010). The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic. BMC Psychiatry, 10(1), 21.Google Scholar
  69. Skodol, A. E., Bender, D. S., Morey, L. C., Clark, L. A., Oldham, J. M., Alarcon, R. D., Krueger, R. F., et al. (2011). Personality disorder types proposed for DSM-5. Journal of Personality Disorders, 25(2), 136.Google Scholar
  70. Sroufe, L. A., & Waters, E. (1977). Attachment as an organizational construct. Child Development, 1184–1199.Google Scholar
  71. Team, R. C. (2015). R: A language and environment for statistical computing. Vienna, Austria; 2015.Google Scholar
  72. Trudeau, L., Spoth, R., Randall, G. K., Mason, W. A., & Shin, C. (2012). Internalizing symptoms: Effects of a preventive intervention on developmental pathways from early adolescence to young adulthood. Journal of Youth and Adolescence, 41(6), 788–801.Google Scholar
  73. Van Voorhees, E. E., Dennis, P. A., Elbogen, E. B., Clancy, C. P., Hertzberg, M. A., Beckham, J. C., & Calhoun, P. S. (2014). Personality assessment inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression. Aggressive Behavior, 40(6), 582–592. Scholar
  74. Verona, E., Sachs-Ericsson, N., & Joiner, T. E. Jr. (2004). Suicide attempts associated with externalizing psychopathology in an epidemiological sample. American Journal of Psychiatry, 161(3), 444–451.Google Scholar
  75. Yamawaki, N., Nelson, J. A. P., & Omori, M. (2011). Self-esteem and life satisfaction as mediators between parental bonding and psychological well-being in Japanese young adults. International Journal of Psychology and Counselling, 3(1), 1–8.Google Scholar
  76. Zennaro, A., Di Nuovo, S., Lis, A., Mazzeschi, C., & Fulcheri, M. (2015). PAI—Personality assessment. Manuale. Firenze: Hogrefe Editore.Google Scholar

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Authors and Affiliations

  1. 1.Department of Developmental and Socialization PsychologyUniversity of PadovaPadovaItaly
  2. 2.Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of PadovaPadovaItaly

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