Disorganized Attachment and Inhibitory Capacity: Predicting Externalizing Problem Behaviors

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and callous-unemotional (CU) traits. General externalizing problem behaviors were also measured at age 5 to allow for a developmental analysis. Outcome variables were rated by parents and teachers. The sample consisted of 65 children with an oversampling of children with high levels of externalizing behaviors. Attachment was evaluated using a story stem attachment doll play procedure. Inhibition was measured using four different tasks. The results showed that both disorganized attachment and poor inhibition were longitudinally related to all outcome variables. Controlling for initial level of externalizing problem behavior, poor inhibition predicted ADHD symptoms and externalizing problem behaviors, independent of disorganized attachment, whereas for ASD symptoms no predictive relations remained. Disorganized attachment independently predicted CU traits.     

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.     

Attachment in foster children associated with caregivers' sensitivity and behavioral problems

This study focused on attachment of foster children by examining factors associated with attachment relationships of children raised from birth by the same parents. The sample included 61 children between 26 to 88 months of age and their foster caregivers. Attachment security and caregiver sensitivity were coded on the basis of, respectively, a home‐observation (Attachment Q‐Set) and a laboratory procedure (Three boxes). Other measures included caregiver reports of child externalizing and internalizing behavior problems and symptoms of attachment disorder, including inhibited and disinhibited attachment as well as secure base distortions. For a subsample of children, teacher ratings of behavior problems also were available. Foster parent sensitivity was positively associated with attachment security, but only if symptoms of disordered attachment were partialled out. Symptoms of inhibited and disinhibited attachment as well as secure base distortions were positively related to parent reports of externalizing and internalizing behavior problems whereas attachment security was negatively related to teacher reports of externalizing behavior problems. Attachment theoretical tenets appeared valid with foster parent–child relationships, except for children with symptoms of attachment disorder.     

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.     

Links Between Disorganized Attachment Classification and Clinical Symptoms in School-Aged Children

Research examining the links between disorganized attachment and clinical symptoms largely has neglected middle childhood due to lack of available measurement tools. The few studies that have examined these links in other developmental phases have found higher clinical symptoms in disorganized individuals. Our study extended this research by using a recently-developed attachment interview measure ideally suited to evaluate disorganized attachment in middle childhood. We examined concurrent associations among disorganized attachment in 8–12 year old children and symptoms of psychopathology theoretically hypothesized for their links with disorganized attachment. Using child- and parent-reports, we measured symptoms of depression, social anxiety, shyness, inattention, and thought problems. During our two-session study, 97 children completed the Child Attachment Interview, and children and parents completed clinical questionnaires. Results suggested that disorganized attachment was associated with higher child reports of depressive symptoms and shyness, and with parent-reports of social anxiety, inattention, and thought problems, and that disorganized children are more likely to have symptoms that meet clinical criteria. Implications for the relation of attachment to psychopathology are discussed.     

Attachment Representation and Sensitivity: The Moderating Role of Posttraumatic Stress Disorder in a Refugee Sample

It has been hypothesized that adult attachment representations guide caregiving behavior and influence parental sensitivity, and thus affect the child's socio‐emotional development. Several studies have shown a link between posttraumatic stress disorder (PTSD) and reduced parental sensitivity, so it is possible that PTSD moderates the relationship between insecure attachment representations and insensitivity. In this study symptoms of PTSD (Harvard Trauma Questionnaire), parental sensitivity (Emotional Availability Scales), and attachment representations (Attachment Script Assessment) were assessed in 53 parents who were asylum seekers or refugees. Results showed that when parents were less able to draw on secure attachment representations, symptoms of PTSD increased the risk of insensitive parenting. These findings suggest that parental sensitivity is affected not just by attachment representations, but by a conjunction of risk factors including symptoms of PTSD and insecure attachment representations. These parents should therefore be supported to establish or confirm secure models of attachment experiences, to facilitate their ability interact sensitively and form a secure relationship with their children.     

Mother–child attachment,emotion regulation,and anxiety symptoms in middle childhood

This study examined whether the relation of mother–child attachment with anxiety symptoms is mediated by emotion regulation (ER) processes (poor emotional awareness, biased interpretations of emotionally charged events, and coping strategies). Attachment patterns were assessed in a sample of eighty‐seven 10‐ to 12‐year‐olds using story‐stem interviews. Children who were less secure and more disorganized reported more anxiety. Attachment was also related to ER; security was associated with less difficulty identifying emotions, and disorganization was associated with more catastrophizing interpretations and less active coping. Anxiety symptoms were related to all three ER processes. Finally, relations of security or disorganization with anxiety symptoms were partially mediated by ER processes.     

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.     

Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms in Children Adopted from Poland and their Atypical Association Patterns: a Bayesian Approach

Although high rates of attention-deficit hyperactivity disorder (ADHD) symptoms have been observed among internationally adopted children, research on these symptoms in Polish adoptees is lacking. Therefore, we examined ADHD symptoms in Polish adoptees and their relationship to pre-adoptive risk factors, that is, time in institutional care, early deprivation, and prenatal alcohol exposure. We further compared the association patterns and gender distribution of ADHD symptoms in children adopted from Poland to those reported in the literature for ADHD symptoms in non-adopted children. Dutch adoptive parents of 121 Polish adoptees (52% boys; M _age = 10.9 years, range 6.2–15.6; M _ageadoption = 3.0 years, range 0.8–6.9) completed questionnaires regarding ADHD symptoms, pre-adoptive risk factors, attachment problems, conduct problems, and executive functioning deficits. Bayesian evaluation of informative hypotheses showed that Polish adoptees had increased levels of ADHD symptoms, compared to Dutch children in the general population. Time in institutional care, early deprivation, and prenatal alcohol exposure were not associated with ADHD symptoms. ADHD symptoms in Polish adoptees were more strongly associated with attachment problems and executive functioning deficits, but less strongly with conduct problems, compared to ADHD symptoms in non-adoptees. Furthermore, ADHD symptoms were more equally distributed among boys and girls than they are in non-adopted children. The findings indicate that Polish adoptees and their adoptive parents need special attention and support. The dissimilarities between ADHD symptoms in Polish adoptees and non-adoptees might indicate a different underlying causal mechanism, which may have important implications for clinical practice.     

Late Adoptions: Attachment Security and Emotional Availability in Mother–Child and Father–Child Dyads

A growing body of research suggests that a history of neglect, abuse and institutionalization can negatively affect late-adopted children’s attachment representations, and that adoptive parents can play a key role in enabling adopted children to earn secure attachments. Still, only a few studies have explored the quality of caregiver–child interaction in adoptive families. The present study aimed at verifying both the concordance of attachment in adoptive dyads (mother–children and father–children) and the relationship between attachment representations and parent–child interaction. The research involved 20 adoptive families in which the child’s arrival had occurred between 12 to 36 months before the assessment, and where children were aged between 4.5 and 8.5 years. Attachment was assessed through the Adult Attachment Interview for parents and through the Manchester Child Attachment Story Task for children. The emotional quality of parent–child interaction was assessed trough the Emotional Availability Scales. Our results pointed out the presence of a relation between attachment representations of late-adopted children and their adoptive mothers (75%, K?=?0.50, p?=?.025). In addition, we found that both insecure children and mothers showed lower levels of EA than secure ones. Some explanations are presented about why, in the early post-adoption period, child attachment patterns and dyadic emotional availability seem to be arranged on different frameworks for the two parental figures.     

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.     

Associations between attachment‐related symptoms and later psychological problems among international adoptees: Results from the FinAdo study

We examined the associations between attachment‐related symptoms (symptoms of reactive attachment disorder (RAD), symptoms of disinhibited social engagement disorder (DSED), and clinging) and later psychological problems among international adoptees. The study population comprised internationally adopted children (591 boys and 768 girls, 6–15 years) from the ongoing Finnish Adoption (FinAdo) study. Data were gathered with self‐administered questionnaires both from adoptive parents and from adoptees aged over 9 years. Attachment‐related symptoms were measured using of a short (8‐item) questionnaire and later behavioral/emotional problems were assessed using the Child Behavior Checklist (CBCL) and the Five to Fifteen (FTF) scale for attention‐deficit/hyperactivity disorder (ADHD) symptoms. RAD and DSED symptom subscales were associated with an increased risk of emotional and behavioral problems and ADHD. Especially the mixed type of attachment‐related symptoms was strongly associated with later emotional and behavioral problems.     

Parenting and Conduct Problems: Moderation by Child Empathy

Child empathy was examined as a moderator of the relations between positive and negative parenting behavior and child conduct problems. Participants were 56 mother-child dyads (child age M?=?10.8 years; 64 % male) and children were recruited with a range of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. Parenting was assessed by direct observations of mothers’ praise and criticism during parent–child interactions and child empathy was measured with mother report. Child conduct problems were assessed via observation and mother-report measures, and a composite variable was created. In regression analyses, child ADHD symptoms were uniquely related to child conduct problems. Second, as hypothesized, child empathy moderated the relations between parenting and conduct problems. Mother praise was negatively related to child conduct problems at lower levels of child empathy, but this relation was not significant at higher levels of child empathy. On the contrary, mother criticism was positively related to child conduct problems at high levels of child empathy, but this relation was not significant at low levels of empathy. The results suggest that different types of parenting behavior may be differentially beneficial to children, depending on their level of empathy.     

Mental representations of attachment in day care providers

Mental representations of attachment of 31 day‐care providers were assessed using the Adult Attachment Interview (AAI), and compared with established observational measures of their behavior with the children under their care. Contrary to expectation, there was no significant association between the caregivers’ mental representations of attachment and their observed behavior. Teacher‐report ratings of aggressive behavior were obtained for 135 children who had been under the care of these providers. Ten of the 13 children who scored in the clinical range for aggressive behavior were known to have been under the care of a provider with a secure mental representation of attachment for an extended period of time (average 14 months), but the average age of first exposure to such a provider in this study was 16 months. For center‐based day‐care providers, standardized observational assessments of caregiving behavior appear to be unrelated to mental representations of attachment. Children who, during the second year of life, were cared for by providers with secure mental representations of attachment were not necessarily protected from abnormally aggressive behavioral outcome.     

儿童中期亲子依恋与焦虑症状的交叉滞后分析

以Kerns依恋安全性量表、Spence儿童焦虑量表为研究工具,对2所普通小学的472名三年级学生进行为期1年的追踪,考察儿童中期亲子依恋和焦虑症状的发展变化,以及亲子依恋与焦虑症状之间的关系。结果发现:(1)儿童中期的亲子依恋和焦虑症状在1年内较为稳定,分离焦虑、社交恐惧、恐慌障碍和强迫冲动障碍表现出一定的发展变化。(2)亲子依恋与焦虑症状呈显著负相关,依恋越安全,儿童的焦虑水平越低。(3)交叉滞后分析显示,亲子依恋在更大程度上影响儿童焦虑;母子依恋只具有同时性的影响,父子依恋既有同时性也有继时性的影响。(4)安全型父子依恋能够有效缓解不安全母子依恋的消极影响,安全型母子依恋对不安全父子依恋的补偿作用较小。     

Associations between Maternal Attention-Deficit/Hyperactivity Disorder Symptoms and Parenting

Mothers of children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for an ADHD diagnosis themselves, which is likely associated with impairments in parenting. The present study utilized a multi-method assessment of maternal ADHD and parenting to examine the extent to which maternal ADHD symptoms are associated with maladaptive parenting. Participants included 70 6–10 year old children with DSM-IV ADHD and their biological mothers. Results suggested that mothers with higher levels of ADHD symptoms reported lower levels of involvement and positive parenting and higher levels of inconsistent discipline. During observed parent–child interactions, maternal ADHD symptoms were negatively associated with positive parenting, and positively associated with negative parenting and repeated commands before giving the child an opportunity to comply. Given prior research suggesting that maladaptive parenting behaviors are risk factors for the later development of conduct problems among children with ADHD, these findings have important clinical implications for family-based assessment and treatment of ADHD.     

Maternal depression and children's attachment representations during the preschool years

This longitudinal study aimed to investigate the impact of chronic and transient maternal depression on children's attachment representations at 4 years of age measured with the Attachment Story Completion Task ( Bretherton, Ridgeway, & Cassidy, 1990 ). The impact of concurrent maternal depressive symptoms was also considered. A secondary aim was to investigate the continuity of attachment classification at 15 months with child attachment representations at 4 years. Children of mothers who were concurrently depressed were more likely to have attachment representations characterized by uncontained physical aggression. In contrast, there were no significant relationships between exposure to prior chronic maternal depression and children's attachment representations at 4 years, nor were there any significant relationships between behavioural assessments of attachment during infancy and later representational assessments. Findings are discussed in the context of caregiving behaviours that may foster secure attachment relationships and influence a child's social‐emotional development, limitations of representational measures, as well as poor attachment stability.     

Maternal depression and dyadic interaction: the role of maternal attachment style

Maternal mental health and the contents of her representational world are important determinants of early parent–child relationship. We examined, first, the role of prenatal and postnatal depressive symptoms and maternal attachment style in predicting the quality of mother–child interaction. Second, we analysed whether the secure‐autonomous attachment style can protect the dyadic interaction from the negative effects of maternal depression. The participants were 59 mother–infant pairs examined during pregnancy (T1), 4–5 months postpartum (T2) and when the children were approximately 14 months old (T3). Maternal attachment style was assessed with a modified Adult Attachment Interview ‐procedure, depressive symptoms with Edinburgh Postnatal Depression Scale, and observed mother–child interaction with Care Index. The results show that autonomous mothers were more sensitive and responsive and their children more co‐operative than dyads with dismissing maternal attachment style. As hypothesized, mothers with the combination of both prenatal and postpartum depressive symptoms were highly unresponsive in their dyadic interaction. Further, prenatal depressive symptoms had a stronger impact on maternal unresponsiveness than postnatal symptoms. As hypothesized, mother's autonomous attachment style protected the mother–child interaction from the negative impact of maternal postnatal depressive symptoms, whereas dyads with preoccupied mothers were especially at risk for interaction problems when mothers had postpartum depressive symptoms. Copyright © 2010 John Wiley & Sons, Ltd.