Mother–Infant Joint Attention and Sharing: Relations to Disorganized Attachment and Maternal Disrupted Communication

The normative development of infant shared attention has been studied extensively, but few studies have examined the impact of disorganized attachment and disturbed maternal caregiving on mother–infant shared attention. The authors examined both maternal initiations of joint attention and infants’ responses to those initiations during the reunion episodes of the Strange Situation Procedure at 12 and 18 months of infant age. The mothers' initiations of joint attention and three forms of infant response, including shunning, simple joint attention, and sharing attention, were examined in relation to infant disorganized attachment and maternal disrupted communication. Mothers who were disrupted in communication with their infants at 18 months initiated fewer bids for joint attention at 12 months, and, at 18 months, mothers of infants classified disorganized initiated fewer bids. However, the infant' responses were unrelated to either the infant' or the mother' disturbed attachment. At both ages, disorganized infants and infants of disrupted mothers were as likely to respond to maternal bids as were their lower risk counterparts. Our results suggest that a disposition to share experiences with others is robust in infancy, even among infants with adverse attachment experiences, but this infant disposition may depend on adult initiation of bids to be realized.     

The heterogeneity of attention‐deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition,emotion regulation,emotionality, and disorganized attachment

This study examined the contributions of several important domains of functioning to attention‐deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms.     

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.     

两岁儿童对母亲的依恋类型

本研究采用实验室观察法,考察122名21-27个月龄的儿童对母亲的依恋类型,实验室程序包括儿童的自由活动、与陌生人的交往、在多种压力情境下的行为表现,与母亲的分离-重聚等.结果发现(1)本研究中使用的实验室观察程序能够有效地测查两岁儿童对母亲的依恋行为.(2)中国两岁儿童对母亲的依恋有四种类型淡漠型依恋、安全型依恋、缠人型依恋、混乱型依恋,分布比例分别为11%,73%,7%,9%.其中安全型和混乱型依恋的表现与国外研究者描述的美国、日本等国家儿童的行为大体相同,但淡漠型和缠人型依恋为我国儿童所特有,其表现特点与国外研究者描述的焦虑-回避型不安全依恋及焦虑-矛盾型不安全依恋有明显区别.     

Exploration of the links among fathers' unresolved states of mind with respect to attachment,atypical paternal behavior,and disorganized infant–father attachment

Atypical maternal behavior has consistently been identified as a precursor of disorganized infant–mother attachment, but to date, no research has examined the role of atypical paternal behavior in the development of disorganized infant–father attachment. This study aims to enhance our understanding and conceptualization of infant–father attachment by examining the role of fathers' unresolved states of mind and the display of atypical paternal behavior in the development of disorganized infant–father attachment. Thirty‐one middle‐class couples participated in this study. Maternal and paternal Adult Attachment Interviews (C. George, N. Kaplan, & M. Main, 1996 ) were completed prenatally and at infant age 6 months, respectively. Infant–mother and infant–father dyads participated in the Strange Situation paradigm (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978 ) when the infants were 12 and 18 months of age, respectively. The Atypical Maternal Behavior Instrument for Assessment and Classification (E. Bronfman, E. Parsons, & K. Lyons‐Ruth, 1999 ) was used to assess maternal and paternal behavior during the Strange Situation. Maternal states of mind regarding attachment predicted infant–mother attachment relationships, and paternal states of mind predicted infant–father attachment relationships. Atypical maternal behavior was associated with infant–mother disorganized attachment; however, atypical paternal behavior did not predict infant–father disorganized attachment. Thus, it is possible that other factors, yet to be uncovered, might contribute to the development of infant–father disorganized attachment.     

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.     

Infant attachment in the Czech Republic: Categorical and dimensional findings from a post-communist country

Infant attachment remains virtually unexplored in former Eastern Bloc countries. The dimensional approach to infant attachment, which could ease common obstacles in cross-cultural attachment research, necessitates more empirical support. This study explores infant attachment in the Czech Republic, a post-communist country with a unique family policy, using both the categorical and the dimensional models. It also compares the Czech infant attachment distribution to infant attachment distributions in other countries and compares infant attachment distributions in European countries to the Baltimore study sample. In the Strange Situation Procedure, forty-nine (74 %) out of sixty-six mother-infant dyads (35 boys, M = 13.8, SD = 0.9) received the B classification. Despite the generous family policy and cultural emphasis on close mother-infant relationships, the Czech distribution of insecure categories did not differ from the Baltimore study sample. Out of other post-communist countries, only the infant attachment distribution in former East Germany differed from the Czech and the Baltimore study samples due to a lower proportion of type B and a higher proportion of type A infants. There were also more type A infants in the Italian sample. Interactive behavior scales accurately predicted attachment categories in 91 % of cases. Contact-maintenance and proximity-seeking scales substantially improve the assessment of insecure resistant behavior. Our findings support the universality and normativity of attachment and the utility of the dimensional approach.     

Revisiting the African origins of attachment research—50 years on from Ainsworth: A descriptive review

Culture plays a significant role in the variations observed in the manifestation, expression, and meaning of attachment behaviors. Africa is home to multiple cultures, with distinct organizations of caregiving relationships underlying the development of attachment. This review aims to consolidate knowledge about African attachment by describing studies of infant attachment conducted in Africa since Mary Ainsworth's Ugandan findings in 1967. Electronic databases were searched with the terms “Africa” (“attachment” or “bond”) and “infant.” Nine studies that assessed infant attachment style with self-report or observation methods were included, but spanned only five countries. The Strange Situation Procedure was most frequently used. Most studies described dyads living in peri-urban or township areas. Multiple socioeconomic factors affecting living conditions were identified, including, unemployment, financial difficulties, limited education, poor housing, single parenthood, lack of partner support, substance abuse, and depression. Overall distributions of attachment classification proportions appear consistent with global attachment-classification patterns. Despite adverse conditions, secure attachment was relatively widespread, and some populations had low rates of avoidant attachment. Relatively high rates of disorganized attachment were found when the category was included. Africa remains an understudied continent regarding infant attachment. The continent's cultural diversity may hold important truths necessary for understanding the complex relationship between infant and attachment figure.     

A Jungian contribution to a dynamic systems understanding of disorganized attachment

This panel emerged from shared clinical concerns when working with adult patients whose presentation style was reminiscent of a disorganized (Type D) infant attachment pattern. Psychotherapeutic work with such patients poses complicated transference and countertransference dilemmas which are addressed by all four panellists via theory and clinical vignettes. In common is an interest in contemporary attachment, neuroscience and trauma theories and their relationship to analytical psychology. Intergenerational trauma seems to be a salient factor in the evolution of fragmented and fragmenting interactions that lead to failures in self-coherence and healthy interpersonal relationships. Such early relational trauma is compounded by further episodes of abuse and neglect leading to failure in a core sense of self. These clinicians share how they have integrated theory and practice in order to help dissociated and disorganized patients to transform their dark and extraordinary suffering through implicit and explicit experiences with the analyst into new, life giving patterns of relationship with self and others. The alchemy of transformation, both positive and negative, is evident in the case material presented.     

Nirvana Road: Dissociative Experiences Predict “Eastern” Beliefs About Postmortem Existence

Three studies (N = 338) tested the idea that endorsement of postmortem beliefs most closely associated with Eastern religious traditions (that is, continuation of consciousness and the explicit dissolution of personal identity, possibly via reincarnation) would map onto a history of dissociative experiences. As hypothesized, a history of dissociative (including depersonalization/derealization) experiences, as well as altered experience of body/space/time during a discrete positive episode, predicted endorsement of “Eastern” postmortem beliefs among religiously heterogeneous (non-Buddhist, non-Hindu) participants. This relationship became stronger when dissociative tendencies were heightened following a traumatic loss (i.e., the suicide of a close other within the past year; Study 3). In contrast, dissociative tendencies did not predict belief in either annihilation or postmortem continuation without identity loss, most typically linked to atheism and Western religious traditions, respectively. These results suggest that some metaphysical beliefs may be embraced because they “make sense” in light of personal experience.     

Maternal attachment representations after very preterm birth and the effect of early intervention

Objective

For very preterm infants the mother-infant relationship may be compromised. Maternal attachment representations 18 (corrected) months after very preterm birth and the effect of the post-discharge Infant Behavioral Assessment and Intervention Program (IBAIP) were studied. The IBAIP is designed to assist parents to support and enhance their infant's regulatory competence and development. The intervention consisted of 6-8 home visits during the first 8 months after birth.

Method

Seventy-eight mothers of very preterm infants (<32 weeks and/or <1500 g) were interviewed, who participated in a randomized controlled trial: 41 from the intervention group and 37 from the control group. Maternal attachment representations were assessed with the Working Model of the Child Interview (WMCI). The interviews resulted in a classification of the attachment representations into balanced or non-balanced.

Results

30% of the mothers had non-balanced attachment representations. Qualitative content analysis of the answers showed that negative feelings when first seeing their baby and negative or ambivalent feelings in the first weeks at home with their baby are related to non-balanced attachment representations. The WMCI revealed no differences between the intervention and control group.

Conclusion

Early support for mothers of very preterm born infants to develop a healthy mother-infant relationship is recommended especially for mothers who report negative first experiences.     

The relationship between attachment, personality and antisocial tendencies in a prison sample: a pilot study

This study examined the role of adult attachment and personality in relation to antisocial tendencies (i.e. convictions for violence and interpersonal problems in romantic relationships) in Norwegian prison inmates (N=92). Attachment styles and personality were measured using self-report questionnaires (RSQ; Griffin & Bartholomew, 1994; and NEO-FFI, Costa & McCrae, 1992a). The prison inmates scored higher on avoidant than on anxious attachment style. While age and agreeableness (negatively associated) emerged as significant predictors of violence, anxious attachment explained most of the variances in aggression in intimate relationships. The study suggests that different types of antisocial tendencies could have different attachment and general personality correlates.     

The dopamine D4 receptor gene,birth weight,maternal depression,maternal attention,and the prediction of disorganized attachment at 36 months of age: A prospective gene × environment analysis

BackgroundEfforts to understand the developmental pathways for disorganized attachment reflect the importance of disorganized attachment on the prediction of future psychopathology. The inconsistent findings on the prediction of disorganized attachment from the dopamine D4 receptor (DRD4) gene, birth weight, and maternal depression as well as the evidence supporting the contribution of early maternal care, suggest the importance of exploring a gene by environment model.MethodsOur sample is from the Maternal Adversity, Vulnerability, and Neurodevelopment project; consisting of 655 mother–child dyads. Birth weight was cross-referenced with normative data to calculate birth weight percentile. Infant DRD4 genotype was obtained with buccal swabs and categorized according to the presence of the 7-repeat allele. Maternal depression was assessed with the Center for Epidemiologic Studies Depression Scale at the prenatal, 6-, 12-, and 24-month assessments. Maternal attention was measured at 6-months using a videotaped session of a 20-min non-feeding interaction. Attachment was assessed at 36-months using the Strange Situation Procedure.ResultsThe presence of the DRD4 7-repeat allele was associated with less disorganized attachment, β = −1.11, OR = 0.33, p = 0.0008. Maternal looking away frequency showed significant interactions with maternal depression at the prenatal assessment, β = 0.003, OR = 1.003, p = 0.023, and at 24 months, β = 0.004, OR = 1.004, p = 0.021, as at both time points, women suffering from depression and with frequent looking away behavior had an increased probability of disorganized attachment in their child, while those with less looking away behavior had a decreased probability of disorganized attachment in their child at 36 months.ConclusionsOur models support the contribution of biological and multiple environmental factors in the complex prediction of disorganized attachment at 36 months.     

Do early parental postnatal depression,attachment style and perceived social support affect neurodevelopmental outcomes of premature infants?

BackgroundThe birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups.MethodsThis prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants’ corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age.ResultsPostnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers’ depression scores were inversely associated with cognitive development (p = 0.030, R² = 0.080, B=-0.283) and mothers’ anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R² = 0.108, B=-0.329) at the age of corrected 6 months old.ConclusionsOur findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers’ depressive symptomatology and maternal anxious/ambivalent attachment.     

父母、同伴依恋与希望的相互作用模型:一项大学新生的追踪研究

为了考察父母、同伴依恋与希望的纵向关系,本研究以大学新生为研究对象,采用父母、同伴依恋问卷与希望量表,对1283名大一学生进行为期一年共三次的追踪研究。结果发现：（1）三次测量的父母、同伴依恋均与希望存在正相关;（2）交叉滞后模型表明,父母、同伴依恋与希望均存在相互影响的关系;（3）基于性别差异的分组模型分析表明,仅同伴依恋与希望的横断关系存在性别差异,女生相关系数显著大于男生。研究揭示,依恋与希望存在稳定的横向相关关系,并且依恋与希望存在相互预测的纵向关系。     

Attachment in low‐SES rural Appalachian infants: Contextual,infant, and maternal interaction risk and protective factors

Attachment classifications were obtained for 95 low‐socioeconomic‐status (SES) rural Appalachian infants in the Strange Situation procedure at 15 months. The distribution of secure (B) and insecure (A, C, D) infants was similar to other low‐SES samples and significantly different from low‐risk samples. Levels of contextual and infant risk, together with maternal responsiveness to crying and pattern of sensitivity from 4 to 9 months, predicted attachment security. High social support, when examined as a protective factor, related to reduced contextual risk, but not to increased likelihood of security. Exploratory discriminant function analyses showed that infants in secure relationships differed in positive directions on contextual and maternal interactional factors. Insecure‐organized (A and C) infants experienced contextual and maternal interaction risks, while insecure‐disorganized (D) infants were best distinguished by infant characteristics, including greater likelihood of being male and low use of mother as a secure base at 9 months. ©2001 Michigan Association for Infant Mental Health.     

THE EYE OF THE BEGETTER: PREDICTING INFANT ATTACHMENT DISORGANIZATION FROM WOMEN'S PRENATAL INTERPRETATIONS OF INFANT FACIAL EXPRESSIONS

Infant–caregiver attachment disorganization has been linked to many long‐term negative psychosocial outcomes. While various prevention programs appear to be effective in preventing disorganized attachment, methods currently used to identify those at risk are unfortunately either overly general or impractical. The current investigation tested whether women's prenatal biases in identifying infant expressions of emotion—tendencies previously shown to relate to some of the maternal variables associated with infant attachment, including maternal traumatization, trauma symptoms, and maternal sensitivity—could predict infant attachment classification at 18 months postpartum. Logistic regression analyses revealed that together with women's adult history of high betrayal traumatization, response concordance with a normative reference sample in labeling infant expressions as negatively valenced, and the number of infant facial expressions that participants classified as “sad” and “angry” predicted subsequent infant attachment security versus disorganization. Implications for screening and prevention are discussed.     

Maternal perinatal representations and their associations with mother–infant interaction and attachment: A longitudinal comparison of Portuguese and Brazilian dyads

Prior research in Western countries (mostly the US, Canada and northern Europe) indicates that mothers' representations are associated with mother–infant interaction quality and their child's attachment security later in the first year. Fewer studies, however, have evaluated whether these associations hold for mother–infant dyads in other countries, such as Brazil and Portugal. Although these countries share a similar language and culture, they differ on societal dimensions that may affect parenting attitudes and mother–infant relationships, such as economic stress, social organisation, social policy, and the availability of services for young families. In this longitudinal study, we followed two independent samples of Brazilian and Portuguese mother–infant dyads from the perinatal period to 12 months post-partum. We assessed mothers' perinatal representations using semi-structured interviews in the first 48 hours after the infant's birth, and evaluated the associations of these representations with mother interaction quality at 9 months and infant attachment at 12 months. Results were similar in each country, corroborating prior research in single Western countries: Mothers with more positive perinatal representations were more sensitive to their infants during free play at 9 months and were more likely to have infants classified as securely attached at 12 months.