Attachment and social competence: a study using MCAST in low-risk Italian preschoolers

The Manchester Child Attachment Story Task (MCAST) is a story stem method suitable for children aged about 4 to 8, aimed at assessing children's attachment representations with a doll-play format that is evaluated with a series of dimensional scales and classifications. Although this instrument has already been validated in previous studies, not all of the findings have been conclusive. The aims of the present study were (1) to examine the factor structure of the MCAST scales, and (2) to test the association between children's dichotomized MCAST classifications and factors with social competence, using the Social Competence and Behavior Evaluation Scale (SCBE) with a normative group of Italian preschoolers (age range 4.4 to 6.1). Results obtained from a sample of 64 children confirm the association of MCAST attachment classifications (security vs. insecurity and organization vs. disorganization) with both social skills and behavioral problems. Further independent studies on the variables analyzed are recommended for corroborating the findings obtained.     

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.     

Continuity and discontinuity of attachment patterns: a short-term longitudinal pilot study using a sample of late-adopted children and their adoptive mothers

This study analysed the attachment patterns of 28 late-adopted children (placed when they were between four and seven years of age) and their adoptive mothers. The change in the children's internal working models (IWMs) within seven to eight months of their placement was evaluated. In addition, we wanted to observe the influence of a secure-autonomous maternal state of mind in facilitating the change in the children's IWMs and the possible associations between the maternal IWMs and the children's IWMs in the adoptive dyads. The separation-reunion procedure (SRP) was used for the late-adopted children in order to assess their attachment behavioural patterns, and the Manchester Child Attachment Story Task (MCAST) was used to evaluate their attachment narrative patterns. The adoptive mothers completed the Adult Attachment Interview (AAI) in order to classify their state of mind with regard to attachment. The results showed a significant change in the attachment behavioural patterns of late-adopted children, from insecure to secure (p = .002). Furthermore, the children who presented this change were predominantly placed with secure-autonomous adoptive mothers (p = .047), although the link between the adoptive mothers' representations of their attachment history and their adopted children's completed narratives was not significant. In conclusion, it seems possible to revise the attachment behaviour of late-adopted children but, for about one-third of children, the adverse history will persist at a narrative/representational level.     

Continuity and discontinuity of attachment patterns: A short-term longitudinal pilot study using a sample of late-adopted children and their adoptive mothers

This study analysed the attachment patterns of 28 late-adopted children (placed when they were between four and seven years of age) and their adoptive mothers. The change in the children's internal working models (IWMs) within seven to eight months of their placement was evaluated. In addition, we wanted to observe the influence of a secure-autonomous maternal state of mind in facilitating the change in the children's IWMs and the possible associations between the maternal IWMs and the children's IWMs in the adoptive dyads. The separation-reunion procedure (SRP) was used for the late-adopted children in order to assess their attachment behavioural patterns, and the Manchester Child Attachment Story Task (MCAST) was used to evaluate their attachment narrative patterns. The adoptive mothers completed the Adult Attachment Interview (AAI) in order to classify their state of mind with regard to attachment. The results showed a significant change in the attachment behavioural patterns of late-adopted children, from insecure to secure (p = .002). Furthermore, the children who presented this change were predominantly placed with secure-autonomous adoptive mothers (p = .047), although the link between the adoptive mothers' representations of their attachment history and their adopted children's completed narratives was not significant. In conclusion, it seems possible to revise the attachment behaviour of late-adopted children but, for about one-third of children, the adverse history will persist at a narrative/representational level.     

Attachment in infancy and preschool in low socioeconomic status rural Appalachian children: stability and change and relations to preschool and kindergarten competence

Attachment classifications were obtained from the Strange Situation at 15 months and at 4 years for a sample of 82 low socioeconomic status rural Appalachian children. The rate of secure attachment in infancy was 50.5%, and the majority of insecure infants were disorganized. At 4 years of age 61.2% of children were secure; early secure relationships were likely to be maintained, and about half of the insecure infants changed to a secure classification by 4 years. Overall, there was low but significant stability in attachment at the level of secure/insecure. Comparisons of (a) children who changed from insecure to secure with those who were stable insecure and (b) stable secure children with those who changed from secure to insecure identified contextual, child, and maternal interaction factors associated with attaining secure attachment. Assessments of cognitive and socioemotional competence at 4 years and kindergarten age suggested a protective effect of secure infant attachment but little benefit from secure preschool attachment.     

Maternal sensitivity and infant attachment security in Korea: cross-cultural validation of the Strange Situation

The present study sought to analyze infant and maternal behavior both during the Strange Situation Procedure (SSP) and a free play session in a Korean sample (N = 87) to help understand whether mother-infant attachment relationships are universal or culture-specific. Distributions of attachment classifications in the Korean sample were compared with a cross-national sample. Behavior of mothers and infants following the two separation episodes in the SSP, including mothers' proximity to their infants and infants' approach to the caregiver, was also observed, as was the association between maternal sensitivity observed during free play session and infant security. The percentage of Korean infants classified as secure versus insecure mirrored the global distribution, however, only one Korean baby was classified as avoidant. Following the separation episodes in the Strange Situation, Korean mothers were more likely than mothers in Ainsworth's Baltimore sample to approach their babies immediately and sit beside them throughout the reunion episodes, even when their babies were no longer distressed. Also, Korean babies less often approached their mothers during reunions than did infants in the Baltimore sample. Finally, the link between maternal sensitivity and infant security was significant. The findings support the idea that the basic secure base function of attachment is universal and the SSP is a valid measure of secure attachment, but cultural differences in caregiving may result in variations in how this function is manifested.     

Developmental protective and risk factors in borderline personality disorder: a study using the Adult Attachment Interview

Mental representations and attachment in a sample of adults with Borderline Personality Disorder were assessed using the George, Kaplan and Main (1985) Adult Attachment Interview (AAI). Eighty subjects participated in the study: 40 nonclinical and 40 with Borderline Personality Disorder (BPD). The results obtained showed a specific distribution of attachment patterns in the clinical sample: free/autonomous subjects (F) represented only 7%, dismissing classifications (Ds) reached about 20%, entangled/preoccupied (E) 23% and unresolved with traumatic experiences (U) 50%. The two samples differed in their attachment patterns distribution by two (secure vs. insecure status), three (F, Ds and E) and four-way (F, Ds, E and U) categories comparisons. In order to identify more specific protective or risk factors of BPD, 25 one-way ANOVAs with clinical status as variable (clinical vs. nonclinical) were conducted on each scale of the coding system of the interview. Results support the hypothesis that some developmental relational experiences seem to constitute pivotal risk factors underlying this disorder. Results demonstrated potential benefits in using AAI scales in addition to the traditional categories. Implications for research and treatment are discussed.     

Disorganized attachment representation and atypical parenting in young school age children with externalizing disorder

We investigated the relationship of child attachment representation, psychopathology, and maternal atypical parenting in a high risk sample. Sixty-one consecutive clinical referrals with externalizing disorder aged 4 - 9 years were assessed for attachment representations measured with Manchester Child Attachment Story Task (MCAST), atypical parental expressed emotion (EE), maternal mood, and parent and teacher ratings of child behaviour. Disorganized attachment representations were found in 58% of cases, independent of ADHD symptoms. Pervasive disorganization was associated with very high maternal EE. Attachment status, maternal depression, and ADHD diagnosis were independently associated with parent-rated child behaviour problems; teacher ratings were associated with child's age and ADHD status. Disorganized attachment shows a high prevalence and independent associations with attention deficit symptomatology and maternal EE.     

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.     

Developmental protective and risk factors in borderline personality disorder: A study using the Adult Attachment Interview

Mental representations and attachment in a sample of adults with Borderline Personality Disorder were assessed using the George, Kaplan and Main (1985) Adult Attachment Interview (AAI). Eighty subjects participated in the study: 40 nonclinical and 40 with Borderline Personality Disorder (BPD). The results obtained showed a specific distribution of attachment patterns in the clinical sample: free/autonomous subjects (F) represented only 7%, dismissing classifications (Ds) reached about 20%, entangled/preoccupied (E) 23% and unresolved with traumatic experiences (U) 50%. The two samples differed in their attachment patterns distribution by two (secure vs. insecure status), three (F, Ds and E) and four-way (F, Ds, E and U) categories comparisons. In order to identify more specific protective or risk factors of BPD, 25 one-way ANOVAs with clinical status as variable (clinical vs. nonclinical) were conducted on each scale of the coding system of the interview. Results support the hypothesis that some developmental relational experiences seem to constitute pivotal risk factors underlying this disorder. Results demonstrated potential benefits in using AAI scales in addition to the traditional categories. Implications for research and treatment are discussed.     

Attachment and behavior problems in middle childhood as reported by adult and child informants

The predictive relation between attachment and mother, teacher, and self-reported psychopathology was examined for a diverse socioeconomic status French Canadian sample of 96 children. Attachment classifications were assigned on the basis of reunion behavior with mother when the children were approximately 6 years old, and child problem behavior was assessed 2 years later using the Child Behavior Checklist (mother report), the Social Behavior Questionaire (teacher report), and the Dominic Questionnaire (child self-report). Results indicated that both insecure/ambivalent and insecure/controlling children children were rated higher than secure children on a composite measure of externalizing problems. Concerning internalizing problems, only the controlling group was significantly higher on both a composite adult (teacher and mother) and self-report measure of internalizing problems. Analyses of clinical cutoff scores showed that only the controlling group had a significantly greater likelihood of overall problem behavior than other children.     

The development of attachment in new relationships: single subject analyses for 10 foster infants

This paper presents single-subject analyses of newly developing attachment relationships in 10 foster infant-caregiver dyads. Using a diary methodology, at least 2 months of daily data were provided by foster parents on infants' attachment behaviors. Foster infant attachment was also assessed using the Strange Situation. Foster mother state of mind regarding attachment was measured using the Adult Attachment Interview. For eight infants, diary data revealed predominant patterns of attachment behavior emerging within 2 months of placement. In most cases, diary data predicted Strange Situation classifications. Both Strange Situation and diary data indicated that the three children placed in foster care before 12 months of age with foster parents having primary or secondary autonomous states of mind were classified as having secure attachments. The five children placed after 12 months of age showed predominantly insecure attachment behavior in the diary and were classified as insecure in the Strange Situation. Contingency analyses of behavioral sequences reported in the diary revealed that foster parents tended to complement their foster childrens' attachment behaviors.     

The relationship between attachment strategies and psychopathology in adolescence

Aim: The majority of research investigating attachment and psychopathology has focused largely on children, and more recently adults. By comparison, few studies have considered the role of attachment on the development of psychopathology during adolescence. The scarcity of studies in this area is surprising given that adolescence is a critical period of psychological adjustment. This study investigates attachment patterns in adolescence and their relationship to symptomatology and interpersonal difficulties. Method: A two‐sample comparative design was employed so that a clinical group of adolescents were compared with a matched non‐clinical group, on attachment classifications (using a modified Separation Anxiety Test), reported interpersonal difficulties and clinical symptoms. Results: Significant differences were found between the clinical and non‐clinical groups on attachment classifications. Adolescents with ambivalent attachment patterns reported significantly more interpersonal difficulties and symptoms compared to young people classified as having secure and avoidant attachment classifications. The results are suggestive of specific differences in the way difficulties are reported. Conclusion: The findings are consistent with two strategies of affect regulation. It is proposed that a ‘hyperactivating’ strategy and a ‘deactivating’ strategy may be operating among those adolescents with ambivalent and avoidant attachment classifications, respectively. The implications of using self‐report measures in clinical work and for evidence‐based practice are discussed.     

Interpersonal vulnerability to depression in high-risk children: the role of insecure attachment and reassurance seeking.

This study examined the relation between insecure attachment and depression in a sample of 140 children (69 boys and 71 girls; ages 6 to 14) whose parents have a history of major depressive episodes. In addition, we examined whether this relation was moderated by excessive reassurance seeking. Children completed measures assessing insecure attachment to parents, excessive reassurance seeking, and current depressive symptoms. In addition, children and their parents participated in a semistructured clinical interview assessing children's current and past history of depressive symptoms and episodes. In line with hypotheses, children who exhibited high levels of both insecure attachment and excessive reassurance seeking experienced higher levels of current depressive symptoms than children who possessed only one or neither of these interpersonal risk factors. Furthermore, the interaction of insecure attachment with excessive reassurance was associated with a past history and greater severity of depressive episodes even after controlling for current depressive symptoms.     

Changing toddlers' and preschoolers' attachment classifications: the Circle of Security intervention

The Circle of Security intervention uses a group treatment modality to provide parent education and psychotherapy that is based on attachment theory. The purpose of this study was to track changes in children's attachment classifications pre- and immediately postintervention. Participants were 65 toddler- or preschooler- caregiver dyads recruited from Head Start and Early Head Start programs. As predicted, there were significant within-subject changes from disorganized to organized attachment classifications, with a majority changing to the secure classification. In addition, only 1 of the 13 preintervention securely attached children shifted to an insecure classification. Results suggest that the Circle of Security protocol is a promising intervention for the reduction of disorganized and insecure attachment in high-risk toddlers and preschoolers.     

Continuities and changes in infant attachment patterns across two generations

This study examined the intergenerational continuities and changes in infant attachment patterns within a higher-risk longitudinal sample of 55 female participants born into poverty. Infant attachment was assessed using the Strange Situation when participants were 12 and 18 months as well as several decades later with participants’ children. Paralleling earlier findings from this sample on the stability of attachment patterns from infancy to young adulthood, results provided evidence for intergenerational continuities in attachment disorganization but not security. Children of adults with histories of infant attachment disorganization were at an increased risk of forming disorganized attachments. Although changes in infant attachment patterns across the two generations were not correlated with individuals’ caregiving experiences or interpersonal stresses and supports during childhood and adolescence, higher quality social support during adulthood was associated with intergenerational changes from insecure to secure infant–caregiver attachment relationships.     

Narratives of attachment in middle childhood: do gender,age, and risk-status matter for the quality of attachment?

Attachment in middle childhood increasingly attracts the interest of developmental psychologists and clinicians. Recent studies using attachment narratives elicited by story stems reported gender-specific aspects of attachment development, potentially evoked by developmental tasks during this period of the life span. There is evidence that children with risk factors present more insecure and disorganized attachment narratives compared to children without risk. Yet, there is little research concerning the joint effects of gender, risk, and age for attachment classifications. The paper presents a pooled analysis of 22 samples (eight risk samples) including 887 children (411 girls), aged between 4.5 and 8.5 years who were assessed with the same “German Attachment Story Completion Procedure” (GASCP). Girls were 1.8 times more likely to present secure and 0.4 times less likely to present disorganized narratives compared to boys when controlling for risk status and age. Children from risk samples were more likely (odd ratio 5.4) to display disorganized and less likely to show a secure attachment (odd ratio 0.3) compared to those from no-risk samples in multilevel logistic regressions. Remarkably, the effect of risk was not moderated by age and gender, and gender effects were not moderated by age.     

Parental PTSD,adverse parenting and child attachment in a refugee sample

In contrast with traumatic experiences, there is a dearth of studies on the link between trauma symptoms, disconnected (frightened, threatening and dissociative) parenting behavior, extremely insensitive parenting behavior and child attachment. This study extends previous work on the impact of posttraumatic stress disorder (PTSD) on families by studying the unique contribution of disconnected and extremely insensitive parenting behavior on child attachment in a highly traumatized sample of 68 asylum seekers and refugees and their children (18–42 months). The results show that parental symptoms of PTSD are directly related to children’s insecure attachment and disorganized attachment. The greatest proportion of the risk could be attributed to factors related to the dyad and not the family. A mediation effect of adverse parenting behavior was not confirmed. On the one hand the results indicate the need for an effective treatment of PTSD symptomatology while on the other hand the results indicate the need for clinical attention to insecure attachment relationships.     

Attachment states of mind, mentalization, and their correlates in a first-episode psychosis sample

Objectives.?Although there has been increased interest in applying attachment theory to the psychological understanding of psychosis, research to date has focused on self-reported attachment and psychotic symptomatology. This study presents evidence for applying attachment and mentalization constructs to understanding engagement and adaptation to first-episode psychosis (FEP), using a narrative based interview. Design.?A cross-sectional cohort design was used. Methods.?Thirty-four individuals with a first episode of psychosis were interviewed using the Adult Attachment Interview. Attachment classifications and reflective function scores were derived from the interview. Psychotic symptomatology, premorbid adjustment, duration of untreated psychosis, and psychological variables were also measured. Results.?Attachment distribution was heterogeneous in the sample, although the majority of participants were classified dismissing of attachment. Mentalization scores were consistent with previous clinical samples. Attachment and mentalization were unrelated to psychotic symptomatology. Conclusions.?The current study demonstrates, albeit with a small clinical sample, the importance of assessing attachment and mentalization via narrative methods. The findings also have clinical implications for understanding the process of engagement and adaptation in FEP.     

Child-parent attachment following early institutional deprivation

Child-parent attachment quality with an adoptive caregiver at age 4 years was examined in a sample of 111 children adopted into the United Kingdom following early severe deprivation in Romania and a comparison group of 52 nondeprived within-United Kingdom adoptees. Findings indicated that, compared with nondeprived adoptees, children who experienced early severe deprivation were less likely to be securely attached and more likely to show atypical patterns of attachment behavior; ordinary forms of insecure attachment were not associated with deprivation. Within the sample of deprived adoptees, there was a dose-response association between duration of deprivation and disturbances in attachment behavior. In addition, a minority of children who experienced severe early deprivation were classified as avoidant, secure, or dependent using conventional classification strategies, despite also exhibiting atypical patterns of attachment behaviors, and this was also more likely among children exposed to prolonged deprivation. The results raise both theoretical and methodological implications for attachment research on very deprived children.