Attachment is a behavioral and physiological system, which enables individual’s dynamic adaptation to its environment. Attachment develops in close interaction between an infant and his/her mother, ...plays an important role in the development of the infant’s brain, and influences the quality of interpersonal relationships throughout life.
Security of attachment is believed to influence individual response to stress, exposing insecurely organized individuals to deregulated autonomic nervous system and exaggerated hypothalamic-pituitary-adrenal activity, which, in turn, produces increased and prolonged exposure to stress-hormones. Such stress responses may have considerable implications for the development of diverse health-risk conditions, such as insulin resistance and hyperlipidemia, shown by numerous studies.
Although the mechanisms are not yet fully understood, there is compelling evidence highlighting the role of psychological stress in the development of type 1 diabetes (T1D). One of the possible contributing factors for the development of T1D may be the influence of attachment security on individual stress reactivity. Thus, the suggestion is that insecurely attached individuals are more prone to experience increased and prolonged influence of stress hormones and other mechanisms causing pancreatic beta-cell destruction. The present paper opens with a short overview of the field of attachment in children, the principal attachment classifications and their historic development, describes the influence of attachment security on individual stress-reactivity and the role of the latter in the development of T1D. Following is a review of recent literature on the attachment in patients with T1D with a conclusion of a proposed role of attachment organization in the etiology of T1D.
Navezanost je vedenjski in fiziološki sistem, ki posamezniku omogoča dinamično prilagajanje na okolje. Navezanost se razvija pri sovplivu med dojenčkom in materjo, igra pomembno vlogo pri razvoju otrokovih možgan in vpliva na kvaliteto posameznikovih socialnih odnosov vse življenje.
Varnost ali oblika navezanosti vpliva na posameznikov odziv na stres (stresno reaktivnost). Tako pride pri negotovo navezanih posameznikih do slabše reguliranega avtonomnega živčnega sistema in pretirane reaktivnosti hipotalamo-hipofizno-suprarenalne osi, zaradi česar so ti v življenju pogosteje in dalj časa izpostavljeni delovanju stresnih hormonov. Tovrsten odziv na stres pa ima pomembno vlogo pri razvoju inzulinske rezistence, hiperlipidemije in drugih stanj, ki predstavljajo tveganje za zdravje.
Čeprav natančni mehanizmi še niso znani, je vedno več dokazov, da psihološki stres pomembno prispeva k razvoju sladkorne bolezni tipa 1 (SBT1). Eden od mehanizmov razvoja te bolezni bi lahko bil tudi vpliv oblike navezanosti na posameznikovo stresno reaktivnost. Tako so lahko negotovo navezani posamezniki pogosteje, dlje in v večji meri izpostavljeni delovanju stresnih hormonov, ki skupaj z drugimi dejavniki povzročajo uničenje beta celic trebušne slinavke.
Ta prispevek prikaže najprej kratek pregled področja navezanosti pri otrocih, glavne oblike navezanosti in njihov zgodovinski razvoj, oriše vpliv oblike navezanosti na posameznikovo stresno reaktivnost in vpliv te reaktivnosti na razvoj SBT1. Zaključi se s predlogom o vlogi oblike navezanosti pri razvoju SBT1 pri otrocih.
To understand the relationship between attachment and diabetes and the role of stress mediators in children with type 1 diabetes (T1D) and their mothers.
The following assessment instruments were ...applied as self-report measures: Attachment Scale (ECR- R), Perceived Stress Scale (PSS), Security Scale (SS), and the Stress in Children (SiC) questionnaire, which were completed by children and their mothers. We analyzed demographic variables, diabetes onset time, and the average of the last three glycosylated hemoglobin (HbA1c) measurements as a parameter of metabolic control in the last year.
Attachment strategies of both mother and child, as well as maternal stress, showed a significant association with the child's diabetes outcomes, although with important gender differences.
Both mother and child attachment strate gies are relevant aspects of the T1D course.
Objetivo: Comprender la relación entre apego y diabetes y el rol mediador del estrés en niños con diabetes mellitus tipo 1 (DM1) y sus madres.Material y Método: Se aplicaron Instrumentos de ...evaluación correspondientes a Escalas de Apego (ECR-R), Estrés percibido (PSS), Seguridad (SS) y Estrés en niños (SiC), como medidas de autoreporte completadas por niños(as) y sus madres. Se analizaron variables demográficas, tiempo de inicio de diabetes, y el promedio de las ultimas 3 mediciones de Hemoglobina glicosilada HbA1c como parámetro del control metabólico del último año.Resultados: Las estrategias de apego maternas e infantiles y el estrés materno mostraron una asociación significativa con los resultados de la diabetes del niño(a), aunque con importantes diferencias de género.Conclusiones: Las estrategias de apego, infantiles y maternas, son relevantes en el cursode la diabetes.
This paper introduces a new measure of attachment in middle childhood(8-13 years), an interview extensively adapted from the AAI and with a new coding system. We report data from a series of studies ...with clinical and normal populations, in which the psychometric properties of reliability, stability and validity are tested and found to be satisfactory. Although work remains to be done, we see the Child Attachment Interview as a promising new attachment measure. (Original abstract)
The current thesis describes the development of the Child Attachment Interview (CAI), a new measure for the assessment of attachment representations in eight to twelve year olds. The first part of ...the thesis presents an historical review of the foundations of attachment theory and examines recent theoretical and empirical developments within the attachment field. The measurement of attachment across the life cycle is subsequently presented and critically evaluated in light of empirical findings, highlighting the "measurement gap" in the assessment of attachment in middle childhood. A review of developmental considerations in the assessment of attachment in the aforementioned age range forms the theoretical and empirical foundation upon which the development of the CAI is subsequently described and piloted. The second part of the thesis concerns the development of, and refinements to, the CAI protocol and classification system. Operational criteria for the identification of central narrative dimensions and guidelines for the classification of attachment patterns are presented. The study of the psychometric properties of the CAI follows with an examination of aspects of reliability including inter-rater and test-retest reliability. The validation of the CAI is subsequently determined focusing upon criterion, discriminant, predictive and concurrent validity. The findings indicated that the CAI constitutes a reliable and valid measure for the assessment of attachment in the eight to twelve years age range. High inter-rater reliability was demonstrated across several samples and judges, in addition to satisfactory test-retest reliability. Attachment security constituted a significant predictor of clinical status and whilst it was not significantly associated with expressive language competence or intelligence, it was moderately associated with behaviour problems. Concordance with maternal attachment status, attachment security assessed concurrently and stability over a three-year period were finally demonstrated. In the final chapter, the findings are discussed and limitations and consideration of the study are presented. The thesis concludes with a discussion of the theoretical and empirical implications of the study and considerations of future directions in the development and validation of the CAI.
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