A secure attachment model of care: meeting the needs of women with mental health problems and antisocial behaviour.
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Antisocial Personality Disorder↗
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Suicidal ideation in an adolescent clinical sample: attachment patterns and clinical implications.
This study investigated the relationship between attachment patterns and suicidal ideation in a clinical sample of adolescents. Participants (n = 116) were assessed on level of current ideation through self-report questionnaires. Lethality of methods contemplated was also rated on a subset of the sample (n = 16) who, in addition to endorsing current suicidal ideation, presented a plan on a diagnostic interview. Quality of attachment to care-givers based on a semi-structured clinical interview was assessed using Bartholomew's two-dimensional, four-category model of attachment. Categorical analyses indicated that youth with predominantly fearful or preoccupied attachment were more likely to endorse suicidal ideation than were predominantly secure or dismissing youth. Severity of suicidal ideation was positively correlated with ratings of fearfulness and negatively correlated with ratings on the secure and dismissing patterns. Greater lethality in methods of contemplated suicide was positively correlated with preoccupied tendencies. The importance of attachment theory for understanding the factors underlying suicidal ideation in troubled youth is discussed and implications for therapeutic intervention are presented.
Adolescent↗
Impact of hyperbilirubinaemia and transient mother-child separation in the neonatal period on mother-child attachment in the 1st year of life.
Hyperbilirubinaemia (HyB) is the most common health disturbance in the neonatal period. The aim of this prospective study is to determine whether HyB and/or phototherapy (PhT) together with transient separation during the neonatal period are associated with impaired mother-child attachment after the 1st year of life. We divided 107 healthy term infants into three groups: 29 markedly icteric infants who underwent PhT (mother-child separation), 40 mildly icteric infants without PhT and a control group of 38 nonicteric infants. At the age of 1 year a paediatric examination and a Denver test were performed, and the mother-infants pairs were observed in Ainsworth's strange situation. The results show a similar distribution of the attachment patterns in the three different groups of infants. HyB and PhT do not negatively seem to affect the quality of attachment. Analysis of additional aspects showed that maternal coping and her perception of the child appear to be more important antecedents of the quality of attachment after the 1st year of life.
Adaptation, Psychological↗
Attachment processes in eating disorders.
Anxious and insecure attachment, fear of abandonment and difficulties with autonomy differentiate young women with eating disorders from their normal peers. This paper uses the Adult Attachment Interview (AAI) as the correlation between eating disorders and state of mind regarding attachment (7 females and 6 males) with anorexia nervosa and EDNOS. There was a higher frequency of dismissing or entangled states of mind. The sample is far too small to allow statistical inferences to be drawn about differences between men and women in the style of state of mind regarding attachment. An inference is none the less made with regard to the role of psychotherapy in these results.
Adolescent↗
A cognitive-behavioral model of compulsive hoarding.
Compulsive hoarding is a little studied phenomenon within the research literature. The information available on compulsive hoarding is diverse and not well integrated. In the present article we propose a tentative cognitive-behavioral model of compulsive hoarding. The purpose of such a model is to provide a framework for the development and testing of hypotheses about compulsive hoarding. In this model hoarding is conceptualized as a multifaceted problem stemming from: (1) information processing deficits; (2) problems in forming emotional attachments; (3) behavioral avoidance; and (4) erroneous beliefs about the nature of possessions. Specific hypotheses about each of these are discussed.
Cognitive Behavioral Therapy↗
Smoking in pregnancy: the role of the transtheoretical model and the mother's attachment to the fetus.
This study investigated whether pregnant smokers demonstrated cognitive and behavioural patterns hypothesised to underpin the different stages of change (SOC) and whether fetal attachment varied according to this process. A cross-sectional design with women categorised by SOC was used and the sample was recruited from hospital maternity services in the U. K at their booking clinics with a mean gestation of 14 weeks. Experiential and behavioural processes together with self-efficacy and attachment to the fetus were measured in 637 women. As predicted by the transthoretical model experiential processes were used mostly by women in contemplation and preparation; behavioural processes mostly by women in preparation and action. However, self-efficacy remained constant between pre-contemplation, contemplation and preparation, but women in action showed significantly higher levels. Women in preparation were significantly more attached to the fetus than women in pre-contemplation and never smokers. The relevance of the transtheoretical model with pregnant smokers is supported. Foetal attachment may be differentially associated with different SOC in smoking cessation and yield potential for the development of new interventions.
Adolescent↗
Using attachment theory to understand illness behavior.
This article examines a model of illness as a stressor that activates an individual's characteristic attachment behaviors. These behaviors are the result of the attachment system, a mammalian trait that exists in order to maximize the odds of survival of an infant born without the necessary maturation for immediate independence. Attachment concepts, such as attachment style, coherence, and reflective functioning, are briefly explained, followed by examples of their application to the psychological management of patients with medical or surgical illness. Attachment theory provides a unique, simple, and pragmatically useful model for understanding the particular ways that individuals can feel and react when stressed by illness, and how the professional may help manage that distress.
Humans↗
The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain.
Attachment theory and research suggest that patterns of interpersonal relationships may be important determinants of illness behavior, care seeking, and treatment response in individuals with chronic health problems, including chronic pain. Attachment styles have been shown to be associated with psychological adjustment in the context of chronic illness, but little research has been conducted so far examining these relationships in patients with chronic pain. We assessed 111 patients with chronic pain participating in a multidisciplinary pain treatment program to determine if attachment style is associated with pain, depression, catastrophizing and physical disability at pre-treatment and 12-month follow-up, and with change in health care utilization pre-treatment to follow-up. At both pre-treatment and follow-up, fearful attachment style was associated with significantly greater depression and catastrophizing, and secure attachment was associated with significantly lower levels of depression. Preoccupied attachment style was associated with greater than weekly pain-related visits at 12 months follow-up, even after controlling for depression, catastrophizing and pre-treatment pain-related health care utilization. The findings suggest that attachment style may be a useful construct for examining factors affecting adjustment and treatment response of patients with chronic pain.
Adult↗
Patterns of risk and trajectories of preschool problem behaviors: a person-oriented analysis of attachment in context.
A small proportion of children exhibit extreme and persistent conduct problems through childhood. The present study employed the multiple-domain model of Greenberg and colleagues as the framework for person-oriented analyses examining whether parent-child attachment combines with parenting, family ecology, and child characteristics in particular configurations of risk that are linked to this problematic developmental pathway. Using prospective data from a community sample of adolescent mothers and their children, latent variable growth mixture modeling identified a normative trajectory with declining problem behaviors during the preschool period. Consistent with research on early-starter pathways, a distinct group of children featured a higher intercept and a positive slope, indicating an escalation in disruptive behaviors. Attachment security played a role in defining specific risk profiles associated with the probability of exhibiting this problem trajectory. Given particular patterns of risk exposure, secure attachment served a protective function. Avoidant, but not disorganized, attachment was associated with significantly higher likelihood of the disruptive problem trajectory. The results also indicated the general accumulation of risk was detrimental, but the particular configuration of risk made a difference. Overall, the findings suggest early attachment operates in conjunction with personal and contextual risk to distinguish the development of later problem behaviors.
Adolescent↗
Adult attachment in a nationally representative sample.
The explosion of adult attachment research in the last decade has been limited by its reliance on college student and distressed samples. Using a large nationally representative sample of American adults, the authors examined the relation of sociodemographics, childhood adversity, parental representations, adult psychopathology, and personality traits to adult attachment in an effort to replicate previous findings and extend the theory. Distribution of adult attachment styles was similar to that in prior studies: 59% secure, 25% avoidant, and 11% anxious. Adult attachment was associated with several sociodemographic variables (e.g., income, age, race) not previously studied. Childhood adversities of an interpersonal nature were strongly related to insecure adult attachment. Various types of adult psychopathologies and personality traits were also strongly related to adult attachment. Implications for adult attachment theory and future research are discussed.
Adolescent↗
Temperament, relationships, and young children's receptive cooperation with their parents.
The authors studied receptive cooperation--a willing, eager stance toward parents--in 15-month-old children (N = 101) in broadly ranging contexts. Children's anger proneness and parents' responsiveness (both observed at 7 months) and children's attachment security (assessed in Strange Situation at 15 months) were examined as predictors of children's receptive cooperation at 15 months. In mother-child dyads, secure attachment was strongly associated with children's higher receptive cooperation. Maternal responsiveness in infancy also promoted children's future receptive cooperation, but its impact was moderated by child anger: Responsiveness had a positive effect for children who as infants were highly anger prone. In father-child dyads, the negative effect of anger proneness on receptive cooperation with father was significantly amplified for insecure children. Mother's responsiveness and child's secure attachment to the mother promoted child receptive cooperation with the father, but there were no similar effects for fathers.
Anger↗
Ethnic and cultural variations in anger regulation and attachment patterns among Korean American and European American male batterers.
This study examined relationships among ethnicity, self-construals, and 2 risk factors for marital violence (anger, insecure attachment) in Korean American and European American male batterers. Korean (vs. European) American batterers experienced more anger and controlled their anger less. Independent self-construal was positively associated with anger experience and anger control and mediated the influence of ethnicity on anger control. Korean batterers were less independent, and less independent batterers controlled their anger less. Korean batterers' attachment styles were more avoidant and less anxious. Independent and interdependent self-construals were negatively associated with anxious and avoidant attachment, respectively. Independent self-construal mediated the influence of ethnicity on avoidant attachment. Clinical severity and adherence to traditional gender roles may help explain these ethnic and cultural variations.
Adaptation, Psychological↗
Hair combing interactions: a new paradigm for research with African-American mothers.
The hair combing interaction is proposed as a naturalistic observational research paradigm, within the conceptual framework of attachment theory, for understanding the socioemotional domains of African-American mother-child relationships. A pilot study of 11 mother-daughter dyads explores the validity of the hair combing context for assessing strategies of racial and gender socialization of children, evolving mother-child relationships, and the formation of internal working models of attachment relationships. The model is discussed as a method for research into enduring qualities of the mother-child relationship.
Adolescent↗
Attachment theory and residential treatment: a study of staff-client relationships.
This qualitative study examines residential child care workers' styles of engaging adolescent clients. Analysis focuses on staff practices and behavior that facilitate a treatment context conducive to healthier client attachments. Findings demonstrate the complexity inherent in residential treatment and illuminate barriers to optimal staff-client relationships. Suggestions are offered for improvement of agency policies and for future research.
Adolescent↗
A new method of evaluating attachment representations in young school-age children: the Manchester Child Attachment Story Task.
We describe a new instrument, using a doll-play vignette completion method, which applies concepts and methodologies from infant and adult attachment research to enable identification and detailed classification of internal representations of attachment relationships in young school-age children. Validation of the Manchester Child Attachment Story Task (MCAST) in a normal population (N = 53) shows good interrater reliability and content validity. Patterns of attachment representation identified show stability over time. Comparisons are made with existing methodologies, and potential applications of the instrument and directions for future research are discussed.
Child↗
Attachment in infancy and personal space regulation in early adolescence.
This study longitudinally assessed associations between secure and ambivalent attachment with mothers, fathers and professional caregivers in infancy, and personal space regulation and perceived interpersonal competence in 64 early adolescents (31 boys, 33 girls). Children classified as ambivalently attached to their mothers and/or professional caregivers in infancy displayed significantly larger permeability of personal space as compared with children classified as securely attached. Attachment classifications with fathers were not associated with personal space behavior at 12 years of age. Children who had an insecure attachment relationship with both the mother and the professional caregiver in infancy displayed smaller personal space boundaries, and tolerated larger intrusions into their personal space as compared with children who had two secure attachments in infancy. Finally, perceived interpersonal competence was positively correlated with personal space permeability.
Adolescent↗
Adult attachment stance and spouses' marital perceptions during the transition to parenthood.
The relationship between adult attachment and marital perceptions was examined in couples making the transition to parenthood. The Adult Attachment Interview was administered to spouses prenatally, and marital perceptions were assessed prenatally and 3, 12, and 24 months postnatally. The couples were also observed during a marital interaction task. Spouses were assigned to groups based on their attachment security (secure/insecure) and mean level (low/high) of negative emotional escalation in their marital interactions. A series of two-way (attachment security by negative emotional escalation) repeated multivariate analyses of variance, followed by univariate analyses, revealed that insecure husbands and the wives of insecure husbands exhibited different patterns in their marital perceptions than secure husbands and the wives of secure husbands when in high negative escalation marriages. Insecure husbands and the wives of insecure husbands in high negative escalation marriages reported greater declines in positive marital perceptions or less positive marital perceptions overall across the two-year postnatal period than secure husbands and wives of secure husbands in similarly high conflict marriages. Such differences between secure and insecure husbands (and their wives) were not apparent in low negative escalation marriages. Findings are discussed in terms of the protective effect a secure attachment may convey upon spouses during stressful periods in their marriage.
Adult↗
Husbands' and wives' marital quality: the role of adult attachment orientations, depressive symptoms, and conflict resolution behaviors.
Although previous research has examined the role of adult attachment orientations, depressive symptoms, and conflict resolution behaviors (attacking and compromising) in marital quality, these variables have typically been considered separately. In the present study, these attributes were examined together in a community sample of 64 married couples. Correlational analyses revealed significant associations among the study variables and generally supported the hypothesized relations. When a regression series was applied to the data in order to examine indirect links between husbands' and wives' attachment orientations and their marital satisfaction, results provided some support for mediation; husbands' conflict resolution behaviors partially mediated the association between husbands' depressive symptoms and marital satisfaction. Interestingly, wives' conflict resolution behaviors did not mediate the association between wives' depressive symptoms and marital satisfaction. Instead, a different pattern was found; wives' conflict resolution behaviors partially mediated the association between wives' attachment anxiety and marital satisfaction. Findings highlight the importance of considering husbands' and wives' attributes separately and suggest directions for future research on this topic.
Adult↗