Abstract
OBJECTIVE: This systematic review and meta-analysis assessed the Friends and Family Interview (FFI) as a tool for measuring attachment in middle childhood and adolescence. METHODS: A comprehensive search was conducted following PRISMA guidelines across Scopus, Web of Sciences, PsycINFO and PubMed, covering literature from 2004 to 2024. Out of 3000 screened records, 52 studies were selected for narrative synthesis and 32 for meta-analysis. Data extraction used a structured coding protocol and quality was assessed with the Newcastle-Ottawa Scale. RESULTS: The meta-analysis included 2867 participants, revealing significant study heterogeneity. At-risk samples (k = 13, n = 598) had a higher prevalence of insecure attachment compared to community samples (k = 11, n = 1080). Clinical samples (three, all with anxiety disorders) mostly showed secure classifications. Cultural differences in attachment were observed between European and Northern American or Latin samples. Attachment disorganization scores correlated positively and significantly with internalizing and thought symptoms, while scores for Security, Insecure-Dismissing, Coherence, Secure Base/Safe Haven mother and father scores were associated to verbal IQ, with moderating effects of (older) age, (female) gender and sample risk. CONCLUSIONS: The FFI shows potential as an attachment assessment tool, but issues like study heterogeneity and cultural bias require further research to improve its applicability across diverse populations.