Attachment Patterns In Children Research Articles

Configurations of mother-child and father-child attachment as predictors of internalizing and externalizing behavioral problems: An individual participant data (IPD) meta-analysis.

An unsettled question in attachment theory and research is the extent to which children's attachment patterns with mothers and fathers jointly predict developmental outcomes. In this study, we used individual participant data (IPD) meta-analysis to assess whether early attachment networks with mothers and fathers are associated with children's internalizing and externalizing behavioral problems. Following a pre-registered protocol, data from 9 studies and 1,097 children (mean age: 28.67 months) with attachment classifications to both mothers and fathers were included in analyses. We used a linear mixed effects analysis to assess differences in children's internalizing and externalizing behavioral problems as assessed via the average of both maternal and paternal reports based on whether children had two, one, or no insecure (or disorganized) attachments. Results indicated that children with an insecure attachment relationship with one or both parents were at higher risk for elevated internalizing behavioral problems compared with children who were securely attached to both parents. Children whose attachment relationships with both parents were classified as disorganized had more externalizing behavioral problems compared to children with either one or no disorganized attachment relationship with their parents. Across attachment classification networks and behavioral problems, findings suggest (a) an increased vulnerability to behavioral problems when children have insecure or disorganized attachment to both parents, and (b) that mother-child and father-child attachment relationships may not differ in the roles they play in children's development of internalizing and externalizing behavioral problems.

Families of Children in Pain: Are Attachment and Sensory Processing Patterns Related to Parent Functioning?

Effective parent functioning is a key predictor of functional outcomes for children with persistent pain. It is therefore important to identify factors that support or limit functioning in parents of these children. Child and parent attachment and child sensory processing patterns have been identified as risk-factors for parent functioning in healthy samples. Our study extends current research by examining whether parent and child attachment patterns and child sensory processing patterns are related to parent functioning in families of children with persistent pain. Using a cross-sectional design, data was collected at a tertiary pain management clinic from 98 parent-child dyads (i.e., a child or adolescent with persistent pain and one parent). Standardized questionnaires were used to assess parent and child attachment patterns, child sensory processing patterns, child pain intensity, and eight domains of parent functioning. Regression analyses revealed that parent attachment avoidance was significantly related to poorer overall parent functioning and three functioning domains: depression, partner relationship, and leisure. Child attachment avoidance was related to higher parental strain and the use of fewer protective parenting behaviors. Parent and child attachment anxiety and child sensory processing patterns were not significantly related to parent functioning. Findings suggest that parent and child attachment avoidance warrant further consideration with regards to parent functioning in clinical settings where children present with persistent pain. This may aid in identifying parents who are at-risk of poorer functioning and could guide the use of attachment-informed interventions for families of children with persistent pain.

Association of Parent–child Experiences with Insecure Attachment in Adulthood: A Systematic Review and Meta‐analysis

AbstractThis study reviewed and synthesized existing research to examine the association of parent–child experiences in childhood with two types of adult insecure attachments styles: anxiety‐related attachment (ANA) and avoidance‐related attachment (AVA). Correlates of adult insecure attachment styles were systematically reviewed and quantitatively synthesized using meta‐analytic methods. Overall, 213 and 177 correlates with ANA and AVA were identified from 56 studies, with these factors further categorized into four thematic domains: perceived attachment with parents, perceived parenting style, perceived relationship with parents, and recalled childhood adversity. Children's attachment patterns with their parents were strongly associated with their pattern of adult attachment. Codependent relationships with parents, childhood neglect, and childhood psychological abuse were also significantly associated with both ANA and AVA. Authoritarian and authoritative parenting styles showed the strongest positive and negative associations with ANA and AVA, respectively. Our findings revealed the importance of early parenting for children's lifelong health and developmental outcomes.

Attachment Patterns in Children and Adolescents With Gender Dysphoria.

The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2 = 52.66; p < 0.001) and had a high rate of unresolved loss/trauma (χ2 = 18.64; p < 0.001). Comorbid psychiatric diagnoses (n = 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88; SD = 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2 = 2.43; p = 0.30) and rates of unresolved loss and trauma (χ2 = 0.70; p = 0.40). Post hoc analyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs.

Associations between Neurodevelopmental Disorders and Attachment Patterns in Preschool-Aged Children: Systematic Review

Attachment is a biological evolutionary system contributing to infant survival. In neurotypical children, secure attachment is critical to healthy brain and organ-system development. Attachment patterns in children with neurodevelopmental disorders (NDDs) have not been extensively explored. The purpose of this review is to appraise and summarize the literature examining attachment in children with NDDs. Children with autism spectrum disorder (ASD), intellectual disability (ID) or developmental language disorder (DLD) displayed behavior indicative of secure attachments. Approximately 42–50% of children with NDDs were deemed securely attached compared with 62% in neurotypical children. Factors influencing attachment patterns were autistic symptoms, developmental level, maternal sensitivity, and maternal insightfulness/resolve. Many children with NDDs can form secure attachments; however, this is based on limited data, primarily focusing on children with ASD. Specific challenges were identified in assessing attachment patterns in children with NDDs. This demonstrates the need for research investigating attachment in children with various NDDs and co-occurring disorders.

Attachment & Child Health (ATTACH) pilot trials: Effect of parental reflective function intervention for families affected by toxic stress.

Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function-parents' capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child-may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.

Mothers with a History of Child Welfare Involvement: A Brief Literature Review of Cross Generational Impact of Maternal Trauma.

A number of studies to this day have examined the role of maternal childhood trauma in parenting styles, mental health, and child attachment patterns; however, there are limited data on parenting of mothers who were raised in institutional care (IC) and involved in the child welfare system. The current review focuses on maternal history of institutionalization and foster care placement and its impact on parenting and child development. Studies show that the history of maternal trauma such as maltreatment, which is often linked to an orphan status, can be transferred to children through maladaptive parenting strategies, evoking a cycle of cross-generational maltreatment. Mothers raised in institutions show an early sexual debut that is often resulting in unplanned pregnancies, and are lacking competence in taking care of their own children. Directions for future research involving mothers with a history of IC are discussed.

Culture and Child Attachment Patterns: a Behavioral Systems Synthesis.

We propose that the two dominant culture institutions (individualist and collectivist) are neither learned nor cognitively represented by the people who practice them. Instead, they exist as group-level payoff structures that reflect differential distributions of child attachment patterns within a society. Individualist societies reflect an overrepresentation of insecure-avoidant attachments and collectivist societies reflect an overrepresentation of insecure-anxious attachments. Moreover, attachment patterns are embodied rather than representational-schedule-induced rather than incrementally shaped or verbally learned. If attachment patterns are schedule-induced, the prospects are poorer for effecting cultural change through economic incentives or informational campaigns (top-down). Rather, cultural practices will be responsive to changes in family practices-to the extent they affect attachment patterns (bottom-up). For example, if breastfeeding rates decline or the workforce participation of women increases, a society will become more individualist and less collectivist. That is because those practices increase avoidant as compared to anxious attachments. Moreover, because insecurely attached children are behaviorally less flexible than are securely attached children, the former have a greater impact on cultural practices than do the latter.

Comparing Attachment Networks During Middle Childhood in Two Contrasting Cultural Contexts.

Cultural psychology assumes that the ecocultural conditions of a particular setting shape children’s pathways, resulting in multiple adaptive solutions to universal developmental tasks. While the adaptivity of attachment and children’s psychosocial development during the early years has been thoroughly investigated, attachment research during middle childhood continues to reflect Western ideals of family. Adhering to ideas of monotropy, most studies only focus on parental attachment figures. However, this restricted empirical perspective does not only result in a Eurocentric bias, it also neglects theoretical reflections on the growing complexity of attachment during middle childhood, thus only considering a limited selection of all individuals contributing to the children’s feeling of security, even in Western settings. To investigate the variability and adaptivity of attachment during middle childhood, this study assessed children’s attachment figures in two extreme settings of development, introducing an exhaustive network perspective on attachment during this developmental stage. Children of the Cameroonian Nseh (N = 11) and German children from Bad Nauheim (N = 11) identified and differentiated all individuals contributing to their attachment need in an exploratory and transdisciplinary approach. The socio-structural composition of children’s attachment networks follows the context-specific systems of care and concepts of interconnectedness and the ecological features of each setting, resulting in marked differences between both contexts. The functional composition, however, reflects children’s preoccupation with similar developmental challenges across settings. Same-aged peers contribute to the children’s feeling of safety in both settings, thereby deviating from previous reflections on their subordinate relevance during middle childhood. Overall, these results support the adaptiveness of children’s attachment patterns while also demonstrating universal trends across contexts. They highlight the collective nature of attachment during middle childhood that exceeds the impact of individual dyads. Thus, broad and context-sensitive research strategies become a necessary addition to attachment research in order to generate an exhaustive understanding for children’s development across cultural contexts.

Middle Childhood Attachment Strategies: validation of an observational measure

ABSTRACTThe purpose of this study was to assess behavioral manifestations of attachment in middle childhood, and to evaluate their relations with key theoretical correlates. The sample consisted of 87 children (aged 10–12 years) and their mothers. Dyads participated in an 8-min videotaped discussion of a conflict in their relationships, later scored with the Middle Childhood Attachment Strategies Coding System (MCAS) for key features of all child attachment patterns described in previous literature (secure, ambivalent, avoidant, disorganized-disoriented, caregiving/role-confused, hostile/punitive). To assess validity, relations among MCAS dimensions and other measures of attachment, parenting, and psychological adjustment were evaluated. Results provide preliminary evidence for the psychometric properties of the MCAS in that its behaviorally assessed patterns were associated with theoretically relevant constructs, including maternal warmth/acceptance and psychological control, and children’s social competence, depression, and behavioral problems. The MCAS opens new grounds for expanding our understanding of attachment and its outcomes in middle childhood.

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.

Efficacy of the Circle of Security Intervention: A Meta-Analysis

ABSTRACTThe Circle of Security (COS) intervention aims to teach caregivers to become more responsive to their children’s needs. The present study is a meta-analysis that examined the efficacy of the COS intervention in relation to child attachment patterns, quality of caregiving, caregiver self-efficacy, and caregiver depression. Studies were eligible if they carried out a version of the COS intervention and provided quantitative data amenable to meta-analysis. A total of 10 studies were determined eligible for this meta-analysis. A random effects model was used and Hedge’s g was calculated for the overall effect sizes. Results indicated a medium effect size for the efficacy of the intervention for child attachment security (g = 0.65, p = .003, k = 4), quality of caregiving (g = 0.60, p = .012, k = 4) and reduction of caregiver depression (g = 0.53, p < .001, k = 3). There was a significant large effect for improved caregiver self-efficacy (g = 0.98, p < .001, k = 2). Results suggest that while the efficacy of the COS intervention demonstrates promising results, more research is needed.

Attachment in institutionalized children: A review and meta-analysis

In this article we review the literature on attachment patterns in institutionalized children and then perform a meta-analysis on data from 10 attachment studies involving 399 children in institutional settings. We computed the overall attachment distribution of secure, insecure, and disorganized rates and explored the effect of a set of moderating variables (i.e., country of institutionalization, attachment assessment procedure, age at entry, and age at assessment). To overcome bias related to the small number of studies, we conducted both classical and Bayesian meta-analysis and obtained comparable results. Distribution of children's attachment patterns was: 18% secure, 28% insecure, and 54% disorganized/cannot classify. Compared to their family-reared peers, children living in an institution were found to be at greater risk for insecure and disorganized attachment, with a similar medium effect size for both distributions (d=0.77 and d=0.76, respectively). The following moderating variables were associated with insecure attachment: representational assessment procedures (d=0.63) and Eastern European countries of origin (d=1.13). Moderators for disorganized attachment were: Eastern European countries of origin (d=1.12), age at institution entry before the first birthday (d=0.93), and age at assessment under three years of age (d=0.91). Implications for child development and policies are discussed.

‘Adoption and attachment theory’ the attachment models of adoptive mothers and the revision of attachment patterns of their late-adopted children

This study examined the attachment patterns of late-adopted children (aged 4-7) and their adoptive mothers during the first 7- to 8-month period after adoption and aimed to evaluate the effect of adoptive mothers' attachment security on the revision of the attachment patterns of their late-adopted children. We assessed attachment patterns in 20 adoptive dyads and 12 genetically related dyads at two different times: T1 (time 1) within 2 months of adoption and T2 (time 2) 6 months after T1. The children's behavioural attachment patterns were assessed using the Separation-Reunion Procedure and the children's representational (verbal) attachment patterns using the Manchester Child Attachment Story Task. The attachment models of the adoptive mothers were classified using the Adult Attachment Interview. We found that there was a significant enhancement of the late-adopted children's attachment security across the time period considered (P= 0.008). Moreover, all the late-adopted children who showed a change from insecurity to security had adoptive mothers with secure attachment models (P= 0.044). However, the matching between maternal attachment models and late-adopted children's attachment patterns (behaviours and representations) was not significant. Our data suggest that revision of the attachment patterns in the late-adopted children is possible but gradual, and that the adoptive mothers' attachment security makes it more likely to occur.

Mother–Child Attachment Patterns and Different Types of Anxiety Symptoms: Is There Specificity of Relations?

The purpose of this study was to test Manassis' proposal (Child-parent relations: Attachment and anxiety disorders, 255-272, 2001) that attachment patterns (secure, ambivalent, avoidant, and disorganized) may relate to different types of anxiety symptoms, and that behavioral inhibition may moderate these relations. Using a story stem interview to assess attachment and children's reports of anxiety symptoms, we found some support for these hypotheses in a sample of 10-12 years olds. Security was related to lower levels of all types of anxieties, except separation anxiety. Ambivalence was positively related to separation anxiety, although this relation was stronger for boys. Although avoidance was not related to anxiety, disorganization was positively related to somatic symptoms, social phobia, and school phobia. Behavioral inhibition moderated the relations of security with social phobia, and of disorganization with school phobia. The findings suggest that it is important to consider specificity between attachment patterns and various types of anxiety symptoms and to recognize that these relations may be altered by other risk factors.

Links between children's attachment behavior at early school-age, their attachment-related representations, and behavior problems in middle childhood

The objective of the present study was to examine associations between children's attachment behavior at early school-age, dimensions of narrative performance, and behavior problems as assessed in middle childhood. Children's attachment patterns with mother were assessed at age 6 (N = 127) using the Main and Cassidy (1988) separation—reunion classification system. Two years later, these children (N = 109) completed the Narrative Story Stem Battery (Bretherton, Oppenheim, Buchsbaum, Emde, & The MacArthur Narrative Group, 1990), and teachers rated their level of behavior problems using the Social Behavior Questionnaire (Tremblay, Vitaro, Gagnon, Piché, & Royer, 1992). Results indicated that secure children depicted fewer conflict themes in their narratives than did disorganized/controlling children, produced more discipline themes than avoidant children, and had higher coherence scores than ambivalent children. Avoidant children also depicted fewer conflict themes than disorganized/controlling children. Finally, children's narrative conflict themes significantly predicted both level of externalizing and total behavior problems, even after controlling for variance explained by gender and disorganized/controlling attachment behavior. Girls' narratives were more likely to evoke discipline and affection/affiliation themes, and to be more coherent than boys' narratives.

ADHD, Temperament, and Parental Style as Predictors of the Child’s Attachment Patterns

This study investigates the impact of temperament and parenting styles on attachment patterns in children with ADHD. The study included 65 children aged 7-15 and their parents. Children diagnosed as Combined or Predominantly Hyperactive Impulsive Type had significantly higher scores than those diagnosed as Predominantly Inattentive Type in anxious and avoidant attachment, emotionality, and activity dimensions of temperament, and their parents reported higher levels of controlling styles. Hierarchic regressions indicated that parental promotion of autonomy with children with temperamental emotionality predicted anxious attachment, while parental restriction of autonomy with children with high levels of temperamental activity predicted avoidant attachment.

Stability of Attachment During the Preschool Period.

Children's attachment patterns at early preschool age and 2 years later as well as factors related to stability-instability were examined in a diverse socioeconomic status French Canadian sample of 120 children. Attachment was assessed during 2 laboratory visits using separation-reunion procedures when the children were approximately 3.5 (J. Cassidy & R. S. Marvin, 1992) and 5.5 (M. Main & J. Cassidy, 1988) years old. Overall, stability of attachment, based on 4-way classification, was moderate (68%, k = .47, p = .01). Change from security to disorganization was associated with the most dramatic decline in interactive quality with mother, lowest marital satisfaction, and greatest likelihood of severe attachment-related family events, namely, loss and parental hospitalization. Families of children who changed from security to organized insecurity presented levels of caregiving and marital dissatisfaction that fell between those of stable secure children and secure children who changed toward disorganization.