Agoraphobia and anxious-ambivalent attachment: an integrative review

Attachment theory proposes that internal working models of attachment, that is, mental representations of attachment relationships, are shaped in childhood experiences with primary caregivers. It is hypothesized that an anxious-ambivalent internal working model of attechment is a risk factor for the development of agoraphobia. Indirect support for this hypothesis was obtained from a meta-analysis of four studies on parental caregiving style and from a secondary analysis of six studies on childhood separation anxiety in adults agoraphobics and normal and clinical control subjects. However, anxious-ambivalent attachment does not seem to be specific to agoraphobia alone, but appears to play an etiological role in other mental disorders as well. Suggestions for future research are offered.