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.     

Frightened, threatening, and dissociative parental behavior in low-risk samples: description, discussion, and interpretations

In 1990 we advanced the hypothesis that frightened and frightening (FR) parental behavior would prove to be linked to both unresolved (U) adult attachment status as identified in the Adult Attachment Interview and to infant disorganized/disoriented (D) attachment as assessed in the Ainsworth Strange Situation. Here, we present a coding system for identifying and scoring the intensity of the three primary forms of FR behavior (frightened, threatening, and dissociative) as well as three subsidiary forms. We review why each primary form may induce fear of the parent (the infant's primary "haven of safety"), placing the infant in a disorganizing approach-flight paradox. We suggest that, being linked to the parent's own unintegrated traumatic experiences (often loss or maltreatment), FR behaviors themselves are often guided by parental fright, and parallel the three "classic" mammalian responses to fright: flight, attack, and freezing behavior. Recent studies of U to FR, as well as FR to D relations are presented, including findings regarding AMBIANCE/FR+. Links between dissociation, FR, U, and D are explored. Parallel processing and working memory are discussed as they relate to these phenomena.     

Attachment linked predictors of women's emotional and cognitive responses to infant distress

The purpose of this study was to examine associations among women's emotional and cognitive responses to infant fear and anger and to identify attachment linked predictors of these responses. Four hundred and forty Caucasian and African American undergraduate college women viewed video clips of two crying infants, one displaying anger and the other displaying fear. They identified what the infants were feeling, made causal attributions about the cause of crying, rated their own emotional reactions to the crying infants, and reported on the extent to which their parents met their emotional needs in childhood and their current adult attachment patterns. Emotional and cognitive responses to infant fear and anger were interrelated. Consistent with prediction, a history of parental emotional rejection and adult attachment anxiety and avoidance correlated negatively with accurate identification of emotions and positively with negative attributions, amusement, and neutral responses to infant distress. Adult attachment security moderated the effects of early parental rejection on emotional and cognitive responses to infant distress, and these results varied based on race and parent gender. Results are discussed from an attachment theory perspective.     

Attachment linked predictors of women's emotional and cognitive responses to infant distress

Abstract

The purpose of this study was to examine associations among women's emotional and cognitive responses to infant fear and anger and to identify attachment linked predictors of these responses. Four hundred and forty Caucasian and African American undergraduate college women viewed video clips of two crying infants, one displaying anger and the other displaying fear. They identified what the infants were feeling, made causal attributions about the cause of crying, rated their own emotional reactions to the crying infants, and reported on the extent to which their parents met their emotional needs in childhood and their current adult attachment patterns. Emotional and cognitive responses to infant fear and anger were interrelated. Consistent with prediction, a history of parental emotional rejection and adult attachment anxiety and avoidance correlated negatively with accurate identification of emotions and positively with negative attributions, amusement, and neutral responses to infant distress. Adult attachment security moderated the effects of early parental rejection on emotional and cognitive responses to infant distress, and these results varied based on race and parent gender. Results are discussed from an attachment theory perspective.     

The psychobiological consequences of child separation at the border: lessons from research on attachment and emotion regulation

ABSTRACT

In the spring of 2018, the Attorney General of the United States issued a memorandum declaring a “zero tolerance policy” under which all adults entering the United States illegally would be criminally prosecuted, and, if traveling with minor children, forcibly separated from their children. Although the government was ordered to reunite the children with their parents it is still unclear how many children have been or remain separated. Given the high risk of permanent harm to a vulnerable population, and the fact that this risk may continue into the near future, we present a review of what nearly eight decades of scholarly research has taught us about the damaging impact of deprivation and separation from parents. The article briefly reviews the origins of attachment theory as well as empirical studies that examine the psychobiological impact on children who experienced parental deprivation or separation. The paper concludes with recommendations, for future research.     

Disorganized attachment in infancy: a review of the phenomenon and its implications for clinicians and policy-makers

Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static “trait” of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.     

The vicarious learning pathway to fear 40 years on

Forty years on from the initial idea that fears could be learnt vicariously through observing other people's responses to a situation or stimulus, this review looks at the evidence for this theory as an explanatory model of clinical fear. First, we review early experimental evidence that fears can be learnt vicariously before turning to the evidence from both primate and human research that clinical fears can be acquired in this way. Finally, we review recent evidence from research on non-anxious children. Throughout the review we highlight problems and areas for future research. We conclude by exploring the likely underlying mechanisms in the vicarious learning of fear and the resulting clinical implications.     

MOTHER-INFANT INTERACTION DURING THE FIRST YEAR WITH A CHILD WHO SHOWS DISORGANIZATION OF ATTACHMENT

ABSTRACT This study details the interaction between a mother and infant where the mother is unresolved with respect to loss as measured by the Adult Attachment Interview and the infant shows the disorganized pattern of attachment behaviour in the Strange Situation at 13 months. The paper discusses the factors which predispose children to becoming disorganized in their attachment behaviour. Working from a psychoanalytic perspective the authors make some suggestions about the unconscious anxieties in the mother which contribute to the development of dysfunctional interactions between mother and child.     

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.     

Naïve observers' perceptions of family drawings by 7-year-olds with disorganized attachment histories

Previous research has succeeded in distinguishing among drawings made by children with histories of organized attachment relationships (secure, avoidant, and resistant); however, drawings of children with histories of disorganized attachment have yet to be systematically investigated. The purpose of this study was to determine whether na?ve observers would respond differentially to family drawings of 7-year-olds who were classified in infancy as disorganized vs. organized. Seventy-three undergraduate students from one university and 78 from a second viewed 50 family drawings of 7-year-olds (25 by children with organized infant attachment and 25 by children with disorganized infant attachment). Participants were asked to (1) circle the emotion that best described their reaction to the drawings and (2) rate the drawings on 6 bipolar scales. Drawings from children classified as disorganized in infancy evoked positive emotion labels less often and negative emotion labels more often than those children classified as organized. Furthermore, drawings from children classified as disorganized in infancy received higher ratings on scales for disorganization, carelessness, family chaos, bizarreness, uneasiness, and dysfunction. These data indicate that naive observers are relatively successful in distinguishing selected features of drawings by children with histories of disorganized vs. organized attachment.     

Developmental correlates and predictors of emotional availability in mother-child interaction: a longitudinal study from infancy to middle childhood

In this investigation we examined the developmental correlates and predictors of maternal emotional availability in interactions with their 7-year-old children among a sample of families at psychosocial risk. We found developmental coherence in maternal interactive behavior, and in the relations between maternal emotional availability and children's functioning in middle childhood. Mothers and children were observed at home and in a laboratory playroom in infancy to assess maternal interactive behavior and child attachment security. When children were 7 years of age, dyads were observed in the lab; maternal emotional availability was coded using the Emotional Availability Scales, and children's disorganized and controlling attachment behavior was assessed. Classroom teachers reported on children's behavior problems; at age 8, children reported on their depressive symptoms. Results showed that aspects of maternal emotional availability (sensitivity, nonhostility, nonintrusiveness [passive/withdrawn behavior]) were associated with children's functioning in middle childhood: (a) controlling and disorganized attachment behavior, (b) behavior problems in school, and (c) self-reported depressive symptoms. Maternal emotional availability in childhood was predicted by early mother-infant relationship dysfunction (maternal hostility, disrupted communication, and infant attachment insecurity).     

Application of attachment theory to the study of sexual abuse.

Research on sexual abuse frequently fails to address the influence of the family as a risk factor for the onset of all kinds of sexual abuse and as a mediator of its long-term effects. Attachment theory provides a useful conceptual framework for understanding the familial antecedents and long-term consequences of sexual abuse. Themes associated with insecure parent-child attachment (rejection, role reversal/parentification, and fear/unresolved trauma) are frequently found in the dynamics of families characterized by sexual abuse, and specific categories of sequelae are related to probable attachment experiences. Implications for intervention and research on sexual abuse are suggested.     

Disorganized attachment in early childhood: meta-analysis of precursors, concomitants, and sequelae

During the past 10 years nearly 80 studies on disorganized attachment involving more than 6,000 infant-parent dyads have been carried out. The current series of meta-analyses have established the reliability and discriminant validity of disorganized infant attachment. Although disorganized attachment behavior is necessarily difficult to observe and often subtle, many researchers have managed to become reliable coders. Furthermore, disorganized attachment shows modest short- and long-term stability, in particular in middle class environments, and it is not just a concomitant of constitutional, temperamental, or physical child problems. The predictive validity of disorganized attachment is established in terms of problematic stress management, the elevated risk of externalizing problem behavior, and even the tendency of disorganized infants to show dissociative behavior later in life. In normal, middle class families, about 15% of the infants develop disorganized attachment behavior. In other social contexts and in clinical groups this percentage may become twice or even three times higher (e.g., in the case of maltreatment). Although the importance of disorganized attachment for developmental psychopathology is evident, the search for the mechanisms leading to disorganization has just started. Frightening parental behavior may play an important role but it does not seem to be the only causal factor involved in the emergence of disorganized attachment.     

Disorganized attachment,absorption, and new age spirituality: a mediational model

In this paper, we present a theoretical model and an empirical review linking disorganized attachment with New Age spiritual beliefs and activities via a proposed mediator; the propensity to enter altered states of consciousness (absorption/dissociation). Utilizing a prospective longitudinal design (N = 62), an empirical test of the mediational model is also provided for illustrational purposes. More specifically, we tested if unresolved/disorganized (U/d) attachment scores, as identified via the Adult Attachment Interview at the first assessment point, predicted New Age spirituality 3 years later, and whether this link was mediated by absorption. Results supported the mediational model, although the bivariate relation between U/d attachment and New Age spirituality was of modest strength. The discussion focuses on the general implications, clinical as well as non-clinical, of the proposed model. Finally, we argue that time is now ripe for attachment researchers to address additional non-pathological sequelae of disorganized attachment and the related propensity to experience altered states of consciousness.     

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.     

Factors associated with the unresolved classification of the Adult Attachment Interview in women who have suffered stillbirth

The "unresolved" state of mind with respect to loss or trauma as assessed in the Adult Attachment Interview is common in clinical and forensic groups, as well as in mothers whose infants are classified as disorganized in their attachment relationship to them. However, questions remain about what the unresolved state represents and what factors predict the unresolved state. This case controlled study reports on 64 women who had suffered stillbirth and who were pregnant with their next child. The study explores attachment, psychiatric, and social factors associated with the unresolved state or higher unresolved scores with respect to stillbirth. Women who had experienced stillbirth were more likely to be unresolved than control women. Although a similar number of stillbirth and control women had experienced childhood trauma, only women who had experienced stillbirth were unresolved with respect to this trauma, suggesting the unresolved state may be evoked or reevoked by subsequent traumatic loss. Higher unresolved scores in relation to stillbirth were predicted by childhood trauma, poor support from family after the loss, and having a funeral for the infant. The results are discussed in terms of the woman's sense of being causal in the loss.     

Attachment and problem behavior of adolescents during residential treatment

Attachment theory suggests that representations of previous attachment experiences may explain differences in psychosocial functioning. However, the nature of the association in clinical populations is unclear. Attachment representations were classified on the basis of Adult Attachment Interviews with 61 adolescents (13–20 years old; 70% female) admitted to a residential treatment institution. Group care workers rated their problem behavior. Compared to dismissing and autonomous adolescents and adolescents unresolved/disorganized with respect to trauma, adolescents with preoccupied attachment representations showed the highest levels of truancy and rule breaking, according to the institution's records, and externalizing behaviour, according to the group care workers. Unresolved/disorganized adolescents displayed lower levels of violence to staff than dismissing and autonomous adolescents. The effectiveness of residential treatment might be enhanced by taking account of the attachment strategies with which adolescents enter institutions.     

Attachment and problem behavior of adolescents during residential treatment

Attachment theory suggests that representations of previous attachment experiences may explain differences in psychosocial functioning. However, the nature of the association in clinical populations is unclear. Attachment representations were classified on the basis of Adult Attachment Interviews with 61 adolescents (13-20 years old; 70% female) admitted to a residential treatment institution. Group care workers rated their problem behavior. Compared to dismissing and autonomous adolescents and adolescents unresolved/disorganized with respect to trauma, adolescents with preoccupied attachment representations showed the highest levels of truancy and rule breaking, according to the institution's records, and externalizing behaviour, according to the group care workers. Unresolved/disorganized adolescents displayed lower levels of violence to staff than dismissing and autonomous adolescents. The effectiveness of residential treatment might be enhanced by taking account of the attachment strategies with which adolescents enter institutions.     

The role of disconnected and extremely insensitive parenting in the development of disorganized attachment: validation of a new measure

Early adverse caregiving experiences constitute an important risk factor for the development of disorganized attachment in infancy, especially extreme insensitivity and frightening behavior associated with an unresolved loss or trauma. Using existing measures for frightening parenting and disrupted communication, we developed a new measure assessing Disconnected and extremely Insensitive Parenting (DIP), in order to investigate the unique contribution of disconnected and extremely insensitive parenting behaviors to infant disorganization. Maternal behavior was assessed during a laboratory session in a low-risk sample of 202 mothers and their infants. Construct and discriminant validity of the DIP was established for both types of parental behavior. Disconnected parental behavior predicted infant disorganization but not organized attachment security, whereas extreme insensitivity was marginally related to organized attachment insecurity in boys but not to attachment disorganization.