Attachment and ADHD: how are they related? Exploring the application of the Learning Theory of Attachment to ADHD

Children with ADHD are often insecurely attached. Despite its importance, there is very little research on, or understanding of, the mechanisms underlying insecure attachment in ADHD. The Learning Theory of Attachment (Bosmans et al., 2020) proposes insecure attachment to be largely grounded in learning experiences; over time the child learns to trust the parent and develops secure attachment through consistent soothing by parents in distressing situations. The Dopamine Transfer Deficit hypothesis (Tripp & Wickens, 2008) proposes learning deficits underlie ADHD behavior. Building on both these theories, we propose that alterations in dopamine-related learning may drive the higher rates of insecure attachment in children with ADHD; potentially linked to altered dopamine functioning they may have more difficulty in learning to trust their parents in daily life, to associate their parents with comfort, and as a result have a higher chance of developing insecure attachment. We present this novel “Learning Theory of Attachment model in ADHD” to explain attachment development in ADHD, integrating important insights from both theories. Finally, we reflect on the potential relevance of this Learning Theory of Attachment model in ADHD for both behavioral and pharmacological interventions for children with ADHD.