[Show abstract][Hide abstract] ABSTRACT: There is a paucity of research examining the stability of Unresolved/Disorganized (Unresolved) representations and associated scales of Unresolved Loss and Trauma, especially in high-risk samples in which Unresolved is more prevalent. Given the negative sequelae associated with Unresolved, understanding its developmental course is important. In this study, 55 adolescents were administered the Adult Attachment Interview prenatally, and again at 6 and 12 months postpartum. Findings revealed significant stability for the Unresolved classification over the transition to parenthood: Adolescents who were Unresolved prenatally were 8 and 18 times more likely to be classified as Unresolved when their infants were 6 and 12 months old, respectively. Growth curve modelling revealed that, on average, there was a steady linear decline in Unresolved loss scores over time, with a rate of change of 27% from the prenatal to 12 months postpartum assessments. There were also significant individual differences in this rate of change. Physical abuse was associated with higher levels of Unresolved loss at the prenatal assessment, and preoccupied attachment attenuated the likelihood of a decline over time in Unresolved loss scores. There was no significant mean rate of change for Unresolved trauma; however, there was considerable variability in scores, with some individuals increasing and others decreasing. Dismissing classifications and a history of sexual abuse were associated with higher levels of Unresolved trauma at the prenatal assessment, and severity of physical abuse was associated with increasing scores of Unresolved trauma over time. Theoretical and methodological implications of these findings are discussed.
Full-text · Article · Jan 2016 · Canadian Journal of Behavioural Science
[Show abstract][Hide abstract] ABSTRACT: Pregnant adolescents are a group at high risk for exposure to traumatic experiences. The present study aimed to examine if Trauma-Focused Cognitive Behavior Therapy (TF-CBT) typically applied to Posttraumatic Stress Disorder (PTSD), could also be applied to unresolved states of mind in a sample of socially at-risk pregnant adolescents. Forty-three adolescents who were in their second trimester of pregnancy and who also had positive indices of unresolved states of mind or symptoms of PTSD were randomly assigned to either the treatment as usual (parenting classes) or intervention (parenting classes + TF-CBT) group. Adolescent mother-infant dyads were then re-assessed at infant ages 6 and 12 months on a broad range of measures, including those specific to attachment, as well as to PTSD, and adolescent behavioral adjustment. Twenty-six of the 43 (60%) recruited subjects completed all components of the study protocol. Although there were no significant effects of the TF-CBT intervention on maternal attachment, infant attachment, PTSD diagnosis and adolescent behavioral adjustment, several study limitations restrict our ability to draw firm conclusions about the efficacy of TF-CBT for use in pregnant adolescents with complex trauma. The discussion offers insight and guidance for clinical work and future intervention research efforts with this vulnerable population.
No preview · Article · Feb 2015 · Attachment & Human Development
[Show abstract][Hide abstract] ABSTRACT: We explored the relation between maternal mind-mindedness (i.e., a mother's tendency to verbally refer to her infant's mental world through use of infant-directed mental state terms) and maternal attachment. Mothers (N = 76), classified prenatally as Autonomous, Dismissing, Preoccupied, and Unresolved using the Adult Attachment Interview (AAI), simulated speaking to their 6-month-old infants in positive and negative emotion contexts. Mothers' utterances were coded for frequency of use of emotion and cognition-related mind-minded terms. Results indicated a significant negative relation between coherence of mind scores on the AAI and emotion mind-mindedness in the positive emotion context. When differences between insecure attachment categories and mind-mindedness were explored, results indicated that mothers with Preoccupied attachments were significantly more likely to use emotion-related terms than mothers with Dismissing attachments and that these differences were most pronounced in the negative emotion context. A similar pattern was found for mothers with Unresolved attachments compared to those with organized (Autonomous, Dismissing, Preoccupied) attachment classifications, however use of emotion mind-minded terms did not differ by emotional context. Future research directions highlighting the importance of exploring the unique contribution of Preoccupied, Dismissing and Unresolved attachment and emotional context in the exploration of mind-mindedness are discussed.
Full-text · Article · Feb 2015 · Attachment & Human Development
[Show abstract][Hide abstract] ABSTRACT: The aim of the current study was to increase understanding of how victimization history impacts the longitudinal course of depression and anxiety in a sample of 55 adolescents emerging into parenthood. Adolescents were interviewed about their victimization experiences during their second trimester of pregnancy, and interviews were subsequently classified according the Maltreatment Classification Scale (Barnett, Manly, & Cicchetti, 1993). Adolescents reported on their symptoms of depression and anxiety prenatally and 6 and 12 months postpartum. Growth curve modeling revealed that, on average, there was a steady linear decline in depression and anxiety symptoms across the transition to parenthood, with a rate of change of 25% and 20%, respectively, from the prenatal assessment to 12 months postpartum. Sexual abuse history attenuated the likelihood of a decrease in depressive symptoms over time. Neglect history was associated with higher prenatal levels of anxiety, as well as a steeper decline in anxiety symptoms over time. Future research is needed to determine the role of poly-victimization in predicting the onset and change of depression and anxiety symptoms. Findings from the current study have the potential to aid in the design of preventative and intervention efforts to reduce risks of mental health difficulties in adolescent parents.
No preview · Article · May 2014 · Child Abuse & Neglect
[Show abstract][Hide abstract] ABSTRACT: Several studies have demonstrated associations between alexithymia, adult attachment styles, personality traits, and relationship adjustment. Only two studies, however, have explored associations between alexithymia and attachment representations. As part of a larger investigation of maternal and infant attachment, the current study explored this association in a sample of 97 pregnant women; in addition, measures of alexithymia and domains of the five-factor model (FFM) of personality were compared in predicting attachment security, assessed with the Adult Attachment Interview Coherence of Mind mind scale, and perceived relationship adjustment. Alexithymia negatively predicted coherence of mind; the domains of the FFM did not add significantly to the prediction. The Openness-to-Experience domain predicted relationship adjustment better than alexithymia. Contrary to findings from studies that assessed adult attachment styles, coherence of mind was unrelated to relationship adjustment and the FFM. The results suggest that alexithymia does not uniquely predict relationship adjustment beyond the domains of the FFM.
Full-text · Article · Mar 2014 · Comprehensive psychiatry
[Show abstract][Hide abstract] ABSTRACT: Empirical research supporting the contention that insecure attachment is related to internalizing behaviors has been inconsistent. Across 60 studies including 5,236 families, we found a significant, small to medium effect size linking insecure attachment and internalizing behavior (observed d = .37, 95% CI [0.27, 0.46]; adjusted d = .19, 95% CI [0.09, 0.29]). Several moderator variables were associated with differences in effect size, including concurrent externalizing behavior, gender, how the disorganized category was treated, observation versus questionnaire measures of internalizing behavior, age of attachment assessment, time elapsed between attachment and internalizing measure, and year of publication. The association between avoidant attachment and internalizing behavior was also significant and small to moderate (d = .29, 95% CI [0.12, 0.45]). The effect sizes comparing resistant to secure attachment and resistant to avoidant attachment were not significant. In 20 studies with 2,679 families, we found a small effect size linking disorganized attachment and internalizing behavior (observed d = .20, 95% CI [0.09, 0.31]); however, the effect size was not significant when adjusted for probable publication bias (d = .12, 95% CI [-0.02, 0.23]). The existing literature supports the general notion that insecure attachment relationships in early life, particularly avoidant attachment, are associated with subsequent internalizing behaviors, although effect sizes are not strong. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Full-text · Article · Jun 2012 · Developmental Psychology
[Show abstract][Hide abstract] ABSTRACT: This present student examines maltreatment experiences reported by 55 high-risk pregnant adolescents in response to a slightly adapted version of the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996 ). Previous research has suggested that the rates of unresolved states of mind regarding trauma in response to the AAI may be underestimated due to the lack of direct questions and associated probes regarding physical, sexual, and emotional abuse. We address this concern by including behaviorally phrased questions and probes regarding maltreatment experiences into the original format of the AAI and examine the concordance between reports of maltreatment experiences in response to the AAI and the Childhood Trauma Questionnaire (CTQ). Maltreatment experiences in response to the AAI were evaluated using the Maltreatment Classification Scale developed by Barnett, Manly, and Cicchetti (1993). We also examine the association between unresolved states of mind and dissociation using the Adolescent Dissociative Experience Scale. Results revealed a significant concordance between reports of maltreatment in response to the AAI and CTQ measures. Reports of maltreatment were prevalent in this sample: across the AAI and CTQ measures, 96% of pregnant adolescents reported some form of emotional abuse, 84% physical abuse, 59% sexual abuse, and 88% reported neglect. Sexual abuse history uniquely predicted unresolved status in response to the AAI. Self-reports of dissociation were significantly associated with unresolved states of mind. Results suggest that the inclusion of behaviorally focused questions and probes regarding maltreatment in the AAI protocol can further contribute to the clinical and theoretical value of this tool.
No preview · Article · Mar 2012 · Attachment & Human Development
[Show abstract][Hide abstract] ABSTRACT: The present study assessed the stability of atypical caregiver behaviors over six years. The sample included 81 mother-child dyads (27 children with cystic fibrosis, 27 with congenital heart disease, and 27 healthy controls). Attachment was assessed using the Strange Situation paradigm when the child was one year old. Atypical caregiver behaviors were assessed in the Strange Situation paradigm at one year and again in a reunion episode at seven years of age using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE). Stability of atypical caregiver behaviors over six years was established. Atypical caregiver behaviors assessed when the child was one year old were related to infant-caregiver disorganized attachment and were not associated with secure infant-caregiver attachment. The current study identifies that atypical caregiver behaviors remain stable over time which suggests that they could be targeted during interventions aimed at preventing or treating disorganized child-caregiver attachment relationships and associated negative outcomes.
Full-text · Article · May 2011 · Attachment & Human Development
[Show abstract][Hide abstract] ABSTRACT: Atypical maternal behavior has consistently been identified as a precursor of disorganized infant-mother attachment, but to date, no research has examined the role of atypical paternal behavior in the development of disorganized infant-father attachment. This study aims to enhance our understanding and conceptualization of infant-father attachment by examining the role of fathers' unresolved states of mind and the display of atypical paternal behavior in the development of disorganized infant-father attachment. Thirty-one middle-class couples participated in this study. Maternal and paternal Adult Attachment Interviews (C. George, N. Kaplan, & M. Main, 1996) were completed prenatally and at infant age 6 months, respectively. Infant-mother and infant-father dyads participated in the Strange Situation paradigm (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978) when the infants were 12 and 18 months of age, respectively. The Atypical Maternal Behavior Instrument for Assessment and Classification (E. Bronfman, E. Parsons, & K. Lyons-Ruth, 1999) was used to assess maternal and paternal behavior during the Strange Situation. Maternal states of mind regarding attachment predicted infant-mother attachment relationships, and paternal states of mind predicted infant-father attachment relationships. Atypical maternal behavior was associated with infant-mother disorganized attachment; however, atypical paternal behavior did not predict infant-father disorganized attachment. Thus, it is possible that other factors, yet to be uncovered, might contribute to the development of infant-father disorganized attachment.
Full-text · Article · May 2011 · Infant Mental Health Journal
[Show abstract][Hide abstract] ABSTRACT: Infant disorganized attachment is a significant predictor for later psychopathology. The Working Model of the Child Interview (WMCI; C.H. Zeanah, D. Benoit, & M.L. Barton, 1986) elicits and classifies caregivers' perceptions and subjective experience of their child and relationship with the child, which are related to concurrent and future attachment to the caregiver. However, when the WMCI was first developed, the disorganized attachment classification had not been fully developed, so the original WMCI did not include a classification that is linked to disorganized attachment. We adapted the WMCI coding scheme to include items similar to those identified by K. Lyons-Ruth, E. Bronfman, and E. Parsons (using the Atypical Maternal Behavior Instrument for Assessment and Classification, or AMBIANCE, 1999), which reflect disrupted caregiver behaviors associated with disorganized attachment. This resulted in a new WMCI-Disrupted (WMCI-D) scale and classification, disrupted. WMCI-D was used to code 35 WMCIs administered prenatally. A prenatal disrupted classification was significantly associated with caregiver unresolved classification on the Adult Attachment Interview (M. Main, N. Kaplan, & J. Cassidy, 1985), infant disorganized Strange Situation classification (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978), and disrupted caregiver behaviors toward the infant (using AMBIANCE; K. Lyons-Ruth et al., 1999), at infant age 12 months. These data suggest WMCI-D can capture disrupted caregiver internal representations, and identify dyads at risk for disorganized attachment and caregivers with unresolved mourning/trauma. These data also provide evidence for the convergent and predictive validity of the WMCI-D Scale.
No preview · Article · Mar 2009 · Infant Mental Health Journal
[Show abstract][Hide abstract] ABSTRACT: Although central to attachment theory, internal working models remain a useful heuristic in need of concretization. We compared the selective attention of organized and disorganized mothers using the emotional Stroop task. Both disorganized attachment and emotional Stroop response involve the coordination of strongly conflicting motivations under conditions of emotional arousal. Furthermore, much is known about the cognitive and neuromodulatory correlates of the Stroop that may inform attempts to substantiate the internal working model construct. We assessed 47 community mothers with the Adult Attachment Interview and the Working Model of the Child Interview in the third trimester of pregnancy. At 6 and 12 months postpartum, we assessed mothers with emotional Stroop tasks involving neutral, attachment, and emotion conditions. At 12 months, we observed their infants in the Strange Situation. Results showed that: disorganized attachment is related to relative Stroop reaction time, that is, unlike organized mothers, disorganized mothers respond to negative attachment/emotion stimuli more slowly than to neutral stimuli; relative speed of response is positively related to number of times the dyad was classified disorganized, and change in relative Stroop response time from 6 to 12 months is related to the match-mismatch status of mother and infant attachment classifications. We discuss implications in terms of automatic and controlled processing and, more specifically, cognitive threat tags, parallel distributed processing, and neuromodulation through norepinephrine and dopamine.
Full-text · Article · Feb 2009 · Development and Psychopathology
[Show abstract][Hide abstract] ABSTRACT: The primary objectives of the current study were: (1)to determine the extent to which caregivers’ conceptualizations of their own attachment history (global attachment representations are congruent with the way in which they conceptualize their relationships with a specific child (relationship-specific attachment representations); and (2)to evaluate whether these relationship-specific representations play a mediating role in the intergenerational transmission of attachment. Prenatal assessments of caregivers’ global attachment representations, as measured by the Adult Attachment Interview (AAI), and relationship-specific attachment representations, as measured by the Working Model of the Child Interview (WMCI), were obtained in a sample of 196 mother-infant dyads. Infant-caregiver attachment status was assessed using the Strange Situation Procedure (SSP) when infants were 12 months of age. Considerable correspondence was found between caregivers’ global and relationship-specific attachment representations; however, there was no evidence for the mediational hypothesis. The current study makes a significant contribution to the literature as it represents the first attempt to directly evaluate the links between caregivers’ global and relationship-specific attachment representations within the domain of caregiver-child relationships.
[Show abstract][Hide abstract] ABSTRACT: Purpose: To examine if a measure of disrupted caregiver behavior is equally effective in differentiating children with disorganized attachment from children with secure and insecure-organized attachment.
Method: One hundred and eighty-four low-risk mother-infant dyads participated in this study. Mother-infant attachment relationships were assessed using the Strange Situation procedure and disrupted caregiver behavior was assessed at 12 and 18 months using the AMBIANCE measure.
Results: Disrupted caregiver behavior distinguished children with disorganized attachment from children with secure attachment but not from children with resistant attachment.
[Show abstract][Hide abstract] ABSTRACT: The present study is a reanalysis of a preexisting study examining the usefulness of the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE; Bronfman, Parsons, & Lyons-Ruth, 1999) measure as an indicator of efficacy in reducing disrupted caregiver behavior in two brief interventions. The current study examines the rate of change in the display of disrupted caregiver behavior over the course of an attachment-based intervention (Modified Interaction Guidance) in a group of 11 caregiver-infant dyads referred to a tertiary care clinic for feeding problems. The AMBIANCE was utilized as an indicator of change in disrupted behavior following an assessment feedback session and three intervention sessions. Results showed a significant decrease in the total display of disrupted caregiver behaviors, as well as a change in classification from disrupted to not-disrupted, after receiving both feedback from the assessment and the first treatment session. A qualitative analysis of the data further revealed different patterns of change between caregivers. These findings provide preliminary empirical support suggesting that a reduction of disrupted caregiver behavior can be observed relatively quickly after the commencement of the Modified Interaction Guidance intervention.
[Show abstract][Hide abstract] ABSTRACT: The current meta-analysis examines the links between unresolved representations of attachment, anomalous parental behavior, and disorganized attachment relationships in 12 studies including 851 families. We found moderate effect sizes for the associations between unresolved states of mind and anomalous behavior (r = .26), unresolved states of mind and infant disorganized attachment relationships (r = .21), and anomalous behavior and disorganized attachment relationships (r = .34). Sample characteristics, observational context, and observational measure were not associated with differences in effect sizes. Only a small part of the association between unresolved states of mind and disorganized attachment relationships was explained by the mediation of anomalous parental behavior (.26* .34 = .09). Other factors yet to be uncovered must mediate the influence of unresolved states of mind on infant disorganized attachment; thus, further exploration of infant, parental, ecological, and genetic factors are warranted.
Full-text · Article · Jul 2006 · Attachment & Human Development
[Show abstract][Hide abstract] ABSTRACT: Attachment theorists assume that maternal mental representations influence responsivity, which influences infant attachment security. However, primary studies do not support this mediation model. The authors tested mediation using 2 mother-infant samples and found no evidence of mediation. Therefore, the authors explored sensitivity as a moderator, studying the (a) interaction of mental representation and sensitivity as it predicts infant attachment security and (b) level of sensitivity in mothers whose infants' attachment security is either concordant or discordant with their own. The interactional analyses were not significant. But the match-mismatch data showed that when mother-infant attachment strategies were discordant, maternal sensitivity was more consistent with infant than maternal attachment strategy. These findings are congruent with an interpretation of sensitivity as a moderator that can block transmission of attachment strategy.
Full-text · Article · Feb 2005 · Developmental Psychology