Attachment in children

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Mother and child MaternalBond.jpg
Mother and child

Attachment in children is "a biological instinct in which proximity to an attachment figure is sought when the child senses or perceives threat or discomfort. Attachment behaviour anticipates a response by the attachment figure which will remove threat or discomfort". [1] [2] [3] Attachment also describes the function of availability, which is the degree to which the authoritative figure is responsive to the child's needs and shares communication with them. Childhood attachment can define characteristics that will shape the child's sense of self, their forms of emotion-regulation, and how they carry out relationships with others. [4] Attachment is found in all mammals to some degree, especially primates.

Contents

Attachment theory has led to a new understanding of child development. Children develop different patterns of attachment based on experiences and interactions with their caregivers at a young age. Four different attachment classifications have been identified in children: secure attachment, anxious-ambivalent attachment, anxious-avoidant attachment, and disorganized attachment. Attachment theory has become the dominant theory used today in the study of infant and toddler behavior and in the fields of infant mental health, treatment of children, and related fields.

Attachment theory and children

Attachment theory (developed by the psychoanalyst Bowlby 1969, 1973, 1980) is rooted in the ethological notion that a newborn child is biologically programmed to seek proximity with caregivers, and this proximity-seeking behavior is naturally selected. [5] [6] [7] Through repeated attempts to seek physical and emotional closeness with a caregiver and the responses the child gets, the child develops an internal working model (IWM) that reflects the response of the caregiver to the child. According to Bowlby, attachment provides a secure base from which the child can explore the environment, a haven of safety to which the child can return when he or she is afraid or fearful. Bowlby's colleague Mary Ainsworth identified that an important factor which determines whether a child will have a secure or insecure attachment is the degree of sensitivity shown by their caregiver:

The sensitive caregiver responds socially to attempts to initiate social interaction, playfully to his attempts to initiate play. She picks him up when he seems to wish it, and puts him down when he wants to explore. When he is distressed, she knows what kinds and degree of soothing he requires to comfort him – and she knows that sometimes a few words or a distraction will be all that is needed. On the other hand, the mother who responds inappropriately tries to socialize with the baby when he is hungry, play with him when he is tired, or feed him when he is trying to initiate social interaction. [8]

However, it should be recognized that "even sensitive caregivers get it right only about 50 percent of the time. Their communications are either out of synch, or mismatched. There are times when parents feel tired or distracted. The telephone rings or there is breakfast to prepare. In other words, attuned interactions rupture quite frequently. But the hallmark of a sensitive caregiver is that the ruptures are managed and repaired." [9]

Attachment classification in children: the Strange Situation Protocol

William Blake's poem "Infant Joy" explores how to name a child and feel emotionally attached to it. This copy, Copy AA, printed and painted in 1826, is currently held by the Fitzwilliam Museum. Blake Infant Joy Copy AA 25.jpg
William Blake's poem "Infant Joy" explores how to name a child and feel emotionally attached to it. This copy, Copy AA, printed and painted in 1826, is currently held by the Fitzwilliam Museum.

The most common and empirically supported method for assessing attachment in infants (12 months – 20 months) is the Strange Situation Protocol, developed by Mary Ainsworth as a result of her careful in-depth observations of infants with their mothers in Uganda(see below). [11] The Strange Situation Protocol is a research, not a diagnostic, tool and the resulting attachment classifications are not 'clinical diagnoses.' While the procedure may be used to supplement clinical impressions, the resulting classifications should not be confused with the clinically diagnosed 'Reactive Attachment Disorder (RAD).' The clinical concept of RAD differs in a number of fundamental ways from the theory and research driven attachment classifications based on the Strange Situation Procedure. The idea that insecure attachments are synonymous with RAD is, in fact, not accurate and leads to ambiguity when formally discussing attachment theory as it has evolved in the research literature. This is not to suggest that the concept of RAD is without merit, but rather that the clinical and research conceptualizations of insecure attachment and attachment disorder are not synonymous.

The 'Strange Situation' is a laboratory procedure used to assess infant patterns of attachment to their caregiver. In the procedure, the mother and infant are placed in an unfamiliar playroom equipped with toys while a researcher observes/records the procedure through a one-way mirror. The procedure consists of eight sequential episodes in which the child experiences both separation from and reunion with the mother as well as the presence of an unfamiliar stranger. [11] The protocol is conducted in the following format unless modifications are otherwise noted by a particular researcher:

Mainly on the basis of their reunion behaviours (although other behaviours are taken into account) in the Strange Situation Paradigm (Ainsworth et al., 1978; see below), infants can be categorized into three 'organized' attachment categories: Secure (Group B); Avoidant (Group A); and Anxious/Resistant (Group C). There are subclassifications for each group (see below). A fourth category, termed Disorganized (D), can also be assigned to an infant assessed in the Strange Situation although a primary 'organized' classification is always given for an infant judged to be disorganized. Each of these groups reflects a different kind of attachment relationship with the mother. A child may have a different type of attachment to each parent as well as to unrelated caregivers. Attachment style is thus not so much a part of the child's thinking, but is characteristic of a specific relationship. However, after about age five the child exhibits one primary consistent pattern of attachment in relationships. [12]

The pattern the child develops after age five demonstrates the specific parenting styles used during the developmental stages within the child. These attachment patterns are associated with behavioural patterns and can help further predict a child's future personality. [13]

Attachment patterns

"The strength of a child's attachment behaviour in a given circumstance does not indicate the 'strength' of the attachment bond. Some insecure children will routinely display very pronounced attachment behaviours, while many secure children find that there is no great need to engage in either intense or frequent shows of attachment behaviour". [14]

Secure attachment

A toddler who is securely attached to its parent (or other familiar caregiver) will explore freely while the caregiver is present, typically engages with strangers, is often visibly upset when the caregiver departs, and is generally happy to see the caregiver return. The extent of exploration and of distress are affected by the child's temperamental make-up and by situational factors as well as by attachment status, however. A child's attachment is largely influenced by their primary caregiver's sensitivity to their needs. Parents who consistently (or almost always) respond to their child's needs will create securely attached children. Such children are certain that their parents will be responsive to their needs and communications. [15]

In the traditional Ainsworth et al. (1978) coding of the Strange Situation, secure infants are denoted as "Group B" infants and they are further subclassified as B1, B2, B3, and B4. [11] Although these subgroupings refer to different stylistic responses to the comings and goings of the caregiver, they were not given specific labels by Ainsworth and colleagues, although their descriptive behaviours led others (including students of Ainsworth) to devise a relatively 'loose' terminology for these subgroups. B1's have been referred to as 'secure-reserved', B2's as 'secure-inhibited', B3's as 'secure-balanced,' and B4's as 'secure-reactive.' In academic publications however, the classification of infants (if subgroups are denoted) is typically simply "B1" or "B2" although more theoretical and review-oriented papers surrounding attachment theory may use the above terminology.

Securely attached children are best able to explore when they have the knowledge of a secure base to return to in times of need. When assistance is given, this bolsters the sense of security and also, assuming the parent's assistance is helpful, educates the child in how to cope with the same problem in the future. Therefore, secure attachment can be seen as the most adaptive attachment style. According to some psychological researchers, a child becomes securely attached when the parent is available and able to meet the needs of the child in a responsive and appropriate manner. At infancy and early childhood, if parents are caring and attentive towards their children, those children will be more prone to secure attachment. [16]

Anxious-resistant insecure attachment

Anxious-resistant insecure attachment is also called ambivalent attachment. [11] In general, a child with an anxious-resistant attachment style will typically explore little (in the Strange Situation) and is often wary of strangers, even when the caregiver is present. When the caregiver departs, the child is often highly distressed. The child is generally ambivalent when they return. [11] The Anxious-Ambivalent/Resistant strategy is a response to unpredictably responsive caregiving, and that the displays of anger or helplessness towards the caregiver on reunion can be regarded as a conditional strategy for maintaining the availability of the caregiver by preemptively taking control of the interaction. [17] [18]

The C1 subtype is coded when:

"...resistant behavior is particularly conspicuous. The mixture of seeking and yet resisting contact and interaction has an unmistakably angry quality and indeed an angry tone may characterize behavior in the preseparation episodes..." [11]

The C2 subtype is coded when:

"Perhaps the most conspicuous characteristic of C2 infants is their passivity. Their exploratory behavior is limited throughout the SS and their interactive behaviors are relatively lacking in active initiation. Nevertheless, in the reunion episodes they obviously want proximity to and contact with their mothers, even though they tend to use signalling rather than active approach, and protest against being put down rather than actively resisting release...In general the C2 baby is not as conspicuously angry as the C1 baby." [11]

Anxious-avoidant insecure attachment

A child with the anxious-avoidant insecure attachment style will avoid or ignore the caregiver – showing little emotion when the caregiver departs or returns. The child will not explore very much regardless of who is there. Infants classified as anxious-avoidant (A) represented a puzzle in the early 1970s. They did not exhibit distress on separation, and either ignored the caregiver on their return (A1 subtype) or showed some tendency to approach together with some tendency to ignore or turn away from the caregiver (A2 subtype). Ainsworth and Bell theorised that the apparently unruffled behaviour of the avoidant infants is in fact as a mask for distress, a hypothesis later evidenced through studies of the heart-rate of avoidant infants. [19] [20]

Infants are depicted as anxious-avoidant insecure when there is:

"...conspicuous avoidance of the mother in the reunion episodes which is likely to consist of ignoring her altogether, although there may be some pointed looking away, turning away, or moving away...If there is a greeting when the mother enters, it tends to be a mere look or a smile...Either the baby does not approach his mother upon reunion, or they approach in 'abortive' fashions with the baby going past the mother, or it tends to only occur after much coaxing...If picked up, the baby shows little or no contact-maintaining behavior; he tends not to cuddle in; he looks away and he may squirm to get down." [11]

Ainsworth's narrative records showed that infants avoided the caregiver in the stressful Strange Situation Procedure when they had a history of experiencing rebuff of attachment behaviour. The child's needs are frequently not met and the child comes to believe that communication of needs has no influence on the caregiver. Ainsworth's student Mary Main theorised that avoidant behaviour in the Strange Situational Procedure should be regarded as 'a conditional strategy, which paradoxically permits whatever proximity is possible under conditions of maternal rejection' by de-emphasising attachment needs. [21] Main proposed that avoidance has two functions for an infant whose caregiver is consistently unresponsive to their needs. Firstly, avoidant behaviour allows the infant to maintain a conditional proximity with the caregiver: close enough to maintain protection, but distant enough to avoid rebuff. Secondly, the cognitive processes organising avoidant behaviour could help direct attention away from the unfulfilled desire for closeness with the caregiver – avoiding a situation in which the child is overwhelmed with emotion ('disorganised distress'), and therefore unable to maintain control of themselves and achieve even conditional proximity. [22]

Disorganized/disoriented attachment

Ainsworth herself was the first to find difficulties in fitting all infant behaviour into the three classifications used in her Baltimore study. Ainsworth and colleagues sometimes observed 'tense movements such as hunching the shoulders, putting the hands behind the neck and tensely cocking the head, and so on. It was our clear impression that such tension movements signified stress, both because they tended to occur chiefly in the separation episodes and because they tended to be prodromal to crying. Indeed, our hypothesis is that they occur when a child is attempting to control crying, for they tend to vanish if and when crying breaks through'. [23] Such observations also appeared in the doctoral theses of Ainsworth's students. Crittenden, for example, noted that one abused infant in her doctoral sample was classed as secure (B) by her undergraduate coders because her strange situation behaviour was "without either avoidance or ambivalence, she did show stress-related stereotypic headcocking throughout the strange situation. This pervasive behaviour, however, was the only clue to the extent of her stress". [24]

Drawing on records of behaviours discrepant with the A, B, and C classifications, a fourth classification was added by Ainsworth's colleague Mary Main and Judith Solomon. [25] In the Strange Situation, the attachment system is expected to be activated by the departure and return of the caregiver. If the behaviour of the infant does not appear to the observer to be coordinated in a smooth way across episodes to achieve either proximity or some relative proximity with the caregiver, then it is considered 'disorganised' as it indicates a disruption or flooding of the attachment system (e.g. by fear). Infant behaviours in the Strange Situation Protocol coded as disorganised/disoriented include overt displays of fear; contradictory behaviours or affects occurring simultaneously or sequentially; stereotypic, asymmetric, misdirected or jerky movements; or freezing and apparent dissociation. Lyons-Ruth has urged, however, that it should be wider 'recognized that 52% of disorganized infants continue to approach the caregiver, seek comfort, and cease their distress without clear ambivalent or avoidant behavior.' [26]

There is 'rapidly growing interest in disorganized attachment' from clinicians and policy-makers as well as researchers. [27] Yet the Disorganized/disoriented attachment (D) classification has been criticised by some for being too encompassing. [28] In 1990, Ainsworth put in print her blessing for the new 'D' classification, though she urged that the addition be regarded as 'open-ended, in the sense that subcategories may be distinguished', as she worried that the D classification might be too encompassing and might treat too many different forms of behaviour as if they were the same thing. [29] Indeed, the D classification puts together infants who use a somewhat disrupted secure (B) strategy with those who seem hopeless and show little attachment behaviour; it also puts together infants who run to hide when they see their caregiver in the same classification as those who show an avoidant (A) strategy on the first reunion and then an ambivalent-resistant (C) strategy on the second reunion. Perhaps responding to such concerns, George and Solomon have divided among indices of Disorganized/disoriented attachment (D) in the Strange Situation, treating some of the behaviours as a 'strategy of desperation' and others as evidence that the attachment system has been flooded (e.g. by fear, or anger). [30] Crittenden also argues that some behaviour classified as Disorganized/disoriented can be regarded as more 'emergency' versions of the avoidant and/or ambivalent/resistant strategies, and function to maintain the protective availability of the caregiver to some degree. Sroufe et al. have agreed that 'even disorganised attachment behaviour (simultaneous approach-avoidance; freezing, etc.) enables a degree of proximity in the face of a frightening or unfathomable parent'. [31] However, 'the presumption that many indices of "disorganisation" are aspects of organised patterns does not preclude acceptance of the notion of disorganisation, especially in cases where the complexity and dangerousness of the threat are beyond children's capacity for response'. [32] For example, 'Children placed in care, especially more than once, often have intrusions. In videos of the Strange Situation Procedure, they tend to occur when a rejected/neglected child approaches the stranger in an intrusion of desire for comfort, then loses muscular control and falls to the floor, overwhelmed by the intruding fear of the unknown, potentially dangerous, strange person'. [33]

Main and Hesse [34] found that most of the mothers of these children had suffered major losses or other trauma shortly before or after the birth of the infant and had reacted by becoming severely depressed. [35] In fact, 56% of mothers who had lost a parent by death before they completed high school subsequently had children with disorganized attachments. [34] Subsequently, studies, whilst emphasising the potential importance of unresolved loss, have qualified these findings. [36] For example, Solomon and George found that unresolved loss in the mother tended to be associated with disorganised attachment in their infant primarily when they had also experienced an unresolved trauma in their life prior to the loss. [37]

Later patterns and the dynamic-maturational model

Studies of older children have identified further attachment classifications. Main and Cassidy observed that disorganized behaviour in infancy can develop into a child using caregiving-controlling or punitive behaviour in order to manage a helpless or dangerously unpredictable caregiver. In these cases, the child's behaviour is organised, but the behaviour is treated by researchers as a form of 'disorganization' (D) since the hierarchy in the family is no longer organised according to parenting authority. [38]

Patricia McKinsey Crittenden has elaborated classifications of further forms of avoidant and ambivalent attachment behaviour. These include the caregiving and punitive behaviours also identified by Main and Cassidy (termed A3 and C3 respectively), but also other patterns such as compulsive compliance with the wishes of a threatening parent (A4). [39]

Crittenden's ideas developed from Bowlby's proposal that 'given certain adverse circumstances during childhood, the selective exclusion of information of certain sorts may be adaptive. Yet, when during adolescence and adult the situation changes, the persistent exclusion of the same forms of information may become maladaptive'. [40]

Crittenden proposed that the basic components of human experience of danger are two kinds of information: [41]

  1. 'Affective information' – the emotions provoked by the potential for danger, such as anger or fear. Crittenden terms this 'affective information'. In childhood this information would include emotions provoked by the unexplained absence of an attachment figure. Where an infant is faced with insensitive or rejecting parenting, one strategy for maintaining the availability of their attachment figure is to try to exclude from consciousness or from expressed behaviour any emotional information that might result in rejection.
  2. Causal or other sequentially ordered knowledge about the potential for safety or danger. In childhood this would include knowledge regarding the behaviours that indicate an attachment figure's availability as a secure haven. If knowledge regarding the behaviours that indicate an attachment figure's availability as a secure haven is subject to segregation, then the infant can try to keep the attention of their caregiver through clingy or aggressive behaviour, or alternating combinations of the two. Such behaviour may increase the availability of an attachment figure who otherwise displays inconsistent or misleading responses to the infant's attachment behaviours, suggesting the unreliability of protection and safety. [42]

Crittenden proposes that both kinds of information can be split off from consciousness or behavioural expression as a 'strategy' to maintain the availability of an attachment figure: 'Type A strategies were hypothesized to be based on reducing perception of threat to reduce the disposition to respond. Type C was hypothesized to be based on heightening perception of threat to increase the disposition to respond' [43] Type A strategies split off emotional information about feeling threatened and type C strategies split off temporally-sequenced knowledge about how and why the attachment figure is available. By contrast, type B strategies effectively use both kinds of information without much distortion. [44] For example: a toddler may have come to depend upon a type C strategy of tantrums in working to maintain the availability of an attachment figure whose inconsistent availability has led the child to distrust or distort causal information about their apparent behaviour. This may lead their attachment figure to get a clearer grasp on their needs and the appropriate response to their attachment behaviours. Experiencing more reliable and predictable information about the availability of their attachment figure, the toddler then no longer needs to use coercive behaviours with the goal of maintaining their caregiver's availability and can develop a secure attachment to their caregiver since they trust that their needs and communications will be heeded.

Significance of patterns

Research based on data from longitudinal studies, such as the National Institute of Child Health and Human Development Study of Early Child Care and the Minnesota Study of Risk and Adaption from Birth to Adulthood, and from cross-sectional studies, consistently shows associations between early attachment classifications and peer relationships as to both quantity and quality. Lyons-Ruth, for example, found that 'for each additional withdrawing behavior displayed by mothers in relation to their infant's attachment cues in the Strange Situation Procedure, the likelihood of clinical referral by service providers was increased by 50%.' [26]

Secure children have more positive and fewer negative peer reactions and establish more and better friendships. Insecure-ambivalent children have a tendency to anxiously but unsuccessfully seek positive peer interaction whereas insecure-avoidant children appear aggressive and hostile and may actively repudiate positive peer interaction. On only a few measures is there any strong direct association between early experience and a comprehensive measure of social functioning in early adulthood but early experience significantly predicts early childhood representations of relationships, which in turn predicts later self and relationship representations and social behaviour.

Studies have suggested that infants with a high-risk for Autism Spectrum Disorders (ASD) may express attachment security differently from infants with a low-risk for ASD. [45] Behavioural problems and social competence in insecure children increase or decline with deterioration or improvement in quality of parenting and the degree of risk in the family environment. [46]

Criticism of the Strange Situation Protocol

Michael Rutter describes the procedure in the following terms: [47]

Father and child Father with child.jpg
Father and child

"It is by no means free of limitations (see Lamb, Thompson, Gardener, Charnov & Estes, 1984). [48] To begin with, it is very dependent on brief separations and reunions having the same meaning for all children. This may be a major constraint when applying the procedure in cultures, such as that in Japan (see Miyake et al., 1985), where infants are rarely separated from their mothers in ordinary circumstances. [49] Also, because older children have a cognitive capacity to maintain relationships when the older person is not present, separation may not provide the same stress for them. Modified procedures based on the Strange Situation have been developed for older preschool children (see Belsky et al., 1994; Greenberg et al., 1990) but it is much more dubious whether the same approach can be used in middle childhood. [50] [51] Also, despite its manifest strengths, the procedure is based on just 20 minutes of behaviour. It can be scarcely expected to tap all the relevant qualities of a child's attachment relationships. Q-sort procedures based on much longer naturalistic observations in the home, and interviews with the mothers have developed in order to extend the data base (see Vaughn & Waters, 1990). [52] A further constraint is that the coding procedure results in discrete categories rather than continuously distributed dimensions. Not only is this likely to provide boundary problems, but also it is not at all obvious that discrete categories best represent the concepts that are inherent in attachment security. It seems much more likely that infants vary in their degree of security and there is need for a measurement systems that can quantify individual variation".

Ecological validity and universality of Strange Situation attachment classification distributions

With respect to the ecological validity of the Strange Situation, a meta-analysis of 2,000 infant-parent dyads, including several from studies with non-Western language and/or cultural bases found the global distribution of attachment categorizations to be A (21%), B (65%), and C (14%). [53] This global distribution was generally consistent with Ainsworth et al.'s (1978) original attachment classification distributions.

However, controversy has been raised over a few cultural differences in these rates of 'global' attachment classification distributions. In particular, two studies diverged from the global distributions of attachment classifications noted above. One study was conducted in North Germany in which more avoidant (A) infants were found than global norms would suggest, and the other in Sapporo, Japan, where more resistant (C) infants were found. [54] [55] Of these two studies, the Japanese findings have sparked the most controversy as to the meaning of individual differences in attachment behaviour as originally identified by Ainsworth et al. (1978).

In a recent study conducted in Sapporo, Behrens et al. (2007) found attachment distributions consistent with global norms using the six-year Main & Cassidy scoring system for attachment classification. [38] [56] In addition to these findings supporting the global distributions of attachment classifications in Sapporo, Behrens et al. also discuss the Japanese concept of amae and its relevance to questions concerning whether the insecure-resistant (C) style of interaction may be engendered in Japanese infants as a result of the cultural practice of amae.

A separate study was conducted in Korea, to help determine if mother-infant attachment relationships are universal or culture-specific. The results of the study of infant-mother attachment were compared to a national sample and showed that the four attachment patterns, secure, avoidance, ambivalent, and disorganized, exist in Korea as well as other varying cultures. [57]

Van IJzendoorn and Kroonenberg conducted a meta-analysis of various countries, including Japan, Israel, Germany, China, the UK and the USA using the Strange Situation. The research showed that though there were cultural differences, the four basic patterns, secure, avoidance, ambivalent, and disorganized can be found in every culture in which studies have been undertaken, even where communal sleeping arrangements are the norm. Selection of the secure pattern is found in the majority of children across cultures studied. This follows logically from the fact that attachment theory provides for infants to adapt to changes in the environment, selecting optimal behavioural strategies. [58] How attachment is expressed shows cultural variations which need to be ascertained before studies can be undertaken. [58]

Discrete or continuous attachment measurement

Regarding the issue of whether the breadth of infant attachment functioning can be captured by a categorical classification scheme, continuous measures of attachment security have been developed which have demonstrated adequate psychometric properties. These have been used either individually or in conjunction with discrete attachment classifications in many published reports. [59] [60] The original Richter's et al. (1998) scale is strongly related to secure versus insecure classifications, correctly predicting about 90% of cases. [60] Readers further interested in the categorical versus continuous nature of attachment classifications (and the debate surrounding this issue) should consult a paper by Fraley and Spieker and the rejoinders in the same issue by many prominent attachment researchers including J. Cassidy, A. Sroufe, E. Waters & T. Beauchaine, and M. Cummings. [61]

See also

Related Research Articles

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Reactive attachment disorder (RAD) is described in clinical literature as a severe and relatively uncommon disorder that can affect children, although these issues do occasionally persist into adulthood. RAD is characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way—known as the "inhibited form". In the DSM-5, the "disinhibited form" is considered a separate diagnosis named "disinhibited attachment disorder".

<span class="mw-page-title-main">Attachment theory</span> Psychological ethological theory about human relationships

Attachment theory is a psychological, evolutionary and ethological theory concerning relationships between humans. The most important tenet is that young children need to develop a relationship with at least one primary caregiver for normal social and emotional development. The theory was formulated by psychiatrist and psychoanalyst John Bowlby.

<span class="mw-page-title-main">John Bowlby</span> British psychiatrist and psychoanalyst (1907–1990)

Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attachment theory. A Review of General Psychology survey, published in 2002, ranked Bowlby as the 49th most cited psychologist of the 20th century.

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Cupboard love is a popular learning theory of the 1950s and 1960s based on the research of Sigmund Freud, Anna Freud, Melanie Klein and Mary Ainsworth. Rooted in psychoanalysis, the theory speculates that attachment develops in the early stages of infancy. This process involves the mother satisfying her infant's instinctual needs, exclusively. Cupboard love theorists conclude that during infancy, our primary drive is food which leads to a secondary drive for attachment.

<span class="mw-page-title-main">History of attachment theory</span>

Attachment theory, originating in the work of John Bowlby, is a psychological, evolutionary and ethological theory that provides a descriptive and explanatory framework for understanding interpersonal relationships between human beings.

Attachment-based therapy applies to interventions or approaches based on attachment theory, originated by John Bowlby. These range from individual therapeutic approaches to public health programs to interventions specifically designed for foster carers. Although attachment theory has become a major scientific theory of socioemotional development with one of the broadest, deepest research lines in modern psychology, attachment theory has, until recently, been less clinically applied than theories with far less empirical support. This may be partly due to lack of attention paid to clinical application by Bowlby himself and partly due to broader meanings of the word 'attachment' used amongst practitioners. It may also be partly due to the mistaken association of attachment theory with the pseudo-scientific interventions misleadingly known as attachment therapy. The approaches set out below are examples of recent clinical applications of attachment theory by mainstream attachment theorists and clinicians and are aimed at infants or children who have developed or are at risk of developing less desirable, insecure attachment styles or an attachment disorder.

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Mary Main was an American psychologist notable for her work in the field of attachment. A Professor at the University of California Berkeley, Main is particularly known for her introduction of the 'disorganized' infant attachment classification and for development of the Adult Attachment Interview and coding system for assessing states of mind regarding attachment. This work has been described as 'revolutionary' and Main has been described as having 'unprecedented resonance and influence' in the field of psychology.

<span class="mw-page-title-main">Secure attachment</span>

Secure attachment is classified by children who show some distress when their caregiver leaves but are able to compose themselves quickly when the caregiver returns. Children with secure attachment feel protected by their caregivers, and they know that they can depend on them to return. John Bowlby and Mary Ainsworth developed a theory known as attachment theory after inadvertently studying children who were patients in a hospital at which they were working. Attachment theory explains how the parent-child relationship emerges and provides influence on subsequent behaviors and relationships. Stemming from this theory, there are four main types of attachment: secure attachment, ambivalent attachment, avoidant attachment and disorganized attachment.

Patricia McKinsey Crittenden is an American psychologist known for her work in the development of attachment theory and science, her work in the field of developmental psychopathology, and for creation of the Dynamic-Maturational Model of Attachment and Adaptation (DMM).

<span class="mw-page-title-main">Maternal sensitivity</span>

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Attachment and health is psychological model which considers how attachment theory pertains to people's preferences and expectations for the proximity of others when faced with stress, threat, danger or pain. In 1982 the American Psychiatrist, Lawrence Kolb, noticed that patients with chronic pain displayed behaviours with their healthcare providers akin to what children might display with an attachment figure, thus marking one of the first applications of attachment theory to physical health. Development of adult attachment theory and adult attachment measures in the 1990s provided researchers with the means to apply attachment theory to health in a more systematic way. Since that time, it has been used to understand variation in stress response, health outcomes and health behaviour. Ultimately, the application of attachment theory to health care may enable health care practitioners to provide more personalized medicine by creating a deeper understanding of patient distress and allowing clinicians to better meet their needs and expectations.

Jude Anne Cassidy is Professor of Psychology and Distinguished Scholar-Teacher at the University of Maryland. Cassidy was awarded the American Psychological Association Boyd McCandless Young Scientist Award in 1991 for her early career contributions to Developmental Psychology. She is a Fellow of the American Psychological Association, Division 7 and the Association for Psychological Science.

Internal working model of attachment is a psychological approach that attempts to describe the development of mental representations, specifically the worthiness of the self and expectations of others' reactions to the self. This model is a result of interactions with primary caregivers which become internalized, and is therefore an automatic process. John Bowlby implemented this model in his attachment theory in order to explain how infants act in accordance with these mental representations. It is an important aspect of general attachment theory.

The dynamic-maturational model of attachment and adaptation (DMM) is a biopsychosocial model describing the effect attachment relationships can have on human development and functioning. It is especially focused on the effects of relationships between children and parents and between reproductive couples. It developed initially from attachment theory as developed by John Bowlby and Mary Ainsworth, and incorporated many other theories into a comprehensive model of adaptation to life's many dangers. The DMM was initially created by developmental psychologist Patricia McKinsey Crittenden and her colleagues including David DiLalla, Angelika Claussen, Andrea Landini, Steve Farnfield, and Susan Spieker.

References

  1. ↑ Prior & Glaser (2006) Understanding Attachment and Attachment Disorders, London: JKP, p.17
  2. ↑ Bowlby, J. (1960). "Separation Anxiety". Int J Psychoanal. 41: 89–113. PMID   13803480.
  3. ↑ Tronick, Morelli, & Ivey, 1992, p.568. "Until recently, scientific accounts ... of the infant's early social experiences converged on the view that the infant progresses from a primary relationship with one individual... to relationships with a growing number of people... This is an epigenetic, hierarchical view of social development. We have labeled this dominant view the continuous care and contact model (CCC...). The CCC model developed from the writings of Spitz..., Bowlby..., and Provence and Lipton... on institutionalized children and is represented in the psychological views of Bowlby...[and others]. Common to the different conceptual frameworks is the belief that parenting practices and the infant's capacity for social engagement are biologically based and conform to a prototypical form. Supporters of the CCC model generally recognize that the infant and caregiver are able to adjust to a range of conditions, but they consider the adjustments observed to reflect biological variation. However, more extreme views (e.g., maternal bonding) consider certain variants as nonadaptive and as compromising the child's psychological development. Bowlby's concept of monotropism is an exemplar of the CCC perspective..." (Tronick, Morelli, & Ivey, 1992, p. 568).
  4. ↑ Kayastha, P. (2010). Security of attachment in children and adolescents. Bangalore: Elsevier B.V.
  5. ↑ Bowlby, J. (1969). Attachment and loss: Vol. I: Attachment. New York: Basic Books.
  6. ↑ Bowlby, J. (1973). Attachment and loss: Vol. II: Separation: Anxiety and anger. New York: Basic Books.
  7. ↑ Bowlby, J. (1980). Attachment and loss: Vol. III: Loss. New York: Basic Books.
  8. ↑ Ainsworth, M. D. S. (1969) Ainsworth maternal scales. Available at http://www.psychology.sunysb.edu/attachment/measures/content/ainsworth_scales.html
  9. ↑ Howe, David (2011). Attachment Across the Lifecourse: A Brief Introduction. Macmillan International Higher Education. p. 70. ISBN   9780230346017.
  10. ↑ Morris Eaves; Robert N. Essick; Joseph Viscomi (eds.). "Songs of Innocence and of Experience, copy AA, object 25 (Bentley 25, Erdman 25, Keynes 25) "Infant Joy"". William Blake Archive . Retrieved January 16, 2014.
  11. 1 2 3 4 5 6 7 8 Ainsworth, M.D.S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Earlbaum.
  12. ↑ Cassidy, Jude; Shaver, Phillip R., eds. (2002). Handbook of Attachment: Theory, Research, and Clinical Applications. NY: Guilford. ISBN   9781572308268.
  13. ↑ Snyder, R.; Shapiro, S.; Treleaven, D. (2012). "Attachment Theory and Mindfulness". Journal of Child & Family Studies. 21 (5): 709–717. doi:10.1007/s10826-011-9522-8. S2CID   56009083.
  14. ↑ Howe, D. (2011) Attachment across the lifecourse, London: Palgrave, p.13
  15. ↑ Schacter, D.L. et al. (2009). Psychology, Second Edition. New York: Worth Publishers. pp.441
  16. ↑ Aronoff, J (2012). "Parental Nurturance in the Standard Cross-Cultural Sample: Theory, Coding, and Scores". Cross-Cultural Research. 46 (4): 315–347. doi:10.1177/1069397112450851. S2CID   147304847.
  17. ↑ Solomon, J.; George, C.; De Jong, A. (1995). "Children classified as controlling at age six: Evidence of disorganized representational strategies and aggression at home and at school". Development and Psychopathology. 7 (3): 447. doi:10.1017/s0954579400006623. S2CID   146576663.
  18. ↑ Crittenden, P. (1999) 'Danger and development: the organisation of self-protective strategies' in Atypical Attachment in Infancy and Early Childhood Among Children at Developmental Risk ed. Joan I. Vondra & Douglas Barnett, Oxford: Blackwell pp. 145-171
  19. ↑ Ainsworth, MD; Bell, SM (1970). "Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation". Child Dev. 41 (1): 49–67. doi:10.2307/1127388. JSTOR   1127388. PMID   5490680.
  20. ↑ Sroufe, A.; Waters, E. (1977). "Attachment as an Organizational Construct". Child Dev. 48 (4): 1184–1199. CiteSeerX   10.1.1.598.3872 . doi:10.1111/j.1467-8624.1977.tb03922.x. JSTOR   1128475.
  21. ↑ Main, M (1979). "The "ultimate" causation of some infant attachment phenomena". Behavioral and Brain Sciences. 2 (4): 640–643. doi:10.1017/s0140525x00064992. S2CID   144105265.
  22. ↑ Main, M. (1977a) Analysis of a peculiar form of reunion behaviour seen in some day-care children. In R. Webb (ed.) Social Development in Childhood (pp.33-78), Baltimore: Johns Hopkins
  23. ↑ Ainsworth, M.D., Blehar, M, Waters, E, & Wall, S. (1978) Patterns of Attachment: A Psychological Study of the Strange Situation, Hillsdale, NJ: Lawrence Erlbaum, p.282
  24. ↑ Crittenden, P.M. (1983) 'Mother and Infant Patterns of Attachment' Unpublished PhD Dissertation, University of Virginia, May 1983, p.73
  25. ↑ Main, Mary; Solomon, Judith (1990). "Procedures for Identifying Infants as Disorganized/Disoriented during the Ainsworth Strange Situation". In Greenberg, Mark T.; Cicchetti, Dante; Cummings, E. Mark (eds.). Attachment in the Preschool Years: Theory, Research, and Intervention. Chicago: University of Chicago Press. pp. 121–60. ISBN   978-0-226-30630-8.
  26. 1 2 Lyons-Ruth, K; Bureau, JF; Easterbrooks, MA; Obsuth, I; Hennighausen, K; Vulliez-Coady, L (2013). "Parsing the construct of maternal insensitivity: distinct longitudinal pathways associated with early maternal withdrawal". Attach Hum Dev. 15 (5–6): 562–582. doi:10.1080/14616734.2013.841051. PMC   3861901 . PMID   24299135.
  27. ↑ Kochanska, G; Kim, S (2013). "Early Attachment Organization With Both Parents and Future Behavior Problems: From Infancy to Middle Childhood". Child Dev. 84 (1): 283–296. doi:10.1111/j.1467-8624.2012.01852.x. PMC   3530645 . PMID   23005703.
  28. ↑ Svanberg, P.O. (2009). Promoting a secure attachment through early assessment and interventions. In J. Barlow & P.O. Svanberg (Eds.) Keeping the Baby in Mind, (pp. 100-114), London: Routledge.
  29. ↑ Ainsworth, M. (1990). 'Epilogue' in Attachment in the Preschool Years, ed. M.T. Greenberg, D. Ciccheti & E.M. Cummings. Chicago, IL: Chicago University Press, pp.463-488
  30. ↑ Solomon, J. & George, C. (1999a) The place of disorganisation in attachment theory. In Judith Solomon & Carol George (Eds) Attachment Disorganisation (pp3-32), p.27, NY: Guilford
  31. ↑ Sroufe, A. Egeland, B., Carlson, E. & Collins, W.A. (2005) The Development of the person: the Minnesota study of risk and adaptation from birth to adulthood, NY: Guilford Press, p.245
  32. ↑ Crittenden, P. (1999) 'Danger and development: the organisation of self-protective strategies' in Atypical Attachment in Infancy and Early Childhood Among Children at Developmental Risk ed. Joan I. Vondra & Douglas Barnett, Oxford: Blackwell pp. 159-160
  33. ↑ Crittenden, P. & Landini, A (2011) Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis, NY: W.W. Norton, p.269
  34. 1 2 Main, Mary; Hesse, Erik (1993). "Parents' Unresolved Traumatic Experiences Are Related to Infant Disorganized Attachment Status: Is Frightened and/or Frightening Parental Behavior the Linking Mechanism?". In Greenberg, Mark T.; Cicchetti, Dante; Cummings, E. Mark (eds.). Attachment in the Preschool Years: Theory, Research, and Intervention. Chicago: University of Chicago Press. pp. 161–84. ISBN   978-0-226-30630-8.
  35. ↑ Colin Murray Parkes (2006). Love and Loss. Routledge, London and New York. p. 13. ISBN   978-0-415-39041-5.
  36. ↑ Madigan, S; Bakermans-Kranenburg, MJ; Van Ijzendoorn, MH; Moran, G; Pederson, DR; Benoit, D (2006). "Unresolved states of mind, anomalous parental behavior, and disorganized attachment: A review and meta-analysis of a transmission gap". Attach Hum Dev. 8 (2): 89–111. doi:10.1080/14616730600774458. PMID   16818417. S2CID   1691924.
  37. ↑ Solomon, J., & George, C. (2006). Intergenerational transmission of dysregulated maternal caregiving: Mothers describe their upbringing and child rearing. In O. Mayseless (Ed). Parenting representations: Theory, research, and clinical implications (pp. 265-295) Cambridge, UK: Cambridge University Press.
  38. 1 2 Main, M.; Cassidy, J. (1988). "Categories of response to reunion with the parent at age 6: Predictable from infant attachment classifications and stable over a 1-month period". Dev Psychol. 24 (3): 415–426. doi:10.1037/0012-1649.24.3.415.
  39. ↑ Crittenden, P.M. (2008) Raising Parents: Attachment, Parenting and Child Safety, London: Routledge
  40. ↑ Bowlby, J. (1980) Loss, London: Penguin, p.45
  41. ↑ Strathearn, L; Fonagy, P; Amico, J; Montague, PR (2009). "Adult attachment predicts mother's brain and peripheral oxytocin response to infant cues". Neuropsychopharmacology. 34 (13): 2655–2666. doi:10.1038/npp.2009.103. PMC   3041266 . PMID   19710635.
  42. ↑ Landa, S.; Duschinsky, R. (2013). "Letters from ainsworth: contesting the 'organization' of attachment (comment on "Crittenden's dynamic–maturational model of attachment and adaptation")". J Can Acad Child Adolesc Psychiatry. 22 (2): 172–177. PMC   3647635 . PMID   23667365.
  43. ↑ p.435 in Crittenden, P; Newman, L (2010). "Comparing models of borderline personality disorder: Mothers' experience, self-protective strategies, and dispositional representations". Clin Child Psychol Psychiatry. 15 (3): 433–451. doi:10.1177/1359104510368209. PMID   20603429. S2CID   206707532.
  44. ↑ Crittenden, PM (1992). "Children's strategies for coping with adverse home environments". Child Abuse Negl. 16 (3): 329–343. doi: 10.1016/0145-2134(92)90043-q . PMID   1617468.
  45. ↑ Haltigan, JD; Ekas, NV; Seifer, R; Messinger, DS (2011). "Attachment security in infants at-risk for autism spectrum disorders". J Autism Dev Disord. 41 (7): 962–967. doi:10.1007/s10803-010-1107-7. PMC   4486071 . PMID   20859669.
  46. ↑ Berlin LJ, Cassidy J, Appleyard K (2008). "The Influence of Early Attachments on Other Relationships". In Cassidy J, Shaver PR (eds.). Handbook of Attachment: Theory, Research and Clinical Applications. New York and London: Guilford Press. pp. 333–47. ISBN   978-1-59385-874-2.
  47. ↑ Rutter, M (1995). "Clinical implications of attachment concepts: retrospect and prospect". J Child Psychol Psychiatry. 36 (4): 549–571. doi:10.1111/j.1469-7610.1995.tb02314.x. PMID   7650083.
  48. ↑ Lamb, M.; Thompson, R. A.; Gardener, W. P.; Charnov, E. L.; Estes, D. (1984). "Security of infantile attachment as assessed in the "strange situation": Its study and biological interpretation". Behav Brain Sci. 7: 127–147. doi:10.1017/s0140525x00026522. S2CID   146217249.
  49. ↑ Miyake, Chen, & Campos (1985). Infant temperament and mother's mode of interaction and attachment in Japan; an interim report; In I. Bretherton & E Waters (Eds), Growing points of attachment theory and research. Monographs of the Society for Research in Child Development, 50, Serial No 209, 276-297.
  50. ↑ Belsky, J. & Cassidy, J. (1994). Attachment Theory and Evidence. In M. Rutter & D. Hay (Eds) Development Through Life; A Handbook For Clinicians (pp. 373-402). Oxford; Blackwell Scientific Publications.
  51. ↑ Greenberg, M. T., Cicchetti, D. & Cummings, M. (Eds), (1990). Attachment in the preschool years; theory research and intervention. Chicago; University of Chicago Press.
  52. ↑ Vaughn, BE; Waters, E (1990). "Attachment behaviour at home and in the laboratory". Child Dev. 61 (6): 1965–1973. doi:10.2307/1130850. JSTOR   1130850. PMID   2083508.
  53. ↑ Van IJzendoorn, M.H.; Kroonenberg, P.M. (1988). "Cross-cultural patterns of attachment: A meta-analysis of the strange-situation". Child Dev. 59 (1): 147–156. doi:10.2307/1130396. hdl: 1887/11634 . JSTOR   1130396.
  54. ↑ Grossmann, K.; Grossmann, K.E.; Huber, F.; Wartner, U. (1981). "German children's behavior toward their mothers at 12 months and their fathers at 18 months in Ainsworth's strange situation". International Journal of Behavioral Development. 4 (2): 157–184. doi:10.1177/016502548100400202. S2CID   145760368.
  55. ↑ Takahashi, K. (1986). "Examining the Strange-Situation procedure with Japanese mothers and 12-month-old infants". Dev Psychol. 22 (2): 265–270. doi:10.1037/0012-1649.22.2.265.
  56. ↑ Behrens, K. Y.; Main, M.; Hesse, E. (2007). "Mothers' Attachment Status as Determined by the Adult Attachment Interview Predicts Their 6-Year-Olds' Reunion Responses: A Study Conducted in Japan". Dev Psychol. 43 (6): 1553–1567. doi:10.1037/0012-1649.43.6.1553. PMID   18020832.
  57. ↑ Jin, MK; Jacobvitz, D; Hazen, N; Jung, SH (2012). "Maternal sensitivity and infant attachment security in Korea: Cross-cultural validation of the Strange Situation". Attach Hum Dev. 14 (1): 33–44. doi:10.1080/14616734.2012.636656. PMID   22191605. S2CID   32742308.
  58. 1 2 van IJzendoorn MH, Sagi-Schwartz A (2008). "Cross-Cultural Patterns of Attachment; Universal and Contextual Dimensions". In Cassidy J, Shaver PR (eds.). Handbook of Attachment: Theory, Research and Clinical Applications. New York and London: Guilford Press. pp. 880–905. ISBN   978-1-59385-874-2.
  59. ↑ Richters, J. E.; Waters, E.; Vaughn, B. E. (1988). "Empirical classification of infant-mother relationships from interactive behavior and crying during reunion". Child Dev. 59 (2): 512–522. doi:10.2307/1130329. JSTOR   1130329. PMID   3359869.
  60. 1 2 Van IJzendoorn, M. H.; Kroonenberg, P. M. (1990). "Cross-cultural consistency of coding the strange situation". Infant Behavior and Development. 13 (4): 469–485. doi:10.1016/0163-6383(90)90017-3. hdl: 1887/11624 .
  61. ↑ Fraley, C. R.; Spieker, S. J. (2003). "Are Infant Attachment Patterns Continuously or Categorically Distributed? A Taxometric Analysis of Strange Situation Behavior". Dev Psychol. 39 (3): 387–404. doi:10.1037/0012-1649.39.3.387. PMID   12760508.
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