Disorganized Attachment Research Articles

A preliminary investigation of parent-child attachment relationship in toddlers with autism traits

Using a cross-sectional design, this study explored attachment insecurity and disorganization (assessed using the Strange Situation Procedure) in 90 toddlers (aged 14–24 months) with and without autism traits and assessed the associations between autism traits (severity and profiles) and both developmental level and attachment classification. Our findings showed no significant differences between the rates of attachment insecurity or attachment disorganisation among toddlers with, and toddlers without, autism traits. However, among the toddlers with autism traits, those with a disorganised attachment were more likely to have autism traits of greater severity. While greater autism trait severity was associated with attachment disorganisation, it remains unclear whether this association is the result of children with autism traits having higher rates of attachment disorganisation or whether autism traits are being misinterpreted as attachment disorganisation indices.

Trauma and social pathways to psychosis: Examining the role of attachment, social rank and dissociation in a clinical sample.

The trauma and social pathways model of psychosis proposes interactions between trauma, attachment, social rank and dissociation in pathways to psychosis, though this model has yet to be empirically investigated. The primary aim of this study was to examine the overall predictive value of the trauma and social pathways model using regression analysis. A secondary aim was to delineate hypothesized pathways between trauma and positive symptoms of psychosis using serial mediation analysis. This was a cross-sectional study of people attending mental health services for a psychosis-related diagnosis (N = 71). Measures of trauma, positive symptoms of psychosis, attachment, social comparison and dissociation were completed. A model of recurrent trauma, insecure attachment, social rank and dissociation predicted 23.2% of the variance in positive symptoms of psychosis. Recurrent trauma, attachment and dissociation contributed significantly to the model, while social rank did not. Further, serial mediation analysis indicated that the sequence of disorganized attachment and dissociation fully mediated the relationship between recurrent trauma and positive symptoms. Results provide preliminary support for the trauma and social pathways model of psychosis, specifically as it relates to recurrent trauma, insecure attachment and dissociation. Results did not support the social rank component of this model, however. These findings provide clear targets for the development of next-wave psychological interventions that focus on trauma-related variables in psychosis. Future studies should replicate these findings with a larger clinical sample, and consider a measure of shame to further elucidate social processes in pathways to psychosis.

Family therapy and EMDR after child abuse and neglect: moderating effects of child attachment style and PTSD symptoms on treatment outcome

ABSTRACT Background: Effective and appropriate care and treatment for children in order to decrease the psychosocial problems that arose after experiencing child abuse and neglect (CAN) is of vital importance, given the severity of symptomatology that may develop. Objective: The purpose of the present study was to examine whether attachment style and core cluster Posttraumatic Stress Disorder symptoms acted as moderators for treatment outcomes of a new integrative treatment model for trauma and attachment. In this treatment model, family therapy is combined with EMDR and obstacles for trauma processing are tackled first. Method: we included children, ages 6–12 years, with a history of CAN, who did not respond to evidence-based trauma treatment. Target treatment outcomes were problems in attachment, posttraumatic stress symptoms, behaviour, and emotion regulation. We conducted a multiple-baseline ABC Single-Case Experimental Design (SCED). We categorized 12 participants into four groups of attachment style and core cluster PTSD symptoms: (1) non-disorganized & re-experiencing; (2) non-disorganized & avoidance/hyperarousal; (3) disorganized & re-experiencing; & (4) disorganized & avoidance/hyperarousal. We compared the four groups with each other and across time, and the interaction between groups and effect over time. We conducted non-parametric permutation tests and estimated q-values for false discovery rate control. Results: Children with a disorganized attachment style had more severe symptomatology in general, except for posttraumatic stress symptoms. The treatment appeared more effective in targeting and successfully treating children with a non-disorganized attachment style, and specifically children with a non-disorganized attachment style and re-experiencing as core cluster PTSD symptoms. Conclusion: Our study underlines the complexity of treating children who developed a complicated combination of symptomatology after CAN and calls for the continuous development of innovative interventions.

Frightening maternal behavior over the first 2 years of life: effects on children’s behavior problems in middle childhood

ABSTRACT Frightening maternal behavior is linked to infant disorganization, which predicts child behavioral problems. We examined continuity in frightening maternal behavior across the first 2 years by developing a new measure of anomalous/frightening (AN/FR) behavior that incorporates changes in parent–child interactions as children acquire symbolic representation. Maternal AN/FR behavior in toddlerhood also was examined in relation to later internalizing and externalizing symptoms. First-time mothers (N = 125) completed the Adult Attachment Interview (AAI) prenatally, and mother–child dyads were observed interacting at 8 months, in Strange Situations at 12–15 months, and playing at 24 months. Teachers rated children’s behavior problems at 7 years. Mothers classified as Unresolved on the AAI displayed more Frightening (FR) behavior at 8 months. Mothers’ FR behavior predicted both attachment disorganization at 12–15 months and maternal AN/FR behavior at 24 months, which then predicted children’s internalizing symptoms at age 7. Infant disorganization was indirectly related to internalizing symptoms, mediated by maternal AN/FR behavior.

Parental History of Childhood Maltreatment and Offspring Attachment Insecurity and Disorganization: Two Meta-Analyses.

Research findings have shown that parental history of childhood maltreatment (CM) increases the risk of insecure and disorganized attachment in offspring. However, the extent of the detrimental effects of childhood trauma on attachment in the next generation is unclear. The current meta-analyses aimed at synthesizing the available literature on the link between parental history of CM and offspring attachment insecurity and disorganization (with no restriction of offspring age). In total, 25 studies (23 unique samples; N = 2,592) comprising u = 61 effect sizes were included. Offspring age ranged from 12 to 79 months (Mweighted = 18.69; SDweighted = 11.53). Findings from two three-level random effects meta-analyses revealed a weak but significant combined effect of parental history of CM on child attachment insecurity (k = 20, u = 35, r = .06) and a non-significant effect on child attachment disorganization (k = 12, u = 26, r = .03). For the meta-analysis on disorganization, effect sizes were weaker in more recent studies, and trim and fill analyses provided evidence of publication bias. These findings provide a nuanced view of the intergenerational transmission of childhood trauma phenomenon, whereby parents' self-reported history of CM does not appear decisive for child attachment. Conclusions could not be drawn for specific types of CM because of the small number of studies. Research with more objective measures of parental exposure to CM is needed to gain a more comprehensive view of the possible intergenerational effects of CM on child attachment.

Resolved or unresolved, that is the question: a case-study approach to discourse about abuse, trauma and maltreatment among mothers with mild intellectual disabilty

ABSTRACT Mary Main played a key role for this study, in which we used an idiographic approach to examine discourse about abuse, trauma, and maltreatment (ATM) among eight mothers with a mild intellectual disability (ID), whose children had been assigned a secure (the “B-group”) or disorganized (the “D-group”) attachment classification. Thematic analysis yielded six ATM discourse themes: openness; coherence; presence of trauma in consciousness; support; agency in response to crisis; and self-concept and caregiving self-efficacy. Mothers in the B-group provided coherent narratives, were open with the interviewer, had memories of seeking and receiving support, and reflected freely and autonomously on their experiences. Contrastingly, the mothers in the D-group expressed a guarded, closed-off stance towards ATM, difficulties seeking support, helplessness in response to crisis, and poor self-concept and -efficacy. Their adverse experiences were nonetheless highly present in consciousness, albeit in unintegrated forms. Our findings suggest that the D-group mothers may be unresolved with respect to loss/abuse

Mary Main: portrait and tribute

ABSTRACT Brett Kahr has referred to the death of Mary Main as the loss of “the queen of attachment research.” However, how well is Main’s work actually known? In this portrait and tribute, I argue that Main’s transformative contributions have become a taken-for-granted part of the basic environment of attachment research, but that readers have faced obstacles in understanding and responding to their strengths and limitations. Drawing from interviews with Main, in this paper I describe some of her early life experiences and mental and physical health challenges, which she felt had influenced what was possible for her in her research. I then highlight less well-known aspects of her ideas regarding the role of attention within attachment strategies, the nature of disorganised attachment, the implications of alarming caregiving behaviours, and what is ultimately measured by the Adult Attachment Interview. My goal throughout is to help reader see both how much Main’s rich and exciting works still have to teach, and identify their many loose threads still to follow.

Classes of child-mother attachment disorganization from infancy to the preschool years

ABSTRACT Mary Main’s operationalization of infant attachment disorganization contributed to our understanding of attachment and psychopathology. Her exploration of attachment patterns at age 6 with Jude Cassidy laid the foundations for studying attachment post-infancy. They found remarkable correspondence from age 1 to age 6 in the disorganization spectrum and documented the emergence of role-reversal. This study proposes a person-centered approach to explore classes of children with respect to attachment disorganization at four time points between infancy and late preschool. Participants (n = 205) were recruited in the UK and formed a socioeconomically diverse community sample of mother–child dyads. We identified three classes of children: 1) a stable organized group; 2) an unstable group becoming organized; and 3) an unstable group becoming disorganized. Results show that major loss predicts membership of the third class of children. These findings contribute to our understanding of disorganization across multiple periods, and thus to Mary Main’s legacy.

Привязанность как необходимость в защите и безопасности

<p>The work aims to clarify the concept of “attachment”. The article, based on materials from foreign sources, examines the development of the main provisions of attachment theory. Attachment is based on an evolutionary need for survival. Depending on the connection with security, the following types of attachment are distinguished: secure attachment, avoidant attachment, ambivalent attachment, and disorganized attachment. For a child, attachment is important for safety and survival. However, attachment style can undergo changes and adaptation to varying degrees in light of different life experiences. Attachment theory suggests that the way the bond develops between a child and their mother early in life will influence their sense of security and social, emotional, and mental development later in life. Research on this topic shows that the initial relationships formed at the very beginning of life give rise to the attachment style characteristic of a person in adulthood, which, as a rule, underlies the degree to which a person feels safe and emotionally secure in different relationships throughout their life. The quality of attachment helps shape a child's internal model of behavior regarding the social world, predicting how well children function in their relationships with teachers and friends, as well as their curiosity and motivation to solve problems. Conclusion: For humans, attachment is important for security and survival. At the same time, attachment style may undergo changes and adaptation to varying degrees in light of different life experiences.</p>

The impact of adolescent profiles of posttraumatic stress, emotion regulation, and disorganized attachment on posttraumatic growth and psychiatric symptoms: Academic stress and egocentrism as covariates.

The present study aimed to examine the profile patterns of co-occurring posttraumatic stress disorder (PTSD), cognitive emotion regulation (CER), and disorganized attachment in traumatized adolescents. It also aimed to examine whether these adolescents with different profiles would differ in posttraumatic growth (PTG) and comorbid psychiatric symptoms after controlling for academic stress and egocentrism. Nine hundred and forty-nine (N = 949) adolescents were recruited from two secondary schools in China. They completed measures on PTSD, comorbid psychiatric symptoms, PTG, CER, disorganized attachment, and covariates of egocentrism and academic stress. Latent profile analysis identified a four-class model as the optimal solution: low trauma group (Class 1), adaptive copers (Class 2), moderate trauma group (Class 3), and high trauma group (Class 4). After controlling for demographics and levels of egocentrism and academic stress, Class 4 had more severe comorbid psychiatric symptoms than the other three classes. Class 3 had higher levels of comorbid psychiatric symptoms than Class 2 and Class 1, while these latter two were comparable in comorbid psychiatric symptoms. Conversely, Class 4 students had lower levels of PTG than individuals in the other three classes. Class 3 had similar levels of PTG to Class 1, and these two classes reported lower levels of PTG than Class 2. Chinese adolescents may experience both negative and positive changes after stressful events. The extent of these psychological outcomes could vary depending on the adolescents' previous trauma experiences, emotion regulation, and attachment qualities. Implications for clinical practice were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Attachment Styles on the Depth of Self-Disclosure and Topic Selection in Initial Psychotherapy Sessions

This paper explores the significant influence of attachment styles on self-disclosure and topic selection in initial psychotherapy sessions, examining how secure, anxious, avoidant, and disorganized attachment patterns impact the therapeutic process and outcomes. Attachment theory, as developed by John Bowlby and Mary Ainsworth, provides a framework for understanding the internal working models that individuals carry into therapy, affecting their openness and engagement. Securely attached clients tend to disclose more freely, facilitating stronger therapeutic alliances, while those with anxious attachment may require reassurance to mitigate fears of rejection. Avoidant clients often struggle with emotional intimacy, necessitating gradual trust-building strategies, and disorganized clients benefit from structured, trauma-informed approaches. Through case studies and research findings, the paper underscores the importance of tailoring therapeutic strategies to accommodate attachment-related dynamics, enhancing client engagement and therapeutic success. The implications for practice include the need for therapist training focused on recognizing and adapting to diverse attachment styles, fostering personalized and effective therapeutic interventions. Future research directions are suggested to further explore the intersection of attachment styles with cultural and socio-economic factors, and to develop specialized techniques for optimizing therapy based on attachment patterns.

Do Attachment, Educator Characteristics and Youth-Educator Relationship Matter in 6-Month Changes of Institutionalized Adolescents?

This longitudinal study involved youths in residential care due to previous adverse experiences and their educators, aiming to investigate the role of youths and educators' attachment, educators' psychopathology, and the quality of youth-educator relationship on change scores of youths' symptoms and youth-educator relationship security over 6 months. Participants were 36 institutionalized youths (Mage = 16.50 ± 2.13) and their 25 main educators (Mage = 38.48 ± 5.75), assessed at baseline (T1) and 6 months later (T2). Youths were assessed in total, internalizing and externalizing problems via a multi-informant approach, and educators in psychopathology levels. Attachment representations of youths and educators were assessed through validated attachment interviews (Friends and Family Interview and Adult Attachment Interview), and both separately rated the youth-educator relationship. (1) Most cases remain stable over 6 months. (2) Educator narrative coherence and the quality of youth-educator relationship at baseline were correlated but not predictive of change in youths' symptoms. (3) Youths' higher attachment disorganization at baseline was the unique predictor of 14% variance of positive change in the youth-educator relationship security perceived by the youth. (4) Youth attachment avoidance uniquely predicted 37% of positive change variance in the youth-educator relationship security perceived by educators. In conclusion, attachment-based assessment of youths and educators can inform intervention to foster youth improvement.

Perinatal Predictors and Mediators of Attachment Patterns in Preschool Children: Exploration of Children's Contributions in Interactions with Mothers.

Insecure and disorganized attachment patterns in children are linked to poor health outcomes over the lifespan. Attachment patterns may be predicted by variables that influence the quality of children's interactions with their primary caregivers/parents (usually mothers) such as prenatal and postnatal exposures and the children's own behaviours in interactions. The purposes of this exploratory study were to examine: (1) prenatal predictors of children's attachment patterns, and (2) postnatal mediators and moderators of associations between prenatal predictors and children's attachment patterns, with adjustment for relevant covariates. Mother-child dyads (n = 214) from the longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) cohort were studied using valid and reliable measures. Hayes' mediation analysis was employed to determine direct and indirect effects. Mothers' prenatal cortisol levels directly predicted disorganized (versus organized) child attachment in unadjusted models. Children's passivity (in adjusted models) and compulsivity (in unadjusted and adjusted models) in parent-child interactions mediated the pathway between mothers' prenatal cortisol levels and children's disorganized attachment patterns. Serial mediation analyses revealed that mothers' cortisol levels predicted their children's cortisol levels, which predicted children's compulsivity, and, ultimately, disorganized attachment in both unadjusted and adjusted models. No predictors were correlated with children's insecure (versus secure) attachment. This exploratory research suggests that prenatal exposure to mothers' cortisol levels and children's behavioural contributions to parent-child interaction quality should be considered in the genesis of children's attachment patterns, especially disorganization. Interventions focused on parent-child interactions could also focus on addressing children's behavioral contributions.

Przywiązanie w dzieciństwie w aspekcie wybranych sytuacji trudnych dzieci

The family plays a crucial role in shaping an individual’s personality and influencing emotional, social, and cognitive development. J. Bowlby underscores the significance of early attachments, particularly with the mother, in the proper formation of an individual. The primary and biologically rooted need for proximity to the caregiver profoundly impacts a child’s well-being. This study explores the repercussions of challenging childhood experiences, including maternal abandonment or frequent distancing, on the individual’s functioning not only in childhood, but also throughout adolescence and adulthood.The behavior of attachment figures, especially the caregiver acting as the mother, determines the quality of the child’s attachment, classified as either trusting, anxiety-avoidant, anxiety-ambivalent, or disorganized. Insecure attachments, specifically anxiety-avoidant and anxiety-ambivalent bonds, along with disorganized attachment, can give rise to various difficult situations for individuals. The focus, particularly on disorganized attachment, highlights the heightened risk of mental disorders, behavioral issues, and personality disorders.This article delves into John Bowlby’s attachment theory, elucidating its key aspects, and draws connections to difficult situations experienced by preschool and early elementary school children with diverse attachment types. These situations encompass conflicts, loneliness, peer rejection, and failures.

The Effect of Parental Experience of Childhood Maltreatment on children’s Attachment Type: The Mediating Role of Parenting Self-Efficacy

ABSTRACT Attachment has emerged as a major topic of contemporary study on children’s social and personality development, with a rising acknowledgment of the impact of attachment type on children’s physical and mental health, personality development, and adult social connections. Although different factors determine attachment type in children, parental influence is the most essential. However, the impact of childhood maltreatment suffered by parents in their original families on the attachment type of their children and its internal mechanisms still needs to be investigated. Based on attachment theory and self-efficacy theory, this study explored the mediating role of parenting self-efficacy between parental childhood maltreatment and children’s different attachment types. The results showed that although parental childhood maltreatment did not directly predict children’s secure attachment, parenting self-efficacy significantly mediated the relationship between parental childhood maltreatment and children’s secure, resistant, avoidant and disorganized attachments. Meanwhile, parental childhood maltreatment negatively predicted parenting self-efficacy scores, and the mediating effect showed consistent significance between parents. These findings not only add to the existing literature of knowledge about the elements that influence attachment type but also give a theoretical foundation for mitigating the harmful impacts of parents’ early maltreatment experiences on their children’s attachment development.

Classification et représentations d'attachement et comportements intériorisés et extériorisés des enfants de la protection de l'enfance

IntroductionChildren who have experienced potentially traumatic situations within their first attachment relationships (e.g., abuse, neglect) are more at risk of presenting attachment insecurity and disorganization as well as insecure attachment representations. These children would also be more at risk of developing internalized (e.g., anxiety, depression) and externalized behaviors (e.g., aggressivity, opposition). ObjectivesThe study aims to provide a portrait of attachment classification and representations and internalized and externalized behaviors in children aged 7 to 12 from three groups: 35 maltreated children, 42 children from a clinical group, and 39 children from a normative group. The study also aims to evaluate associations between attachment and internalized and externalized behaviors and to detect predictors of internalized and externalized behaviors amongst attachment-related variables. MethodParticipants took part in The Attachment Story Completion Task (ASCT) and a semi-structured interview, the Child Attachment Interview (CAI). Caregivers completed the Child behaviour Checklist to assess internalized and externalized behaviors. ResultsResults show lower levels of attachment security as well as higher levels of insecure attachment representations and internalized and externalized behaviors in maltreated children. Only disorganized attachment was found to be associated with internalized and externalized behaviors. The ASCT could not differentiate the groups and showed little association with internalized and externalized behaviors. ConclusionDisorganized attachment is mainly associated with maltreatment and internalized and externalized behaviors, contrary to ASCT variables, thus generating questions regarding this tool's suitability for school-aged children.

Helping Institutionalised Children through a Trusting Relationship-Findings from a One-Year Psychosocial Intervention Programme.

Children growing up in institutions lack a stable relationship-essential for development. A significant proportion of them have disorganised attachment, which is associated with negative outcomes. Therefore, interventions aimed at improving attachment security are needed. We conducted a case series study (involving five participants aged 8-11 years) in a newly established psychosocial rehabilitation daycare centre to describe the changes in attachment security and mental health of institutionalised children after one year of attendance. The intervention consisted of individualised care focusing on staff building a trusting relationship with participants using the principles of Trust-Based Relational Intervention® (TBRI). Measures such as the Child Attachment Interview, SDQ, CBCL6/18, TRF6/18, and clinical interviews were used to follow change. The descriptive data of five participants are presented. All five children improved in mental health, and for two participants, organisation of attachment changed. Three children experienced relational ruptures. The findings suggest that psychosocial interventions that focus on building trusting relationships may be beneficial in institutionalised children. For these children, given their life history, it can be damaging to experience repeated breakdowns. Thus, the practical implication is that any new relationship for them with an adult should be established after an assessment of whether the relationship can be sustained.

Examining the Connection Between Attachment and Risk for Psychopathology in Adolescents : A Comprehensive Review

The foundation of attachment theory is the notion that early relationships – such as the one between a child and primary caregiver – play a crucial role in patterns of emotional regulation, interpersonal behaviors and adult functioning. This review explores how attachment styles are associated with psychopathology in adolescents by systematically assessing research studies up to May 2024. Studies have shown that insecure attachment styles are risk factors for adaptation and psychopathology in adolescence, including anxiety disorders, dissociative disorders, borderline personality disorder, conduct disorder and substance use. Securely attached adolescents have better mental health outcomes. Longitudinal studies have also confirmed that early attachment affects later psychopathology. Insecure infant attachment is linked to depression, suicidality, substance use and dissociation in adolescents. Emerging attachment-based interventions – including, for example, Attachment-Based Family Therapy (ABFT) – have demonstrated promise in treating adolescent mental health by targeting attachment disorganization level. Ultimately, working on reflective functioning, parental sensitivity and emotion regulation skills can help adolescents repair their attachments. Even in light of these findings, attachment does not appear as straightforwardly explanatory as one might expect, given the developmental importance of attachment entering a new stage. Attachment researchers should consider participants’ experiences of early attachment, in light of patterns of change during individual development, as well as in light of a family systems perspective – for instance, understanding that some adolescents who become disaffected from their families have parents who tend to be dismissive of their emotional needs. All of these could help in effective prevention and treatment of adolescent psychopathology.

Attachment security and disorganization in infants of mothers with severe psychiatric disorder: Exploring the role of comorbid personality disorder

The aim of this preliminary study was to explore infant-mother attachment quality in a Dutch clinical sample of mothers with severe psychiatric disorder, with or without comorbid personality disorder. Thirty-two mothers were recruited through specialized secondary and tertiary outpatient clinics and mental health institutions. Maternal psychiatric and personality diagnoses were verified with structured clinical interviews during pregnancy. Maternal concurrent level of psychiatric symptoms was assessed by self-report and infant-mother attachment quality by observation in the Strange Situation Procedure at 14 months postpartum. In the full sample, almost half of the infants were classified as disorganized. All infants of mothers with a comorbid personality disorder were classified as either insecure or disorganized. Infants of mothers with a comorbid personality disorder had a significantly higher disorganization score than infants of mothers with a psychiatric disorder only. Continuous attachment security scores did not differ significantly between groups. In the full sample, continuous infant attachment security and disorganization score were not significantly correlated with the level of maternal concurrent psychiatric symptoms. Our exploratory findings suggest a specific link between maternal psychiatric and comorbid personality disorder and attachment disorganization. Moreover, chronicity of symptoms appears more relevant for attachment behaviors than the severity of concurrent psychiatric symptoms. Maternal personality disorder may have a strong formative impact on infant attachment security and disorganization, which warrants further research to inform clinical practice, in order to reduce the risk of intergenerational transmission of maternal psychopathology.

The relationship between attachment representations and minimal intergroup bias in preschool-aged children.

Attachment theory proposes that young children's experiences with their caregivers has a tremendous influence on how children navigate their social relationships. By the end of early childhood, intergroup contexts play an important role in their social life and children build strong ties to their ingroups. Although both domains relate to the same psychological processes-children's affective ties to others-surprisingly very little research has addressed how children's attachment relates to their intergroup attitudes and behavior. In this study, we investigate the link. For that purpose, 5-year-old children (n=100) first underwent the German Attachment Story Completion Task (GEV-B). Then we allocated children into minimal groups based on T-Shirt color and assessed their intergroup attitudes and intergroup behavior. Results showed that while most children showed a strong and robust ingroup bias in their attitudes and behavior, children with an insecure-ambivalent attachment representation treated in- and outgroup similarly. Overall, this study provides novel perspectives on the relationship between children's attachment representation and their interactions in the social world. RESEARCH HIGHLIGHTS: This study provides novel insights into the relationship between children's attachment security and the development of intergroup bias in a minimal group context Children with secure, insecure-avoidant and disorganized attachment representation showed a strong intergroup bias in explicit attitudes and behavior Children with insecure-ambivalent attachment representation displayed no intergroup bias Insecure-ambivalent attachment representations might be detrimental to the formation of ingroup attachment.