Secure Relationships Research Articles

Attachment Representation and Sensitivity: The Moderating Role of Posttraumatic Stress Disorder in a Refugee Sample

It has been hypothesized that adult attachment representations guide caregiving behavior and influence parental sensitivity, and thus affect the child's socio-emotional development. Several studies have shown a link between posttraumatic stress disorder (PTSD) and reduced parental sensitivity, so it is possible that PTSD moderates the relationship between insecure attachment representations and insensitivity. In this study symptoms of PTSD (Harvard Trauma Questionnaire), parental sensitivity (Emotional Availability Scales), and attachment representations (Attachment Script Assessment) were assessed in 53 parents who were asylum seekers or refugees. Results showed that when parents were less able to draw on secure attachment representations, symptoms of PTSD increased the risk of insensitive parenting. These findings suggest that parental sensitivity is affected not just by attachment representations, but by a conjunction of risk factors including symptoms of PTSD and insecure attachment representations. These parents should therefore be supported to establish or confirm secure models of attachment experiences, to facilitate their ability interact sensitively and form a secure relationship with their children.

So why have you added me? Adolescent girls’ technology-mediated attachments and relationships

Technology plays an almost ubiquitous role in contemporary British society. Despite this, we do not have a well-theorised understanding of the ways adolescent girls use digital devices in the context of their developing secure relationships with their families and friends. This study aims to address this gap in understanding. Fifteen young women based in the Midlands and from across the socio-economic spectrum participated between 2012 and 2013. Participants completed three research tools exploring technology-mediated attachment and relationships, and participated in a face-to-face interview. The findings suggest that it is possible for girls to develop attachments with others through, and with, technology; technology use brings people together and mediates relationships in a range of ways encapsulated by attachment functions. The study highlights the ongoing importance of parental and peer relationships by suggesting that technology can act as a means by which the positive and negative attributes of existing relationships can be amplified.

The Indirect Effect of the Mindful Parenting of Mothers and Fathers on the Child’s Perceived Well-Being Through the Child’s Attachment to Parents

The main goal of this study is to explore whether the mindful parenting of both mothers and fathers is associated with the well-being of children through the attachment to their parents as well as to explore the moderating role of a child’s age on such associations. Moreover, this study examines the differences between mothers and fathers in their mindful parenting levels. The sample comprised 243 family triads that included a child or adolescent (aged between 8 and 19 years old) and both parents, recruited at school settings. Parents completed the Interpersonal Mindfulness in Parenting Scale and the Hospital Anxiety and Depression Scale, whereas children completed the KIDSCREEN-10 and the People in My Life questionnaire. Mothers reported higher levels of mindful parenting than fathers. The child’s perception of security in the relationship with their parents mediated the link between the mindful parenting of both parents and the well-being of their child, and these associations were not moderated by the child’s age. Our findings suggest that mindful parenting is positively associated with a child’s well-being through a more secure perception of the relationship with the parents. This result highlights the importance of including mindful parenting practices in parental training programs directed at both mothers and fathers of children and adolescents with the aim of promoting a more secure parent-child relationship and, consequently, the child’s well-being.

Understanding the Food Insecurity and Obesity Relationship by Examining Potential Mediators: An Exploratory Analysis

ABSTRACTEpidemiologic studies have demonstrated a positive association between obesity and food insecurity, but the mechanisms of this relationship are not well established. The purpose of the current study was to explore 5 potential mediating variables of the relationship between food insecurity and obesity: (1) home food environment, (2) eating out, (3) unhealthy food preparation, (4) food cost, and (5) mental health. Data were from 116 participants enrolled in a community-based weight gain prevention study in rural south Georgia. No evidence of complete mediation was found; however, strong relationships among demographic factors, food insecurity, and obesity were documented. Future research should seek to confirm our findings in larger, more diverse samples. Practice implications include working with communities to develop multilevel interventions that could address both overweight and food insecurity.

Food Insecurity and Young Child BMI Status in the U.S. Affiliated Pacific (USAP) Region: Findings from the Children's Healthy Living Program

Food insecurity may negatively impact children's growth and weight status. The purpose of this study is to: (1) examine prevalence of food insecurity among young children in the Pacific region and by indigenous ethnic populations; (2) examine the relationship of food insecurity and child's weight status and whether there is a race modification of such relationship. Data used were from 11 USAP jurisdictions that participated in the Children's Healthy Living Program (CHL): Alaska, American Samoa, Commonwealth of Northern Mariana Islands, Guam, Hawai‘i, Republic of Marshall Islands, Republic of Palau, Pohnpei, Yap, Kosrae and Chuuk.Food insecurity was considered present if in the past 12 months, a child's household self‐reported that money for food ran out before the end of the month sometimes, most times or always. Child weight and height were measured by trained and standardized staff and child's weight status was determined according to the following CDC categories: underweight (BMI percentile<5), healthy weight (5≤BMI percentile<85), overweight (85≤BMI percentile<95) and obese (BMI percentile ≥95). Child's race was categorized according to the US Office of Management and Budget (OMB) definitions: American Indian or Alaska Native (AIAN), Asian, Black, Native Hawaiian or Other Pacific Islander (NHPI), White, and More than one race. Child's race was also examined using Pacific ethnic definitions such as Native Hawaiian, Samoan, Chamorro, Chuukese, Marshallese, Kosraean, etc. Logistic regression models were used to examine the relationship of overweight and obesity (OWOB) and underweight with food insecurity, controlling for child's age, sex, and race.Of the 4,838 children included, 68% were healthy weight, 29% were OWOB, and 3% were underweight. Slightly over half experienced food insecurity (52%). Food insecurity differed significantly by race, with highest prevalence among Chuukese (81%), Marshallese (76%), Kosraean (74%), Pohnpeian (71%) and Yapese (60%). Logistic regression found significant race/ethnicity modification on the relationship of OWOB and underweight with food insecurity. Among Pohnpeians, children with food insecurity were 69% more likely to be OWOB than those without (OR=1.69, p=0.005). Among Chuukese, Samoan, and Mixed Race, however, children with food insecurity were 60–80% less likely to be OWOB than those without (ORs 0.2–0.4, p<0.01). Among Hawaiian, Kosraean, Mixed Race, and White, food insecure children were more likely to become underweight than those with no insecurity. No significant association was observed among other race/ethnic groups.The Pacific region is experiencing the dual burden of obesity and underweight, as well as rapid dietary change. Food insecurity is an importing underlying driving force of such change. Interventions targeting food insecurity or childhood obesity should take consideration the stage of the nutrition transition and the complex ethnic composition in this region.Support or Funding InformationSupported by Agriculture and Food Research Initiative Grant no 2011‐68001‐30335 from the USDA National Institute of Food and Agriculture

It Takes a Village-Taming High Conflict With the “2 PC Model”

Prolonged litigation frequently leaves once-married and functional parents unable to communicate effectively and coparent with each other. The damage can be even more profound for never-married parents without a history of ever functioning as life partners or parenting partners. High-conflict parents often enter into parenting coordination following litigation through stipulation or court order. For some parents, this modality fails to provide enough support and containment of conflict, and postjudgment litigation continues long after the initial divorce. A clinical case study illustrates the use of an experimental, alternative dispute-resolution intervention we call "the 2 Parenting Coordinator (PC) model." The 2 PC model evolved by applying the collaborative divorce 2-coach intervention to parenting coordination for a family in which traditional parenting coordination had twice failed. The case presented involved never-married parents, whose tenuous and mistrustful connection was threatening to contaminate the child's ability to have an emotionally secure relationship with her father.

Parents’ Relationship with Healthcare Providers During the Child’s Dying Process with Cancer at the Hospital (S797)

•Identify meanings bereaved parents assign to the relationship established with healthcare providers.•Identify the elements that help parents and healthcare providers to establish a secure relationship during the child's end of life. The relationship established between healthcare providers, parents and children during end-of-life caring is complex and multidimensional. There are still little evidence that explores how these relationships during the child’s last hospitalization influence parental adaptation after their child’s death. This study aimed to understand the experience of parents in their relationships with nurses during their children with cancer’s dying process in the hospital. The philosophical hermeneutic was used to conduct the study. Family members were interviewed at least six months after their child’s death from cancer in the hospital. For the recruitment, a search in a pediatric hospital's obituary helped identify families. Each interview was audiotaped and transcribed. For the analysis, units of meaning and clusters were identified, then categories were inductively determined and submitted to an interpretation process. The most relevant aspects that emerged in parents' experience regarding the relationship established with healthcare providers were: communication, bond, care access, competence, values, and beliefs. The presence of these elements influences the way parents perceive their role while they live the unexpected experience of losing a child, and they remain in their memories associated with the meanings attributed for the illness and the loss. These relationships serve as the basis to strengthen and support the parenting role, and they become a remarkable reminder that parents keep as a permanent connection to their deceased child. By revisiting these memories, meanings arise that contribute to their grieving process.

The relationship between leader-follower exchange and job insecurity: The mediating role of trust

The study examines the extent and nature of mediational roles of affective and cognitive trusts on the predictive relationship between leader-member exchange (LMX) and job insecurity. Six hundred and twenty-six employees are surveyed through questionnaire administration. Analysis of the data is done with simple regression and multiple regression analyses. The findings show no significant prediction of job insecurity by affective trust as well as no significant mediation of the LMX and job insecurity relationship by affective trust. The study also shows significant prediction of job insecurity by LMX, and significant mediation of the LMX-job insecurity relationship by cognitive trust. The results are discussed in the light of reviewed literature and current realities. The implications of the study are also highlighted.

Analyzing multiple relationships between psychological, social, and family factors and the academic success of female high school students in Isfahan

Aim: The aim of this study was to investigate relationships between psychological factors (self-esteem, attachment styles, and body image), family factors (family relationships), social factors (teacher-student relationship), and the academic achievement of female high school students in Isfahan. Methods: The study was descriptive and correlational. For sampling, 210 female high school students from all female high schoolers in Isfahan with an average age of 16 were selected through cluster sampling. Research instruments were questionnaires of self-esteem, attachment style, body image, and family relationship and a researcher-made scale of the teacher-student relationship. The data were analyzed using descriptive and inferential statistics. Results: Analyzing the results of the study that was done through step-wise multiple regression analysis showed that there was a significant relationship between insecure maternal attachment style, body image, kinds of teacher-student relationships, and academic achievement; and from among these variables, body image had the ability of predicting academic achievement. Other predictor variables were not significantly related to academic achievement Therefore, it could be concluded that changes in insecure maternal attachment style, body image, and teacher-student relationships were associated with the changes of the academic achievement. Conclusion: There was not any significant relationship between self-esteem and the students' academic achievement. Insecure maternal attachment styles, from among different styles, had a negative significant relationship with academic achievement. It means that increasing insecure maternal attachment style causes decreasing the students' academic achievement. The negative and significant relationship between negative body image and academic achievement means that increasing the negative body image causes decreasing academic achievement. In this research, no significant relationship between family and academic achievement was observed. By taking different kinds of significant teacher-student relationships into consideration, changing teacher-students relationships in adolescence period is more important than other variables related to academic achievement.

Continuity of Care, Caregiver–Child Interactions, and Toddler Social Competence and Problem Behaviors

ABSTRACTResearch Findings: Continuity of care is a recommended practice in child care intended to promote secure and supportive relationships between infants and toddlers and their caregivers. Toddlers (N = 115) between 12 and 24 months were observed in 30 continuity and 29 noncontinuity classrooms. The average duration of care for toddlers with caregivers was 14 months in the continuity rooms and 5 months in noncontinuity rooms. Toddlers observed in continuity rooms experienced higher levels of interactive involvement with their caregivers and were rated by their caregivers as having fewer problem behaviors compared with the toddlers in noncontinuity rooms. Toddlers in rooms with higher staff–child ratios also experienced more involved caregiving. We did not find evidence that the level of involved caregiving mediated the association between continuity of care and toddlers’ social competence or problem behaviors. Practice or Policy: Continuity of care may be a promising practice for programs that strive to provide high-quality care for infants and toddlers.

Doctors’ Attachment Orientations, Emotion Regulation Strategies, and Patient Satisfaction: A Multilevel Analysis

Extending recent research on emotion regulation in doctor–patient interaction, the present study examined relationships between doctors’ attachment orientations, their emotion regulation strategies, and patients’ satisfaction with the encounter. Forty doctors completed scales of attachment orientations and emotion regulation strategies, and 160 of their patients reported on a standard measure of satisfaction with their doctor. Results from multilevel analyses showed that doctors’ avoidant and anxious attachment orientations were independently associated with lower satisfaction for patients higher on serious illness perceptions. Doctors’ emotion regulation strategies did not mediate insecure attachment orientation relationships with patients’ satisfaction as anticipated, but these regulatory strategies were an independent factor associated with satisfaction levels of patients with higher illness severity perceptions. The study confirms predictions based on attachment theory that doctors’ insecure attachment can have adverse effects for doctor–patient interaction.

Modelo de Trocas Sociais entre Tríades de Agentes utilizando confiança, reputação e dependência social.

<div><p class="SPabstract">Esse artigo propõe um cenário em que os agentes interagem realizando trocas de serviços que, após serem realizadas, são avaliadas pelos participantes, gerando os conceitos de valores dessas trocas. A teoria desenvolvida por Piaget propõe um modelo de troca social entre dois agentes. Nesse trabalho, se propõe a adição de um novo agente, denominado agente intermediário, que em uma mesma troca atua como fornecedor e recebedor de um serviço. Dessa forma, busca-se complementar o modelo de Piaget, em que as trocas em relações sociais são realizadas entre dois agentes.</p><p class="SPabstract">Para manter a continuidade do processo de trocas sociais é necessário garantir a existência de trocas futuras e a correta escolha do parceiro. Para tal, precisa-se conhecer a informação dos valores de trocas ocorridas durante o processo, a informação dos agentes com respeito à reputação de cada um dos participantes e o grau de dependência social entre eles. Esses critérios são utilizados para orientar a decisão dos agentes sobre seus parceiros, se convertendo no foco para as análises do processo de transferência de confiança entre os agentes. Pela mesma razão, o conhecimento do grau de confiança e reputação envolvido no processo das trocas promove relações de dependência mais seguras entre os agentes e credibilidade a eles, favorecendo a possibilidade de futuras interações.</p></div>

Infant and Early Childhood Mental Health

Infant and Early Childhood Mental Health

Crying as communication in psychotherapy: The influence of client and therapist attachment dimensions and client attachment to therapist on amount and type of crying.

Nelson (2005) associated 3 types of crying (inhibited, protest, despair) with 3 dimensions of attachment (avoidant, anxious, and secure). To test this theory, trained judges rated the intensity of inhibition, protest, and despair in 347 crying episodes for 40 clients and 14 therapists in 1,074 psychotherapy sessions. Crying occurred once out of every 7 sessions, and usually was characterized by protest or inhibition. Pre-therapy attachment dimensions of both therapist and client influenced crying. Therapists with high attachment avoidance had clients who cried frequently but less over time, whereas therapists with high attachment anxiety had clients who cried with more protest over time. Clients with high attachment anxiety initially cried with more protest and inhibition, but decreased over time, whereas clients with low attachment anxiety increased protest over time. Throughout the course of psychotherapy, therapists who were seen by their clients as establishing a secure attachment elicited more overall crying and a higher intensity of protest, whereas therapists who were seen by their clients as establishing insecure attachments had clients who cried less. Clients who established a secure or avoidant relationship with their therapists, relative to other clients of that therapist, cried infrequently and with inhibition, whereas clients who established a preoccupied relationship cried relatively often. Changes are suggested for Nelson's (2005) typology.

NARRATIVE AND META-ANALYTIC REVIEW OF INTERVENTIONS AIMING TO IMPROVE MATERNAL-CHILD ATTACHMENT SECURITY.

Early secure maternal-child attachment relationships lay the foundation for children's healthy social and mental development. Interventions targeting maternal sensitivity and maternal reflective function during the first year of infant life may be the key to promoting secure attachment. We conducted a narrative systematic review and meta-analysis to examine the effectiveness of interventions aimed at promoting maternal sensitivity and reflective function on maternal-child attachment security, as measured by the gold standard Strange Situation (M. Ainsworth, M. Blehar, B. Waters, & S. Wall, 1978) and Q-set (E. Waters & K. Deane, 1985). Studies were identified from electronic database searches and included randomized or quasi-randomized controlled parallel-group designs. Participants were mothers and their infants who were followed up to 36 months' postpartum. Ten trials, involving 1,628 mother-infant pairs, were included. Examination of the trials that provided sufficient data for combination in meta-analysis revealed that interventions of both types increased the odds of secure maternal-child attachment, as compared with no intervention or standard intervention (n = 7 trials; odds ratio: 2.77; 95% confidence interval: 1.69, 4.53, n = 965). Of the three trials not included in the meta-analyses, two improved the likelihood of secure attachment. We conclude that interventions aimed at improving maternal sensitivity alone or in combination with maternal reflection, implemented in the first year of infants' lives, are effective in promoting secure maternal-child attachments. Intervention aimed at the highest risk families produced the most beneficial effects.

The relationships between shyness and unsociability and peer difficulties

The main purpose of the study was to examine the moderating role of the insecure mother–child attachment in the relations between social withdraw and peer difficulties. Participants were 487 urban children (247 boys, 240 girls) in elementary schools in Shanghai, the People’s Republic of China. Data on attachment-relevant coping styles in insecure relationships with mother were collected from children’s self-reports. Information concerning social withdrawal (i.e., shyness and unsociability) and peer difficulties (i.e., peer victimization and rejection) was obtained from peer nomination. Among the results, both shyness and unsociability were positively related to peer victimization and rejection. However, several interaction effects were also observed. Both avoidant and ambivalent attachment served an exacerbating role for peer difficulties for shy and unsociable children, with these patterns differing by gender. Implications for the contributions of attachment to socially withdrawn children’s peer adjustment are discussed.

The Effect of Job Insecurity on Attitude towards Change and Organizational Citizenship Behavior : Moderating Role of Islāmic Work Ethics

The main purpose of this study is to examine the direct and interactive effects of job insecurity and Islāmic work ethics on employee’s attitude towards change and organizational citizenship behavior. The data was collected from 171 male and female university teachers in Pakistan. Selfadministered, closed-ended questionnaires were used to collect the data. Moderated regression analysis was used to analyze the data. Results of data analysis showed that job insecurity has a strong negative effect on the attitude towards change in university teachers. On the contrary, job insecurity exhibits no significant effect on organizational citizenship behavior of university teachers. A positive direct effect of Islāmic work ethics on a ttitude towards change and organizational citizenship is also confirmed. It is also established that Islāmic work ethics do not moderate the relation of job insecurity and attitude towards change; however a moderation effect of Islāmic work ethics is found in the relationship between job insecurity and organizational citizenship behavior. This study provides the first ever examination of the relationship of job insecurity with employee’s attitude towards change and organizational citizenship behavior with the moderating effect of Islāmic work ethics.

Judith A. Ryder: Girls & Violence: Tracing the Roots of Criminal Behavior

Judith A. Ryder’s book, Girls & Violence: Tracing the Roots of Criminal Behavior is a qualitative study looking at 24 female juvenile violent offenders adjudicated and remanded to custody in New York in the mid 1990’s. Ryder examines the problems with this particular demographic to explain female violence. She includes quotes that show female juvenile violent offenders described as monsters due to societal views of women and violence. The book uses attachment theory to address why the girls commit violent crime as well as show that they are not particularly monstrous. Additionally, Ryder offers ideas for policy changes that could address the unique psychological needs of female violent offenders. In the introduction, Ryder gives the reader a broad overview of female juvenile violent offenders’ problems, some of the background issues that could explain their reasons for offending, and statistical information on the qualitative sample that she used. She explains that the background trauma and abuse the girls experienced could explain why they offended. She does, however, simultaneously state that female juvenile violent offenders should not be seen as monstrous in comparison to their male counterparts, but that female juvenile violent offenders should be assessed differently from violent male juvenile offenders specifically because of their different backgrounds. Ryder begins her argument in chapter two by laying the foundations of attachment theory. Her basic premise is that the female juvenile violent offenders experience impaired bonding when psychological needs are not met and, as a result, act out in violent behaviors as an avoidant coping mechanism when later attachment problems manifest themselves. Ryder indicates that, generally, females use self-harm or drug and alcohol abuse as coping mechanisms; but those coping mechanisms can, in some female juvenile violent offenders, lead to violence as well. She concludes the chapter by proposing that violent behavior should be viewed as a consequence of abandonment and other attachment issues. The next chapter addresses attachment theory’s argument that the early attachments that children form with the primary caregivers affect them throughout the rest of their lives. When children are unable to form secure attachments to their primary caregivers, the children can display early signs of problems like the inability to handle different emotional states. Ryder uses this chapter as the first direct link between attachment theory and her qualitative sample. The girls interviewed for this indicated that they had insecure relationships with their mothers. They appeared incapable of interacting on an emotional level with their mothers and frequently chose to remain silent instead of expressing how they were feeling or attempting to work out their problems with anyone else. Most of the girls’ senses of emotional security were unstable and demonstrated a lack of basic family support. Subsequent chapters link other early childhood experiences, primarily trauma, in the sample to outcomes of violence. In chapter four, Ryder shows that the girls also experienced serious childhood traumas and exposure to violence. Many of the girls recounted early exposure to violence, such as fist fights and other physical abuses. All of the girls reported dealing with sexual harassment and sexual advances from adults around them as well as family members. Additionally, several of the girls experienced sexual violence. In addition to primary victimization, the & Ashley L. Hemsath ahemsath@indiana.edu

Relationship of household food insecurity and anemia in children receiving the benefit from food assistance programs in San Luis Potosi, Mexico

ObjectiveTo investigate the association of household food insecurity in children with anemia beneficiaries of food assistance programs.Methods: Within the Study of Impact evaluation of Food assistance Programs (FAP) in San Luis Potosi, México we obtained information from 1366 households with children (<5y) beneficiaries of one out of the three FAP: Prospera (before Oportunidades); School Breakfast Program (DIF); Rescue to Malnutrition with amaranth; and Control group. We used the Latin American and Caribbean Household Food Security measurement scale (ELCSA). Anemia in children was determined with the cut‐off values <110 g/L.The effect of FAP and the food insecurity (FI) level on the prevalence of anemia in children, a logistic regression model was constructed. Stunting, socioeconomic level, age, and sex were included in the model as corrective variables.Results: The prevalence of anemia increased when children were stunted (p=0.001) A higher socioeconomic index and major age were protective for the probability of anemia. Significant interactions were observed between Prospera and mild food insecurity level (p=0.095) and between anemia and DIF and mild insecurity (p=0.009) in children.Conclusions29.3% of the children from households with FI suffered anemia and the probability of being anemic increased if the children were stunted. Households with anemic children that did not receive assistance were more food secure than those that did.Supported by FOMIX, SLP‐COPOCYT.Project: FMSLP‐213‐CO2‐208475

Attachment-based family therapy for depressed and suicidal adolescents: theory, clinical model and empirical support

Attachment-Based Family Therapy (ABFT) is a manualized family-based intervention designed for working with depressed adolescents, including those at risk for suicide, and their families. It is an empirically informed and supported treatment. ABFT has its theoretical underpinnings in attachment theory and clinical roots in structural family therapy and emotion focused therapies. ABFT relies on a transactional model that aims to transform the quality of adolescent–parent attachment, as a means of providing the adolescent with a more secure relationship that can support them during challenging times generally, and the crises related to suicidal thinking and behavior, specifically. This article reviews: (1) the theoretical foundations of ABFT (attachment theory, models of emotional development); (2) the ABFT clinical model, including training and supervision factors; and (3) empirical support.