A picture is worth a thousand words: children's representations of family as indicators of early attachment

To ascertain whether attachment representations at age 7 are related to early attachment behaviour, family drawings of 123 7-year-olds of known infant attachment status (25 avoidant, 80 secure, 18 resistant) were scored in four ways. Three of these were based in previous attachment research and one was based on a clinical method. The attachment-based coding schemes included specific markers for each attachment pattern (Kaplan & Main, 1985), global ratings (Fury, Carlson, & Sroufe, 1997) and efforts to classify each drawing as belonging to one of the three primary infant attachment groups (secure, avoidant, resistant). In the clinical scheme, children who had been resistant infants were distinguished from the others by use of overlapping and encapsulated figures. For the attachment based schemes, although individual markers were not successful in discriminating attachment groups, the more global approaches (aggregation of markers, global rating scales and judgments of attachment classification) succeeded in this task. In regression analyses controlling for concurrent child and parent measures, infant attachment did not make a significant contribution to predicting insecurity markers in drawings, although child current emotional functioning did. These findings linking attachment relationships with later representations of family relationships were in accord with the conception that avoidant attachment strategies de-emphasize intimate relationships, while resistant attachment strategies are preoccupied with close relationships. These links are most evident in global interpretive strategies rather than those that rely on specific markers.     

Japanese children's family drawings and their link to attachment

The secure base construct represents one of attachment theory’s most important contributions to our understanding of parent–child relationships and child development. The present study represents the first examination of how parents’ self-reported attachment styles relate to parental secure base provision and adolescent (mean age = 16.6 years, SE = .59) secure base use during an observed parent–adolescent interaction. Further, the present study is the first to examine how fathers’, as well as mothers’, attachment styles relate to observed behavior in a parent–child interaction. At the bivariate level, maternal avoidance, but not anxiety, was negatively associated with observed adolescent secure base use. In addition, path analysis revealed that maternal avoidance was indirectly related to less adolescent secure base use through mothers’ self-reported hostile behavior toward their adolescents and through adolescents’ less positive perceptions of their mothers. Further, paternal anxiety, but not avoidance, was indirectly related to less adolescent secure base use through fathers’ self-reported hostile behavior toward their adolescents. No significant findings emerged in relation to parental secure base provision. We discuss these results in the context of attachment theory and suggest directions for future research.     

A new method of evaluating attachment representations in young school-age children: The Manchester Child Attachment Story Task

We describe a new instrument, using a doll-play vignette completion method, which applies concepts and methodologies from infant and adult attachment research to enable identification and detailed classification of internal representations of attachment relationships in young school-age children. Validation of the Manchester Child Attachment Story Task (MCAST) in a normal population (N = 53) shows good interrater reliability and content validity. Patterns of attachment representation identified show stability over time. Comparisons are made with existing methodologies, and potential applications of the instrument and directions for future research are discussed.     

Insecure family bases and adolescent drug abuse: A new approach to family patterns of attachment

Abstract

A new approach to assessing family attachment patterns is presented, using a composite measure of individual attachment representations based on the Bartholomew Attachment Interview. A cluster analysis yielded three different patterns in a sample of N = 37 families with a drug dependent adolescent (age 14 – 25) and both biological parents. A “triangulated” pattern (mothers: preoccupied; fathers: dismissing; adolescents: fearful) was found in 65% of the sample. A total of 19% showed an “insecure” pattern (mothers, fathers, and adolescents: fearful) and 16% a “near-secure” pattern (mothers and adolescents: secure; fathers preoccupied). Preliminary comparisons between these groups indicate differences in comorbid psychiatric disorders, in individual and family functioning, but not in addiction severity. There is a trend towards differences in outcome of family therapy. Implications for treatment and further research are discussed.     

Expectant parents' representations of early attachment relationships: associations with mental health and family history

The association between adult representations of early attachment relationships and history of individual and family mental health was examined in a sample of 233 expectant mothers and fathers. As predicted, security of attachment was linked to mental health. Parents classified as Preoccupied were more likely than other parents to report suicidal ideation. Whereas parents classified as Unresolved more often reported suicidal ideation, emotional distress, and substance abuse. With respect to family history. Unresolved and Preoccupied attachment classifications were significantly related to child abuse involving a relative and parental separation or divorce. These findings support theoretical conceptualizations regarding the link between adult attachment and mental health in middle-class American adults.     

Assessing disorganized attachment representations: a systematic psychometric review and meta-analysis of the Manchester Child Attachment Story Task

Narrative story stem measures are increasingly popular for the assessment of attachment representations among early school-age children. Given their clinical and theoretical importance, disorganized representations are typically a focus of assessment procedures. The Manchester Child Attachment Story Task (MCAST) is one such measure. A systematic literature review and meta-analysis was conducted to evaluate the documented reliability and validity of the MCAST with a focus on assessing disorganized representations. Twenty-five studies were included in the review encompassing 1,876 children from nine countries. Results suggest that inter-rater reliability for the MCAST is acceptable and the prevalence of disorganization identified on the MCAST among various subgroups (e.g. community, clinical, adopted/maltreated) is comparable to prevalence estimates from other developmental periods using other assessment methods. In addition, prevalence of disorganization on the MCAST differed in hypothesized ways between the various subgroups. However, MCAST disorganization did not correlate in predictable ways with many constructs when relationships were examined within samples. Few studies examined the relationship of disorganization on the MCAST with parenting variables, aspects of adoption and maltreatment, and emotion regulation skills. Recommendations for further study of the MCAST and for how the tool might be integrated into clinical and developmental research are provided.     

Mental representations of attachment in Eating Disorders: a pilot study using the Adult Attachment Interview

Mental representations of attachment in a sample of adults with Eating Disorders (ED) were assessed using the Adult Attachment Interview (AAI). Sixty subjects participated in the study: 30 non-clinical and 30 clinical. The results obtained showed a specific distribution of attachment patterns in the clinical sample: 10% Free/Autonomous (F), 47% Insecure-Dismissing (Ds), 17% Insecure-Entangled/Preoccupied (E) and about 26% disorganized (CC/U). The two samples differed in their attachment pattern distribution and were significantly different on some coding system scales. Further information was obtained by analyzing differences between the three ED subtypes considered (i.e. Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder) and by investigating the differential role of the two parental figures in the definition of attachment representations. Results showed potential benefits in using the AAI coding system scales in addition to the main classifications in order to understand better the developmental issues involved in these disorders. Implications for developmental research and clinical nosology are discussed.     

The origins of cognitive vulnerability in early childhood: mechanisms linking early attachment to later depression

This paper examines the theory and research linking attachment relationships to cognitive vulnerability to depression and assesses evidence that early attachment experiences contribute to the development of these cognitive processes. Most research in this area has involved adult participants using self-report measures of both attachment and depressive vulnerabilities and thus cannot convincingly speak to the existence of such a developmental pathway. Several studies, however, have followed individuals from infancy and examined the emergence of self-esteem and responses to failure throughout childhood and adolescence. These studies suggest that early experiences in non-secure attachment relationships place an individual at-risk for developing a cognitive framework that increases their vulnerability to depression following stressful life events. The paper concludes with a discussion of how future research might best explore specific mechanisms through which distinct attachment relationships may lead to divergent developmental pathways sharing the common outcome of cognitive processes that place individuals at risk for depression.     

Early preventive attachment-oriented psychotherapeutic intervention program with parents of a very low birthweight premature infant: Results of attachment and neurological development

The birth of a very small preterm infant ( 1500 grams) can be a traumatizing experience for many parents. A developmental risk model is presented that is the background to an early attachment-oriented preventive psychotherapeutic intervention. This comprehensive parent-centered intervention program is composed of supportive group psychotherapy, attachment-oriented focal individual psychotherapy, a home visit and video-based sensitivity training. The intervention aims at improving parental coping, the process of attachment and parent-infant interaction. In a prospective longitudinal design mothers were randomly assigned to a control (N = 44) and an intervention group (N = 43) after preterm delivery. Results show that the percentage of secure (control vs. intervention group: 77.8% vs. 59.4%) and insecure (control vs. intervention group: 8.3% vs. 31.3% avoidant, 13.9% vs. 9.4% ambivalent) attachment quality in high-risk preterm infants is comparable to results from studies with term infants. There was no significant statistical difference in terms of quality of attachment of the preterm infants between the control group and the intervention group. However, only in the control group, impaired neurological development corresponded significantly with an insecure quality of attachment, but not in the intervention group, although there were significantly more neurologically impaired infants in the intervention group. This result is discussed as an effect of the intervention program.     

Individual differences in children's understanding of emotion: The roles of attachment and language

There is accumulating evidence of a relationship between secure attachment and children's understanding of emotion (Fonagy & Target, 1997; Harris, 1999). The current experiment asked if this relationship is particularly evident when the test of emotion understanding includes attachment-related material or is equally marked on tests with and without attachment-related material. Children ranging from 3–6 years were given a novel test of emotion understanding (the Mother-Infant Separation Test Video) that incorporated provocative attachment themes and also an affectively neutral test of emotion understanding. They performed quite consistently on both types of test - either passing both or failing both. In addition, attachment security, measured concurrently by means of the Separation Anxiety Test, contributed to a correct performance on both tests. This contribution remained when other individual differences were controlled for (age, verbal mental age and gender). Possible explanations of the relationship between attachment and emotion understanding are discussed.     

Analyzing development of working models for disrupted attachments: the case of hidden family violence

This article offers a developmental model of attachment theory rooted in dynamic skill theory. Dynamic skill theory is based on the assumption that people do not have integrated, fundamentally logical minds, but instead develop along naturally fractionated strands of a web. Contrary to traditional interpretations of attachment theory, dynamic skill theory proposes that individuals continue to modify their working models of attachments throughout the lifespan. In particular, working models of close relationships develop systematically through a series of skill levels such that the skills vary across strands in the web and will not automatically form a unified whole. The continual modification of working models is particularly pertinent for the consequences of hidden family violence for individuals' development. Dynamic skill theory shows how trauma can produce not developmental delay or fixation, as has been proposed previously, but instead the construction of advanced, complex working models.     

Attachment representations of school-aged Korean children: comparing family drawing and narrative assessments in a clinical and a community sample

This study explored the links between two different methods of assessing children’s attachment representations, a narrative task (the Manchester Attachment Story Task, MCAST) and a drawing task (the Family Drawing Task, FDT), in a clinical sample of 51 and a community sample of 45 Korean children aged 7–9. In both samples, attachment classifications derived from the MCAST were related to attachment classifications and global ratings derived from the FDT. In addition, rates of insecure attachment determined by MCAST classifications and by FDT global scales indicative of insecure attachment were higher in the clinical sample than the community sample. Variations in attachment patterns for these Korean samples are discussed in relation to Korean child-rearing customs. Results of this study contribute to the cross-cultural validation of both of these instruments, as well as extending our understanding of patterns of attachment in Korea from infancy to middle childhood.     

The differential roles of early emotion socialization and adult attachment in adult emotional experience: Testing a mediator hypothesis

The goal of the present study was to model the relations among self-reported early emotion socialization, adult attachment styles, and positive and negative adult emotion experiences in younger (mean age — 28) and older (mean age — 74) adults. Using structural equation modeling, we found that reports of early emotion socialization had both direct and indirect effects (the latter mediated by attachment style) on adult emotional experiences. There was also some support for the expectation that age would interact with emotion socialization in the effect on adult emotions. Results are discussed in terms of their implications for understanding how attachment and emotion relate across the lifespan.     

Emotional intelligence as a mediator between attachment security and empathy in pre-clinical medical students: A multi-center cross-sectional study

ObjectiveTo explore the association of emotional intelligence (EI) and attachment security (AS) with empathy dimensions in medical students by examining the mediating role of EI.MethodsIn a cross-sectional design, the Interpersonal Reactivity Index (IRI), the Emotional Quotient Inventory (EQ-i), the Attachment Style Questionnaire (ASQ), and demographic questions were administrated to second-year medical students of two medical schools in Northern Italy.Results253 medical students (56.13% female), aged 19–29, participated in this study. AS positively correlated to Empathic Concern (r = 0.17, p = 0.008) and Perspective Taking (r = 0.24, p < 0.001), and negatively to Personal Distress (r = ?0.33, p < 0.001). Individuals with the same level of AS and a higher score on EQ-i had a higher score (β = 0.072, p = 0.033) on empathy latent factor (at the basis of Empathic Concern and Perspective Taking) and a lower score (β = ?0.290, p < 0.001) on Personal Distress than those with a lower EQ-i score.ConclusionThis study shows that EI completely mediated the relationship between AS and empathy dimensions among medical students.Practice implicationsEI training and workshop should be considered when designing educational interventions and programs to enhance empathy and decrease interpersonal distress in medical students.     

Measuring sensitivity moment-by-moment: A microanalytic look at the transmission of attachment

Meta-analyses have indicated that the mediating power of sensitivity in the transmission of attachment across generations is not nearly as great as would be predicted by attachment theory (van IJzendoorn, 1995; De Wolff & van IJzendoorn, 1997). To make sense of these findings, the author suggests that current measures of sensitivity should be expanded to include the assessment of mother-infant behavior on a micro-behavioral level. This paper reviews evidence for two central propositions: (1) The internal working model of mothers is expressed in subtle, fine-grained interactive behaviors with their infants, and (2) infants perceive and remember these behaviors in the form of interactional expectancies. Following these propositions, hypothesized representational micromodels for each major attachment organization are then offered, based on the Parallel Distributed Processing (PDP) approach to information processing. In closing, this paper presents some of the most pressing unresolved issues for attachment researchers as they seek to empirically identify the mechanisms by which attachment is transmitted across generations.     

Unresolved states of mind,anomalous parental behavior,and disorganized attachment: A review and meta-analysis of a transmission gap

Abstract

The current meta-analysis examines the links between unresolved representations of attachment, anomalous parental behavior, and disorganized attachment relationships in 12 studies including 851 families. We found moderate effect sizes for the associations between unresolved states of mind and anomalous behavior (r = .26), unresolved states of mind and infant disorganized attachment relationships (r = .21), and anomalous behavior and disorganized attachment relationships (r = .34). Sample characteristics, observational context, and observational measure were not associated with differences in effect sizes. Only a small part of the association between unresolved states of mind and disorganized attachment relationships was explained by the mediation of anomalous parental behavior (.26? .34 = .09). Other factors yet to be uncovered must mediate the influence of unresolved states of mind on infant disorganized attachment; thus, further exploration of infant, parental, ecological, and genetic factors are warranted.     

Adolescent insecure attachment as a predictor of maladaptive coping and externalizing behaviors in emerging adulthood

This study investigated whether insecure adolescent attachment organization (i.e., preoccupied and dismissing) longitudinally predicted self- and peer-reported externalizing behavior in emerging adulthood. Secondarily, maladaptive coping strategies were examined for their potential role in mediating the relationship between insecure attachment and future externalizing behaviors. Target participants (N = 184) were given the Adult Attachment Interview (AAI) at age 14 and re-interviewed seven and eight years later with their closest peer. Qualities of both preoccupied and dismissing attachment organization predicted self-reported externalizing behaviors in emerging adulthood eight years later, but only preoccupation was predictive of close-peer reports of emerging adult externalizing behavior. Maladaptive coping strategies only mediated the relationship between a dismissing stance toward attachment and future self-reported externalizing behaviors. Understanding the role of coping and emotional regulation in attachment may help us to understand the unique aspects of both dismissing and preoccupied stances toward attachment.     

A developmental model of addictions: integrating neurobiological and psychodynamic theories through the lens of attachment

ABSTRACT

Although substance use and abuse may impact brain and behavior, it is still unclear why some people become addicted while others do not. Neuroscientific theories explain addiction as a series of between- and within-system neuroadaptations that lead to an increasingly dysregulating cycle, affecting reward, motivation, and executive control systems. In contrast, psychoanalysis understands addiction through a relational perspective wherein there is an underlying failure in affect regulation, a capacity shaped early developmentally. Considering recent findings suggesting the neurobiological overlap of addiction and attachment, it may be possible to integrate both perspectives into a developmental model through the lens of attachment. The goal of the present review is to evaluate the value of neurobiological and psychodynamic perspectives to inform our understanding of addiction, particularly substance-use disorders.     

Attachment behavior and mother-child conversations as predictors of attachment representations in middle childhood: A longitudinal study

This study examines longitudinal links between mother–child conversations and attachment patterns in early childhood and later attachment representations. It also tests the role of conversations as mediators in the association between behavioral security and attachment representations. Mother–child conversations (snack-time) and attachment behaviors (Separation-Reunion procedure) were assessed for 83 5.5-year-olds while attachment representations (attachment narratives) were measured at 8.5 years of age. Results showed correspondence between attachment behaviors and representations for secure-confident, ambivalent-preoccupied, and disorganized/controlling-frightened groups. Affective quality of mother–child conversations predicted both child attachment behaviors and representations. Secure and confident children showed greater integration of affective information, ambivalent and preoccupied children more affect exaggeration, and disorganized/controlling and frightened children more chaotic conversations. Avoidant children tended to show more affect minimization in conversations. Finally, mother–child conversations centered on the sharing of emotions and thoughts mediated the relation between behavioral and representational attachment security, which underscores the importance of mother–child conversations in the development of attachment representations in childhood.