Strange Situation Procedure Research Articles

Cortisol regulation in 12-month-old human infants: Associations with the infants' early history of breastfeeding and co-sleeping

Experiences during early life are suggested to affect the physiological systems underlying stress responses, including the hypothalamic–pituitary–adrenal axis (HPA axis). While stressful early experiences have been associated with dysregulated HPA-axis functioning, positive early experiences, i.e. high maternal caregiving quality, contribute to more optimal HPA-axis functioning. Influences of other early caregiving factors, however, are less well documented. The goal of this study was to examine whether breastfeeding and co-sleeping during the first 6 months of life were associated with infant cortisol regulation, i.e. cortisol reactivity and recovery, to a stressor at 12 months of age. Participants were 193 infants and their mothers. Information on breastfeeding and co-sleeping was collected using weekly and daily sleep diaries, respectively, for the first 6 months of life. Co-sleeping was defined as sleeping in the parents' bed or sleeping in the parents' room. At 12 months of age, infants were subjected to a psychological stressor [Strange Situation Procedure (SSP); Ainsworth et al. 1978]. Salivary cortisol was measured prestressor and at 25, 40, and 60 min poststressor to measure reactivity and recovery. Regression analyses showed that after controlling for maternal sensitivity, infant attachment status, feeding, and sleeping arrangements at 12 months of age and other confounders, more weeks of co-sleeping predicted lower infant cortisol reactivity to the SSP. Also, more weeks of breastfeeding predicted quicker cortisol recovery. These results indicate that an early history of co-sleeping and breastfeeding contributes positively to cortisol regulation in 12-month-olds.

Maternal sensitivity mediates the link between maternal insightfulness/resolution and child–mother attachment: the case of children with Autism Spectrum Disorder

This study examined the hypothesis that maternal sensitivity mediates the association between maternal Insightfulness/Resolution and child attachment in a sample of preschool age boys with Autism Spectrum Disorders. This study used the Insightfulness Assessment to assess insightfulness and the Reaction to Diagnosis Interview to assess mothers' resolution. Maternal sensitivity was assessed from mother–child play observations, and the security of children's attachment was assessed using the Strange Situation Procedure. The results supported the mediation model, and their implications for attachment research, research on intervention in autism, and clinical work are discussed.

Infant Attachment, Parenting Stress, and Child Emotional and Behavioral Problems at Age 3 Years

SYNOPSIS Objective. To examine the role of infant attachment classification and parenting stress for toddler emotional and behavior problems. Design. Participants were 606 infant–mother dyads who took part in a population-based cohort study in the Netherlands. Infant–mother attachment classification was assessed using the Strange Situation Procedure when the children were 14 months old. At 18 months, parenting stress was measured with the Dutch version of the Parenting Stress Index. When the children were 3 years old, both mothers and fathers completed the Child Behavior Checklist. Results. Infant attachment moderated the effect of parenting stress on child emotional and behavior problems. Parenting stress was related to more aggression and attention problem behaviors in insecurely attached children, but not in securely attached children. Moreover, higher parenting stress was associated with more withdrawal problem behaviors in insecurely attached children, in particular in insecure-resistant and in disorganized children. Conclusion. In the presence of an insecure attachment relationship, more parenting stress is related to more (internalizing) withdrawal problem behavior and to more (externalizing) aggression and attention problems. Attachment security in infancy buffers the influence of parenting stress on child emotional and behavior problems.

The missing link: Mothers’ neural response to infant cry related to infant attachment behaviors

This study addresses a gap in the attachment literature by investigating maternal neural response to cry related to infant attachment classifications and behaviors. Twenty-two primiparous mothers and their 18-month old infants completed the Strange Situation (SS) procedure to elicit attachment behaviors. During a separate functional MRI session, mothers were exposed to their own infant's cry sound, as well as an unfamiliar infant's cry and control sound. Maternal neural response to own infant cry related to both overall attachment security and specific infant behaviors. Mothers of less secure infants maintained greater activation to their cry in left parahippocampal and amygdala regions and the right posterior insula consistent with a negative schematic response bias. Mothers of infants exhibiting more avoidant or contact maintaining behaviors during the SS showed diminished response across left prefrontal, parietal, and cerebellar areas involved in attentional processing and cognitive control. Mothers of infants exhibiting more disorganized behavior showed reduced response in bilateral temporal and subcallosal areas relevant to social cognition and emotion regulation. No differences by attachment classification were found. Implications for attachment transmission models are discussed.

Remaining or becoming secure: Parental sensitive support predicts attachment continuity from infancy to adolescence in a longitudinal adoption study.

In a longitudinal study with 125 early adopted adolescents, we examined continuity of attachment from infancy to adolescence and the role of parental sensitive support in explaining continuity or discontinuity of attachment. Assessments of maternal sensitive support and infant attachment (Strange Situation Procedure) were completed when infants were 12 months old. When the children were 14 years old, we observed mothers' sensitive support during a conflict discussion. The adolescents' attachment representations were assessed with the Adult Attachment Interview. Mothers of secure adolescents showed significantly more sensitive support during conflicts than did mothers of insecure adolescents. Overall, no continuity of attachment from infancy to adolescence was found. However, maternal sensitive support in early childhood and adolescence predicted continuity of secure attachment from 1 to 14 years, whereas less maternal sensitive support in early childhood but more maternal sensitive support in adolescence predicted children's change from insecurity in infancy to security in adolescence. We conclude that both early and later parental sensitive support are important for continuity of attachment across the first 14 years of life.

Genetic and Caregiving-Based Contributions to Infant Attachment

In the longitudinal study reported here, we examined genetic and caregiving-based contributions to individual differences in infant attachment classifications. For 154 mother-infant pairs, we rated mothers’ responsiveness to their 6-month-old infants during naturalistic interactions and classified infants’ attachment organization at 12 and 18 months using the Strange Situation procedure. These infants were later genotyped with respect to the serotonin-transporter-linked polymorphic region (5-HTTLPR). Maternal responsiveness uniquely predicted infants’ attachment security. Infants’ 5-HTTLPR variation uniquely predicted their subtype of attachment security at 12 months and their subtype of attachment insecurity at 12 and 18 months. The short allele for 5-HTTLPR was associated with attachment classifications characterized by higher emotional distress. These findings suggest that 5-HTTLPR variation contributes to infants’ emotional reactivity and that the degree to which caregivers are responsive influences how effectively infants use their caregivers for emotion regulation. Theoretical implications for the study of genetic and caregiving influences are discussed.

Use of selective serotonin reuptake inhibitors during pregnancy and disorganised infant–mother attachment

Objective: To examine the quality of infant–mother attachment in a prospective case series of infants whose mothers took selective serotonin reuptake inhibitors (SSRIs) during pregnancy. Background: SSRIs are prescribed to 2–6% of pregnant women. Recent articles on the use of SSRIs during pregnancy note the increased risk for problematic infant–mother relationships among mothers with untreated postpartum depression. However, little is known about the quality of infant–mother relationships among mothers who took SSRIs during pregnancy. Methods: Five mothers who took SSRIs during pregnancy were recruited from a community study of infant development. Mothers completed ratings of postpartum depression symptoms (Beck Depression Inventory) 4–6 times between 1 month and 1 year following the infant’s birth. At 1 year postpartum, quality of infant–mother attachment was assessed using the strange situation procedure. Results: Four of the five infant–mother dyads (80%) were classified as disorganised, a rate considerably higher than in postpartum depression samples. Conclusion: These results are used to raise questions about the clinical implications of research on in utero exposure to SSRIs, perinatal depression, and disorganised attachment. Specifically, this case series raises questions about using research on the link between postpartum depression and infant–mother attachment as a rationale for the use of SSRIs during pregnancy. Current research indicates use of SSRIs during pregnancy may: (1) increase risk for disorganised attachment, (2) decrease risk for disorganised attachment, or (3) have no effect on disorganised attachment.

Temperament, disordered attachment, and parental sensitivity in foster care: differential findings on attachment security for shy children

In a foster care sample, the moderating effect of temperamental shyness on the association between parental sensitivity and attachment quality was tested. The foster parents of 59 foster children (age M = 57 months, SD = 16.4) filled out the Child Behavior Questionnaire. To control for confounds, symptoms of inhibited and disinhibited disordered attachment were derived from the Disturbances of Attachment Interview. The Strange Situation Procedure as well as a 15 minute parent–child interaction task were administered. Analyses indicated an interaction effect between parental perceptions of shyness and parental sensitivity for attachment quality. Shy children who had more sensitive foster parents were more often securely attached. For less shy children, no differences in attachment security were found in relation to the foster parents’ sensitivity. These results are partially consistent with the differential susceptibility hypothesis. Shy children may benefit more from more sensitive foster parents when entering foster care.

Breastfeeding and Its Relation to Maternal Sensitivity and Infant Attachment

To examine the association of breastfeeding with maternal sensitive responsiveness and infant-mother attachment security and disorganization. We included 675 participants of a prospective cohort study. Questionnaires about breastfeeding practices were administered at 2 and 6 months postpartum. At 14 months, maternal sensitive responsiveness was assessed in a 13-minute laboratory procedure using Ainsworth's sensitivity scales, and attachment quality was assessed with the Strange Situation Procedure. Mothers were genotyped for oxytocin receptor genes OXTR rs53576 and OXTR rs2254298. Linear regressions and analyses of covariance adjusted for various background variables were conducted. We tested for mediation and moderation by maternal sensitive responsiveness and maternal oxytocin receptor genotype. Continuous analyses showed that longer duration of breastfeeding was associated with more maternal sensitive responsiveness (B = 0.11, 95% confidence interval [CI] 0.02; 0.20, p < .05), more attachment security (B = 0.24, 95% CI = 0.02; 0.46, p < .05), and less attachment disorganization (B = -0.20, 95% CI -0.36; -0.03, p < .05). Duration of breastfeeding was not related to the risk of insecure-avoidant or insecure-resistant versus secure attachment classification, but longer duration of breastfeeding predicted a lower risk of disorganized versus secure attachment classification (n = 151; odds ratio [OR] = 0.81, 95% CI 0.66 to 0.99, p = .04). Maternal sensitive responsiveness did not mediate the associations, and maternal oxytocin receptor genotype was not a significant moderator. Although duration of breastfeeding was not associated with differences in infant-mother attachment classifications, we found subtle positive associations between duration of breastfeeding and sensitive responsiveness, attachment security, and disorganization.

Intercepting the intergenerational cycle of maternal trauma and loss through mother–infant psychotherapy: A case study using attachment-derived methods

Some mothers who have recently lost a significant attachment figure may become mentally incoherent and sporadically even enter a trancelike, dissociative state. Such states of mind have been shown to predict infant attachment disorganization. Infants born close to the time of a parental loss are at a greater risk for intergenerational trauma. A background of maternal substance abuse is also known to increase such risk. We illustrate by way of a case study how a mother-infant group psychotherapy programme aimed at substance-abusing mothers may help to prevent the transmission of mother's unresolved trauma to the infant. Another goal was to discuss how attachment-derived methods (namely, Adult Attachment Interview, Strange Situation Procedure and the Emotional Availability Scales) may aid in understanding the effects of the intervention.

Affective and Behavioral Features of Jealousy Protest: Associations with Child Temperament, Maternal Interaction Style, and Attachment

This study explored variation in affective and behavioral components of infants’ jealousy protests during an eliciting condition in which mother and an experimenter directed differential attention exclusively toward a rival. Variation was examined in relation to child temperamental emotionality, maternal interaction style, and attachment security. At 45 weeks, intensity of infants’distress and durations of mother‐ and stranger‐directed behavioral responses, including gaze, touch, and proximity‐seeking, were observed in the eliciting condition. We also assessed infants’positive emotionality (PE) and negative emotionality (NE) and maternal interaction styles of sensitivity and engagement. At 54 weeks, attachment security was measured in the Strange Situation Procedure. Findings revealed that distress differed with temperamental emotionality and maternal interaction style. Specifically, distress was greater in infants with lower PE and having mothers who displayed less sensitivity and engagement. Analyses on behavioral responses toward the experimenter revealed linkages with maternal interaction style. Specifically, experimenter‐directed gaze and touch were greater among infants of mothers who demonstrated less sensitivity and engagement. Behavioral responses toward mother were found associated with quality of attachment. Specifically, mother‐directed proximity and touch were highest among infants later judged insecure resistant and lowest among those later judged insecure/avoidant; with infants later judged secure displaying moderate durations of mother‐directed proximal contact.

INDISCRIMINATE BEHAVIOR OBSERVED IN THE STRANGE SITUATION AMONG INSTITUTIONALIZED TODDLERS: RELATIONS TO CAREGIVER REPORT AND TO EARLY FAMILY RISK.

Socially disinhibited or indiscriminate behavior (IB) has traditionally been investigated using caregiver reports. More recently, an observational measure based on the Strange Situation Procedure (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978), the Rating of Infant and Stranger Engagement (RISE; C. Riley, A. Atlas-Corbett, & K. Lyons-Ruth, 2005), was validated in home-reared at-risk children. The present study aimed to validate the RISE in an institutionally reared sample using the caregiver report, to assess whether IB assessed with the RISE was elevated among the institutionalized children, and to explore potential risk factors associated with IB. The study was conducted among 74 institutionalized toddlers aged 11 to 30 months. Sociodemographic questionnaires were used to assess pre-admission experiences, and aspects of institutional placement were coded from the children's files in the institution and staff's report. Institutionalized children displayed high frequencies of IB as assessed on the RISE, and this instrument was validated against caregiver report. Pre-admission experiences of the institutionalized children in their biological families-namely, prenatal risk and maternal emotional neglect risk-predicted IB. Results suggest that the RISE is adequate to use among institutionally reared toddlers and point to aspects of the early familial environment that may be implicated in IB.

Child anger proneness moderates associations between child-mother attachment security and child behavior with mothers at 33 months.

Child-mother attachment security, assessed via a modified Strange Situation procedure (Cassidy & Marvin, with the MacArthur Attachment Working Group, 1992), and parent-reported child proneness to anger were examined as correlates of observed child behavior toward mothers during a series of interactive tasks (N = 120, 60 girls). Controlling for maternal sensitivity and child gender and expressive language ability, greater attachment security, and lower levels of anger proneness were related to more child responsiveness to maternal requests and suggestions during play and snack sessions. As hypothesized, anger proneness also moderated several security-behavior associations. Greater attachment security was related to (a) more committed compliance during clean-up and snack-delay tasks for children high on anger proneness, (b) more self-assertiveness during play and snack for children moderate or high on anger proneness, and (c) more help-seeking during play and snack for children moderate or low on anger proneness. Findings further our understanding of the behavioral correlates of child-mother attachment security assessed during late toddlerhood via the Cassidy-Marvin system and underscore child anger proneness as a moderator of attachment-related differences in child behavior during this developmental period.

Infants' responsiveness, attachment, and indiscriminate friendliness after international adoption from institutions or foster care in China: Application of Emotional Availability Scales to adoptive families

In a short-term longitudinal design we investigated maternal sensitivity, child responsiveness, attachment, and indiscriminate friendliness in families with children internationally adopted from institutions or foster care in China. Ninety-two families with 50 postinstitutionalized and 42 formerly fostered girls, aged 11-16 months on arrival, were studied 2 and 6 months after adoption. Maternal sensitivity and child responsiveness were observed with the Emotional Availability Scales, attachment was assessed with the Strange Situation procedure, and mothers reported on children's indiscriminate friendliness. The postinstitutionalized children showed less secure attachment, whereas the former foster children did not differ from the normative distribution of attachment security. However, at both assessments the two groups of adopted children showed more disorganized attachments compared to normative data. Adoptive mothers of postinstitutionalized and former foster children were equally sensitive and their sensitivity did not change over time. Postinstitutionalized and former foster children did not differ on indiscriminate friendliness, but children with more sensitive adoptive mothers showed less indiscriminate friendliness. The former foster children showed a larger increase in responsiveness over time than the postinstitutionalized children, suggesting that children's responsiveness is more sensitive to change than attachment, and that preadoption foster care is more beneficial for the development of children's responsiveness after adoptive placement than preadoption institutional care.

Maternal Sensitivity: Evidence of Stability across Time, Contexts, and Measurement Instruments

Although maternal sensitivity is widely understood as having a direct impact on the quality of the mother–child relationship, empirical evidence supporting this has been inconsistent, possibly because of varied definitions of the construct and limitations of measurements. The Maternal Behavior Q‐Set (MBQS) appears to be a promising measure of sensitivity, showing associations with attachment security (r = .60) higher than those reported (r = .24) in a highly‐regarded meta‐analysis of other sensitivity measures. The present study aimed to further establish the validity and utility of the MBQS by exploring its consistency with a contingency‐based measure of sensitivity, while also seeking evidence of stability across contexts and times. Seventy‐two mothers and their 10‐month‐olds participated in a procedure that included two episodes of Floor Play and Reunions following maternal differential treatment. Mothers were scored on contingent responsivity and warmth. At 12 months, the dyads underwent the Strange Situation Procedure where sensitivity was assessed using a 72‐item version of the MBQS. The findings revealed the stability of maternal sensitivity across times, contexts, and measures. However, linkages applied only to 10‐month scores from reunion, not play, episodes, supporting Pederson and Moran's (1995) assertion that high‐demand circumstances reveal more meaningful differences in maternal sensitivity. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Convergence between attachment classifications and natural reunion behavior among children and parents in a child care setting

The current study examined the convergence between young children's attachment classifications in the laboratory-based Strange Situation Procedure and children's and parents' behaviors during naturalistic reunions after a day in child care. Fifty-eight parent–child dyads participated in this study. Children's attachment security assessed from the Strange Situation Procedure was significantly associated with ratings of children's security, avoidance, and delight toward their parents during the natural reunion episodes, and with parents' responsiveness during the natural reunion episodes. These findings suggest that natural reunions at the end of the day in child care reflect the quality of attachment relationships between young children and their parents.

Security of attachment and quality of mother–toddler social interaction in a high-risk sample

The quality of children's social interactions and their attachment security with a primary caregiver are two widely studied indices of socioemotional functioning in early childhood. Although both Bowlby and Ainsworth suggested that the parent–child interactions underlying the development of attachment security could be distinguished from other aspects of parent–child interaction (e.g., play), relatively little empirical research has examined this proposition. The aim of the current study was to explore this issue by examining concurrent relations between toddler's attachment security in the Strange Situation Procedure and quality of mother–child social interaction in a high-risk sample of toddlers characterized by prenatal cocaine exposure and low levels of maternal education. Analyses of variance suggested limited relations between attachment security and quality of social interaction. Further research examining the interrelations among various components of the parent–child relationship is needed.

Cortisol Diurnal Rhythm and Stress Reactivity in Constipation and Abdominal Pain

The aim of this study was to assess whether diurnal cortisol rhythm and cortisol stress reactivity were associated with functional constipation and abdominal pain in infancy. This study was embedded in a subset of the Generation R Study, a prospective cohort study from fetal life onward in Rotterdam, the Netherlands. Data of infants between 14 and 24 months of age (N =483) were used. Salivary cortisol diurnal rhythm and salivary cortisol stress reactivity after a Strange Situation Procedure were assessed at age 14 months. Data on functional constipation were available according to the Rome II criteria, and data on abdominal pain on the basis of the Abdominal Pain Index were available from questionnaire data at 24 months. In the second year of life, 13% of the infants had functional constipation and 17% had abdominal pain. Only 4% had symptoms of both functional constipation and abdominal pain. Diurnal cortisol rhythm did not differ significantly between children with and children without functional constipation and abdominal pain. Cortisol stress reactivity was slightly higher in infants with abdominal pain than in those without it, but this was not statistically significant (odds ratio 1.41; 95% confidence interval 0.46-4.31). No association was found between the cortisol stress reactivity and functional constipation. Our results suggest that cortisol as a marker for stress does not play a major role in functional constipation or abdominal pain in infancy.

Study of mother–infant attachment patterns and influence factors in Shanghai

BackgroundIn contrast to the considerable volume of international research on infant attachment development, significantly less research has been conducted in China. AimThe present study was designed to identify the patterns of mother–infant attachment in Shanghai and to explore the influence factors. Study design and subjectsThe subjects included 160 healthy infant–mother dyads. Infant attachment and temperament were assessed with the Strange Situation Procedure and Carey's temperament questionnaire, respectively; the mother's personality, maternal sensitivity and marital satisfaction were assessed with Eysenck's personality questionnaire, Maternal Behavior Q-sort Manual Version 3.1 and Olson's marital questionnaire, respectively. A self-formulated questionnaire of family environment factors was completed by the infant's mother. ResultsOf the 160 infants, 68.2% were rated as securely attached (B) and 31.8% as insecurely attached. Of those infants rated as insecurely attached, 7.5% were characterized as avoidant (A), 21.8% as resistant (C) and 2.5% as disorganized (D). Maternal sensitivity and marital satisfaction as well as the approachability dimension of infant temperament, were significantly different between securely attached infants and insecurely attached infants. From a temperament perspective, resistant infants showed higher-level intensity of reaction than avoidant infants. Moreover, multiple caregivers in the family and infant's sleeping with other caregivers at night were more likely to be associated with insecure mother–infant attachment. ConclusionThere exist certain cultural characteristics in mother–infant attachment patterns in Shanghai. The influence factors are related with the high involvement of non-mother caregivers as well as maternal sensitivity, marital satisfaction and infant's temperament characteristics.

Children adopted from China: Attachment security two years later

Background This study continues the examination of the process of attachment formation of mothers and their adopted Chinese daughters two years postadoption. Method 30 children adopted from China (mean age = 13.6 months at adoption) were assessed and followed two years following adoption. They were compared to 31 nonadopted Canadian girls of similar age and family background. In earlier reported longitudinal studies of the adopted children, maternal reports of attachment security were employed. In the current study the Strange Situation Procedure was used. Results Adopted children show signs of having a secure attachment with their mothers two years following adoption. There was some evidence that disorganized attachment characterized these children more so than for children in the comparison group. Conclusions The moderate degree of emotional deprivation experienced by Chinese adoptees does not hinder their ability to form a new attachment with adoptive mothers. Attachment appears open to change, even after a time when children should have already formed an attachment relationship and the change is maintained.