The risk-taking and self-harm inventory for adolescents: Development and psychometric evaluation

In this study, we report on the development and psychometric evaluation of the Risk-Taking (RT) and Self-Harm (SH) Inventory for Adolescents (RTSHIA), a self-report measure designed to assess adolescent RT and SH in community and clinical settings. 651 young people from secondary schools in England ranging in age from 11.6 years to 18.7 years and 71 young people referred to mental health services for SH behavior in London between the ages of 11.9 years and 17.5 years completed the RTSHIA along with standardized measures of adolescent psychopathology. Two factors emerged from the principal axis factoring, and RT and SH were further validated by a confirmatory factor analysis as related, but different, constructs, rather than elements of a single continuum. Inter-item and test–retest reliabilities were high for both components (Cronbach's α = .85, rtt = .90; Cronbach's α .93, rtt = .87), and considerable evidence emerged in support of the measure's convergent, concurrent, and divergent validity. The findings are discussed with regard to potential usefulness of the RTSHIA for research and clinical purposes with adolescents

The neural correlates of emotion processing in juvenile offenders

Individuals with severe antisocial behaviour often demonstrate abnormalities or difficulties in emotion processing. Antisocial behaviour typically onsets before adulthood and is reflected in antisocial individuals at the biological level. We therefore conducted a brain-based study of emotion processing in juvenile offenders. Male adolescent offenders and age-matched non-offenders passively viewed emotional images whilst their brain activity was recorded using electroencephalography. The early posterior negativity (EPN) and the late positive potential (LPP) components were used as indices of emotion processing. For both juvenile offenders and non-offenders, the EPN differentiated unpleasant images from other image types, suggesting that early perceptual processing was not impaired in the offender group. In line with normal emotion processing, the LPP was significantly enhanced following unpleasant images for non-offenders. However, for juvenile offenders, the LPP did not differ across image categories, indicative of deficient emotional processing. The findings indicated that this brain-based hypo-reactivity occurred during a late stage of cognitive processing and was not a consequence of atypical early visual attention or perception. This study is the first to show attenuated emotion processing in juvenile offenders at the neural level. Overall, these results have the potential to inform interventions for juvenile offending

Poverty, early care and stress reactivity in adolescence: findings from a prospective, longitudinal study in a low-middle income country

A considerable body of evidence suggests that early caregiving may affect the short-term functioning and longer-term development of the hypothalamic-pituitary adrenocortical (HPA) axis. Despite this, most research to date has been cross-sectional in nature or restricted to relatively short–term longitudinal follow-ups. More importantly, there is a paucity of research on the role of caregiving in low and middle income countries, where the protective effects of high quality care in buffering the child’s developing stress regulation systems may be crucial. In this paper, we report findings from a longitudinal study (N = 232) conducted in an impoverished peri-urban settlement in Cape Town, South Africa. We measured caregiving sensitivity and security of attachment in infancy and followed children up at age 13 years, when we conducted assessments of HPA axis reactivity, as indexed by salivary cortisol during the Trier Social Stress Test. The findings indicated that insecure attachment was predictive of reduced cortisol responses to social stress, particularly in boys, and that attachment status moderated the impact of contextual adversity on stress responses: secure children in highly adverse circumstances did not show the blunted cortisol response shown by their insecure counterparts. Some evidence was found that sensitivity of care in infancy was also associated with cortisol reactivity, but in this case insensitivity was associated with heightened cortisol reactivity, and only for girls. The discussion focuses on the potentially important role of caregiving in the long-term calibration of the stress system and the need to better understand the social and biological mechanisms shaping the stress response across development in low and middle income countries

The perspectives of senior researchers in applied disciplines on the current state of developmental attachment research: an interview study

Based on interviews with leading researchers and researcher-clinicians in fields allied to attachment research, this paper describes participants’ perceptions of contemporary attachment research in the developmental tradition. Semi-structured qualitative interviews were conducted with 13 research leaders in applied disciplines cognate to attachment research. Participants perceived attachment research as having played a foundational role for developmental science, including highlighting the importance of a developmental perspective and attention to early caregiving experiences. They also identified important contemporary strengths in developmental attachment research, including the observational acuity and insightfulness of its measures, its attention to dyadic processes in contrast to much of biomedicine, the development of a number of attachment-based interventions with well-articulated mechanisms of action, and the capacity of developmental attachment concepts to resonate with clinical and popular audiences. However, participants suggested that the developmental tradition is also perceived as having a comparatively high “cost of entry,” and consequently they warned that it has become somewhat separated from wider developmental science, with its growing prominence of biological research, scalability of methods, and less reliance on theory. Participants perceived both strengths and weaknesses to contemporary developmental attachment research. However they felt that the classic concerns of developmental attachment research were placing the field potentially at odds with current trends in developmental science

The Collaboration on Attachment Transmission Synthesis (CATS): A Move to the Level of Individual-Participant-Data Meta-Analysis

Generations of researchers have tested and used attachment theory to understand children’s development. To bring coherence to the expansive set of findings from small-sample studies, the field early on adopted meta-analysis. Nevertheless, gaps in understanding intergenerational transmission of individual differences in attachment continue to exist. We discuss how attachment research has been addressing these challenges by collaborating in formulating questions and pooling data and resources for individual-participant-data meta-analyses. The collaborative model means that sharing hard-won and valuable data goes hand in hand with directly and intensively interacting with a large community of researchers in the initiation phase of research, deliberating on and critically reviewing new hypotheses, and providing access to a large, carefully curated pool of data for testing these hypotheses. Challenges in pooling data are also discussed

The significance of attachment security for children’s social competence with peers: a meta-analytic study

This meta-analytic review examines the association between attachment during the early life course and social competence with peers during childhood, and compares the strength of this association with those for externalizing and internalizing symptomatology. Based on eighty independent samples (N = 4,441), the association between security and peer competence was significant (d = 0.39, CI 0.32; 0.47) and not moderated by the age at which peer competence was assessed. Avoidance (d = 0.17, CI 0.05; 0.30), resistance (d = 0.29, CI 0.09; 0.48), and disorganization (d = 0.25, CI 0.10; 0.40) were significantly associated with lower peer competence. Attachment security was significantly more strongly associated with peer competence than internalizing (but not externalizing) symptomatology. Discussion focuses on the significance of early attachment for the development of peer competence versus externalizing and internalizing psychopathology

Serotonin transporter gene (SLC6A4) polymorphism and susceptibility to a home-visiting maternal-infant attachment intervention delivered by community health workers in South Africa: reanalysis of a randomized controlled trial

Background Clear recognition of the damaging effects of poverty on early childhood development has fueled an interest in interventions aimed at mitigating these harmful consequences. Psychosocial interventions aimed at alleviating the negative impacts of poverty on children are frequently shown to be of benefit, but effect sizes are typically small to moderate. However, averaging outcomes over an entire sample, as is typically done, could underestimate efficacy because weaker effects on less susceptible individuals would dilute estimation of effects on those more disposed to respond. This study investigates whether a genetic polymorphism of the serotonin transporter gene moderates susceptibility to a psychosocial intervention. Methods and findings We reanalyzed data from a randomized controlled trial of a home-visiting program delivered by community health workers in a black, isiXhosa-speaking population in Khayelitsha, South Africa. The intervention, designed to enhance maternal-infant attachment, began in the third trimester and continued until 6 mo postpartum. Implemented between April 1999 and February 2003, the intervention comprised 16 home visits delivered to 220 mother–infant dyads by specially trained community health workers. A control group of 229 mother–infant dyads did not receive the intervention. Security of maternal-infant attachment was the main outcome measured at infant age 18 mo. Compared to controls, infants in the intervention group were significantly more likely to be securely attached to their primary caregiver (odds ratio [OR] = 1.7, p = 0.029, 95% CI [1.06, 2.76], d = 0.29). After the trial, 162 intervention and 172 control group children were reenrolled in a follow-up study at 13 y of age (December 2012–June 2014). At this time, DNA collected from 279 children (134 intervention and 145 control) was genotyped for a common serotonin transporter polymorphism. There were both genetic data and attachment security data for 220 children (110 intervention and 110 control), of whom 40% (44 intervention and 45 control) carried at least one short allele of the serotonin transporter gene. For these 220 individuals, carrying at least one short allele of the serotonin transporter gene was associated with a 26% higher rate of attachment security relative to controls (OR = 3.86, p = 0.008, 95% CI [1.42, 10.51], d = 0.75), whereas there was a negligible (1%) difference in security between intervention and control group individuals carrying only the long allele (OR = 0.95, p = 0.89, 95% CI [0.45, 2.01], d = 0.03). Expressed in terms of absolute risk, for those with the short allele, the probability of secure attachment being observed in the intervention group was 84% (95% CI [73%, 95%]), compared to 58% (95% CI [43%, 72%]) in the control group. For those with two copies of the long allele, 70% (95% CI [59%, 81%]) were secure in the intervention group, compared to 71% (95% CI [60%, 82%]) of infants in the control group. Controlling for sex, maternal genotype, and indices of socioeconomic adversity (housing, employment, education, electricity, water) did not change these results. A limitation of this study is that we were only able to reenroll 49% of the original sample randomized to the intervention and control conditions. Attribution of the primary outcome to causal effects of intervention in the present subsample should therefore be treated with caution. Conclusions When infant genotype for serotonin transporter polymorphism was taken into account, the effect size of a maternal-infant attachment intervention targeting impoverished pregnant women increased more than 2.5-fold when only short allele carriers were considered (from d = 0.29 for all individuals irrespective of genotype to d = 0.75) and decreased 10-fold when only those carrying two copies of the long allele were considered (from d = 0.29 for all individuals to d = 0.03). Genetic differential susceptibility means that averaging across all participants is a misleading index of efficacy. The study raises questions about how policy-makers deal with the challenge of balancing equity (equal treatment for all) and efficacy (treating only those whose genes render them likely to benefit) when implementing psychosocial interventions

Author Correction: A consensus-based transparency checklist.

An amendment to this paper has been published and can be accessed via a link at the top of the paper