Conference Agenda

Entering higher education can pose significant challenges for young students' adaptation. Supportive family relationships and mental health literacy can act as protective factors, favouring regulatory mechanisms that promote adaptive experiences. This study aims to analyse the role of attachment to parents in well-being and psychopathological symptoms, as well as the role of mental health literacy in the same outcomes. It also aims to test the mediating role of emotional regulation in the above associations. The sample comprised 2258 young adults aged 18 to 35. The results reveal indirect effects of emotional regulation on the association between parental attachment and well-being, as well as with psychopathological symptoms. Similarly, there are positive associations between mental health literacy and well-being and psychopathological symptoms in young students. The results will be discussed in light of attachment theory, emphasising individual and relational resources in promoting well-being and mental health among university students.

Background: Adolescence is widely recognized as a developmental stage characterized by heightened emotional sensitivity and an increased risk of psychological difficulties. Although insecure attachment has been consistently associated with poorer mental health outcomes, the specific processes that account for this relationship remain only partially understood. Drawing on self-determination theory, this study aims to investigate how different emotion regulation styles —namely dysregulated, suppressive, and integrative— mediate the association between insecure attachment (i.e., anxious and avoidant attachment) and mental health symptoms, including internalizing and externalizing symptoms, and suicidal and non-suicidal self-injury. Methods: Participants were 286 adolescents (Mage = 15.20, SD = 1.20; 52.1% female) who completed self-report measures of attachment, Emotion Regulation (ER) modes, internalizing and externalizing symptoms, as well as suicidal and non-suicidal self-injury, across two time points. Data were analyzed using multilevel modeling in Mplus. Results: results indicated that both anxious and avoidant attachment were associated with higher levels of dysregulated and suppressive ER. In addition, avoidant attachment was uniquely related to lower levels of integrative ER. Importantly, dysregulated ER emerged as a robust mediator, explaining the link between insecure attachment and a wide range of psychological outcomes, including internalizing problems, externalizing behaviors, and self-injurious tendencies. Suppressive ER further mediated the relationship between avoidant attachment and internalizing symptoms, while integrative ER functioned as a protective pathway, mediating the association between avoidant attachment and externalizing symptoms. Conclusion: Together, these findings highlight dysregulated ER as a central mechanism by which insecure attachment contributes to adolescent psychopathology, while also pointing to the potential buffering role of integrative ER. From a clinical perspective, interventions that simultaneously address maladaptive attachment patterns and strengthen adaptive ER strategies may hold promise in reducing adolescents’ vulnerability to mental health difficulties and self-harming behaviors.

The relationship between attachment theory and psychoanalysis has had a turbulent history. Attachment theory first developed methods – such as the Strange Situation – for empirical research. Measures operationalizing psychoanalytic concepts emerged later and were continuously refined (Kerber, Behringer, …, Ehrenthal, 2025). The Operationalized Psychodynamic Diagnosis system (OPD; Task Force OPD, 2023), and its Childhood and Adolescence counterpart (Task Force OPD CA, 2020) provide a quantification of structural integration, which can be regarded as a conceptual precursor of personality functioning, capturing Self-regulation, Identity, Interpersonality, and Attachment.

Structural integration is associated with psychopathology (Kerber, Ehrenthal, et al., 2024). Attachment theory and psychoanalysis both assume that vulnerabilities for relationship difficulties and mental health problems are rooted in early relationship experiences. More recently, body representation, a concept stemming from psychoanalysis and attachment alike, and operationalized in the Mirror Interview (MI; Buhl-Nielsen, Steele, & Steele, 2024; Muzi, 2021) emerged as another aspect of vulnerability for mental health problems.

Our longitudinal study following a sample of 75 infants, of whom 49 were re-recruited at age 17 strives to confirm pathways from early observations of maternal sensitivity, and infant attachment (using the Strange Situation) via impairments of structural integration and body representation towards internalizing and externalizing problems. At age 17, we administered OPD-CA interviews and questionnaires to assess structural integration, and the Youth Self Report (YSR; Achenbach) for internalizing and externalizing problems. At age 19, the MI is being administered assessing body representation, and the YSR for internalizing and externalizing problems.

Results: Structural integration mediates the relationship between early maternal sensitivity and internalizing problems at age 17. Adolescents who were securely attached as infants had fewer problems with self-regulation at age 17. Results using body representation as outcome of development and as mediator between early maternal sensitivity and mental health problems will be presented at the conference.