Attachment representations and socio-emotional difficulties in alternative care: A comparison between residential,foster and family based children in Chile

Attachment has been assessed in children living in alternative care (AC) settings, such as Residential Homes (RC) and Foster Care (FC). However, no study has been conducted to compare attachment styles in residential, foster and parental care conducted as usual in the same country at the same point in time. There is also a lack of studies conducted in less developed countries. Therefore, the aim of this study was to compare outcomes for children living in three different types of care in Chile. Three groups of children (N = 77), living in (RC), (FC) and with biological parents (PC) were compared. Attachment styles, Indiscriminate Friendliness (IF) and socio-emotional/behavioral difficulties were assessed.Higher rates of secure attachment were observed in the RC group (36.1%) when compared to studies in RC in other countries (mean 18%). However, children in both types of AC were significantly more likely to have insecure and/or disorganized attachment styles than PC children. Higher rates of socio-emotional and behavioral problems were observed in RC (55.6%) and FC (50%) compared to PC (10%). Within type of AC, no significant differences were found, for attachment styles or for socio-emotional/behavioral difficulties, the only difference were the levels of IF, with children in RC having higher levels. As a conclusion, impact of placement in AC can vary between different countries, other factors, rather than only type of AC could better explain differences in attachment security for children. Implications for research and practices are discussed.     

Intervention effects on negative affect of CPS-referred children: Results of a randomized clinical trial

Exposure to early adversity places young children at risk for behavioral, physiological, and emotional dysregulation, predisposing them to a range of long-term problematic outcomes. Attachment and Biobehavioral Catch-up (ABC) is a 10-session intervention designed to enhance children's self-regulatory capabilities by helping parents to behave in nurturing, synchronous, and non-frightening ways. The effectiveness of the intervention was assessed in a randomized clinical trial, with parents who had been referred to Child Protective Services (CPS) for allegations of maltreatment. Parent–child dyads received either the ABC intervention or a control intervention. Following the intervention, children from the ABC intervention (n = 56) expressed lower levels of negative affect during a challenging task compared to children from the control intervention (n = 61).     

Attachment Quality in Very Low-Birthweight Premature Infants in Relation to Maternal Attachment Representations and Neurological Development

Objective. To study the development of attachment in very low-birthweight preterm infants with respect to neurological development and maternal attachment representations. Design. Emotional development in a high-risk sample (N = 79) of very low-birthweight preterm infants (≤ 1,500 g) is reported. The quality of attachment in preterm infants was classified using the Strange Situation Procedure at 14 postnatal months (corrected for prematurity) and was associated with maternal attachment representation assessed with the Adult Attachment Interview at 6 postnatal months. Neurological development at 14 months was taken into account. Results. The distribution of the quality of attachment in preterm infants (60.3% secure, 23.5% insecure - avoidant, 2.9% insecure - ambivalent, 10.3% insecure - disorganized, and 2.9% not classifiable) was comparable with results of studies of term infants. There was no correspondence between maternal representations of attachment and infant quality of attachment. However, neurologically impaired infants were more often insecurely than securely attached. Conclusions. Very low-birthweight preterm infants more often develop an insecure quality of attachment if their neurological outcome is impaired. Therefore, minimizing risk factors for the development of neurological deficits may have a preventive effect both on the somatic and on the emotional development of high-risk infants.     

Preschool teacher attachment,school readiness and risk of learning difficulties

Attachment is the emotional bond between children and their caregivers (parents or otherwise). Infants and young children usually have more than one selective attachment, and all of these attachment relationships, including those between children and teachers, have important effects on cognitive and social development. Secure attachment to a preschool teacher may help children to improve their preschool experience. Recent studies suggest that the adverse effect of inadequate preschool experiences can lead to skill deficiencies that mimic the effects of basic cognitive deficits. This study evaluates the relationships among attachment to preschool teachers, school readiness, and the risk for developing learning difficulties in preschoolers using three measures: the School Readiness 4-5 battery, the Precocious Identification of Learning Difficulties, and the Attachment Q Set. This study examined 152 preschoolers. The results showed that attachment to preschool teachers is related to linguistic development level, the psychomotor skills involved in school readiness, and learning difficulty risk.     

Moving an Evidence‐Based Parenting Program Into the Community

Attachment and Biobehavioral Catch‐up (ABC) is a parenting program developed to enhance sensitivity among parents of infants who experience early adversity. In several randomized clinical trials, the intervention's efficacy has been demonstrated. Moving interventions into the community with adequate fidelity is challenging, though, and intervention effects are often much smaller than when tested in randomized clinical trials. To enhance the likelihood that ABC is delivered with high fidelity, a microanalytic fidelity assessment was developed. Using this fidelity tool as a central component of training, supervision, and certification, changes in parent sensitivity for 108 families with children ages 6 months to 2 years were as large as those seen in laboratory settings. These findings are discussed with regard to implications for moving other evidence‐based interventions into the community.     

Maternal Depression, Children's Attachment Security, and Representational Development: An Organizational Perspective

Relations among maternal depression, child attachment, and children's representations of parents and self were examined. Participants included toddlers and their mothers with a history of major depressive disorder ( n = 63) or no history of mental disorder ( n = 68). Attachment was assessed at 20 and 36 months and representations of parents and self were assessed at 36 and 48 months. Depressive symptoms were assessed at all 3 time points. While early-occurring maternal depression had a negative impact on children's negative and positive representations of parents, attachment security mediated the relation between depressive symptoms and negative representations. Attachment security served as an intervening variable between maternal depression and changes in children's negative representations of self. Implications for prevention are highlighted.     

Placement in Foster Care Enhances Quality of Attachment Among Young Institutionalized Children

This study examined classifications of attachment in 42-month-old Romanian children ( N  = 169). Institutionalized since birth, children were assessed comprehensively, randomly assigned to care as usual (CAU) or to foster care, and compared to family-reared children. Attachment classifications for children in foster care were markedly different from those in the CAU. Importantly, children placed in foster care before 24 months were more likely to have secure attachments and if placed earlier were less likely to have disorganized or insecure-other attachments. Cognitive status predicted greater likelihood of organized attachment in the CAU and greater likelihood of secure attachment in the foster care and never-institutionalized groups. Foster care is an important intervention to reduce the adverse effects following early deprivation.     

Community implementation outcomes of Attachment and Biobehavioral Catch-up

Bringing evidence-based treatments to community practice is a critical challenge for the field. When implemented in the community, evidence-based treatments often fail to provide the benefits shown in laboratory settings. Therefore, when evidence-based treatments are transported to the community, it is essential to investigate implementation process and outcomes. The present study assessed whether Attachment and Biobehavioral Catch-up (ABC), an intervention for high-risk parents that has been shown to be efficacious in randomized clinical trials (RCTs), changed parent behavior in a community-based setting. This study examined data collected from 78 cases by 9 parent coaches in a diverse community setting in Hawaii, and compared data to benchmarks from RCTs. Parent coach fidelity was coded from intervention session video clips, and was also compared with benchmarks. Caregivers participating in ABC were primarily birth parents, and most were referred through Child Protective Services involvement or for reasons of harsh parenting or neglect. Parental behavior was assessed before and after intervention using a semi-structured play task. Increases in parental following the lead and delight, and decreases in parental intrusiveness, were observed; these changes were comparable to effect sizes observed in RCTs. Intent to treat analyses were conducted using behavioral data from videotaped sessions, and suggested that ABC also improved following the lead in parents who subsequently dropped out of treatment. These results support the viability of ABC for enhancing parenting behavior among parents at high risk for maltreatment, and demonstrate that parent coaches in community agencies can successfully implement ABC.     

Attitudes Toward Deafness and Security of Attachment Relationships Among Young Deaf Children and Their Parents

This study investigated deaf children's "security of attachment" relationships with their hearing parents and the relationship of parental attitudes toward deafness. Subjects included 30 deaf children and their hearing parents. The children ranged in age from 20 to 60 months. Instruments used included the Attachment Q-Set, the Attitudes to Deafness Scale, and parental interviews. As a group there were no differences between security of attachment scores of deaf children toward either of their parents; however, there were marked differences within individual dyads of mother-child/father-child relationships. In addition, negative correlations were found between parents' attitudes towards deafness scores and their deaf children's security of attachment scores. Implications for the field include the importance of inclusion of fathers in attachment studies and fathers' active participation in early intervention programs. The relationship between parental attitudes toward their children's disability (deafness) and attachment relationship provides further evidence for the critical role of early intervention in the development of children with special needs.     

The similarity of siblings' attachments to their mother

Do siblings develop similar attachment relationships with their mother? Attachment theory suggests that brothers and sisters growing up in the same family are likely to relate in similar ways to their parents, at least when parental attachment representations and interactive styles remain stable across time. In the current study, sibling attachment data from three research groups (from Pennsylvania State University, Leiden University, and the University of Western Ontario) have been pooled to assemble a sufficiently large sample of observations (N = 138 sibling pairs) for a detailed comparison of sibling attachment relationships. Spacing between the births, differences in maternal sensitivity, and gender of siblings were examined as possible sources of concordance of nonconcordance. Attachment security (including disorganized attachment) of each sibling was assessed with the Strange Situation procedure between 12 and 14 months after birth. Maternal sensitivity was observed with the same rating scale in a laboratory play session in one of the studies and in home observations in the others. Sibling relationships were found to be significantly concordant when classified as secure/nonsecure (62% concordance, p < .01, 1-tailed, intraclass correlation = .23) but not when further subcategorized. Maternal insensitivity to both siblings (shared environment) was associated with concordance of sibling nonsecurity. Siblings of the same gender were more likely to form concordant relationships with their mother (68%; p < .01, 1-tailed, intraclass correlation = .37) than those of opposite gender. Same-sex sibling concordance was comparable to the concordance found for monozygotic twins in earlier studies. Genetic factors may, therefore, play a relatively small role in the development of attachment.     

Attitudes Toward Deafness and Security of Attachment Relationships Among Young Deaf Children and Their Parents

This study investigated deaf children's "security of attachment" relationships with their hearing parents and the relationship of parental attitudes toward deafness. Subjects included 30 deaf children and their hearing parents. The children ranged in age from 20 to 60 months. Instruments used included the Attachment Q-Set, the Attitudes to Deafness Scale, and parental interviews. As a group there were no differences between security of attachment scores of deaf children toward either of their parents; however, there were marked differences within individual dyads of mother–child/father–child relationships. In addition, negative correlations were found between parents' attitudes towards deafness scores and their deaf children's security of attachment scores. Implications for the field include the importance of inclusion of fathers in attachment studies and fathers' active participation in early intervention programs. The relationship between parental attitudes toward their children's disability (deafness) and attachment relationship provides further evidence for the critical role of early intervention in the development of children with special needs.     

Supplementation of urban home visitation with a series of group meetings for parents and infants: results of a "real-world" randomized, controlled trial

OBJECTIVE: Home visitation has been shown to be effective in reducing rates of child maltreatment and in enhancing psychosocial outcomes in children and their parents. Even when available, however, it is underutilized by parents in some urban settings. We tested a supplemental 10-session group intervention for its ability to increase active participation in home visitation, enhance the quality of caregiving behavior of parents, and improve social developmental outcome in children. METHOD: A randomized controlled design was utilized, involving two separate cohorts of parents of 3- to 18-month old infants, totaling 148 parent-child dyads. The intervention focused on practical experience in promoting parent-infant attachment relationships. RESULTS: At 6 months follow-up, there was a substantial increase in the proportion of intervention group parents participating in home visitation, compared to parents in the control group (Fisher's exact p = .008). Parents in the intervention group exhibited a trend for improvement in their capacity to appropriately interpret infants' emotional cues (p = .08), independent of the effects of home visitation itself. Attrition in both the treatment and control groups was inversely associated with income and level of education. CONCLUSIONS: Group meetings may constitute an effective means of engaging stressed urban families in home visitation.     

Attachment in Chronically Underweight Young Children

This study, conducted in Chile with a low-income population, was designed to assess quality of mother-infant attachment in 17-21-month-old children of different nutritional status. 43 nutritionally healthy and 42 chronically underweight children were seen with their mothers in the Ainsworth Strange Situation. Children were classified in the conventional B (secure) and A and C (anxious) attachment patterns. In addition, an A/C pattern of anxious attachment was found to be frequent among children who consistently fail to gain adequate weight-for-age. Results showed a greater proportion (93%) of anxious attachments in the underweight group as compared to the group of children without a history of nutritional deficits (50%). Children classified as A/C presented the most serious weight deficits within the underweight group, indicating an association between severity of the nutritional deficits and insecure/disorganized attachments. Various hypotheses concerning the association between chronic nutritional deficits and insecure/disorganized attachments in infancy are discussed.     

Attachment Disorganization in Infancy: A Developmental Precursor to Maladaptive Social Information Processing at Age 8

This study examined infant attachment as a predictor of social information processing (SIP) in middle childhood (n = 82) while controlling for parental sensitivity in middle childhood. Attachment quality was assessed using the Strange Situation. Although attachment insecurity did not predict SIP, attachment disorganization positively predicted the early SIP steps of hostile attributional bias and aggressive goals. Children with disorganized attachments interpreted ambiguous provocations more negatively (as indicating more hostility, rejection, and disrespect and as resulting in more anger) and endorsed significantly more revenge and dominance goals than children with organized attachments. In contrast, parental sensitivity negatively predicted the later SIP step of positive expectations for aggressive responses. Results further our understanding of the adverse outcomes associated with attachment disorganization.     

Attachment status in children prenatally exposed to cocaine and other substances

Attachment status of children exposed in utero to cocaine, opiates, and other substances was examined at 18 months (n=860) and 36 months (n=732) corrected age. Children exposed to cocaine and opiates had slightly lower rates of attachment security (but not disorganization), and their insecurity was skewed toward ambivalent, rather than avoidant, strategies. Continued postnatal alcohol use was associated with higher rates of insecurity and disorganization at 18, but not 36, months of age. Stability of attachment across the 18-month period was barely above chance expectation. Attachment status at 18 months was associated with child temperament and caregiver-child interaction; at 36 months, attachment was associated with child temperament, child behavior problems, and caregivers' parenting self-esteem.     

Attachment in institutionalized children: A review and meta-analysis

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

留守儿童心理一致感、同伴依恋和心理健康的关系研究

为了探讨农村留守儿童的心理一致感、同伴依恋和心理健康之间的关系,对327名西南地区留守儿童施测心理一致感量表简版(SOC-13)、父母同伴依恋问卷(IPPA)中的同伴依恋分问卷和中国中学生心理健康量表(MSSMHS)。结果发现:(1)留守儿童的心理一致感、同伴依恋性别差异显著,女生的同伴依恋、心理一致感均显著高于男生;(2)留守儿童的心理一致感、同伴信任、同伴沟通、同伴依恋与心理健康水平呈显著正相关,同伴信任、心理一致感显著正向预测留守儿童的心理健康水平;同伴疏远与心理健康水平呈显著负相关,前者显著负向预测后者;(3)心理一致感在同伴依恋和心理健康之间存在部分中介效应,中介效应占总效应的4.9%。因此,可通过调节留守儿童的心理一致感和同伴依恋水平对其心理健康进行干预。     

Supplementation of urban home visitation with a series of group meetings for parents and infants: results of a “real-world” randomized, controlled trial

Objective: Home visitation has been shown to be effective in reducing rates of child maltreatment and in enhancing psychosocial outcomes in children and their parents. Even when available, however, it is underutilized by parents in some urban settings. We tested a supplemental 10-session group intervention for its ability to increase active participation in home visitation, enhance the quality of caregiving behavior of parents, and improve social developmental outcome in children.Method: A randomized controlled design was utilized, involving two separate cohorts of parents of 3- to 18-month old infants, totaling 148 parent-child dyads. The intervention focused on practical experience in promoting parent-infant attachment relationships.Results: At 6 months follow-up, there was a substantial increase in the proportion of intervention group parents participating in home visitation, compared to parents in the control group (Fisher’s exact p = .008). Parents in the intervention group exhibited a trend for improvement in their capacity to appropriately interpret infants’ emotional cues (p = .08), independent of the effects of home visitation itself. Attrition in both the treatment and control groups was inversely associated with income and level of education.Conclusions: Group meetings may constitute an effective means of engaging stressed urban families in home visitation.     

Tolerance of Infant Distress Among Working Parents: Examining the Roles of Attachment Anxiety and Work–Family Conflict

SYNOPSIS

Objective. Working parents of young children often face work–family conflict, but little is known about the impact of this stressor on distress tolerance in the parenting role. We examined whether work–family conflict is associated with heightened work–family guilt and reduced infant distress tolerance, and we tested whether these effects are strongest among parents high in attachment anxiety. Design. In an experimental study of 233 parents of children ages 1–3 years, parents first reported their attachment anxiety, then were randomly assigned to read a vignette depicting a subtype of work–family conflict—work-interfering-with-family (WIF) conflict—or to an attention control condition. Finally, parents reported their feelings of WIF-guilt and completed an infant distress tolerance paradigm. Results. Attachment anxiety predicted greater WIF-guilt and less distress tolerance cry task persistence and moderated associations between experimental condition and outcomes: Parents with low attachment anxiety reported less WIF-guilt when primed with WIF-conflict than parents with average or high attachment anxiety, and parents with high attachment anxiety displayed less distress tolerance when primed compared to parents with low or average attachment anxiety. Conclusions. Working parents with low attachment anxiety may fare better emotionally in the face of WIF-conflict than their peers with higher attachment anxiety. High attachment anxiety may represent a risk factor for the negative effects of WIF-conflict on distress tolerance in response to infant crying. Future work should explore interventions to support working parents with high attachment anxiety.     

Security of attachment and preschool friendships

Attachment theory proposes that the quality of the mother-child tie predicts the quality of a child's other close relationships. The purpose of this study was to test whether security of attachment to mother is related to the quality of a preschooler's best friendships. 33 4-year-old and their best friends participated (mean age = 46 months). Attachment Q-set data were collected to score security of mother-child attachment. Security data were used to classify the friend pairs as secure-secure or secure-insecure. Best friend dyads were observed for a 1-hour free-play session. Each pair's behavior was described with the Dyadic Relationships Q-set, a measure designed to describe the behavior of a pair of children. Secure-secure pairs were more harmonious, less controlling, more responsive, and happier than secure-insecure pairs. The results are related to previous work on attachment and social competence.