Insecure Attachment Representations Research Articles

Maternal insecure attachment representation as a long-term risk factor for disrupted mother–child-interaction and child mental health

Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother–child-interaction und maternal helplessness and fear. N = 103 mother–child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p = .060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p < .001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p < .001) and fear (F(9, 93) = 7.40, p < .001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p < .001; F(10, 92) = 3.87, p < .001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families.

Visualizing the invisible tie: Linking parent-child neural synchrony to parents' and children's attachment representations.

It is a central tenet of attachment theory that individual differences in attachment representations organize behavior during social interactions. Secure attachment representations also facilitate behavioral synchrony, a key component of adaptive parent-child interactions. Yet, the dynamic neural processes underlying these interactions and the potential role of attachment representations remain largely unknown. A growing body of research indicates that interpersonal neural synchrony (INS) could be a potential neurobiological correlate of high interaction and relationship quality. In this study, we examined whether interpersonal neural and behavioral synchrony during parent-child interaction is associated with parent and child attachment representations. In total, 140 parents (74 mothers and 66 fathers) and their children (age 5-6 years; 60 girls and 80 boys) engaged in cooperative versus individual problem-solving. INS in frontal and temporal regions was assessed with functional near-infrared spectroscopy hyperscanning. Attachment representations were ascertained by means of the Adult Attachment Interview in parents and a story-completion task in children, alongside video-coded behavioral synchrony. Findings revealed increased INS during cooperative versus individual problem solving across all dyads (𝛸2(2)=9.37, p=0.009). Remarkably, individual differences in attachment representations were associated with INS but not behavioral synchrony (p>0.159) during cooperation. More specifically, insecure maternal attachment representations were related to higher mother-child INS in frontal regions (𝛸2(3)=9.18, p=0.027). Conversely, secure daughter attachment representations were related to higher daughter-parent INS within temporal regions (𝛸2(3)=12.58, p=0.006). Our data thus provide further indication for INS as a promising correlate to probe the neurobiological underpinnings of attachment representations in the context of early parent-child interactions. RESEARCH HIGHLIGHTS: We assessed attachment representations using narrative measures and interpersonal neural synchrony (INS) during parent-child problem-solving. Dyads including mothers with insecure attachment representations showed higher INS in left prefrontal regions. Dyads including daughters with secure attachment representations showed higher INS in right temporo-parietal regions. INS is a promising correlate to probe the neurobiological underpinnings of attachment representations in the context of parent-child interactions, especially within the mutual prediction framework.

Parenting during the COVID‐19 pandemic: Insecure or unresolved attachment representation is a risk factor for harmful parenting behavior

AbstractBackgroundThe current COVID‐19‐pandemic confronted a large number of young families with stressors. For mothers with a history of childhood maltreatment (CM), the distress during the current pandemic added to their already increased risk for a less sensitive, maltreating parenting behavior.ObjectiveThis study aims to investigate whether maternal attachment representation mediates the relationship between maternal CM experiences and changes in parenting behavior during the pandemic.MethodAs a part of a longitudinal study, mothers' experiences of CM and their attachment status were assessed. For the present study, 92 mothers (mean age: 38.14 years, SD = 4.08; attachment representation: 36% secure, 64% insecure and unresolved) completed an online SARS‐CoV‐2‐pandemic survey assessing their parenting behavior since the beginning of the pandemic.ResultsThe odds of an insecure maternal attachment representation in adulthood increased with higher levels of CM load. Mediation analyses revealed that maternal attachment representation fully explained the relationship between maternal CM load to changes in sensitive, endangering, and overall parenting quality.ConclusionsCM has lasting effects on maternal adult attachment representations. Mothers' attachment representations contribute to a further understanding of intergenerational transmission mechanisms of CM later in adulthood through a more endangered parenting approach in challenging times.ImplicationsThe results of this study should be considered in the development of programs offered to families facing stressful circumstances. In particular, we recommend increased implementation of telephone‐ or web‐based programs.

Attachment representations in 7-year-old children at familial high risk of schizophrenia or bipolar disorder: Associations with mental disorders and daily functioning: The Danish High Risk and Resilience Study, VIA 7-A population-based cohort study.

Attachment quality may affect psychological functioning. However, evidence on attachment representations and their correlates in children born to parents with schizophrenia and bipolar disorder is sparse. We compared attachment representations in a Danish sample of 482 children aged 7 years at familial high risk of schizophrenia, bipolar disorder, and population-based controls and examined associations between attachment and mental disorders and daily functioning. Attachment representations were examined with the Story Stem Assessment Profile (SSAP). Mental disorders were ascertained in diagnostic interviews. Daily functioning was assessed with the Children's Global Assessment Scale. We found no between-group differences in attachment. Higher levels of secure attachment were associated with decreased risk of concurrent mental disorders in the schizophrenia high-risk group. Higher levels of insecure and disorganized attachment were associated with increased risk of mental disorders across the cohort. Higher levels of secure and insecure attachment were associated with better and poorer daily functioning, respectively. In the current study, results regarding defensive avoidance could not be reported due to methodological limitations. Familial high risk of schizophrenia (FHR-SZ) or bipolar disorder is not associated with less secure or more insecure attachment at age 7. Insecure and disorganized attachment representations index risk of mental disorders and poorer functioning. Secure attachment may be a protective factor against mental disorders in children at FHR-SZ. Validation of the SSAP is needed.

Role of transgenerational transmission of trauma in development of schizophrenia: A case report of a patient whose parents survived genocide in Srebrenica

IntroductionDevelopmental predisposition to schizophrenia can be a consequence of early experienced traumas. Transgenerational trauma is process in which traumatic experience of one generation is passed on to the next generation.ObjectivesTo show connection between transgenerational transmission of trauma and development of schizophrenia.MethodsPsychiatric interview, psychological testing.ResultsPatient G.E. age 29, admitted to Psychiatry Clinic due to altered behavior, aggressiveness and presence of delusions and hallucinations. First mental problems in form of a catatonic stupor appeared 6 years ago. Patient has history of earlier abuse of psychoactive substances. A drug test performed at admission was negative. Patient was born in Srebrenica in 1993, he escaped to Tuzla with his mother in July 1995, while father survived escaping on foot. Patient is a first child from his father’s second marriage. The father’s first wife and two minor children were shot by Bosnian Serbs in early 1992. Patient was born a year and a half after death of his siblings and was named after his half-sister. Patient’s father consumed alcohol after the war and was aggressive towards children. In the last two years, patient had frequent hallucinations, he told his parents that voices were telling him to kill his mother and told his father that his children were still alive. Diagnostic processing was performed and diagnosis of schizophrenia was stated. During hospitalization, patient was treated with olanzapine and low doses of haloperidol, along with haloperidol decanoate, which resulted in significant reduction of productive psychotic symptoms. A partial remission is achieved, negative schizophrenic symptoms and cognitive impairments verified by psychological instruments remain.ConclusionsCase report emphasize transgenerational transmission of trauma: father‘s untreated trauma, alcohol dependency and abuse of the patient in childhood. These findings are important for treatment and therapeutic considerations. Mentalizing is a possible mediator between childhood abuse and negative symptoms. Parental bonding was explored within high expressed emotions theory as a risk factor for relapse to psychosis, especially the “affectionless control” in the parental (mainly father‘s) bonding style. Studies also stated that psychotic patients often show insecure attachment representations. Possible pathway for further analysis could be discussed: a cold parental bonding style leading to experienced emotional neglect and attachment avoidance might be reflected in lower capacity to mentalize. To improve the mentalization capacity, it would be essential to establish a sustainable therapeutic treatment frame.Disclosure of InterestNone Declared

Negative effects of the SARS-CoV-2 pandemic: The interlinking of maternal attachment representation, coping strategies, parental behavior, and the child's mental health.

For more than two years, young families have been confronted with a large number of restrictions and following burdens as a result of the SARS-CoV-2 pandemic. In fact, it became evident, that the current circumstances are particularly stressful for child's mental health. With regard to the child's mental health in times of a pandemic, additional factors within the family, such as maternal attachment representations as well as coping strategies and parental behavior, may play an important role. This study aims to investigate the interplay of maternal attachment representation, coping strategies, parental behavior and child's mental health during the SARS-CoV-2 pandemic. In this longitudinal study, previously collected data regarding maternal attachment representation and newly attained data from the SARS-CoV-2-pandemic-assesment (lack of coping strategies, children's mental health and parental behavior) were combined and analyzed. The data were collected in an online survey since beginning of the pandemic, including N = 73 mothers. A path model was calculated in form of multiple linear regression. A path model could be confirmed, which indicates that insecure maternal attachment representation predicts lack of coping strategies during the pandemic [b = 5.55, 95%-CI = (4.51; 6.55), p = 0.001]. Furthermore, lack of coping strategies predicts harmful parental behavior during the pandemic [b = -0.77, 95%-CI = (-1.27; -0.21), p = 0.007], which in turn predicts children's mental health problems, namely behavioral problems [b = -0.08, 95%-CI = (-0.14; -0.01), p = 0.027]. Presence of short-time work and decrease in income since beginning of the pandemic were used as control variables. This means that since the pandemic mothers with insecure attachment representation have an increased risk of having only a few coping mechanisms available, leading to harmful parental behaviors and ultimately affecting the mental health of their children. In conclusion, the pandemic could potentially have a particularly negative influence on mothers with an insecure attachment type and therefore on their children. Therefore, tailored interventions for families should be offered that both focus on the different types of mental health problems in children and support parents in their coping skills.

Maternal Attachment Style and her Perinatal Wellbeing Influence Early Childhood Development

An increasing number of children show signs of behavioral problems and dysregulation in early childhood. It is assumed that maternal depression and her attachment representations affect child development. This was investigated in a prospective study with 161 primiparae women. Via standardized questionnaires during the third trimester, 3 weeks, 6 months and 18 months postpartum, prenatal attachment of the mother to the unborn child, her general attachment style and postpartum depression as well as the child's dysregulation at 18 months were assessed. In the GLM, longer-lasting pre- and postpartum depressivity and insecure partnership attachment representation were associated with child dysregulation. Therefore, early detection of pre- and postpartum depression is important in order to support both the affected women and the children for better child development.

Let’s talk about love: Perceptions of children in residential care

BackgroundAll children need sensitive adults who can respond to their needs and love them enough to develop their capacity to love in return. Yet, due to their past experiences of trauma and their insecure attachment representations, it may be more difficult for them to benefit from a restorative experience with adults. ObjectiveThis study aimed to better understand the experience of children placed in out-of-home care following a maltreatment report to child protective services. MethodsTwenty children between 6 and 15 years of age placed in residential care were interviewed. Semi-structured interviews included questions about the place where they live and their feelings of being loved by the child workers who looked after them. ResultsFindings showed that the majority of the children did not conceive affection and love as being at the heart of the child workers’ role. The children’s representations of their experience with placement were positioned along two axes: physical anchorage relating to their placement setting and affective anchorage to the people looking after them. Based on their position on these two axes, the children were classified into four distinct groups: the adrift (no anchorage), the moored (physical anchorage), the interlaced (affective anchorage), and the rooted (double anchorage). Only a quarter of the children exhibited characteristics related to double anchorage. ConclusionsThese findings could serve as a base to develop a tool to support reflection on the services offered to children in out-of-home care settings. This could help to broach the subject of their experience by going beyond the physical setting and by developing warm and stable relationships within that environment.

Attachment mediates the link between childhood maltreatment and loneliness in persistent depressive disorder

BackgroundA central concept of attachment theory is that early experiences with close attachment figures shape the way we interact with and relate to other social partners throughout life. As such, early experiences of childhood maltreatment (CM) have been suggested as a key precursor of adult insecure attachment representations. As CM has been linked to feelings of loneliness in adulthood, this study examines whether insecure attachment could explain the relationship between CM and loneliness. Also, the moderating role of a diagnosis of persistent depressive disorder (PDD) is investigated, a disorder characterized by high levels of CM and loneliness. Method60 patients with PDD (DSM-5) and 60 gender- and age-matched non-clinical control participants (NC) completed self-report questionnaires measuring attachment, loneliness, and CM. Mediation analyses (PDD as a moderator) were performed. ResultsPDD patients reported higher levels of CM, attachment anxiety, attachment avoidance, and loneliness than NC. CM was positively associated with loneliness in both groups. Mediation analyses demonstrated that the relationship between CM and loneliness was mediated by avoidant, but not anxious attachment, regardless of a diagnosis of PDD. LimitationsCaution when interpreting these results is crucial as the study lacked a clinical control group, relied on self-report measures, and the cross-sectional design limits the ability to draw causal inferences. ConclusionsAll constructs studied were present to a greater degree in PDD. Above, findings provide initial evidence that avoidant attachment may explain the relationship between CM and loneliness. Potentially, adult avoidant attachment may lead to and maintain feelings of loneliness, regardless of PDD.

Mediational Effect of Fairburn's Transdiagnostic Mechanisms Between Attachment to the Mother and Eating Disorder Symptoms in a Clinical Sample.

ObjectiveResearch has supported a link between insecure attachment and eating disorders (EDs); however, little is known about how this influence is exerted in young female EDs patients. This study tested, for the first time, a multiple mediational model, wherein the four Fairburn’s transdiagnostic mechanisms mediated the relationship between attachment to the mother and ED symptoms.MethodsA total of 101 female young EDs patients aged 15–24 were administered the Inventory of Parent and Peer Attachment, Eating Disorder Inventory-3 and Eating Attitudes Test-26 to assess attachment, the four transdiagnostic maintaining mechanisms and ED symptoms, respectively.ResultsComparison analyses showed that there were no significant differences between the diagnostic groups in terms of attachment and the transdiagnostic variables. Multiple mediational analyses indicated that low self-esteem and clinical perfectionism were significant mediators between insecure attachment to the mother and ED symptoms, while controlling for depressive symptoms.ConclusionThese findings suggest that the distal risk influence of insecure attachment to the mother in the development of ED symptoms might be explained by low self-esteem and high clinical perfectionism, controlling for depressive symptoms. Further investigation into the efficacy of cognitive-behavioral treatments targeting insecure attachment representations for young EDs patients is recommended.

Peer Power! Secure Peer Attachment Mediates the Effect of Parental Attachment on Depressive Withdrawal of Teenagers.

Adolescents’ depressive social withdrawal is a relevant concern for mental health professionals, and it is widespread among community teenagers in form of subclinical symptoms. Different studies suggest that insecure attachment representations increase the adolescents’ likelihood to show symptoms of withdrawal (e.g., loneliness). This study explored the effect of the general attachment internal working model (IWM) and the independent and cumulative effects of the specific attachment representations of parents—in terms of secure base/safe haven—and peers on adolescents’ withdrawal. Additionally, the mediation of peer attachment on the effect of parental attachment on symptoms was explored. All analyses were conducted controlling for the difference between teenagers living with parents together or divorced/separated, as children of divorcees are considered more exposed to stressors. Ninety-one adolescents aged 12–17 years old were assessed online during the COVID pandemic period, employing the Youth Self-Report to assess withdrawal and the Friends and Family Interview to assess attachment-general IWM and attachment-specific representations. Results show no influence of parents together/separated or of the general IWM on withdrawal, but higher parent secure base/safe haven and peer attachment cumulatively predicted 10–21% less withdrawal. Moreover, more positive peer attachment mediated 61% of the effect of the parental secure attachment on withdrawal, revealing an indirect effect of parental attachment on withdrawal through peer attachment. In conclusion, both parents and peers are influential on adolescent mental health, and fostering positive peer relationships can buffer the effect of dysfunctional family relationships on teenagers’ withdrawal.

Attachment Representations and Burnout of Social Workers

This paper examines the distribution of attachment representations among social work professionals using the Adult Attachment Projective Picture System (AAP; George, West, Pettem, 1997). In this sample, the influence of attachment on the occurrence of burnout syndrome is investigated, as this is considered as a trigger for further mental and physical illnesses. For this purpose, 79 social pedagogical professionals from the German-speaking part of Switzerland were examined over four time points using the Burnout Screening Scales - BOSS. The following distribution of attachment representations was found using the AAP: 25.3 % secure, 38.0 % insecure dismissing, 27.8 % insecure preoccupied, and 8.9 % unresolved trauma. This distribution differs significantly from other samples of non-clinical adults and psychotherapists. Interestingly, no general associations emerged between insecure attachment representations and burnout. A significant positive correlation was shown between "unresolved trauma" and the suspected diagnosis of "burnout occupation". The so far few but contradictory empirical findings on attachment representations among professionals require further research activities as well as an intensive sensitization with regard to attachment theory in basic and further training courses and a further establishment of self-awareness and supervision components in all psychosocial fields of work.

The effects of childhood unpredictability and harshness on emotional control and relationship quality: A life history perspective.

Being able to control oneself in emotionally upsetting situations is essential for good relationship functioning. According to life history theory, childhood exposure to harshness and unpredictability should forecast diminished emotional control and lower relationship quality. We examined this in three studies. In Studies 1 and 2, greater childhood unpredictability (frequent financial, residential, and familial changes), but not harshness (low SES), was associated with lower emotional control in adolescents (N = 1041) and adults (N = 327). These effects were stronger during the participants' reproductive years. Moreover, in Study 2, greater childhood unpredictability was indirectly associated with lower relationship quality through lower emotional control. In study 3, we leveraged the Minnesota Longitudinal Study of Risk and Adaptation (N = 160). Greater early-life unpredictability (ages 0-4) prospectively predicted lower relationship quality at age 32 via lower emotional control at the same age. This relation was serially mediated by less supportive observed early maternal care (ages 1.5-3.5) and insecure attachment representations (ages 19 and 26). Early unpredictability also predicted greater observed emotional distress during conflict interactions with romantic partners (ages 19-36). These findings point to the role of emotional control in mediating the effects of unpredictable childhood environments on relationship functioning in adulthood.

Attachment Representations in Children with and without Attention-Deficit/Hyperactivity Disorder (ADHD).

Attention-Deficit/Hyperactivity Disorder (ADHD) in children is associated with several adverse family characteristics, such as higher parenting stress, more conflicted parent–child relationships, lower parental competence, and higher levels of parental psychopathology. Hence, children with ADHD more often grow up under suboptimal circumstances, which may impact the development of their attachment representations. Here, we investigated whether children with ADHD have more insecure and disorganized attachment representations than their typically developing peers, and which factors could explain this association. We included 104 children between 4 and 11 years old, 74 with ADHD (without Conduct Disorder) and 30 typically developing control children. Children completed a state-of-the-art story stem task to assess their attachment representation, and we measured parents’ expressed emotion (as an index of parent–child relationship quality), parents’ perceived sense of competence, parental education levels, and parent-rated ODD symptoms of the child. We found that, after controlling for multiple comparisons, children with ADHD had less secure and more ambivalent and disorganized attachment representations relative to their typically developing peers. These group differences were independent of comorbid ODD and parental education levels. There were no group differences on avoidant attachment representations. Explorative analyses within the ADHD group showed that attachment representations were not related to parent–child relationship quality, perceived parenting competence, parental education levels, and comorbid ODD symptoms. We conclude that children with ADHD disproportionately often have attachment problems. Although this conclusion is important, treatment implications of this co-occurrence are yet unclear as research on ADHD and attachment is still in its infancy.

Post-traumatic Stress Disorder in Sexually Abused Children: Secure Attachment as a Protective Factor.

The aim of the present study was to examine the hypothesis that attachment and childhood sexual abuse (CSA) interacted such that school aged CSA survivors with insecure attachment to parents would be at an elevated risk of developing post-traumatic stress disorder (PTSD) and trauma symptoms. Participants (n = 111, ages 7–12) comprised two groups, child CSA survivors (n = 43) and a matched comparison group of children (n = 68) recruited from the community. Children completed the Child Attachment Interview (CAI) as well as the Trauma Symptom Checklist for Children (TSCC). There was a significant interaction between sexual abuse history and attachment security, such that sexually abused children with insecure attachment representations had significantly more PTSD and trauma symptoms than sexually abused children with secure attachment to parents. The findings show that using a dual lens of attachment and CSA can facilitate the identification of children most at risk and has important implications for understanding risk and resilience processes.

Fuel to the fire: The escalating interplay of attachment and maltreatment in the transgenerational transmission of psychopathology in families living in refugee camps.

Maltreatment by parents can be conceptualized as pathogenic escalations of a disturbed parent-child relationship that have devastating consequences for children's development and mental health. Although parental psychopathology has been shown to be a risk factor both for maltreatment and insecure attachment representations, these factors` joint contribution to child psychopathology has not been investigated. In a sample of Burundian refugee families living in refugee camps in Western Tanzania, the associations between attachment representations, maltreatment, and psychopathology were examined by conducting structured interviews with 226 children aged 7 to 15 and both their parents. Structural equation modeling revealed that children's insecure attachment representations and maltreatment by mothers fully mediated the relation between maternal and child psychopathology [model fit: comparative fit index (CFI) = 0.96; root mean square error of approximation (RMSEA) = 0.05]. A direct association between paternal and child psychopathology was observed (model fit: CFI = 0.96; RMSEA = 0.05). The findings suggest a vicious cycle, wherein an insecure attachment to a mother suffering from psychopathology may be linked to children's risk to be maltreated, which may reinforce insecure representations and perpetuate the pathogenic relational experience. Interventions targeting the attachment relationship and parental mental health may prevent negative child outcomes.

Preoccupied and Dismissing Attachment Representations Are Differentially Associated With Anxiety in Adolescence and Adulthood: A Meta-Analysis

The claim that insecure attachment predisposes individuals to anxiety was put forth by attachment theorists more than 45 years ago, yet evidence of this association has produced mixed results. By conducting a series of meta-analyses ( k = 53, N = 4,970), we found that individuals with secure and insecure attachment representations did not differ in their reported anxiety symptoms. However, individuals with preoccupied ( d = 0.35) but not dismissing attachment representations ( d = −0.02) endorsed significantly more anxiety symptoms than secure individuals. Individuals with preoccupied attachment representations also endorsed greater anxiety symptoms than people with dismissing attachment representations ( d = 0.31), and this difference was stronger when assessed in high-risk samples than low-risk samples. Unresolved individuals were more anxious than nonunresolved individuals ( d = 0.29), but exploratory analysis suggested that secondary preoccupied attachment subtype drove this effect. Results highlight the relevance of attachment representations for prevention and intervention efforts targeting anxiety.

Attachment classification and years of service in a sample of human service providers working in child welfare

ABSTRACT Employee turnover is a pressing problem facing human service professions, especially professionals providing services in the child welfare system. Few studies have examined whether psychological characteristics contribute to turnover. Research suggests that insecure attachment representations may impact burnout and secondary traumatic stress, both common causes of turnover. However, little is known about whether attachment representations vary by years of service among human service providers working with the child welfare system. The purpose of this study was to determine if attachment classifications predicted number of years of service in a sample of 467 service providers working in the child welfare system. Participants completed a demographic questionnaire, including the number of years in the human service profession, and the Adult Attachment Interview (AAI). Multiple regression models were conducted to determine if attachment classification and demographic variables predicted number of years of service. Data revealed that having a dismissing attachment classification predicted more years of service. Having a preoccupied attachment classification predicted fewer years of service. Possible causes and well as implications of these differences are discussed.

Bindungsrepräsentationen, belastende Lebensereignisse und ADHS bei Jungen im Alter von 6 bis 10 Jahren

Attachment Representations, Critical Life Events and ADHD in Boys at 6 to 10 Years of Age The importance of the attachment theory was repeatedly pointed out in the literature for understanding children with attention deficit hyperactivity disorder (ADHD) with regard to their emotional state. Symptoms of ADHD, like attention deficits, motor agitation and impulsivity are seen as risk factors for insecure attachment in the parent-child relationship. The acquisition of attachment representations in children with ADHD might help to describe - and individual classify - the syndromes of this behavioural disorder better. The aims of the present study are, therefore, the investigation of attachment representations and critical life events in boys with ADHD. We focused on boys only, since they are particularly prone to develop ADHD. Using the story-completion technique, we investigated whether boys with ADHD showed insecure attachment more frequently compared to boys without ADHD. 31 boys with ADHD at six to ten years of age were recruited in two different clinics. Of these, 29 % showed a secure and 71 % showed an insecure attachment representation. Within insecure attachment, the ambivalent attachment representation occurred most frequently (41 %). On average, we found 2.3 critical life events. The enhanced frequency of the ambivalent attachment representation indicates that ADHD might be linked to externalizing behaviour. The results support the hypothesis that ADHD is increasingly associated with insecure attachment. The binding theory is able to contribute to a better understanding of the emotional state in boys with ADHD.

Attachment security and attention to facial emotional expressions in preschoolers: An eye-tracking study.

According to attachment theory, internal working models of attachment affect the way in which social and emotional information is processed. The current study examined this theoretical claim by investigating the association between attachment security and attention to facial emotional expressions in 5-year-old children. Attachment security was assessed on a representational level using an Attachment Story Completion Task. Children's attention to facial emotional expressions was measured during an eye-tracking task. Gaze data (fixation duration) were collected during the presentation of pictures displaying five different facial emotional expressions (neutral, angry, fearful, sad, and happy) of unfamiliar persons. Moreover, the Emotionality-Activity-Sociability Temperament Inventory was used to control for children's temperament and was filled out by children's mothers. Regression analyses revealed that attachment security was a significant predictor of children's attention to neutral and sad expressions while controlling for age, gender, and temperament. Moreover, a t-test revealed that securely attached children looked longer at the fearful expression than insecurely attached children. These findings provide direct evidence that even on a basic perceptional level attachment security is a predictor of children's emotional information processing. Statement of contribution What is already known on this subject? Attachment representations substantially affect the way in which emotional information is processed. Insecure attachment representations are negatively related to children's attention to emotional stimuli. What does this study add? Eye-tracking technology was used to measure children's visual attention to facial emotional expressions. Secure attachment was related to prolonged visual attention to neutral and negative facial emotional expressions. Attachment security influences children's emotional information processing even on a basic perceptual level.