Failure‐to‐thrive is associated with disorganized infant–mother attachment and unresolved maternal attachment

This study provides further evidence for the co‐occurrence of atypical patterns of attachment and failure‐to‐thrive (FTT). Eighty‐three children with FTT and 130 normally growing comparison children were seen in Ainsworth's Strange Situation at ages 11 to 32 months. These subjects were highly diverse with respect to social, economic, and ethnic characteristics. Children with FTT were significantly less likely to show secure and more likely to show anxious, disorganized attachments than normally growing comparisons: only 34% of FTTs were secure, while 46% showed disorganized attachments. In contrast, 66% of comparisons were secure and 16% were disorganized. In addition, a subsample of 59 mothers (23 FTT and 36 comparison) were interviewed with the Adult Attachment Interview (AAI). Mothers of FTTs were more than twice as likely as comparisons (65% versus 22%) to use discourse indicating unresolved loss or trauma. Similarly, mothers of FTTs were less likely to show autonomous (secure) discourse than mothers of well‐nourished children (13% versus 58%). There were no differences in infant or adult attachment classifications between organic and nonorganic FTT groups, further discrediting this as a psychologically meaningful distinction. These results support the notion that disturbed patterns of attachment are common in FTT, regardless of the etiology of growth failure. The findings suggest that evaluations and treatments of FTT should address psychological, as well as medical problems in these families. © 2000 Michigan Association for Infant Mental Health.     

Attachment to God,Stressful Life Events,and Changes in Psychological Distress

Considerable research shows that social relationships, attachments, and support systems promote emotional well-being. The present study adds to this literature by examining the connection between attachments to God and psychological distress. Analyzing longitudinal data (two waves) from a study of Presbyterian (PCUSA) elders and rank-and-file laypersons, results show that: (1) a secure attachment to God at baseline is associated with a decrease in distress over time; (2) a secure attachment to God buffers against the deleterious effects of stressful life events on distress; and (3) an anxious attachment to God exacerbates the harmful effects of stress. In these analyses, a secure attachment to God is a more robust predictor of changes in distress than many, more commonly studied variables including race, gender, SES, and church attendance. Future research should therefore replicate and extend this line of promising scholarship by examining additional outcomes such as psychiatric illness, physical health, and even mortality risk.     

Infant carrying as a tool to promote secure attachments in young mothers: Comparing intervention and control infants during the still-face paradigm

Infants of adolescent mothers have a greater risk of developing insecure attachment types and attachment disorders into adulthood. Previous research suggests that skin-to-skin contact predicts secure attachment; however, it is largely unknown whether infant carrying or “babywearing” has similar benefits. We hypothesized that adolescent mothers (Mage=19.1 years, SD = 2.0; 40.6 % Hispanic; 40 %< = 11th grade) who were randomly assigned to an infant carrying condition at 2–4 weeks’ post-partum (n = 16; 1 h daily for 3 months), compared to a control group (n = 17; reading), would be more likely to have securely attached infants at 7 months (M = 29.0 weeks, SD = 3.4). We coded infant gaze orientation, fretfulness, affect, self-soothing behaviors, and vocalizations in the reunion phase of the Still-Face Paradigm, and used an algorithm derived from the infant Global Rating Scales to determine attachment type. Infants in the intervention condition were more likely to have secure attachments and less likely to have disorganized attachments compared to the control condition. Hours spent babywearing was positively correlated with secure attachment, r_pb = .40, and negatively correlated with disorganized attachment, r_pb =−0.36. There were no statistically significant differences between the conditions or babywearing hours for avoidant or resistant attachment types. The results suggest that infant carrying may be an effective tool at promoting secure attachments, particularly for mothers and infants at greater risk for attachment insecurity.     

Disorganized infant attachment and preventive interventions: A review and meta‐analysis

Infant disorganized attachment is a major risk factor for problematic stress management and later problem behavior. Can the emergence of attachment disorganization be prevented? The current narrative review and quantitative meta‐analysis involves 15 preventive interventions (N = 842) that included infant disorganized attachment as an outcome measure. The effectiveness of the interventions ranged from negative to positive, with an overall effect size of d = 0.05 (ns). Effective interventions started after 6 months of the infant's age (d = 0.23). Interventions that focused on sensitivity only were significantly more effective in reducing attachment disorganization (d = 0.24) than interventions that (also) focused on support and parent's mental representations (d = ?0.04). Most sample characteristics were not associated with differences in effect sizes, but studies with children at risk were more successful (d = 0.29) than studies with at‐risk parents (d = ?0.10), and studies on samples with higher percentages of disorganized attachment in the control groups were more effective (d = 0.31) than studies with lower percentages of disorganized children in the control group (d = ?0.18). The meta‐analysis shows that disorganized attachments may change as a side effect of sensitivity‐focused interventions, but it also illustrates the need for interventions specifically focusing on the prevention of disorganization.     

Attachment at early school age and developmental risk: examining family contexts and behavior problems of controlling-caregiving, controlling-punitive, and behaviorally disorganized children

Preschool to school-age trajectories of 242 children, including 37 with insecure-disorganized and 66 with insecure-organized attachment patterns, were examined. Child attachment and stressful life events (the latter retrospectively) were measured at ages 5-7, and mother-child interactive quality, parenting stress, marital satisfaction, and teacher-reported behavior problems were evaluated concurrently and 2 years earlier. Results indicated that all three disorganized subgroups had poorer mother-child interactive patterns and more difficult family climates than secure or insecure-organized children. The controlling-punitive group showed significant increases in maternal reports of child-related stress between preschool and school age. The controlling-caregiving group showed greater likelihood of loss of a close family member, and mothers of the insecure-other group reported lower marital satisfaction and greater likelihood of their own or a spouse's hospitalization. Controlling-punitive children had higher externalizing scores, and controlling-caregiving children higher internalizing scores, than secure children.     

Overcoming a child's resistance to late adoption: how one new attachment can facilitate another

The paper describes the difficulty which late-adopted children may have in forming attachments to their new parents. It considers the nature of the disorganized attachment pattern which many of these deprived, abused children display and the origin of this pattern in experiences of 'fright without solution'. The psychotherapy of a 9-year-old, late-adopted boy is used to illustrate long-standing resistance to new attachments on account of defences on which security depends, and the persistence of loyalty to prior internal attachment representations. Change becomes possible through psychotherapy in which earlier negative attachment models are externalized together with their associated feelings of 'fright without solution'. For this boy, a long period of rejection of the therapist gave way to a new capacity to play together; this was associated with the development of positive attachments to the boy's adoptive parents.     

Behavioural precursors of attachment representations in middle childhood and links with child social adaptation

Concordance between age‐6 attachment behaviour and age‐8 doll play attachment representations during the school‐age period, and associations between these measures and child social adaptation at school were examined. One hundred and twenty‐nine 6‐year‐olds and their mothers participated in a separation/reunion protocol. Two years later, 104 children completed a doll play narrative task. Teachers evaluated child behaviour problems and prosocial behaviour at both ages. Results showed a significant four‐way concordance between age‐6 attachment behaviour and age‐8 doll play classifications. Each of the four attachment classifications was concordant in the absence of major negative life‐events, but only the disorganized classifications remained concordant when at least one negative life‐event occurred between the two assessment times. Children with a disorganized attachment classification or representation had higher externalizing scores than secure and avoidant children at both timepoints. Finally, the avoidant and disorganized behavioural classifications predicted avoidant and disorganized representations, respectively, even when controlling for age‐6 teacher reports of social adaptation.     

Risks and Outcomes Associated with Disorganized/Controlling Patterns of Attachment at Age Three in the NICHD Study of Early Child Care and Youth Development

Disorganized/controlling attachment in preschool has been found to be associated with maternal and child maladjustment, making it of keen interest in the study of psychopathology. Additional work is needed, however, to better understand disorganized/controlling attachment occurring as early as age three. The primary aims of this study were to evaluate risk factors and outcomes associated with disorganized/controlling behavior at age three and to evaluate the risk factors and outcomes differentiating the four subtypes of disorganized/controlling attachment. Analyses were conducted with the first two phases of the NICHD Study of Early Child Care and Youth Development, a prospective study of 1,364 children from birth. At 36 months of age, across the attachment-relevant domains of maternal well-being, mother-child interactions, and child social adaptation, the disorganized/controlling group evidenced the most maladaptive patterns in comparison to both secure and insecure-organized groups. At 54 months of age, the disorganized/controlling group displayed the highest levels of internalizing and externalizing behavior problems, as rated by mothers and teachers, and the lowest quality relationships with teachers. Significant differences found among the disorganized/controlling subtypes indicated that the behaviorally disorganized and controlling-punitive subtypes had more maladaptive patterns across variables than did the controlling-caregiving and controlling-mixed subtypes.     

Maternal attachment disturbances in failure to thrive

Psychological characteristics pertaining to attachment relationships were measured in mothers of 25 hospitalized failure-to-thrive (FTT) infants and mothers of 25 hospitalized, normally growing infants. The groups were matched for race, socioeconomic status, maternal education, and infant's age and sex. Results showed that 96% of mothers of FTT infants were classified as insecure with respect to attachment, as assessed by the Adult Attachment Interview (George, Kaplan, & Main, 1985), compared to 60% of control group mothers. Lack of resolution of mourning over the loss of a loved one was found in 52% of the mothers in the FTT group and in 32% of mothers in the control group. Mothers of FTT infants reported receiving less support from their families and rated their current relationship with their partner as less satisfying. These findings provide empirical support for the widely held clinical notion that FTT in infants is often a relationship disorder between infant and caregiver.     

Emotion Regulation and Coping Strategies in Pedagogical Students with Different Attachment Styles

Abstract : Emotion regulation (ER) and coping strategies were compared in 242 pedagogical students from the Faculty of Education, University of Ljubljana, with different attachment styles: secure (51.3%), fearful (31.9%), preoccupied (14.2%), and dismissive (2.7%). The students’ ages ranged from 18 to 24 years ( M = 19.02; SD = .92), and the majority were female (95.0%). They completed three questionnaires assessing their attachment styles and their use of ER and coping strategies. It was determined that the students used the majority of ER and coping strategies sometimes. Somewhat different patterns in the use of ER and coping strategies were, however, present in each attachment‐based group. Significant differences between these groups appeared in their use of the ER strategies of social support, suppression, and comfort eating, and in the coping strategies of seeking social support and escaping or avoiding stressful situations.     

Predicting infant attachment classification from multiple, contemporaneous measures of maternal care

This investigation was designed to test whether stylistic differences in maternal caregiving were associated with both secure and insecure mother-infant attachment classifications in a low-income sample. Multiple measures of maternal interactive behavior and care were collected from a sample of 95 urban, low-income mothers and their 12-month-old infants. Contemporaneous relations to attachment were found only at the broad level of composite scores of caregiving. Scores derived from different measures were aggregated to create composites reflecting three caregiver styles—sensitive, controlling, and unresponsive. Mothers of infants with secure attachment classifications showed greater sensitivity and less controlling behavior than mothers of infants with resistant and avoidant attachments, respectively. Mothers of infants with resistant attachments appeared less responsive to their infants' signals than those of infants with avoidant attachments. Group differences were significant, but modest. These results contribute to the growing body of studies relating parental care with infant attachment patterns and indirectly support the more recent conceptual work on intergenerational transmission of attachment. They also raise methodological issues that need to be considered in future work on caregiving and infant-mother attachment.     

The Association between Attachment Styles and Physical Intimate Partner Violence Perpetration and Victimization: A Meta‐Analysis

In this meta‐analysis, we examine attachment styles—something commonly incorporated into couples therapy—and their association with physical intimate partner violence (IPV) perpetration and victimization among men and women. This meta‐analysis incorporated 33 studies that looked at the association between four different attachment styles and IPV. This study examined the strength of the correlation among different attachment styles and IPV perpetration and victimization, examined gender differences in the strength of the association among attachment styles and IPV, and compared the strength of the association with IPV among different attachment styles. We found that anxious attachment, avoidant attachment, and disorganized attachment styles were all significantly associated with physical IPV perpetration and victimization. Secure attachment was significantly negatively related to IPV perpetration and victimization. There was a significantly stronger association between avoidant attachment and IPV victimization for women compared to men. Clinical implications related to the importance of fostering secure attachments when working with couples or individuals who have experienced IPV are addressed.     

Correlates of attachment at age 3: construct validity of the preschool attachment classification system

This study examined correlates of attachment at age 3 to further validate preschool separation-reunion measures. Three-year-olds (N = 150) and their mothers participated in a separation-reunion protocol, the Preschool Attachment Classification System (PACS: J. Cassidy & R. S. Marvin with the MacArthur Working Group on Attachment, 1992), and a mother-child interaction session during a laboratory visit. Mothers also completed psychosocial measures and, along with teachers, evaluated child behavior problems. The secure and disorganized groups received, respectively, the highest and lowest interaction scores. Disorganized children showed a higher level of teacher-reported externalizing and internalizing problems than did secure children. Mothers of insecure children reported higher child externalizing (all insecure groups) and internalizing (avoidant group) scores, more personal distress related to emotional bonding (disorganized group), childrearing control (ambivalent group), and child hyperactivity (avoidant group). Results strongly support the validity of the PACS as a measure of attachment in 3-year-olds.     

Attachment and motivational strategies in adolescence: exploring links

Within the framework of attachment theory and of motivation goal theory, this study explored the relation between quality of attachment strategies and quality of motivational strategies in a sample of young adolescents. Specifically, this study examined patterns of thoughts, behaviors, and emotions as they related to representations of attachment and motivational functioning in situations that challenge or threaten three psychological needs (emotional security, competence, and autonomy). Forty-four students, aged 11 to 14 years, responded to imagined stressful situations in order to: (a) assess attachment strategies; (b) identify and assess students' motivational strategies in stressful classroom circumstances; (c) assess motivational strategies of students with high and low control and agency beliefs; and (d) examine the relations between attachment and motivational strategies. Four distinct action patterns were identified: flexible action, rigid action, passive behavior, and disorganized behavior. Significant relations were found between control beliefs and motivational strategies, as well as a trend toward relations between attachment and motivational strategies, suggesting that secure adolescents show more constructive motivational strategies and less disorganized strategies when compared to insecure adolescents.     

Attachment security differs by later autism spectrum disorder: A prospective study

Although difficulties with social relationships are key to autism spectrum disorder (ASD), no previous study has examined infant attachment security prior to ASD diagnosis. We prospectively assessed attachment security at 15 months in high‐risk infants with later ASD (high‐risk/ASD, n = 16), high‐risk infants without later ASD (high‐risk/no‐ASD, n = 40), and low‐risk infants without later ASD (low‐risk/no‐ASD, n = 39) using the Strange Situation Procedure. High‐risk/ASD infants were disproportionately more likely to be classified as insecure (versus secure) and more likely to be classified as insecure‐resistant (versus secure or avoidant) than high‐risk/no‐ASD and low‐risk/no‐ASD infants. High‐risk infants with insecure‐resistant attachments were over nine times more likely to receive an ASD diagnosis than high‐risk infants with secure attachments. Insecure‐resistant attachment in high‐risk infants suggests a propensity toward negative affect with the parent in conditions of stress. Insecure‐resistant attachment may prove useful as a potential early index of propensity toward ASD diagnosis in high‐risk siblings, while insecure‐resistant attachment in the context of emergent autism may contribute to difficulties experienced by children with ASD and their families.     

Care vs Food as an Emotional Regulation Strategy in Elementary School Children: The Role of the Attachment Style

Abstract

According to attachment theory, potentially threatening stimuli tend to activate the attachment system for the search of the protective figure. In secure attachments, the experience of responsive relationships increases the probability of resorting to available figures as a strategy for regulating emotions in stressful situations. The aim of the research was to verify whether, in conditions of mild threat, children’s attachment styles affect the choice between caring relationships and food as a form of emotion regulation. We used a mixed experimental design to perform this research. Here, we presented children (N?=?65; M_age= 9.4) with threatening and neutral images and, afterwards, asked them to select from images of caring relationship or images of food. The results indicate that securely and ambivalently attached but not avoidantly attached children under both the neutral and threatening image conditions chose the care pictures over the food pictures. Second, only the securely attached increased their choice of care over food images in the threatening condition, and third, this difference was significant when compared with the avoidant children. In conclusion, the results show that although in general the choice of care is primary with respect to food, children with insecure attachments differ from secure children between the two options of emotional regulation.     

Paternal/maternal attachment, peer support, social expectations of peer interaction, and depressive symptoms

The aim of this study was to investigate how paternal and maternal attachment might relate to adolescents' peer support, social expectations of peer interaction, and depressive symptoms; 1,144 8th graders in Taiwan participated in the study. The relationships were examined through a structural equating modeling. Consistent with theoretical formulations, adolescents with secure attachments to parents reported higher peer support, fewer negative expectations, and fewer depressive symptoms. Paternal and maternal attachment contribute almost equally to adolescents' social expectations of peer interaction and depressive symptoms. Attachment to the same-sex parent was related to adolescents' perceived peer support.     

A model for brief assessment of attachment and its application to women in inpatient treatment for trauma-related psychiatric disorders

We adapted self-report measures of attachment style to the psychological assessment of women in specialized inpatient treatment for trauma-related disorders. The study employed 2 measures of adult attachment style, the Relationship Questionnaire (Bartholomew & Horowitz, 1991) and the Adult Attachment Scale (Collins & Read, 1990) as well as our Current Attachment Relationships questionnaire, which assesses the extent of social support in secure attachments. We administered these measures to 99 patients and to a convenience sample of 154 women in the community. We found modest correspondence between the 2 attachment style measures and substantial relations between attachment styles and range of secure attachment relationships. Women in the trauma sample reported insecure attachment styles and relatively few secure attachment figures. We discuss the implications of these findings for clinical assessment.     

How Gene-Environment Interactions Shape Biobehavioral Development: Lessons From Studies With Rhesus Monkeys

Recent research has found marked individual differences in patterns of rhesus monkey biobehavioral development throughout the life span. Approximately 20% of monkeys growing up in naturalistic settings consistently display unusually fearful and anxious-like behavioral reactions to novel, mildly stressful social situations throughout development; another 5%-10% are likely to exhibit impulsive and/or inappropriately aggressive responses under similar circumstances. These distinctive behavioral patterns and their biological correlates appear early in life and remain remarkably stable from infancy to adulthood. Both genetic and experiential mechanisms are implicated not only in the expression of these patterns but also in their transmission across successive generations of monkeys. For example, a specific polymorphism in the serotonin transporter gene is associated with deficits in infant neurobehavioral functioning and in juvenile and adolescent control of aggression and serotonin metabolism in monkeys that experienced insecure early attachments but not in monkeys that developed secure attachment relationships with their mothers during infancy (maternal buffering). Moreover, because the attachment style of a monkey mother is typically "copied" by her daughters when they grow up and become mothers themselves, similar buffering is likely to occur for the next generation of infants carrying that specific polymorphism.