Childhood Maltreatment and Adult Attachment: A Three-Level Meta-Analytic Review

Childhood maltreatment is widely recognized as a significant risk factor for the development of insecure attachment. However, empirical evidence on the strength and direction of this relationship remains mixed. To address this gap, we conducted two three-level meta-analyses to (a) estimate the overall associations between childhood maltreatment and adult attachment and (b) examine key moderators of these associations. A comprehensive literature search was conducted across five databases. Two three-level meta-analyses were employed to account for the dependence among effect sizes within studies. The analyses comprised 1,304 effect sizes derived from 228 independent samples across 211 studies, with 82,376 participants. Results revealed significant and positive correlations between childhood maltreatment and both attachment anxiety ( r  = 0.23) and avoidance ( r  = 0.20), with stronger associations observed for emotional maltreatment and when multidimensional measurement tools were employed. These findings suggest that adverse caregiving experiences have an enduring impact on attachment across the lifespan. This highlights the importance of implementing policies to reduce the incidence of childhood maltreatment and developing intervention programs to help affected adults rebuild secure attachment bonds.