Twenty years ago, meta-analytic results (k = 19) confirmed the association between caregiver attachment representations and child-caregiver attachment (Van IJzendoorn, 1995). A test of caregiver ...sensitivity as the mechanism behind this intergenerational transmission showed an intriguing "transmission gap." Since then, the intergenerational transmission of attachment and the transmission gap have been studied extensively, and now extend to diverse populations from all over the globe. Two decades later, the current review revisited the effect sizes of intergenerational transmission, the heterogeneity of the transmission effects, and the size of the transmission gap. Analyses were carried out with a total of 95 samples (total N = 4,819). All analyses confirmed intergenerational transmission of attachment, with larger effect sizes for secure-autonomous transmission (r = .31) than for unresolved transmission (r = .21), albeit with significantly smaller effect sizes than 2 decades earlier (r = .47 and r = .31, respectively). Effect sizes were moderated by risk status of the sample, biological relatedness of child-caregiver dyads, and age of the children. Multivariate moderator analyses showed that unpublished and more recent studies had smaller effect sizes than published and older studies. Path analyses showed that the transmission could not be fully explained by caregiver sensitivity, with more recent studies narrowing but not bridging the "transmission gap." Implications for attachment theory as well as future directions for research are discussed.
Background
While considered a rare diagnosis, reactive attachment disorder (RAD) is simultaneously the subject of considerable debate. A recent report suggested that RAD is overdiagnosed in community ...settings and that conduct problems may be used to make a diagnosis of RAD (Woolgar & Baldock, Child and Adolescent Mental Health, 20, 2015, 34–40). This study seeks to replicate and extend these findings.
Method
Clinical assessment data from 100 consecutive admissions of maltreated foster and adopted children (ages 3–17) to a specialty treatment clinic in the United States were reviewed. Measures included semi‐structured interviews of RAD and disinhibited social engagement disorder (DSED) symptoms and caregiver‐report questionnaires of emotional problems, conduct problems, and the quality of the parent–child relationship.
Results
Of the 100 cases reviewed, 39 presented with a diagnostic history of RAD, DSED, or ‘attachment disorder’. Of these cases, three were diagnosed in‐clinic with DSED; no cases met diagnostic criteria for RAD according to DSM‐5 criteria. However, analyses found that those diagnosed with RAD by community‐based clinicians were significantly more likely to display conduct problems and to be adopted (as opposed to in foster care).
Conclusions
These findings confirm those of Woolgar and Baldock (Child and Adolescent Mental Health, 20, 2015, 34–40). It appears that the diagnostic criteria of RAD are commonly being inaccurately applied in general community‐based practice. Clarification of diagnostic criteria for RAD in recent revisions of diagnostic taxonomies, the accumulation of empirical data on RAD, and improved instrumentation are either poorly disseminated or inadequately implemented in community‐based practice settings.
Read the Commentary on this article at doi: 10.1111/camh.12357
Background
A digital micro-intervention offering attachment psychoeducational videos was explored regarding its feasibility in parents of children with severe disabilities. Method: A mixed-methods ...study (including daily diaries and one-time questionnaires) with 16 parents (75.0% female) of children with severe disabilities (up to 10 years of age) was done during a three-week intervention. Results: Parents were positive about the video series and almost no drop-out occurred. The videos stimulated their learning and thinking and offered parents some personal meaning. Preliminary efficacy tests showed no major changes in parents’ parenting self-efficacy (PSE) or perceptions of statements on parent–child attachment. Conclusions: The study showed promising results regarding the micro-interventions’ acceptability and implementation. The limited efficacy testing did not show major changes in parents’ PSE. Further research is needed to investigate the differential relevance of the micro-intervention, based on parents’ needs, as well as its optimal embeddedness in a broader intervention trajectory.
Visiting a natural environment such as a garden or park helps people to recover from stressful circumstances. Women’s shelters and homeless shelters have started to integrate nature in their work, ...especially for families who seek temporary refuge, with the aim to support parents’ functioning and resilience. For professionals who want to facilitate engagement with nature among their clients, it may be helpful to learn how other professionals choose nature activities for the support of parents. The current study was aimed to uncover how social workers choose a nature activity for the support of parents, resulting in a model that can be used as a reflective tool among shelter professionals. The model is based on an analysis of actions of professionals, captured in case descriptions written by shelter professionals about parenting supportive nature activities that they facilitated for families under their care. The model shows that social workers promoted a back-and-forth between children’s exploration away from the parent and being with the parent. In facilitating these interactions, social workers used nature as an environment with stress reducing and strengthening capacities for parents and as an environment with supportive qualities for children’s play. A dimensional framework was extracted that described how professionals may choose activities.
Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some ...false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static "trait" of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.
The Attachment and Biobehavioral Catchup intervention potentially offsets psychosocial risks facing dyads in which children have intellectual disability or developmental delays. In this single-case ...multiple-baseline study the efficacy of this intervention was tested across three such South African families. Maternal sensitivity, attachment security, and child affect regulation were measured weekly during a baseline and intervention period, using the Ainsworth Maternal Sensitivity Scales, Attachment Q-sort and salivary cortisol, respectively. Furthermore, post-intervention interviews invited parents’ and intervenors’ evaluations of the intervention. Visual analysis broadly indicated improvement in maternal sensitivity and attachment security across subjects over time following the introduction of the intervention, although randomisation tests were not statistically significant. Effects on affect regulation were not clearly observed and may have been influenced by case-specific variables. Parent-participants and intervenors also identified particularly helpful contributions from the intervention. Findings underscore the importance of individual-level effects evaluation, especially when implementing interventions outside the original population.
Learning to love the null Schuengel, Carlo
Journal of child psychology and psychiatry,
March 2022, 2022-03-00, 20220301, Letnik:
63, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Children’s behaviour and mental health has the power to surprise us, readers and authors of the Journal of Child Psychology and Psychiatry and laymen alike, if not for the endless variation among ...people, then for the ever‐changing context in which they develop. The hypothetico‐deductive method in combination with null‐hypothesis significance testing has turned surprise into scientific knowledge. Null effects may in themselves also be surprising and informative, but appear less well represented in the literature. This editorial highlights emerging methodological practices for studying null effects in the most informative way.
Objective:
A comprehensive approach is needed for diagnosing disordered attachment behavior due to the multifaceted nature of attachment. Differences between various indicators can pose a challenge ...for deciding on the proper diagnosis. This study assessed the convergence between clinical interview assessment and observation-based clinical diagnosis, and their linkages with inadequate care.
Method:
Participating children (N = 55) had intelligence quotients (IQs) between 50 and 85 and were referred for psychiatric consultation. Data were obtained by structured review of medical records, the Disturbances of Attachment Interview (DAI), and the Clinical Observation of Attachment (COA) procedure.
Results:
Of the 18 children identified using the DAI with Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM-5) diagnosis of reactive attachment disorder (RAD) and/or disinhibited social engagement disorder (DSED), only 7 received a clinical DSM-5 diagnosis of RAD and/or DSED. Observed maladaptive attachment behavior in the COA was strongly associated with DAI scores and with clinical diagnosis of DSM-5 RAD and/or DSED. There was a significantly higher prevalence of extremes of insufficient care in children who were classified with RAD by DAI or DSM-5 and/or with DSED by DSM-5 compared to those with no attachment disorder.
Conclusions:
Using structured observation and record assessment leads to more conservative identification of RAD or DSED than using the DAI.
This article examines the construct of disorganized attachment originally proposed by Main and Solomon, developing some new conjectures based on inspiration from a largely unknown source: John ...Bowlby’s unpublished texts, housed at the Wellcome Trust Library Archive in London (with permission from the Bowlby family). We explore Bowlby’s discussions of disorganized attachment, which he understood from the perspective of ethological theories of conflict behavior. Bowlby’s reflections regarding differences among the behaviors used to code disorganized attachment will be used to explore distinctions that may underlie the structure of the current coding system. The article closes with an emphasis on the importance Bowlby placed on Popper’s distinction between the context of discovery and the context of justification in developmental science.
Family violence is a common problem with direct adverse effects on children as well as indirect effects through disruption of parenting and parent-child relationships. The complex interrelationships ...between family violence, parenting, and relationships make recovery from psychological responses difficult. In more than half of the families referred to mental health care after family violence, the violence continues. Also, the effect sizes of "golden standard" treatments are generally lower for complex trauma compared to other forms of trauma. In the treatment of complex trauma, trauma-focused therapies including cognitive restructuring and imaginal exposure are most effective, and intensifying therapy results in faster symptom reduction. Furthermore, there is promising evidence that adding a parental component to individual trauma treatment increases treatment success. In family-based intensive trauma treatment (FITT), these factors are addressed on an individual and family level in a short period of time to establish long-term effects on the reduction of trauma symptoms and recovery of security in the family. This randomized controlled multicentre study tests if FITT is an effective treatment for concurrent reduction of trauma symptoms of children, improvement of parenting functioning, and increasing emotional and physical security in children, through the improvement of parent-child relationships.
The effectiveness of FITT will be tested by a RCT design. A total of 120 adolescents with a history of family violence and PTS symptoms will be randomized to (a) an intensive trauma treatment with a parent and systemic component (FITT), (b) an intensive trauma treatment without these components (ITT), and (c) treatment as usual (TAU, low-frequency trauma treatment with parent therapy and family sessions). Changes in children's trauma symptoms, child and parent functioning, and emotional and physical security in the family will be monitored before, during, after, and at 3 months follow-up.
Comparing these interventions with and without a high intensive frequency and parenting and family components can help to understand if and how these interventions work and can contribute to the ambition to recover from the impact of family violence and restore emotional and physical security for children and young people.
Netherlands Trial Register Trial NL8592 . Registered on 4 May 2020.
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