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A comparative study of attachment behavior in young children with autism or other psychiatric disorders.

The present study examined attachment behavior in children with autism and children with other developmental or psychiatric disorders. The groups were matched on chronological and mental age, IQ, and socioeconomic status. When a modified Strange Situation paradigm was used, no group differences were found in proximity seeking, contact maintenance, proximity avoidance, or contact resistance; the groups also did not differ in their overall security ratings. Attachment security was related to several developmental variables in the autistic group but not in the nonautistic comparison group. This suggests that attachment formation may involve different processes in autistic children than in nonautistic children of equivalent intellectual level.

Autistic Disorder↗

Transition to child care: associations with infant-mother attachment, infant negative emotion, and cortisol elevations.

Seventy 15-month-old infants were studied at home before starting child care, during adaptation (mothers present) and separation (first 9 days without mothers) phases, and 5 months later. Security of infant-mother attachment was assessed before and 3 months after child care began. In the separation phase, salivary cortisol rose over the first 60 min following the mothers' departures to levels that were 75% to 100% higher than at home. Compared with insecure infants, secure infants had markedly lower cortisol levels during the adaptation phase and higher fuss and cry levels during the separation phase, and their fuss and cry levels were significantly correlated with their cortisol levels. Attachments remained secure or became secure if mothers spent more days adapting their children to child care.

Adaptation, Psychological↗

A review of interventions in the parent-child relationship informed by attachment theory.

Bowlby's attachment theory has inspired a dramatic shift in the way we understand the development of the early relationship between infant and caregiver(s). Though almost all infants develop an attachment relationship to their primary caregiver(s), not all of them are able to use their caregiver(s) as a secure base or haven of safety from which to explore the world. Mary Ainsworth was the first to describe in detail the aspects of the caregiving system that are most important for the development of the attachment relationship. During the last decade several studies have started to evaluate the possibility that insensitive and perhaps even inadequate parenting can be effectively ameliorated by interventions. The present article sketches the theory behind attachment-based interventions and reviews the evidence for the effectiveness of such interventions. Finally, the article gives examples of successful preventive as well as therapeutic interventions.

Child, Preschool↗

Association of attachment style to lifetime medically unexplained symptoms in patients with hepatitis C.

In this study, we sought to establish whether there was an association between adult attachment style and number of medically unexplained physical symptoms in patients with hepatitis C. Thirty-two patients with hepatitis C were assessed with regard to attachment style classification, number of lifetime medically unexplained symptoms, lifetime psychiatric diagnoses, medical comorbidity, disease severity, use of interferon, and demographic characteristics. Analysis of covariance was used to compare the four attachment groups on number of lifetime medically unexplained symptoms, and Pearson correlations were used to assess the association of continuous ratings of attachment style with lifetime medically unexplained symptoms. Number of lifetime medically unexplained symptoms varied significantly as a function of attachment style group, with patients with fearful attachment reporting significantly more medically unexplained symptoms than patients with secure attachment (P < 0.01). Number of lifetime medically unexplained symptoms was positively correlated with continuous ratings of fearful attachment (r = 0.53, P < 0.01) and preoccupied attachment (r = 0.46, P < 0.01). Implications for treatment are discussed.

Adult↗

Multiple personality: a psychiatric misadventure.

Though multiple personality disorder has been diagnosed with increasing frequency over the past decade, its validity has been called into question. A brief review of the literature indicates a likelihood of socio-cultural influences and iatrogenicity in many if not most cases. Symptoms of multiple personality disorder parallel other psychiatric syndromes but are usually given diagnostic priority. The author has described five cases diagnosed multiple personality disorder by another health professional in which iatrogenic influences are clearly evident. All renounced both the diagnosis and the alleged sex abuse etiology. The patients possess insight into the role their attachment and dependency on their former therapist played in the development of their apparent multiple personality disorder.

Adult↗

Attachment behavior and its antecedents in offspring born to methadone-maintained women.

Videotaped 35 full-term, African American infants exposed in utero to methadone and 46 comparison infants at 12 months participating in a separation-reunion procedure to assess aspects of the infant's attachment relationship to the mother. Mothers in the two groups were comparable on education, age (18-35 years), socioeconomic status, parity, IQ and marital status. Offspring born to methadone-maintained women did not differ from comparison infants in indexes of proximity-seeking at reunion but did display higher scores on indexes of disorganized and avoidant behavior and lower scores on indexes of contact-maintaining behavior. Mothers' perceptions during pregnancy of their future infants' degree of bothersomeness were also related to higher scores on contact-maintaining behavior and lower scores on avoidant behavior. Finally, antecedents of attachment behavior within the opioid group alone were considered. The implications of using dimensional attachment ratings for uncovering more subtle attachment antecedents are discussed.

Adult↗

Influences of adult attachment in exploration.

Research into the relationship between attachment quality in both children and adults suggests links with patterns of exploration; however, exploration has been operationalized differently in studies of adults and children. This study examined adults' patterns of exploration operationalized in terms of novelty seeking, curiosity, and impulsivity, as in studies of children. Analysis indicated avoidant adults reported significantly lower curiosity than did securely attached adults, while preoccupied subjects showed no differences from either secure or avoidant groups. As in studies of children, groups did not differ on measures of novelty seeking or impulsivity.

Adult↗

Adult attachment and the perception of facial expression of emotion.

Adult attachment orientation has been associated with specific patterns of emotion regulation. The present research examined the effects of attachment orientation on the perceptual processing of emotional stimuli. Experimental participants played computerized movies of faces that expressed happiness, sadness, and anger. Over the course of the movies, the facial expressions became neutral. Participants reported the frame at which the initial expression no longer appeared on the face. Under conditions of no distress (Study 1), fearfully attached individuals saw the offset of both happiness and anger earlier, and preoccupied and dismissive individuals later, than the securely attached individuals. Under conditions of distress (Study 2), insecurely attached individuals perceived the offset of negative facial expressions as occurring later than did the secure individuals, and fearfully attached individuals saw the offset later than either of the other insecure groups. The mechanisms underlying the effects are considered.

Adult↗

The neurobiology of attraction.

In these last years, emotions and feelings, such as attachment, couple and parental bonding and even love, typical of higher mammals, neglected for centuries by experimental sciences, have become the topic of extensive neuroscientific research in order to elucidate their biological mechanisms. Several observations have highlighted the role of monoamines and of neuropeptides, in particular oxytocin, vasopressin and opioids, but this is only the beginning of the story. Love, the most typical human feeling, can be viewed as a dynamic process that represents the result of different components probably subserved by distinct neural substrates at different times. As such, some steps can be identified, in particular its beginning, which is the process of attraction, followed by the attachment process that, in some cases, can last forever. This paper will make some general speculations on the attraction process, in the light of the experience of the Authors.

Behavior↗

Maternal attachment behavior and the mother's self-concept: the effect of early skin-to-skin contact.

The problem was to determine the effect of skin-to-skin contact between mother and infant during the first hour following delivery on later maternal attachment behavior and self concept. Twenty primiparous women were randomly assigned skin-to-skin contact with their infant during the first hour after birth. There were no significant differences in 36-hour or three-month attachment behaviors or in prenatal or three month self-concept scores. For most mothers, first time motherhood appeared to have a positive effect on their self-concepts.

Adult↗

Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress.

The authors tested a cognitive-interpersonal hypothesis of depression by examining the role of interpersonal cognitions in the prediction of depression associated with interpersonal stressors. A measure of adult attachment assessed interpersonal cognitions about ability to be close to others and to depend on others and anxiety about rejection and abandonment. Participants were women who had recently graduated from high school; they were followed for 1 year with extensive interview evaluation of life events, depression, and other symptomatology. Generally, cognitions, interpersonal events, and their interactions contributed to the prediction of interview-assessed depressive symptoms, but the effects were not specific to depression and predicted general symptomatology measured by diagnostic interviews as well, and results also varied by attachment subscale. Results were discussed in terms of a developmental psychopathology approach to disorders in young women.

Cognition↗

Engagement in community service among college students: is it affected by significant attachment relationships?

This study served as an exploratory analysis of how engagement in community service activities among college students is affected by significant attachment relationships. More specifically, this study investigated the difference between community service and non-service students in terms of their motivation to engage in community service activities as a function of the quality of their attachment to parents and close personal friends. A quantitative approach was used to analyse these issues. The findings revealed that students who had some community service experience evidenced more secure attachments to close personal friends while their attachments to parents were varied. Closer examination of the attachment data revealed that the community service students were more likely to have either very high or very low attachment relationships with their parents. These findings suggest that when incorporating service-learning into the college curriculum, one should examine the influence of other important contexts, (i.e. parents and peers) on community service outcomes.

Adolescent↗

Mental representations of attachment in identical female twins with and without conduct problems.

Insecure mental representations of attachment, a nearly invariant feature of cluster B personality disorders, have never previously been studied in twins. We conducted the Adult Attachment Interview (AAI) on 33 pairs of monozygotic (MZ) female twins reared together as an initial exploration of causal influences on mental representations of attachment. As predicted by attachment theory, we observed substantial twin-twin concordance for attachment security (odds ratio 13.8; P = 0.001), a similar level of concordance between twins and their non-twin siblings, and an inverse relationship between attachment security and current level of aggression (P = 0.01). These data indicate that there are minimal effects of non-shared environmental influences (or measurement error) on attachment classifications derived from the AAI. In this sample of twins with and without histories of Conduct Disorder, mental representations of attachment appear to be highly familial, i.e., strongly influenced by either shared environmental factors, genetic factors, or both.

Adolescent↗

Child abuse and neglect in infancy: sources of hostility within the parent-infant dyad and disorders of attachment in infancy.

The human infant is prepared during fetal life and arrives on the scene ready to participate actively as a partner with the parent in structuring his own development. Parents are normally prepared for this participant activity by achieving a high degree of sensitivity to the signals of distress of and by the infant's affective engagement with them. The meaning of ordinary distress signals is in instances of child abuse and neglect determined by an unconscious mythology which the parent has about the infant, and also by what the parent finds unacceptable in oneself and projects onto the infant. The recent research on mother-infant attachment is reviewed. Landmarks for normal attachment behaviors from birth to age 3 are defined within seven different age groupings, and the psychiatric syndrome, "Reactive Attachment Disorder of Infancy," is described and is found almost universally in failure to thrive without organic cause babies. The diagnosis of Reactive Attachment Disorder is preferable because it leads to appropriate preventive and interventive action.

Adult↗

Neuroendocrine perspectives on social attachment and love.

The purpose of this paper is to review existing behavioral and neuroendocrine perspectives on social attachment and love. Both love and social attachments function to facilitate reproduction, provide a sense of safety, and reduce anxiety or stress. Because social attachment is an essential component of love, understanding attachment formation is an important step toward identifying the neurobiological substrates of love. Studies of pair bonding in monogamous rodents, such as prairie voles, and maternal attachment in precocial ungulates offer the most accessible animal models for the study of mechanisms underlying selective social attachments and the propensity to develop social bonds. Parental behavior and sexual behavior, even in the absence of selective social behaviors, are associated with the concept of love; the analysis of reproductive behaviors, which is far more extensive than our understanding of social attachment, also suggests neuroendocrine substrates for love. A review of these literatures reveals a recurrent association between high levels of activity in the hypothalamic pituitary adrenal (HPA) axis and the subsequent expression of social behaviors and attachments. Positive social behaviors, including social bonds, may reduce HPA axis activity, while in some cases negative social interactions can have the opposite effect. Central neuropeptides, and especially oxytocin and vasopressin have been implicated both in social bonding and in the central control of the HPA axis. In prairie voles, which show clear evidence of pair bonds, oxytocin is capable of increasing positive social behaviors and both oxytocin and social interactions reduce activity in the HPA axis. Social interactions and attachment involve endocrine systems capable of decreasing HPA reactivity and modulating the autonomic nervous system, perhaps accounting for health benefits that are attributed to loving relationships.

Animals↗

The Vulnerable Attachment Style Questionnaire (VASQ): an interview-based measure of attachment styles that predict depressive disorder.

BACKGROUND: The Vulnerable Attachment Style Questionnaire (VASQ) was developed to provide a brief self-report tool to assess adult attachment style in relation to depression and validated against an existing investigator-based interview (Attachment Style Interview--ASI). This paper describes the development and scoring of the VASQ and its relationship to poor support and major depression. METHOD: Items for the VASQ reflected behaviours, emotions and attitudes relating to attachment relationship style, drawn directly from the ASI. The VASQ was validated against the ASI for 262 community-based subjects. Test-retest was determined on 38 subjects. RESULTS: Factor analysis derived two factors, labelled 'insecurity' and 'proximity-seeking'. The VASQ insecurity dimension had highest mean scores for those with interview-based Angry-dismissive and Fearful styles and was significantly correlated with degree of interview-based insecurity. The proximity-seeking VASQ scores had highest mean for those with Enmeshed interview attachment style and was uncorrelated with ASI insecurity. VASQ scores were highly correlated with a well-known self-report measure of insecure attachment (Relationship Questionnaire) and text-retest reliability of the VASQ was satisfactory. The total VASQ score and the insecurity subscale proved highly related to poor support and to depressive disorder. This was not the case for the proximity-seeking subscale. CONCLUSION: The VASQ is a brief self-report measure that distinguishes individuals with attachment styles vulnerable for depressive disorder. The use of the measure for screening in research and clinical contexts is discussed.

Aged↗

Attachment patterns across multiple family relationships in adulthood: associations with maternal depression.

We explored attachment in a family context by applying family systems principles to the investigation of multiple attachment relationships within families. This study focused on maternal adult attachment with respect to family of origin experiences (assessed using the Adult Attachment Interview [AAI]) as well as maternal marital attachment (assessed using the Marital Attachment Interview [MAI]). We examined associations between maternal adult attachment (or marital attachment) and three levels of family functioning including individual maternal depression symptoms, dyadic marital satisfaction (reported by mothers), and family unit functioning. We also examined associations between combined attachment security (consistent secure, AAI secure/MAI insecure, AAI insecure/MAI secure, and consistent insecure) and family outcomes. Finally, we assessed the extent to which attachment representations operate differently in the context of family stress, namely maternal depression. We found that attachment security with respect to particular relationships was differentially associated with different levels of family functioning. Examination of the security of combined adult and marital attachment further supported the multilevel organization of the family system.

Adult↗

Disorganized reasoning in Holocaust survivors.

In 2 related studies of nonclinical Israeli samples, the long-term sequelae of traumatic Holocaust experiences were investigated from an attachment perspective. In each study, Holocaust survivors were compared with participants who had not experienced the Holocaust, and their attachment style and state of mind with regard to past and present attachment experiences as well as their state of mind regarding unresolved loss were assessed. In both studies, the Holocaust groups were found to be significantly more inclined to show disoriented thought processes around trauma than were the groups without Holocaust background. From an attachment perspective, the authors showed that even after 50 years, traumatic traces of Holocaust experiences are present in the survivors.

Adolescent↗