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Results for “Reactive Attachment Disorder”

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PubMed2005

Adult attachment, alexithymia, and symptom reporting: an extension to the four category model of attachment.

OBJECTIVE: A previous study using a three-category attachment model found that avoidant attachment was associated with increased symptom reporting, and that this relationship was largely mediated by negative affectivity and alexithymia. The present study aimed to advance on these findings by using a four-category model of attachment to determine which aspect of avoidant attachment (fearful or dismissing) is related to symptom reporting, and via which mediating variables. METHOD: One hundred and forty-two male and female undergraduates, aged 17-44, completed questionnaire measures of attachment style, alexithymia, self-esteem, positive and negative affectivity, and symptom reporting. RESULTS: Fearful and preoccupied attachment styles, negative affectivity, and alexithymia were all significantly associated with increased symptom reporting, while the dismissing attachment style was not. Regression analyses showed that the relationship between fearful attachment and symptom reporting was partly, but not fully, mediated by alexithymia and negative affectivity, while that between preoccupied attachment and symptom reporting was mediated mainly by negative affectivity. Low self-esteem was associated with symptom reporting only via its association with negative affectivity. CONCLUSIONS: Fearful and preoccupied attachment styles are both associated with symptom reporting via a negative model of the self and increased negative affectivity, but alexithymia is an additional predictor of symptom reporting in individuals with fearful attachment. This difference is thought to be linked to the model of others developed in early interactions with caregivers.

Adolescent↗
PubMedDate not supplied

Representations of attachment relationships in children of incarcerated mothers.

Representations of attachment relationships were assessed in 54 children ages 2.5 to 7.5 years whose mothers were currently incarcerated. Consistent with their high-risk status, most (63%) children were classified as having insecure relationships with mothers and caregivers. Secure relationships were more likely when children lived in a stable caregiving situation, when children reacted to separation from the mother with sadness rather than anger, and when children were older. Common reactions to initial separation included sadness, worry, confusion, anger, loneliness, sleep problems, and developmental regressions. Results highlight need for support in families affected by maternal imprisonment, especially efforts to promote stable, continuous placements for children, in addition to underscoring the importance of longitudinal research with this growing but understudied group.

Anxiety, Separation↗
PubMed2002

Infant-mother attachment security, contextual risk, and early development: a moderational analysis.

In light of evidence that the effects of attachment security on subsequent development may be contingent on the social context in which the child continues to develop, we examined the effect of attachment security at age 15 months, cumulative contextual risk from 1 to 36 months, and the interaction of attachment and cumulative risk to predict socioemotional and cognitive linguistic functioning at age 3 years, using data from the National Institute of Child Health and Human Development Study of Early Child Care. Results indicated that early attachment predicts both socioemotional development and language skills, but not cognitive functioning as indexed by a measure of school readiness, and that the effect of attachment on socioemotional development and expressive language varied as a function of social-contextual risk. Insecure-avoidant infants proved most vulnerable to contextual risk, not children classified as secure or insecure more generally, although in one instance security did prove protective with respect to the adverse effects of cumulative contextual risk. Findings are discussed in terms of risk and resilience and in light of the probabilistic nature of the relation between early attachment and later development.

Affective Symptoms↗
PubMed2004

Comparing criteria for attachment disorders: establishing reliability and validity in high-risk samples.

OBJECTIVE: To determine whether published subtypes of attachment disorder can be reliably identified by trained clinicians reviewing data from high-risk populations and to investigate the relationship between disorder classification and standardized measures of attachment behavior. METHOD: Twenty or more children aged 18 to 48 months and their primary caregivers were recruited from three sites: a treatment team for maltreated young children (n = 20), a homeless shelter (n = 25), and Head Start centers (n = 24). All dyads completed a semistructured clinical assessment and laboratory and home-based attachment measures. RESULTS: All but one type of attachment disorder could be identified reliably by clinician raters (kappa range = 0.62-0.74, depending on subtype). Children from the maltreatment sample were significantly more likely to meet criteria for one or more attachment disorders than children from the other groups (p <.001). As predicted, children without an attachment disorder were more likely to be classified as securely attached than those with an attachment disorder (p =.03); however, children classified as having disorganized attachment were not more likely to receive an attachment disorder diagnosis. CONCLUSIONS: Attachment disorders can be reliably diagnosed in young children, though research on refining disorder criteria should precede intervention trials.

Child, Preschool↗
PubMed2006

Attachment and externalizing disorders: a developmental psychopathology perspective.

OBJECTIVE: Attachment theory offers an intriguing formulation of protection and risk that ties together key aspects of behavior, emotion, and cognition. The authors present links among attachment status, other developmental domains, and the development and maintenance of externalizing disorders to illustrate an approach to integrating attachment theory and relationship research with the study of externalizing symptoms. METHOD: The authors review the literature on the attachment system's theoretical and empirical associations with domains of emotion regulation, social attributions, socialization and moral development, and intergenerational transmission of behavior, as well as with externalizing behaviors. RESULTS: There are a number of risk and protective connections between attachment security and other developmental processes that are associated with externalizing disorders. CONCLUSIONS: Knowledge of relational processes, in this case, attachment relationships, can contribute to an understanding of etiology, maintenance, and treatment of externalizing disorders.

Anxiety↗
PubMed2003

Attachment dimensions and drinking-related problems among young adults: the mediational role of coping motives.

Recent research has found a positive association between insecure adult attachment styles and harmful drinking patterns. In the present study, we examined the relation between alcohol-related consequences and two dimensions underlying attachment, 'model of self' and 'model of others,' among a population of college student drinkers (N=366). It was predicted that a negative model of self would contribute significantly to the variance in drinking problems over and above that accounted for by level of alcohol consumption. In an attempt to clarify the nature of the relationship among these variables, it was further hypothesized that coping drinking motives would mediate the relationship between the self attachment dimension and alcohol consequences. Hierarchical multiple regression analyses revealed results consistent with the predictions. There was a significant relationship between negative model of self and problems which was fully mediated by coping drinking motives. The findings support the basic theoretical supposition that one primary function of interpersonal attachment is the regulation of emotions.

Adaptation, Psychological↗
PubMed2003

[One cannot be careful enough in the choice of one's parents--on the biopsychosocial development of adaptation systems for distress in Homo sapiens].

Actual results of brain research show that we might have more than one system to cope with distress. The most archaic one might be the system freeze/dissociation. The second one is the system attachment/relationship/herd/support. Articles by Allan N. Schore show that the central regulation of the self, the affects, and the interpersonal relations are impaired permanently by relational traumata/attachment traumata during early childhood. Jaak Panksepp differentiates the distress systems panic versus fear. On the one side we find the cluster panic--periaqueductal gray PAG--lateral septum--gyrus cinguli--glutamate--opioids--attachment--parasympathetic autonomic nerve system--trophotorphic state--hypometabolism--freeze reaction--dissociation, on the other side the cluster fear--enemy--sympathetic autonomic nerve system--ergotrophic state--hypermetabolism--fight and flight--cognition and learning. It can be helpful for therapy strategies to differentiate these systems.

Adaptation, Psychological↗
PubMed2005

An attachment insecurity model of negative affect among women seeking treatment for an eating disorder.

The purpose of this study was to propose and test a model of attachment insecurity in a clinical sample of 268 eating disordered women. Structural relationships among attachment insecurity, BMI, perceived pressure to diet, body dissatisfaction, restrained eating, and negative affect were assessed. A heterogeneous sample of treatment seeking women with a diagnosed eating disorder completed psychometric tests prior to receiving treatment. The data were analysed using structural equation modeling. Fit indices indicated that the hypothesized model fit adequately to the data. Although cross-sectional in nature, the data suggested that attachment insecurity may lead to negative affect. As well, attachment insecurity may lead to body dissatisfaction, which in turn may lead to restrained eating among women with eating disorders. Attachment insecurity could be a possible vulnerability factor for the development of eating disorder symptoms among women.

Adolescent↗
PubMed2004

Serial murder and the case of Aileen Wuornos: attachment theory, psychopathy, and predatory aggression.

The extant research on female homicide has yet to offer any systematic assessment of why women murder serially. Part of the explanation is attributed to existing literature focusing on justifiable and excusable homicide, or women who kill their abusive partners because they have been battered, fear that their lives are in danger, or are otherwise victimized. Thus, predatory homicide perpetrated by women has not received extensive attention in the relevant literature. This article aims to address this deficiency by providing a detailed case study analysis of Aileen Wuornos, a convicted serial murderer executed at Broward Correctional Institution in Pembroke Pines, FL, on October 9, 2002. By linking the literature on attachment theory with the research on psychopathy and predatory aggression, this article argues that Aileen Wuornos was a cold blooded and calculated killer: a serial offender responsible for her delinquent and criminal behavior. Generalizing from the case of Aileen Wuornos, several tentative recommendations are proposed as linked to clinical and forensic prevention, diagnosis, and treatment, as well as future research on women, psychopathy, and predatory serial homicide.

Adult↗
PubMedDate not supplied

[Diagnosis of attachment disorders].

After an introduction about the basic concepts of attachment theory the diagnostic classification systems ICD, DSM and ZERO TO THREE are reviewed for descriptions and diagnosis of attachment disorders. It is demonstrated how over the last few years attachment theory has been partly adopted in those diagnostic systems. In addition different types of clinically relevant attachment disorders are described. The authors argue that it would be necessary to integrate attachment disorders on a broader base into the current diagnostic classification systems. The diagnostic importance of attachment disorders and their impact on the technique of child psychotherapy are finally discussed.

Child↗
PubMed2000

Attachment disorder behavior following early severe deprivation: extension and longitudinal follow-up. English and Romanian Adoptees Study Team.

OBJECTIVE: To examine attachment disturbances and disorder in a sample of children adopted into the U.K. following severe early privation and in a comparison sample of nondeprived, within-country, early-placed adoptees. METHOD: The subjects, 165 children adopted from Romania and 52 adoptees from the U.K., were assessed at age 6 years; longitudinal data (at ages 4 and 6 years) were available on the 111 Romanian adoptees placed in U.K. homes before 24 months of age and on all U.K. adoptees. Information on attachment disorder was derived from a semistructured interview with the parent; in addition, data on children's cognitive and social development were assessed using standardized assessments. RESULTS: Analyses revealed a close association between duration of deprivation and severity of attachment disorder behaviors. In addition, attachment disorder behaviors were correlated with attentional and conduct problems and cognitive level but nonetheless appeared to index a distinct set of symptoms/behaviors. Finally, there was marked stability in individual differences in attachment disorder behaviors and little evidence of a mean decrease over this 2-year period. CONCLUSIONS: The findings offer construct validation for the attachment disorder construct and highlight clinical and conceptual questions that require further research.

Adoption↗
PubMed2006

Frightened, threatening, and dissociative parental behavior in low-risk samples: description, discussion, and interpretations.

In 1990 we advanced the hypothesis that frightened and frightening (FR) parental behavior would prove to be linked to both unresolved (U) adult attachment status as identified in the Adult Attachment Interview and to infant disorganized/disoriented (D) attachment as assessed in the Ainsworth Strange Situation. Here, we present a coding system for identifying and scoring the intensity of the three primary forms of FR behavior (frightened, threatening, and dissociative) as well as three subsidiary forms. We review why each primary form may induce fear of the parent (the infant's primary "haven of safety"), placing the infant in a disorganizing approach-flight paradox. We suggest that, being linked to the parent's own unintegrated traumatic experiences (often loss or maltreatment), FR behaviors themselves are often guided by parental fright, and parallel the three "classic" mammalian responses to fright: flight, attack, and freezing behavior. Recent studies of U to FR, as well as FR to D relations are presented, including findings regarding AMBIANCE/FR+. Links between dissociation, FR, U, and D are explored. Parallel processing and working memory are discussed as they relate to these phenomena.

Adult↗
PubMed2000

Disorganized infant, child, and adult attachment: collapse in behavioral and attentional strategies.

This presentation focuses on the disorganized/disoriented (Group D) categories of infant, child, and adult attachment. The infant D category is assigned on the basis of interruptions and anomalies in organization and orientation observed during Ainsworth's strange situation procedure. In neurologically normal low-risk samples, D attachment is not substantially related to descriptions of infant temperament, and usually appears with respect to only one parent. At six, former D infants are often found to be role-inverting (D-Controlling) towards the parent, while drawings and separation-related narratives (D-Fearful) suggest continuing states of fear and disorganization. In adults, marked lapses in reasoning and discourse surrounding the discussion of loss or abuse during the Adult Attachment Interview (AAI) causes a transcript to be assigned to Unresolved/disorganized (U/d) adult attachment status, which predicts infant D attachment. Bowlby's theory is extended, with the proposal that certain forms of frightening parental behavior will arouse contradictory biologically channeled propensities to approach and to take flight from the parent. Maltreated infants are therefore highly likely to be disorganized. Also identified are subtler forms of frightening parental behavior (including dissociative behavior and anomalous forms of frightened behavior) that appear to lead to infant disorganization. This suggests that infant D attachment may at times represent a second-generation effect of the parent's own continuing unresolved responses to trauma. Infant D attachment predicts disruptive/aggressive and dissociative disorders in childhood and adolescence, while U/d adult attachment appears frequently in psychiatric and criminal populations. Clinical implications are discussed.

Adolescent↗
PubMed1998

Attachment disorders in infancy and early childhood: a preliminary investigation of diagnostic criteria.

OBJECTIVE: The primary purpose of this study was to compare the reliability of differing sets of criteria for attachment disorders by using a retrospective case review. METHOD: Forty-eight consecutive clinical case summaries from an infant behavior clinic were reviewed by four experienced clinicians. Attachment disorders were coded as present or absent by using competing criteria and were scored by using a continuous scale of relationship functioning. RESULTS: The reliability of alternative criteria was acceptable, but the reliability of DSM-IV criteria in diagnosing attachment disorders was marginal. Preliminary validity for the criteria was demonstrated by the fact that more severe relationship disturbances were seen in infants diagnosed with attachment disorders than in infants diagnosed with other disorders. CONCLUSIONS: Standardized assessments of at-risk populations should be used to replicate these preliminary results; revision of DSM-IV criteria may be necessary to obtain adequate reliability for diagnosing attachment disorders.

Adult↗
PubMed2001

Can inattention/overactivity be an institutional deprivation syndrome?

Elevated rates of attention deficit and overactivity have been noted previously in samples of institution-reared children. This study examined the hypothesis that inattention/overactivity(I/O) might constitute a specific deprivation syndrome. One hundred and sixty five children adopted at varying ages (e.g., 0-42 months of age) into the UK following severe early deprivation were compared with 52 within-UK adoptees who did not suffer deprivation. The children were rated by teachers and parents on levels of I/O, conduct difficulties, and emotional difficulties using the Revised Rutter Scales. Data were collected at age 6 for the entire sample and at age 4 for the UK adoptees and for the subsample of Romanian children who entered the UK before the age of 2 years. Mean level analyses suggested a significant effect of duration of deprivation on I/O, but not on conduct or emotional difficulties. The effects of duration of deprivation were specific to I/O and were not accounted for by low birth weight, malnutrition, or cognitive impairment. Levels of I/O correlated with attachment disturbances. Furthermore, the effects of duration of deprivation on I/O did not attenuate over time. We conclude that I/O may well constitute an institutional deprivation syndrome, but that the type of attention deficit and overactivity exhibited by these children may present a different clinical picture from that of "ordinary" varieties of attention deficit disorder or hyperkinetic syndrome.

Adoption↗
PubMed2002

Snake oil, ethics, and the first amendment: what's a profession to do?

This article considers the appropriate legal and ethical response to those whose advocacy of "alternative" or unvalidated therapies places people at risk of harm. What are our professional responsibilities with respect to such advocacy, and what sorts of harm will justify government intervention?

Adolescent↗