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Relationship between Childhood Parentification, Adult Attachment Styles, and Addiction: A Review

Yıl 2025, Cilt: 26 Sayı: 4, 1 - 1

Sinem Çetin Demirtaş , Caner Yeşiloğlu , Lut Tamam

Öz

Childhood parentification—a role reversal in which children assume caregiving responsibilities for their parents—has emerged as a significant early-life risk factor for adverse mental health outcomes in adulthood. This narrative review synthesizes the literature on the long-term psychological effects of parentification, focusing particularly on adult attachment styles and addiction risk. Drawing from attachment theory, family systems theory, and developmental psychopathology, the paper explores how unmet emotional needs and disrupted caregiving dynamics contribute to insecure attachment patterns, emotion regulation deficits, and the use of maladaptive coping strategies, including substance use and behavioral addictions. Evidence from cross-sectional, longitudinal, and intergenerational studies is presented, highlighting consistent associations between childhood parentification and increased rates of depression, anxiety, personality disorders, and addictive behaviors. Special attention is given to the mediating role of adult attachment insecurity and the intergenerational transmission of caregiving dynamics. Clinical implications include the importance of assessing early family roles in psychotherapy and addiction treatment, with recommendations for attachment-informed interventions. Gaps in the literature are discussed, emphasizing the need for longitudinal research, cultural comparisons, and examination of resilience factors. The review underscores that while parentified children often carry invisible burdens into adulthood, therapeutic insight and targeted interventions may offer pathways to healing and relational growth.

Anahtar Kelimeler

Family Relations attachment parentification adverse childhood experiences

Kaynakça

  • Nuttall AK, Zhang Q, Valentino K, Borkowski JG. Intergenerational risk of parentification and infantilization to externalizing moderated by child temperament. J Marriage Fam 2019; 81(3): 648–661.
  • Nuttall AK, Valentino K, Borkowski JG. Maternal history of parentification, maternal warm responsiveness, and children’s externalizing behavior. J Fam Psychol 2012; 26(5): 767–775.
  • Katz J, Petracca M, Rabinowitz J. A retrospective study of daughters’ emotional role reversal with parents, attachment anxiety, excessive reassurance seeking, and depressive symptoms. Am J Fam Ther 2009; 37(3): 185–195.
  • Hooper LM, Decoster J, White N, Voltz ML. Characterizing the magnitude of the relation between parentification and psychopathology: A meta-analysis. J Clin Psychol 2011; 67(10): 1028–1043.
  • Kuperminc GP, Jurkovic GJ, Casey S. Relation of filial responsibility to the personal and social adjustment of Latino adolescents from immigrant families. J Fam Psychol 2009; 23(1): 14–22.
  • Baggett E, Shaffer A, Muetzelfeld H. Father–daughter parentification and young adult romantic relationships among college women. J Fam Issues 2015; 36(6): 760–783.
  • Schier K, Herke M, Nickel R, Egle UT, Hardt J. Long-term sequelae of emotional parentification: A cross-validation study using sequences of regressions. J Child Fam Stud 2014; 24(5): 1307–1321.
  • Schindler A, Bröning S. A review on attachment and adolescent substance abuse: Empirical evidence and implications for prevention and treatment. Subst Abuse 2015; 36(3): 304–313.
  • Kabat R. A role-reversal in the mother-daughter relationship. Clin Soc Work J 1996; 24(3): 255–269.
  • Keigher S, Zabler B, Robinson N, et al. Young caregivers of mothers with HIV: Need for supports. Child Youth Serv Rev 2005; 27(8): 881–904.
  • Madden AR, Shaffer A. The relation between parentification and dating communication: The role of romantic attachment-related cognitions. Fam J 2016; 24(3): 313–318.
  • Sheinbaum T, Bifulco A, Ballespí S, et al. Interview investigation of insecure attachment styles as mediators between poor childhood care and schizophrenia-spectrum phenomenology. PLoS One 2015; 10(8): e0135150.
  • Bifulco A, Kwon J, Jacobs C, et al. Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety. Soc Psychiatry Psychiatr Epidemiol 2006; 41(10): 796–805.
  • Berberian M, Davis B. Art Therapy Practices for Resilient Youth: A Strengths-Based Approach to Positive Youth Development. New York: Routledge; 2019.
  • Barnett B, Parker G. The parentified child: Early competence or childhood deprivation? Child Adolesc Ment Health 1998; 3(4): 146–155.
  • Boszormenyi-Nagy I. Invisible Loyalties, 1st ed. New York: Routledge; 1984.
  • Nuttall AK, Valentino K, Wang L, et al. Maternal history of parentification and warm responsiveness: The mediating role of knowledge of infant development. J Fam Psychol 2015; 29(6): 863–872.
  • Sheinbaum T, Kwapil TR, Barrantes-Vidal N. Fearful attachment mediates the association of childhood trauma with schizotypy and psychotic-like experiences. Psychiatry Res 2014; 220(1–2): 691–693.
  • Dabbs JM, Jurkovic GJ, Frady RL. Salivary testosterone and cortisol among late adolescent offenders. J Abnorm Child Psychol 1991; 19(4): 469–478.
  • Preciado B. Developmental Implications of Parentification: An Examination of Ethnic Variation and Loneliness. [Doctoral dissertation]. Los Angeles: University of California, 2020.
  • DiMarzio K, Parent J, Forehand R, et al. Parent-child role confusion: Exploring the role of family processes in the context of parental depression. J Clin Child Adolesc Psychol 2022; 51(6): 982–996.
  • Fitzgerald MM, Schneider RA, Salstrom S, et al. Child sexual abuse, early family risk, and childhood parentification: Pathways to current psychosocial adjustment. J Fam Psychol 2008; 22(2): 320–324.
  • Dariotis JK, Chen FR, Park YR, et a. lParentification vulnerability, reactivity, resilience, and thriving: A mixed methods systematic literature review. Int J Environ Res Public Health 2023; 20(13): 6197.
  • Jankowski PJ, Hooper LM, Sandage SJ, Hannah NJ. Parentification and mental health symptoms: Mediator effects of perceived unfairness and differentiation of self. J Fam Ther 2013; 35(1): 43–65.
  • Çimşir E, Akdoğan R. Childhood emotional incest scale (CEIS): Development, validation, cross-validation, and reliability. J Couns Psychol 2021; 68(1): 98–111.
  • Borchet J, Schneider WS, Lewandowska-Walter A et al. Psychometric evaluation of the parentification inventory in a Polish adolescent sample. Fam J 2023; 31(3): 488–497.
  • Jenkins Tucker C, Whitworth TR, Finkelhor D. Clarifying labels, constructs, and definitions: Sibling aggression and abuse are family violence. J Soc Pers Relat 2025; 42(7): 1800–1817.
  • Schier K, Herke M, Nickel R, et al. Long-term sequelae of emotional parentification: A cross-validation study using sequences of regressions. J Child Fam Stud 2014; 24(5): 1307–1321.
  • Reeb BT, Wu EY, Martin MJ, et al. Long-term effects of fathers’ depressed mood on youth internalizing symptoms in early adulthood. J Res Adolesc 2015; 25(1): 151–162.
  • Carroll JJ, Robinson BE. Depression and parentification among adults as related to parental workaholism and alcoholism. Fam J 2000; 8(4): 360–367.
  • Estevez A, Jauregui P, Lopez-Gonzalez H. Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies. Scand J Psychol 2019; 60(4): 348–360.
  • Chambers JE, Perkins SM, Mosesso KM, et al. Adverse childhood experiences, insecure attachment, and appointment compliance in an outpatient addiction psychiatry treatment population. Am J Addict 2025; 34(3): 334–341.
  • Peris TS, Goeke-Morey MC, Cummings EM, Emery RE. Marital conflict and support seeking by parents in adolescence: Empirical support for the parentification construct. J Fam Psychol 2008; 22(4): 633.
  • Carroll JJ, Robinson BE. Depression and parentification among adults as related to parental workaholism and alcoholism. Fam J 2000; 8(4): 360–367.
  • Olson M, Gariti P. Symbolic loss in horizontal relating: Defining the role of parentification in addictive/destructive relationships. Contemp Fam Ther 1993; 15(3): 197–208.
  • Sebalo I, Königová MP, Sebalo Vňuková M, et al. The associations of adverse childhood experiences (ACEs) with substance use in young adults: A systematic review. Subst Abuse 2023; 17(1): 11782218231178931.
  • Guastaferro K, Linden-Carmichael AN, Chiang SC. Association between child maltreatment and substance use disorder across emerging adulthood. Child Maltreat 2024; 29(2): 340–349.
  • Liese BS, Kim HS, Hodgins DC. Insecure attachment and addiction: Testing the mediating role of emotion dysregulation in four potentially addictive behaviors. Addict Behav 2020; 107: 106432.
  • McGauran A, Brooks M, Khan R. The role of emotional resilience, childhood parentification, and attachment style on antisocial behaviour in adulthood: A comparison of an offender and normative population. J Crim Psychol 2019; 9(2): 75–87.
  • Madden AR, Shaffer A. The relation between parentification and dating communication: The role of romantic attachment-related cognitions. Fam J 2016; 24(3): 313–318.
  • Chatziioannidis S, Andreou C, Agorastos A, et al. The role of attachment anxiety in the relationship between childhood trauma and schizophrenia-spectrum psychosis. Psychiatry Res 2019; 276: 223–231.
  • Trull TJ, Freeman LK, Vebares TJ, et al. Borderline personality disorder and substance use disorders: An updated review. Borderline Pers Disord Emot Dysregul 2018; 5(1): 1–12.
  • National Center for Children. Parentification: An overview of theory, research, and societal issues. In: Burdened children. https://sk.sagepub.com/book/edvol/burdened-children/chpt/parentification-overview-theory-research-societal (Accessed 01.07.2025)
  • Byng‐Hall J. Relieving parentified children’s burdens in families with insecure attachment patterns. Fam Process 2002; 41(3): 375–388.
  • Oznobishin O, Kurman J. Parent-child role reversal and psychological adjustment among immigrant youth in Israel. J Fam Psychol 2009; 23(3): 405–415.
  • Murrin M, Beffel JH, Nuttall AK. The moderating role of self-disclosure among typically developing siblings of individuals with autism spectrum disorder. J Child Fam Stud 2021; 30(2): 364–374.
  • Monaco SB, Heesacker M. Perceived family benefits overshadowed parentification in predicting life satisfaction and relationship satisfaction. Am J Fam Ther 2025; 53(4): 426–449.
  • Khantzian EJ. The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harv Rev Psychiatry 1997; 4(5): 231–244.
  • Wakschlag LS, Hans SL. Relation of maternal responsiveness during infancy to the development of behavior problems in high-risk youths. Dev Psychol 1999; 35(2): 569–579.

Çocukluk Çağı Ebeveynleşmesi, Erişkin Bağlanma Stilleri ve Bağımlılık Arasındaki İlişki: Bir Derleme

Yıl 2025, Cilt: 26 Sayı: 4, 1 - 1

Sinem Çetin Demirtaş , Caner Yeşiloğlu , Lut Tamam

Öz

Çocuklukta ebeveynleşme—çocukların ebeveynlerine bakım verme sorumluluğunu üstlendiği rol değişimi—erişkinlikte olumsuz ruh sağlığı sonuçları için önemli bir erken dönem risk faktörü olarak ortaya çıkmıştır. Bu narratif derleme, ebeveynleşmenin uzun vadeli psikolojik etkilerine dair literatürü sentezlemekte, özellikle erişkin bağlanma stilleri ve bağımlılık riski üzerine odaklanmaktadır. Bağlanma kuramı, aile sistemleri kuramı ve gelişimsel psikopatoloji çerçevelerinden yola çıkarak; karşılanmamış duygusal ihtiyaçlar ile bozulmuş bakım verme dinamiklerinin güvensiz bağlanma örüntülerine, duygu düzenleme güçlüklerine ve madde kullanımı ile davranışsal bağımlılıklar gibi uyumsuz başa çıkma stratejilerine nasıl yol açtığı ele alınmaktadır. Kesitsel, boylamsal ve kuşaklar arası çalışmalardan elde edilen kanıtlar, çocuklukta ebeveynleşmenin depresyon, anksiyete, kişilik bozuklukları ve bağımlılık davranışları oranlarında artışla tutarlı biçimde ilişkili olduğunu ortaya koymaktadır. Özellikle erişkinlikteki güvensiz bağlanmanın aracı rolü ve bakım verme kalıplarının kuşaklar arası aktarımı vurgulanmaktadır. Klinik açıdan, psikoterapi ve bağımlılık tedavisinde erken dönem aile rolleri hakkında değerlendirme yapılmasının önemi vurgulanmakta; bağlanma temelli müdahalelere yönelik öneriler sunulmaktadır. Literatürdeki boşluklar ele alınmakta, boylamsal çalışmalara, kültürel karşılaştırmalara ve psikolojik dayanıklılık etmenlerinin incelenmesine olan ihtiyaç vurgulanmaktadır. Bu derleme, ebeveynleşmiş çocukların erişkinlikte sıklıkla görünmeyen yükler taşıdığını, ancak terapötik farkındalık ve hedefe yönelik müdahalelerle iyileşme ve ilişkisel gelişim için yollar açılabileceğini ortaya koymaktadır.

Anahtar Kelimeler

Aile İlişkileri Bağımlılık Davranışı Ebeveynleşme Olumsuz Çocukluk Deneyimleri

Kaynakça

  • Nuttall AK, Zhang Q, Valentino K, Borkowski JG. Intergenerational risk of parentification and infantilization to externalizing moderated by child temperament. J Marriage Fam 2019; 81(3): 648–661.
  • Nuttall AK, Valentino K, Borkowski JG. Maternal history of parentification, maternal warm responsiveness, and children’s externalizing behavior. J Fam Psychol 2012; 26(5): 767–775.
  • Katz J, Petracca M, Rabinowitz J. A retrospective study of daughters’ emotional role reversal with parents, attachment anxiety, excessive reassurance seeking, and depressive symptoms. Am J Fam Ther 2009; 37(3): 185–195.
  • Hooper LM, Decoster J, White N, Voltz ML. Characterizing the magnitude of the relation between parentification and psychopathology: A meta-analysis. J Clin Psychol 2011; 67(10): 1028–1043.
  • Kuperminc GP, Jurkovic GJ, Casey S. Relation of filial responsibility to the personal and social adjustment of Latino adolescents from immigrant families. J Fam Psychol 2009; 23(1): 14–22.
  • Baggett E, Shaffer A, Muetzelfeld H. Father–daughter parentification and young adult romantic relationships among college women. J Fam Issues 2015; 36(6): 760–783.
  • Schier K, Herke M, Nickel R, Egle UT, Hardt J. Long-term sequelae of emotional parentification: A cross-validation study using sequences of regressions. J Child Fam Stud 2014; 24(5): 1307–1321.
  • Schindler A, Bröning S. A review on attachment and adolescent substance abuse: Empirical evidence and implications for prevention and treatment. Subst Abuse 2015; 36(3): 304–313.
  • Kabat R. A role-reversal in the mother-daughter relationship. Clin Soc Work J 1996; 24(3): 255–269.
  • Keigher S, Zabler B, Robinson N, et al. Young caregivers of mothers with HIV: Need for supports. Child Youth Serv Rev 2005; 27(8): 881–904.
  • Madden AR, Shaffer A. The relation between parentification and dating communication: The role of romantic attachment-related cognitions. Fam J 2016; 24(3): 313–318.
  • Sheinbaum T, Bifulco A, Ballespí S, et al. Interview investigation of insecure attachment styles as mediators between poor childhood care and schizophrenia-spectrum phenomenology. PLoS One 2015; 10(8): e0135150.
  • Bifulco A, Kwon J, Jacobs C, et al. Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety. Soc Psychiatry Psychiatr Epidemiol 2006; 41(10): 796–805.
  • Berberian M, Davis B. Art Therapy Practices for Resilient Youth: A Strengths-Based Approach to Positive Youth Development. New York: Routledge; 2019.
  • Barnett B, Parker G. The parentified child: Early competence or childhood deprivation? Child Adolesc Ment Health 1998; 3(4): 146–155.
  • Boszormenyi-Nagy I. Invisible Loyalties, 1st ed. New York: Routledge; 1984.
  • Nuttall AK, Valentino K, Wang L, et al. Maternal history of parentification and warm responsiveness: The mediating role of knowledge of infant development. J Fam Psychol 2015; 29(6): 863–872.
  • Sheinbaum T, Kwapil TR, Barrantes-Vidal N. Fearful attachment mediates the association of childhood trauma with schizotypy and psychotic-like experiences. Psychiatry Res 2014; 220(1–2): 691–693.
  • Dabbs JM, Jurkovic GJ, Frady RL. Salivary testosterone and cortisol among late adolescent offenders. J Abnorm Child Psychol 1991; 19(4): 469–478.
  • Preciado B. Developmental Implications of Parentification: An Examination of Ethnic Variation and Loneliness. [Doctoral dissertation]. Los Angeles: University of California, 2020.
  • DiMarzio K, Parent J, Forehand R, et al. Parent-child role confusion: Exploring the role of family processes in the context of parental depression. J Clin Child Adolesc Psychol 2022; 51(6): 982–996.
  • Fitzgerald MM, Schneider RA, Salstrom S, et al. Child sexual abuse, early family risk, and childhood parentification: Pathways to current psychosocial adjustment. J Fam Psychol 2008; 22(2): 320–324.
  • Dariotis JK, Chen FR, Park YR, et a. lParentification vulnerability, reactivity, resilience, and thriving: A mixed methods systematic literature review. Int J Environ Res Public Health 2023; 20(13): 6197.
  • Jankowski PJ, Hooper LM, Sandage SJ, Hannah NJ. Parentification and mental health symptoms: Mediator effects of perceived unfairness and differentiation of self. J Fam Ther 2013; 35(1): 43–65.
  • Çimşir E, Akdoğan R. Childhood emotional incest scale (CEIS): Development, validation, cross-validation, and reliability. J Couns Psychol 2021; 68(1): 98–111.
  • Borchet J, Schneider WS, Lewandowska-Walter A et al. Psychometric evaluation of the parentification inventory in a Polish adolescent sample. Fam J 2023; 31(3): 488–497.
  • Jenkins Tucker C, Whitworth TR, Finkelhor D. Clarifying labels, constructs, and definitions: Sibling aggression and abuse are family violence. J Soc Pers Relat 2025; 42(7): 1800–1817.
  • Schier K, Herke M, Nickel R, et al. Long-term sequelae of emotional parentification: A cross-validation study using sequences of regressions. J Child Fam Stud 2014; 24(5): 1307–1321.
  • Reeb BT, Wu EY, Martin MJ, et al. Long-term effects of fathers’ depressed mood on youth internalizing symptoms in early adulthood. J Res Adolesc 2015; 25(1): 151–162.
  • Carroll JJ, Robinson BE. Depression and parentification among adults as related to parental workaholism and alcoholism. Fam J 2000; 8(4): 360–367.
  • Estevez A, Jauregui P, Lopez-Gonzalez H. Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies. Scand J Psychol 2019; 60(4): 348–360.
  • Chambers JE, Perkins SM, Mosesso KM, et al. Adverse childhood experiences, insecure attachment, and appointment compliance in an outpatient addiction psychiatry treatment population. Am J Addict 2025; 34(3): 334–341.
  • Peris TS, Goeke-Morey MC, Cummings EM, Emery RE. Marital conflict and support seeking by parents in adolescence: Empirical support for the parentification construct. J Fam Psychol 2008; 22(4): 633.
  • Carroll JJ, Robinson BE. Depression and parentification among adults as related to parental workaholism and alcoholism. Fam J 2000; 8(4): 360–367.
  • Olson M, Gariti P. Symbolic loss in horizontal relating: Defining the role of parentification in addictive/destructive relationships. Contemp Fam Ther 1993; 15(3): 197–208.
  • Sebalo I, Königová MP, Sebalo Vňuková M, et al. The associations of adverse childhood experiences (ACEs) with substance use in young adults: A systematic review. Subst Abuse 2023; 17(1): 11782218231178931.
  • Guastaferro K, Linden-Carmichael AN, Chiang SC. Association between child maltreatment and substance use disorder across emerging adulthood. Child Maltreat 2024; 29(2): 340–349.
  • Liese BS, Kim HS, Hodgins DC. Insecure attachment and addiction: Testing the mediating role of emotion dysregulation in four potentially addictive behaviors. Addict Behav 2020; 107: 106432.
  • McGauran A, Brooks M, Khan R. The role of emotional resilience, childhood parentification, and attachment style on antisocial behaviour in adulthood: A comparison of an offender and normative population. J Crim Psychol 2019; 9(2): 75–87.
  • Madden AR, Shaffer A. The relation between parentification and dating communication: The role of romantic attachment-related cognitions. Fam J 2016; 24(3): 313–318.
  • Chatziioannidis S, Andreou C, Agorastos A, et al. The role of attachment anxiety in the relationship between childhood trauma and schizophrenia-spectrum psychosis. Psychiatry Res 2019; 276: 223–231.
  • Trull TJ, Freeman LK, Vebares TJ, et al. Borderline personality disorder and substance use disorders: An updated review. Borderline Pers Disord Emot Dysregul 2018; 5(1): 1–12.
  • National Center for Children. Parentification: An overview of theory, research, and societal issues. In: Burdened children. https://sk.sagepub.com/book/edvol/burdened-children/chpt/parentification-overview-theory-research-societal (Accessed 01.07.2025)
  • Byng‐Hall J. Relieving parentified children’s burdens in families with insecure attachment patterns. Fam Process 2002; 41(3): 375–388.
  • Oznobishin O, Kurman J. Parent-child role reversal and psychological adjustment among immigrant youth in Israel. J Fam Psychol 2009; 23(3): 405–415.
  • Murrin M, Beffel JH, Nuttall AK. The moderating role of self-disclosure among typically developing siblings of individuals with autism spectrum disorder. J Child Fam Stud 2021; 30(2): 364–374.
  • Monaco SB, Heesacker M. Perceived family benefits overshadowed parentification in predicting life satisfaction and relationship satisfaction. Am J Fam Ther 2025; 53(4): 426–449.
  • Khantzian EJ. The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harv Rev Psychiatry 1997; 4(5): 231–244.
  • Wakschlag LS, Hans SL. Relation of maternal responsiveness during infancy to the development of behavior problems in high-risk youths. Dev Psychol 1999; 35(2): 569–579.
Toplam 49 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Psikiyatri
Bölüm Derleme
Yazarlar

Sinem Çetin Demirtaş 0000-0001-9536-2335

Caner Yeşiloğlu 0000-0002-9997-351X

Lut Tamam 0000-0002-9750-7531

Yayımlanma Tarihi
Gönderilme Tarihi 16 Haziran 2025
Kabul Tarihi 14 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 26 Sayı: 4

Kaynak Göster

AMA Çetin Demirtaş S, Yeşiloğlu C, Tamam L. Relationship between Childhood Parentification, Adult Attachment Styles, and Addiction: A Review. Bağımlılık Dergisi. 26(4):1-1.

Bağımlılık Dergisi - Journal of Dependence