Longitudinal association between infant disorganized attachment and childhood posttraumatic stress symptoms

The purpose of this study was to evaluate whether children with a history of disorganized attachment in infancy were more likely than children without a history of disorganized attachment to exhibit symptoms of posttraumatic stress disorder (PTSD) at school age following trauma exposure. The sample consisted of 78 8.5-year-old children from a larger, ongoing prospective study evaluating the effects of intrauterine cocaine exposure (IUCE) on children's growth and development from birth to adolescence. At the 12-month visit, children's attachment status was scored from videotapes of infant-caregiver dyads in Ainsworth's strange situation. At the 8.5-year visit, children were administered the Violence Exposure Scale-Revised, a child-report trauma exposure inventory, and the Diagnostic Interview for Children and Adolescents by an experienced clinical psychologist masked to children's attachment status and IUCE status. Sixteen of the 78 children (21%) were classified as insecure-disorganized/insecure-other at 12 months. Poisson regressions covarying IUCE, gender, and continuity of maternal care indicated that disorganized attachment status at 12 months, compared with nondisorganized attachment status, significantly predicted both higher avoidance cluster PTSD symptoms and higher reexperiencing cluster PTSD symptoms. These findings suggest that the quality of early dyadic relationships may be linked to differences in children's later development of posttraumatic stress symptoms following a traumatic event.     

Trajectories of mothers’ emotional availability: relations with infant temperament in predicting attachment security

The present study examined observations of parenting quality (mothers’ emotional availability – EA) during infant bedtimes at 4 points across the infants’ first year, assessing relations between levels and trajectories of EA and infant attachment at 12 months and the role of infant temperament in moderating these associations. The sample (N = 128) was predominantly Euro-American (82.5%) and at low socioeconomic risk. Latent growth curve modeling with latent basis coefficients indicated substantial individual differences in initial levels and slopes in EA trajectories across the first year. Both levels of maternal EA and EA trajectories across the first year predicted 12-month infant attachment security. Although maternal EA tended to decrease across the first year in the full sample, EA trajectories that showed a “bounce-back” between 6 and 12 months, suggesting more successful maternal adaptation to an expanding infant developmental repertoire, predicted greater infant security at 12 months. In addition, linkages between latent EA trajectories and 12-month attachment were moderated by 3-month infant temperamental reactivity and regulation. These findings indicate that infant attachment security is sensitive to both static and dynamic aspects of parenting quality across the first year, and that infant temperament can interact with both in predicting infant attachment.     

Longitudinal associations between attachment quality in infancy,C-reactive protein in early childhood,and BMI in middle childhood: preliminary evidence from a CPS-referred sample

ABSTRACT

In the current pilot study, we examined whether insecure or disorganized attachment was associated with elevated inflammation (i.e. C-reactive protein [CRP]) in children with histories of child protective services (CPS) involvement, and whether early childhood CRP predicted body mass index (BMI) in middle childhood. Participants included 45 CPS-referred children and 39 low-risk comparison children, for whom we assessed levels of CRP in early childhood (Mean age = 4.9 years). For the CPS-referred children, who were drawn from an ongoing longitudinal study, we had attachment classifications (assessed during infancy with the Strange Situation) and BMI data (assessed during early and middle childhood); these data were not available for the low-risk comparison group. CPS-referred children who had insecure or disorganized attachments during infancy had higher levels of CRP in early childhood than CPS-referred children who had secure attachments, who had similar levels of CRP to low-risk comparison children. Among CPS-referred children, early childhood CRP predicted age 8 BMI, controlling for BMI at age 4. Findings offer preliminary support for the association between attachment quality and inflammation in early childhood, which may have implications for later physical health.     

Attachment in middle childhood: predictors,correlates, and implications for adaptation

Middle childhood is a relative lacuna in behavioral attachment research. We examined antecedents, correlates, and implications of parent–child attachment at age 10 in a longitudinal study of community families from a Midwestern US state (N = 102, mothers, fathers, and children). Dimensions of security, avoidance, ambivalence, and disorganization of children’s attachment to each parent were observed in lengthy naturalistic interactions and assessed using Iowa Attachment Behavioral Coding (IABC). IABC scores were meaningfully associated with history of parental responsiveness (7–80 months) and with earlier and concurrent attachment security, assessed with other established instruments (parent- and observer-rated Attachment Q-Set at 25 months, children’s reports at age 8 and 10). Structural equation modeling analyses revealed that the overall history of responsive care was meaningfully associated with Security, Avoidance, and Disorganization at age 10, in both mother–child and father–child relationships, and that most recent care uniquely predicted Security. IABC scores were also meaningfully related to a broad range of measures of child adaptation at ages 10–12. Cumulative history of children’s security from infancy to middle childhood, integrating measures across relationships and methodologies, also predicted child adaptation at ages 10–12.     

Contributions of early adversity to pro-inflammatory phenotype in infancy: the buffer provided by attachment security

Adversity early in life is associated with systemic inflammation by adolescence and beyond. At present, few studies have investigated the associations between different forms of adversity and inflammation during infancy, making it difficult to specify the origins of disease vulnerability. This study examined the association between multiple forms of early adversity – socioeconomic status disadvantage, familial stress, maternal depression, and security of attachment – and individual differences in a composite measure of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, and tumor necrosis factor-alpha) and the inflammatory protein C-reactive protein that were collected via saliva when (n = 49) children were 17 months old. In addition to gauging the direct effects of adversity, we also tested the hypothesis that infants’ attachment relationship with their mother might buffer infants against the immunologic effects of early adversity. Results show that familial stress, maternal depression, and security of attachment were directly associated with infant salivary inflammation and that attachment status moderated the effect of maternal depression. The findings suggest that exposure to certain forms of adversity very early in life may engender a pro-inflammatory phenotype with possible life-long implications for health.     

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.     

Forming attachments in foster care: infant attachment behaviors during the first 2 months of placement

This study investigated the development of attachment relationships in 38 foster infant-caregiver dyads over the first 2 months of placement. We used the Parent Attachment Diary to measure foster infants' daily attachment behaviors, the Adult Attachment Interview to examine foster parents' attachment states of mind, and Ainsworth's Strange Situation to capture attachment classifications. We examined differences in diary scales (secure, avoidant, resistant, and coherence) as they related to age at placement and foster parent attachment, using hierarchical linear modeling and analyses of variance. The results indicated infants with autonomous foster parents and infants placed at younger ages showed higher early and overall levels of secure behavior, less avoidant behavior, and more coherent attachment strategies compared to infants placed with nonautonomous foster parents. Changes in attachment behaviors over time were not predicted by the models; however, there was a significant decrease in the daily coherence of attachment behaviors associated with Strange Situation disorganization. Finally, we found significant concordance between the diary and Strange Situation scales for secure and avoidant behaviors.     

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.     

Associations between early caregiving and rural,low-SES,African-American children’s representations of attachment relationships

Little research has examined the legacy of early maternal care for later attachment representations among low-income and ethnic minority school-aged children. Using data from a sample of 276 rural, low-income, African-American families, this study examined associations between maternal care in infancy and children’s representations of attachment figures in middle childhood. Maternal care was coded from 10-min home-based observations at 6, 15, and 24 months of age. Representations of attachment figures were assessed using the Manchester Child Attachment Story Task at 6 years of age. Sensitive maternal care in infancy was not significantly related to attachment security or episodic disorganized behaviors in children’s representations. However, children exposed to more harsh–intrusive parenting during infancy displayed less secure representations of attachment figures in middle childhood and more episodic disorganized behaviors, even after controlling for numerous child and family contextual covariates. Findings inform conceptualizations of attachment formation among rural, low-income, African-American parent–child dyads.     

Cortisol secretion moderates the association between mother–infant attachment at 17 months and child behavior at age 5 years

This study examined infant cortisol secretion as a moderator of the association between mother–infant attachment security at age 17 months and child behavior at age 5 years. A longitudinal community sample of 96 mother–child dyads participated in the strange situation procedure (SSP) at age 17 months. Cortisol was collected at baseline, and at 20 and 40 min post-SSP. Maternal reports of child behavior were collected at age 5 years. Results revealed that the associations between nonsecure mother–infant attachment and higher total, internalizing, and externalizing behavior were stronger for infants with high cortisol secretion, relative to infants with low cortisol secretion. The model of interaction differed depending on the outcome, with diathesis-stress explaining variance in total as well as internalizing behavior, and with differential susceptibility explaining variance in externalizing behavior. These findings augment our understanding of risk and resilience to the impact of the early rearing environment on later psychopathology.     

Infant emotional responses to challenge predict empathic behavior in toddlerhood

Although emotional responses are theorized to be important in the development of empathy, findings regarding the prediction of early empathic behavior by infant behavioral and physiological responses are mixed. This study examined whether behavioral and physiological responses to mild emotional challenge (still face paradigm and car seat task) in 118 infants at age 6 months predicted empathic distress and empathic concern in response to an empathy-evoking task (i.e, experimenter's distress simulation) at age 20 months. Correlation analyses, corrected for sex and baseline levels of physiological arousal, showed that stronger physiological and behavioral responses to emotional challenge at age 6 months were positively related to observed empathic distress, but not empathic concern, at age 20 months. Linear regression analyses indicated that physiological and behavioral responses to challenge at 6 months independently predicted empathic distress at 20 months, which suggests an important role for both physiological and behavioral emotional responses in empathy development. In addition, curvilinear regression analyses showed quadratic associations between behavioral responses at 6 months, and empathic distress and empathic concern at 20 months, which indicates that moderate levels of behavioral responsivity predict the highest levels of empathic distress and empathic concern.     

Toward the next quarter-century: conceptual and methodological challenges for attachment theory

Attachment theory and research have offered fundamental insights into early sociopersonality development for the past quarter-century. As its scope expands throughout the life course with applications to developmental psychopathology, however, attachment work faces important conceptual and methodological challenges. These include (a) expanding Bowlby's theoretical formulations to address developmental changes in the nature of attachment organization beyond infancy, the converging influence of multiple attachment relationships, and the nature and development of internal working models: (b) systematically validating assessments of attachment security for older ages in the context of enhanced theoretical understanding of how attachment itself changes with age; (c) new methodological approaches to understanding the relations between attachment and later behavior in light of empirical evidence of stability and change in attachment security and the need for explicit theoretical predictions of the sequelae of attachment security; and (d) more complex conceptualizations of the associations among attachment, contextual risk, and later behavior. These are similar to the challenges facing the original pioneers of attachment theory and research, suggesting that familiar problems must now be reconsidered against the landscape of new applications of attachment work and the insights of contemporary developmental science.     

Attachment stability and emotional and behavioral regulation from infancy to preschool age

Relations between attachment and child emotional and behavioral regulation were studied longitudinally in a sample of 223 children from urban, low-income families. Attachment in the Strange Situation at 12 and 18 months was scored using the infant classification system and at 24 months was scored using a preschool classification system. Only modest stability was found in attachment whether within or across classification systems, with the percentage of insecure attachments consistently increasing over time. Results indicated both concurrent and predictive associations with indices of child regulation based on observer ratings or maternal report. However, only the 24-month classification predicted maternal report of externalizing and internalizing behavior problems at age 3.5 years. with additional variance accounted for by selected measures of child emotional and behavior regulation from the same assessment. Attachment security (B) and atypical attachment classifications (D, A/C, and AD) appear to provide the most consistently useful information about child functioning. Results are discussed in terms of continuity and change from the perspective of developmental psychopathology.     

Continuity,discontinuity, and coherence in attachment from infancy to late adolescence: Sequelae of organization and disorganization

This longitudinal study examines continuity and discontinuity of attachment quality from infancy to late adolescence in a sample of 125 participants considered at birth to be at high-risk due to poverty. Strange Situations were conducted at 12 and 18 months; Adult Attachment Interviews were administered at age 19. Child and maternal characteristics and experiences and observational assessments of the families were explored as correlates of continuity and discontinuity in attachment. Contrary to findings of continuity from low-risk samples, analyses demonstrated no significant overall continuity in attachment security. Disorganized infants were significantly more likely than organized infants to be insecure or unresolved in late adolescence. Additionally, infant disorganization predicted unresolved abuse scores on the AAI for those participants who experienced childhood abuse. Significant correlates of continuity and change spanned a variety of age periods and included infant temperament, maternal life stress, family functioning at pre-adolescence, child maltreatment and features of the home environment. Findings are discussed as supporting the coherence of attachment over time.     

Attachment stability and the emergence of unresolved representations during adolescence

This 15-year longitudinal study examined the stability of attachment representations from infancy to adolescence and investigated the emergence of unresolved representations during adolescence in a sample of 47 16-year-olds. Attachment was assessed at 12 months using the Strange Situation Procedure, at 4 years using the modified Strange Situation Procedure, and again at 16 years with the Adult Attachment Projective (AAP). The emergence of unresolved classifications in adolescence (AAP) was associated with higher rates of negative life events, low levels of early mother–child relationship security (an aggregate measure of the 12-month and 4-year measures), negative teacher–child relationship experiences in middle childhood, and low early adolescent friendship quality. The results support the growing body of evidence suggesting that changes in attachment are lawful, while adding to the growing understanding of the emergence of unresolved attachment representations.     

Continuity, discontinuity, and coherence in attachment from infancy to late adolescence: sequelae of organization and disorganization

This longitudinal study examines continuity and discontinuity of attachment quality from infancy to late adolescence in a sample of 125 participants considered at birth to be at high-risk due to poverty. Strange Situations were conducted at 12 and 18 months; Adult Attachment Interviews were administered at age 19. Child and maternal characteristics and experiences and observational assessments of the families were explored as correlates of continuity and discontinuity in attachment. Contrary to findings of continuity from low-risk samples, analyses demonstrated no significant overall continuity in attachment security. Disorganized infants were significantly more likely than organized infants to be insecure or unresolved in late adolescence. Additionally, infant disorganization predicted unresolved abuse scores on the AAI for those participants who experienced childhood abuse. Significant correlates of continuity and change spanned a variety of age periods and included infant temperament, maternal life stress, family functioning at pre-adolescence, child maltreatment and features of the home environment. Findings are discussed as supporting the coherence of attachment over time.     

Disentangling levels of mother–infant neuroendocrine attunement and longitudinal relations with maternal risk and protective factors

Scientific understanding of mother–infant HPA axis attunement has been limited by discrepant methods for assessing attunement that often conflate different levels of association. We sought to refine the conceptualization of attunement by investigating whether mother–infant cortisol attunement exists as coupling of response trajectories within an acute stress episode, separate from shared developmental patterns and/or overall dyadic similarity in cortisol levels, and whether the degree of attunement depends on within‐ or between‐dyad differences in maternal risk and protective factors. We examined these questions using a longitudinal study with mother/infant salivary cortisol during dyadic stressors at 6, 12, and 18 months postnatal. A three‐level hierarchical linear model showed that sample‐wide associations between mother and infant cortisol were not significant at any level, suggesting normative lack of attunement; however, there was significant variability in degree of attunement across dyads. Concurrent levels of family resources and social support satisfaction predicted lower mother–infant cortisol attunement within the session, and overall (mean) parenting stress predicted the opposite. Follow‐up analyses showed this was typically due to an increase in infants’ (but not their mothers’) within‐session cortisol response slopes with increasing support and decreasing stress. Implications for the role of mother–infant cortisol attunement in intergenerational stress transmission are discussed.     

Attachment security and parenting quality predict children's problem-solving,attributions, and loneliness with peers

The influence of early relational experience on later social understanding has evoked rich theoretical discussion but relatively little empirical inquiry. Enlisting data from the NICHD Study of Early Child Care and Youth Development, measures of the security of attachment in infancy, toddlerhood, and early childhood, together with measures of parenting quality (maternal sensitivity and depressive symptoms) gathered longitudinally throughout infancy and early childhood, were used to predict differences in children's thoughts and feelings about peers (i.e., social problem solving, negative attributional biases, aggressive solutions to ambiguous social situations, and self-reported loneliness) when children were 54 months and in first grade. Relational experiences, especially before 36 months, were significantly predictive of later peer-related representations. Attachment security at 24 and 36 months was associated with enhanced social problem-solving skills and less loneliness, but security of attachment at 15 months was nonpredictive. Early maternal sensitivity was positively associated with later social problem-solving and negatively with aggressive responses, and early maternal depressive symptoms were positively associated with children's negative attributions. Concurrent parenting quality was also associated with children's thoughts and feelings about peers, but less consistently. These findings shed new light on how early relational experiences may contribute to social information processing with peers at the end of the preschool years, and that the timing of relational influences may be crucial.     

Maternal distress,DNA methylation,and fetal programing of stress physiology in Brazilian mother–infant pairs

Maternal prenatal psychosocial stress is associated with adverse hypothalamic–pituitary–adrenal axis (HPAA) function among infants. Although the biological mechanisms influencing this process remain unknown, altered DNA methylation is considered to be one potential mechanism. We investigated associations between maternal prenatal psychological distress, infant salivary DNA methylation, and stress physiology at 12 months. Mother's distress was measured via depression and anxiety in early and late pregnancy in a cohort of 80 pregnant adolescents. Maternal hair cortisol was collected during pregnancy. Saliva samples were collected from infants at 12 months to quantify DNA methylation of three stress-related genes (FKBP5, NR3C1, OXTR) (n = 62) and diurnal cortisol (n = 29). Multivariable linear regression was used to test for associations between prenatal psychological distress, and infant DNA methylation and cortisol. Hair cortisol concentrations in late pregnancy were negatively associated with two sites of FKBP5 (site 1: B = −22.33, p = .003; site 2: B = −15.60, p = .012). Infants of mothers with elevated anxiety symptoms in late pregnancy had lower levels of OXTR2 CpG2 methylation (B = −2.17, p = .03) and higher evening salivary cortisol (B = 0.41, p = .03). Furthermore, OXTR2 methylation was inversely associated with evening cortisol (B = −0.14, p-value ≤ .001). Our results are, to our knowledge, the first evidence that the methylation of the oxytocin receptor may contribute to the regulation of HPAA during infancy.