Attachment and alexithymia as risk factors for emotional-behavioral problems in institutionalized, late-adopted and community teenagers: mixed-method multi-informant prediction models.

Introduction. Italy counts more than 50.000 adolescents placed in residential-care [RC] or late-adopted [LA] due to adverse experiences in their family of origin. Despite different life conditions of RC and LA adolescents, they both show greater vulnerability to emotional-behavioral problems and psychological risk factors -as insecure/disorganized attachment and alexithymia- compared to low-risk community peers [COM]. For the first time, this study investigated attachment and alexithymia as independent and mutual predictors for emotional-behavioral problems in either institutionalized, late-adopted, and community adolescents, employing a mixed-method multi-informant approach. Method. 174 adolescents (Mage = 15 years old, 53% boys) -50 RC, 33 LA, and 91 COM- were assessed in emotional-behavioral problems (total, internalizing and externalizing type) through both a parent-report and a self-report questionnaire; both attachment and alexithymia through both interviews and self-report questionnaires. Results. General linear models of predictions were significant for all types of problems (p <.001). Belong to both RC or LA group was a risk factor for more total problems. Moreover, an interactive effect of attachment insecurity and more alexithymia predicted 50% more internalizing problems, while only alexithymia predicted 18% more externalizing problems in all adolescents, regardless of the belonging group (RC, LA, COM). Lastly, few discrepancies were detected according to the informant or method used. Discussion. In conclusion, belong to the RC or LA group, higher attachment insecurity and alexithymia were all risk factors for more emotional-behavioral problems, even if they followed different pathways. Indeed, practitioners should be aware that the aforementioned risk factors showed different mechanisms of risk depending on the group, type of problems, problems’ informant, or method of assessment.