Abstract
Diagnosis and treatment of children affected by disruptions of attachment (out of home placement, multiple changes of primary caregiver) is an area of considerable controversy. The possible contribution of psychobiological theories is discussed in three parts. The first part relates the attachment theoretical perspective to major psychobiological theories on the developmental associations of parent-child relationships and emotional response. The second part reviews studies of autonomic reactivity and HPA-axis activity with foster children, showing that foster children show more reactivity within physiological systems facilitating fight or flight behaviours rather than social engagement, especially foster children with atypical attachment behaviour. The third part is focused on treatment of children suffering from the consequences of disrupted attachment, based on a psychotherapy study with psychophysiological outcome measures. Implications are discussed for theory, diagnosis, and intervention.
Highlights
Psychophysiological regulation of affect and attachment disruptions Attachment refers to a behavioural propensity to seek contact and proximity to an attachment figure when feeling insecure, due to perceived danger, illness, exhaustion, or other natural cues to danger [9]
Another implication of Hofer's view is that the impact on developmental outcomes of disruptions as well as variations in quality of parent-child interaction may be mediated by multiple and sometimes interrelated regulatory processes, including but not limited to the attachment behavioural system proposed by Bowlby
Psychobiological theory may be an important complement to theories such as attachment theory to explain the consequences of the complex experiences surrounding disruptions of attachment, and to identify mechanisms through which developmental change can be effected
Summary
Psychobiological theory may be an important complement to theories such as attachment theory to explain the consequences of the complex experiences surrounding disruptions of attachment, and to identify mechanisms through which developmental change can be effected. Links between disorganized attachment relationships and sympathetic reactivity on reunion with the caregiver would in Porges' framework be highly consistent with the interpretation by attachment theorists that disorganized attachment patterns are the result of the opposing tendencies engendered by the fear system (fight or flight) and the attachment system (seek contact) [55]. These direct links have, not been found in the one study that examined this. Rather than giving up on the potential of children severely affected by disruptions of attachment to participate in mutually fulfilling social relationships, practice may build on the initial findings reviewed to expand the number of evidence based interventions on offer for this vulnerable group of children
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