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"Attachment disorders"
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Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care
Two disorders of attachment have been consistently identified in some young children following severe deprivation in early life: reactive attachment disorder and disinhibited social engagement disorder. However, less is known about whether signs of these disorders persist into adolescence. We examined signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years in 111 children who were abandoned at or shortly after birth and subsequently randomized to care as usual or to high-quality foster care, as well as in 50 comparison children who were never institutionalized. Consistent with expectations, those who experienced institutional care in early life had more signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years than children never institutionalized. In addition, using a conservative intent-to-treat approach, those children randomized to foster care had significantly fewer signs of reactive attachment disorder and disinhibited social engagement disorder than those randomized to care as usual. Analyses within the ever institutionalized group revealed no effects of the age of placement into foster care, but number of caregiving disruptions experienced and the percentage of the child's life spent in institutional care were significant predictors of signs of attachment disorders assessed in early adolescence. These findings indicate that adverse caregiving environments in early life have enduring effects on signs of attachment disorders, and provide further evidence that high-quality caregiving interventions are associated with reductions in both reactive attachment disorder and disinhibited social engagement disorder.
Journal Article
Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial
Young children who have experienced early adversity are at risk for developing disorganized attachments. The efficacy of Attachment and Biobehavioral Catch-up (ABC), an intervention targeting nurturing care among parents identified as being at risk for neglecting their young children, was evaluated through a randomized clinical trial. Attachment quality was assessed in the Strange Situation for 120 children between 11.7 and 31.9 months of age (M = 19.1, SD = 5.5). Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment.
Journal Article
Attachment theory in adult mental health : a guide to clinical practice
\"In the fifty years since its inception, John Bowlby's attachment theory has been powerfully influential on developmental psychology and, more recently, mental health. Bringing together the experience of a diverse range of mental health practitioners and researchers who routinely use attachment theory in their own work, Attachment Theory in Adult Mental Health provides a guide to using attachment theory in everyday practice. Adam N. Danquah and Katherine Berry present a wide-ranging and practical approach to the topic which includes studies on clinical practice, the provision of mental health services and accommodating intercultural perspectives. Section One covers the basics of attachment theory and practice. Section Two presents clinical problems and presentations including, among others, the treatment of depression, anxiety disorders, psychosis, personality disorder and eating disorders. Section Three addresses the needs of specific populations, discussing the influence of sociocultural factors like gender, ethnicity and age. Finally, Section Four examines the organisation and the practitioner, including using the theory to organise services and how individual therapists can integrate their own attachment histories into their approach. Including the most up-to-date theories and practice in the field, Attachment Theory in Adult Mental Health is ideal for psychologists and psychological therapists, counsellors, psychiatrists, occupational therapists, social workers and mental health service managers and commissioners\"--Provided by publisher.
Book
The Significance of Insecure and Disorganized Attachment for Children's Internalizing Symptoms: A Meta-Analytic Study
This meta-analytic review examines the association between attachment and internalizing symptomatology during childhood, and compares the strength of this association with that for externalizing symptomatology. Based on 42 independent samples (N = 4,614), the association between insecurity and internalizing symptoms was small, yet significant (d = 0.15, CI 0.06~0.25) and not moderated by assessment age of internalizing problems. Avoidance, but not resistance (d = 0.03, CI - 0.11~0.17) or disorganization (d = 0.08, CI - 0.06~0.22), was significantly associated with internalizing symptoms (d = 0.17, CI 0.03~0.31). Insecurity and disorganization were more strongly associated with externalizing than internalizing symptoms. Discussion focuses on the significance of attachment for the development of internalizing versus externalizing symptomatology.
Journal Article
Dying to be Ill : true stories of medical deception
Most of us can recall a time when we pretended to be sick to reap the benefits that go along with illness. By playing sick, we gained sympathy, care, and attention, and were excused from our responsibilities. Though doing so on occasion is considered normal, there are those who carry their deceptions to the extreme. In this book, Dr. Marc Feldman describes people's strange motivations to fabricate or induce illness or injury to satisfy deep emotional needs. Doctors, family members, and friends are lured into a costly, frustrating, and potentially deadly web of deceit. From the mother who shaves her child's head and tells her community he has cancer, to the co-worker who suffers from a string of incomprehensible \"tragedies,\" to the false epilepsy victim who monopolizes her online support group, \"disease forgery\" is ever-present in the media and in many people's lives.
Book
Infant negative reactivity defines the effects of parent–child synchrony on physiological and behavioral regulation of social stress
How infants shape their own development has puzzled developmentalists for decades. Recent models suggest that infant dispositions, particularly negative reactivity and regulation, affect outcome by determining the extent of parental effects. Here, we used a microanalytic experimental approach and proposed that infants with varying levels of negative reactivity will be differentially impacted by parent–infant synchrony in predicting physiological and behavioral regulation of increasing social stress during an experimental paradigm. One hundred and twenty-two mother–infant dyads (4–6 months) were observed in the face-to-face still face (SF) paradigm and randomly assigned to three experimental conditions: SF with touch, standard SF, and SF with arms’ restraint. Mother–infant synchrony and infant negative reactivity were observed at baseline, and three mechanisms of behavior regulation were microcoded; distress, disengagement, and social regulation. Respiratory sinus arrhythmia baseline, reactivity, and recovery were quantified. Structural equation modeling provided support for our hypothesis. For physiological regulation, infants high in negative reactivity receiving high mother–infant synchrony showed greater vagal withdrawal, which in turn predicted comparable levels of vagal recovery to that of nonreactive infants. In behavioral regulation, only infants low in negative reactivity who received high synchrony were able to regulate stress by employing social engagement cues during the SF phase. Distress was reduced only among calm infants to highly synchronous mothers, and disengagement was lowest among highly reactive infants experiencing high mother–infant synchrony. Findings chart two pathways by which synchrony may bolster regulation in infants of high and low reactivity. Among low reactive infants, synchrony builds a social repertoire for handling interpersonal stress, whereas in highly reactive infants, it constructs a platform for repeated reparation of momentary interactive “failures” and reduces the natural tendency of stressed infants to disengage from source of distress. Implications for the construction of synchrony-focused interventions targeting infants of varying dispositions are discussed.
Journal Article
Subtypes in bulimia nervosa: the role of eating disorder symptomatology, negative affect, and interpersonal functioning
The aim of the study was to investigate whether patients with bulimia nervosa (BN) could be subdivided into clinically meaningful groups reflecting the complex patterns of eating disorder symptoms and personality characteristics that face the clinician.
Seventy patients diagnosed with BN using the Eating Disorder Examination were assessed with measures of negative affect, attachment patterns, and interpersonal problems. An exploratory hierarchical cluster analysis was performed.
The study found two main subtypes differing primarily in terms of symptom severity and level of negative affect, but these subtypes were further subdivided into four clinically relevant subtypes: A dietary restraint/negative affect/high symptomatic group, an emotionally overcontrolled group, a low dietary restraint/emotionally underregulated group, and a high functioning/securely attached group.
The study indicates that cluster-analytic studies, including a broad range of instruments measuring eating disorder symptoms as well as negative affect, relational patterns, and other personality characteristics, may contribute to an integration of previously suggested models of subtypes in BN.
Journal Article