Okul Öncesi Çocukların Psikososyal Sorunları ile Ebeveynlerinin Bağlanma Biçimleri Arasındaki İlişki: Aile Sağlığı Merkezlerinden Kanıtlar

Abstract

Amaç: Bu çalışma, ebeveynlerin bağlanma biçimleri ile okul öncesi çocukların davranış sorunları arasındaki ilişkiyi incelemek amacıyla yapılmıştır. 

Yöntem: Kesitsel ve korelasyonel tasarımdaki araştırma aile sağlığı merkezlerinde kayıtlı 670 ebeveyn ve çocukları ile yürütülmüştür. Veriler Çocuk-Ebeveyn Bilgi Formu, Resimli Psikososyal ve Davranış Sorunları Kontrol Listesi ve Yakın İlişkilerde Yaşantılar Envanteri-II ile toplandı. Veriler tanımlayıcı analizler, Pearson korelasyon  ve lojistik regresyon analizleri ile incelendi.

Bulgular: Ebeveynlerin yaş ortalaması 35,00±5,19’du. Okul öncesi çocuklarda psikososyal sorunların oranı %26,3 bulundu. Ebeveynlerin bağlanma düzeyleri ile çocukların psikososyal sorunları arasında pozitif, zayıf bir ilişki saptandı (p<0,05). Ebeveynlerin birlikte yaşama durumu ve kaygılı bağlanma biçimi, okul öncesi çocuklarda psikososyal problemlerle ilişkiliydi (p=0.001). 

Sonuçlar: Okul öncesi çocuklarda psikososyal sorunlar yaygındır, her dört çocuktan birinde görülmektedir Ebeveynlerin birlikte yaşama durumu ve kaygılı bağlanma biçimi okul öncesi çocuklarda psikososyal sorunlar için önemli risk faktörleridir. Birinci basamak sağlık hizmetlerinde psikososyal taramalar uygulanmalıdır. Sağlık profesyonelleri risk altındaki aileler için aile hekimliği erken müdahale programları uygulayabilir.

Keywords

• bağlanma biçimi
• davranış sorunları
• okul öncesi çocuklar
• psikososyal problem
• yetişkin bağlanması

The Relationship Between Psychosocial Problems of Preschool Children and Their Parents' Attachment Styles: Evidence From Family Health Centers

Abstract

Objective: This study aims to examine the relationship between parents’ attachment styles and behavioural problems of preschool children. 

Materials and Methods: Utilizing a cross-sectional and correlational design, data were collected from 670 parents and their children registered at family health centers. Data were collected using the Child/Parent Information Form, the Pictorial Paediatric Symptom Checklist, and the Experiences in Close Relationships-Revised. Data were analysed using descriptives, Pearson correlation, and logistic regression analyses.

Results: The mean age of the parents was 35.00±5.19 years. The rate of psychosocial problems in preschoolers was 26.3%. A positive, weak relationship was found between parents’ attachment and psychosocial problems in children (p<0.05). Parental cohabitation status and anxious attachment style significantly predicted psychosocial problems in preschoolers (p = 0.001). 

Conclusions: Psychosocial problems are highly prevalent among preschoolers, affecting one in four children. Parental cohabitation status and anxious attachment styles constitute significant risk factors. Therefore, primary care services should implement psychosocial screenings. Health professionals can implement early intervention programs for at-risk families within family medicine. 

Keywords

• adult attachment
• attachment style
• behavioral problems
• preschool children
• psychosocial problems

References

1. 1. Ilter Bahadur E, Zengin Akkus P, Yan M, Yılmaz Celebi M, et al. The risk factors for preschoolers’ behavioral problems in a low/middle‐income country. Pediatr Int. 2025 Jan-Dec;67(1):e15829. doi: 10.1111/ped.15829.
2. 2. McLean RK, Tully LA, Dadds MR, et al. Reliability, predictive validity and normative data for the Pediatric Symptom Checklist–17 in a national Australian sample. Aust N Z J Psychiatry. 2025 Aug;59(8):702–712. doi: 10.1177/00048674251342952.
3. 3. Karabekiroğlu K, Rodopman–Arman A. Parental attachment style and severity of emotional/behavioral problems in toddlerhood. Noro Psikiyatr Ars. 2011;48(2):147–154. doi: 10.4274/npa.y5684.
4. 4. Bowlby J. The nature of the child’s tie to his mother. Int J Psychoanal. 1958;39(5):350–73.
5. 5. Bowlby J. Attachment and loss: Volume 1. Attachment. New York: Basic Books; 1969;37–39.
6. 6. Smit S, Martens C, Ackland P, et al. Combining attachment and mindfulness to improve family functioning: Pilot of an attachment-based mindfulness program. J Fam Psychother. 2018;29(4):336–58. doi: 10.1080/08975353.2018.1487247
7. 7. Ahmadova P, Yavuz M. An ınvestigation of the relationshıp between mother's attachment characteristics, parental attitudes, mental and behavioral status. Biruni Health and Education Sciences Journal (BHESJ). 2019;3:1–28. [cited 2026 May 12]. Available from: https://openaccess.biruni.edu.tr/xmlui/handle/20.500.12445/2886
8. 8. Algan GA, Şendil G. The relations among parents’ and preschool children’s attachment security and child rearing attitudes. Studies in Psychology. 2013;33(1):55–68.

9. 9. Ferreira T, Matias M, Carvalho H, et al. Parent-partner and parent-child attachment: Links to children’s emotion regulation. J Appl Dev Psychol. 2024;91:101617. doi: 10.1016/j.appdev.2023.101617
10. 10. Bilaç Ö, Önder A, Kavurma C, et al. Evaluation of the parental attitudes, competency and attachment styles of the mothers of the children at preschool period who were admitted to child psychiatry services. Turkish J Clin Psy. 2020;23(1):83–91. doi: 10.5505/kpd.2020.07078
11. 11. Fonseca A, Nazaré B, Canavarro MC. Mothers’ and fathers’ attachment and caregiving representations during transition to parenthood: an actor–partner approach. J Reprod Infant Psychol. 2018 Jul;36(3):246–260. doi: 10.1080/02646838.2018.1449194.
12. 12. Jones JD, Stern JA, Fitter MH, et al. Attachment and attitudes toward children: Effects of security priming in parents and non-parents. Attach Hum Dev. 2022;24(2):147–68. doi: 10.1080/14616734.2021.1881983.
13. 13. Jing B, Michiyo K. Associations between adult attachment, maternal emotion socialization and child behavior. Psychol Rep. 2025 Dec;128(6):4513–4532. doi: 10.1177/00332941231218422.
14. 14. Hatakka E, Flykt M, Rusanen E, et al. Longitudinal associations between parental bonding and child preschool social-emotional problems: the unique and combined role of mothers and fathers. Child Psychiat Hum D. 2025 Jul. doi: 10.1007/s10578-025-01886-4.
15. 15. Sümer N, Sakman E, Harma M, et al. Turkish mothers’ attachment orientations and mental representations of their children. J Reprod Infant Psychol. 2015;34(1):49–63. doi: 10.1080/02646838.2015.1092020
16. 16. Shirkhanlou Z, Tahmasebi S, Mohammadi Arya A, et al. An investigation of relationship between parental attachment styles, mental health and parenting styles towards behavioral problems of preschool children by ıntervention of child attachment: An explanation to the structural equation. Journal of Childhood Health and Education. 2021;2(2): 93–113. http://jeche.ir/article-1-48-en.html
17. 17. Republic of Türkiye Ministry of Industry and Technology. Sosyo-Ekonomik Gelişmişlik Sıralaması Araştırmaları (SEGE). (2022). [cited 2021 Feb 28]. Available from: https://www.sanayi.gov.tr/merkez-birimi/b94224510b7b/sege
18. 18. Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91. doi: 10.3758/bf03193146
19. 19. Leiner MA, Balcazar H, Straus DC, et al. Screening Mexicans for psychosocial and behavioral problems during pediatric consultation. Rev Invest Clin. 2007; 59(2):116–23.
20. 20. Leiner MA, Puertas H, Caratachea R, et al. Sensitivity and specificity of the pictorial pediatric symptom checklist for psychosocial problem detection in a Mexican sample. Rev Invest Clin. 2010;62(6):560–7.
21. 21. Ardıç E, Ünsal G, Bayram S. Validity and reliability of the Pictorial Pediatric Symptom Checklist. J Psy Nurs. 2020;11(1):20–7. doi: 10.14744/phd.2019.56933
22. 22. Cortina JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol. 1993;78(1):98–104. doi: 10.1037/0021-9010.78.1.98.
23. 23. Fraley RC, Waller NG, Brennan KA. An item response theory analysis of self-report measures of adult attachment. J Pers Soc Psychol. 2000;78(2):350–65. doi: 10.1037//0022-3514.78.2.350
24. 24. Selçuk E, Günaydın G, Sümer N, et al. A new scale developed to measure adult attachment dimensions: Experiences in Close Relationships- Revised (ECR-R)-psychometric evaluation in a Turkish sample. Turkish Psychological Articles. 2005;8(16):1–11. https://search.trdizin.gov.tr/tr/yayin/detay/65434
25. 25. Hutchings J, Williams ME, Leijten P. Attachment, behavior problems and interventions. Front Child Adolesc Psychiatry. 2023;2: 1156407. doi: 10.3389/frcha.2023.1156407.
26. 26. Kaya İ. Problem behavior and early intervention. In Problem behaviors in children: Understanding and prevention. [in Turkish]. Istanbul: IUC University Press; 2024. p. 1–5. doi: 10.5152/8700.
27. 27. Leiner M, Villanos MT, Puertas H, et al. The emotional and behavioral problems of children exposed to poverty and/or collective violence in communities at the Mexico-United States border: A comparative study. Salud Ment (Mex). 2015;38(2):95–102. doi: 10.17711/SM.0185-3325.2015.013.
28. 28. Mokashi MV. Impact of parenting practices on behavioral problems of rural and urban preschool children of Dharwad district, Karnataka, India. Braz J Dev. 2024;10(3):e68486-e68486. doi: 10.34117/bjdv10n3-081.
29. 29. Öner O, Karaca S, Cangur S. The validity and reliability of pictorial pediatric symptom checklist in children of 4-5 ages. Anatol J Psychiatry. 2019;20(SI1): 73–81. doi: 10.5455/apd.39053.
30. 30. Republic of Turkey Ministry of Health General Directorate of Public Health Department of Child and Adolescent Health [Internet]. (2018). Infant, child, adolescent monitoring protocols. Ankara. [cited 2021 March 03]. Available from: https://platform.who.int/docs/default-source/mca-documents/policy-documents/guideline/TUR-MN-62-02-GUIDELINE-2018-tur-Infant-Child-and-Adolescent-Follow-up-Protocols.pdf
31. 31. Cowan PA, Cohn DA, Cowan CP, et al. Parents’ attachment histories and children’s externalizing and internalizing behaviors: Exploring family systems models of linkage. J Consult Clin Psychol. 1996; 64(1):53–63 doi: 10.1037/0022-006X.64.1.53.
32. 32. Marchand JF, Schedler S, Wagstaff DA. The role of parents’ attachment orientations, depressive symptoms, and conflict behaviors in children’s externalizing and internalizing behavior problems. Early Child Res Q. 2004;19(3):449–62. doi: 10.1016/j.ecresq.2004.07.003.
33. 33. Klemfuss JZ, Wallin AR, Quas JA. Attachment, household chaos, and children’s health. Fam Syst Health. 2018;36(3):303–314. doi: 10.1037/fsh0000303.
34. 34. Bolattekin A. Examining the effect of parents' attachment and parents' attitudes on childrens' behavior problems [master’s thesis]. İstanbul: İstanbul Arel University; 2014. p. 64–6.
35. 35. Cowan PA, Cowan CP, Pruett MK, et al. Fathers’ and mothers’ attachment styles, couple conflict, parenting quality, and children’s behavior problems: An intervention test of mediation. Attach Hum Dev. 2019;21(5):532–50. doi: 10.1080/14616734.2019.1582600.
36. 36. Bergström M, Salari R, Hjern A, et al. Importance of living arrangements and coparenting quality for young children's mental health after parental divorce: a cross-sectional parental survey. BMJ Paediatr Open. 2021;26;5(1):e000657. doi: 10.1136/bmjpo-2020-000657.
37. 37. Grüning Parache L, Vogel M, Meigen C, et al. Family structure, socioeconomic status, and mental health in childhood. Eur Child Adolesc Psychiatry. 2024;33:2377–2386. doi: 10.1007/s00787-023-02329-y.
38. 38. Jugovac S, O'Kearney R, Hawes DJ, et al. Attachment- and emotion-focused parenting ınterventions for child and adolescent externalizing and ınternalizing behaviors: A meta-analysis. Clin Child Fam Psychol Rev. 2022;25(4):754–73. doi: 10.1007/s10567-022-00401-8.