Disorganized and Unresolved States in Adulthood

Fear plays a central role in attachment theory and disorganization in adulthood. Fear associated with traumatic memories interferes with resolution of trauma resulting in disorganized mental states, captured as unresolved/disorganized speech surrounding loss and/or abuse in the Adult Attachment Interview. Mothers who are unresolved experience fear stemming from traumatic memories and display frightening behavior towards their infants. Disorganization can predispose individuals to dissociative mental processes, including altered states (absorption), PTSD, and depersonalization. Social psychologists have conceptualized adult disorganization as fear of the romantic partner. Studies examining stability of adult disorganization indicate unresolved loss is more readily resolved than unresolved abuse. Understanding disorganization in adulthood, including experiences that support reparation and reorganization, is important for developing effective interventions.Wellcome Trust Grant number RHZB/13

Adult attachment and birth experience: importance of a secure base and safe haven during childbirth.

OBJECTIVE: Examine connections between mothers' adult attachment and subjective birth experience in the context of parity and mode of delivery. BACKGROUND: Research has established a clear connection between adult attachment and birth experience. This study extended previous research with an in-depth self-report attachment measure examining different dimensions of mothers' attachment representations and their relation to subjective birth experience.  Interactions between mode of delivery and parity were also considered. Method: Participants were 257 mothers who gave birth 4 days to 12 months prior to the study. Mothers' mean age was 30.5 years, 61% primiparas, and 26% delivered by caesarean.  Participants completed an online survey with the Birth Experience Questionnaire, the Reciprocal Attachment Questionnaire, and demographic information. RESULTS: Hierarchical moderated regression analyses showed direct effects from adult attachment dimensions to mothers' subjective birth experiences, specifically perceived availability, feared loss, separation protest, angry withdrawal, and compulsive careseeking. Interactions emerged for parity and/or mode of delivery for overall subjective birth experience, perceived control, perceived social support, and satisfaction. CONCLUSION: Adult attachment representations related to subjective birth experience, indicating that attachment figures serve as secure bases and safe havens for mothers during childbirth. These results have implications for practitioners and provide direction for future research.This research was supported by a Medical Humanities New Investigator 17 Award from the Wellcome Trust (Grant WT103343MA

Understanding the connection between attachment trauma and maternal self-efficacy in depressed mothers

Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy is associated with a higher incidence of postpartum depression. Maternal self-efficacy and postpartum depression can both be buffered by social support. Maternal self-efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self-efficacy, with emotional support as a moderator. Participants were 278 first-time mothers of infants under 14 months. Cross-sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self-efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus’ estimate of indirect effects. Postpartum depression fully mediated the relation between trauma and maternal self-efficacy. Emotional support moderated only the pathway between postpartum depression and maternal self-efficacy. Attachment trauma's implications for maternal self-efficacy should be understood in the context of overall mental health. Mothers at the greatest risk for low maternal self-efficacy related to attachment trauma also are those suffering from postpartum depression. Emotional support buffered mothers from postpartum depression, though, which has implications for intervention and future research.This research was made possible by a Medical Humanities New Investigator Award from the Wellcome Trust (Grant WT103343MA)

Fathers' attachment representations and infant feeding practices.

This study examined how fathers' adult attachment representations, assessed before the birth of their first child, predict feeding practices with their 8-month-old infants. Fathers have been underrepresented in child feeding research, particularly in longitudinal and observational studies. Feeding is a key parenting task of infancy and a growing number of studies have begun to explore the connection between attachment and parental feeding practices and behavior, revealing a clear link between mothers' adult attachment and how they feed their children. This is the first longitudinal examination of attachment as a prenatal predictor of fathers' infant feeding behavior. Participants were 118 first-time fathers and their infants. Adult Attachment Interviews were conducted in the third trimester of pregnancy, and father-infant feeding interactions were observed at home when the infant was 8-months-old. Videotaped feedings were coded using Chatoor's Feeding Scale (1997). Compared to other fathers, (1) those with secure attachment representations were more attuned to their infants during feeding, (2) those with dismissing representations were less attuned, and (3) those with unresolved trauma displayed more controlling behaviors. Fathers were more controlling with their sons than their daughters across all attachment representations. Study results suggest that father's infant feeding behaviors may influence by their own attachment representations. The links to fathers' controlling feeding practices are noteworthy because of the negative implications controlling parental feeding practices can have on child outcomes. The prediction of paternal feeding behaviors from assessments conducted prenatally has important intervention implications

Do toddlers prefer the primary caregiver or the parent with whom they feel more secure? The role of toddler emotion

This study tested Bowlby and Ainsworth’s hypothesis that a hierarchy of caregivers exists whereby infants prefer one caregiver over another when distressed. We examined parent gender (mother vs. father), primary caregiver status (defined as the parent who spent most time with the infant and performed most of the caregiving tasks), and role of toddlers’ history of attachment security with each parent, as predictors of toddlers’ preference for a particular caregiver when the toddlers are distressed and when they are content. Infants’ attachment security with each parent was assessed at 12–15 months. At 24 months, mother–child and father–child interactions were observed in triadic (mother, father, toddler) home interactions. When distressed, regardless of the security of their attachment to each parent, toddlers more often interacted with the primary caregiver. When content, toddlers did not show this preference. As expected, toddlers’ recovery from distress was predicted by their security of attachment with the parent whom they approached when distressed

Disorganized Attachment in Infancy: A Review of the Phenomenon and Its Implications for Clinicians and Policy-Makers

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

L'attaccamento va in tribunale: protezione e affidamento dei minori

In molti contesti professionali, compreso quello del Tribunale per i minorenni, si fa riferimento alla teoria dell’attaccamento e alla relativa ricerca, con fraintendimenti ampiamente diffusi che spesso si traducono in applicazioni scorrette. La finalità di questa dichiarazione di consenso è, pertanto, quella di migliorarne la comprensione, contrastare la disinformazione a riguardo e guidarne l’uso nel contesto del tribunale per i minorenni secondo una modalità basata sulle evidenze, considerando in particolare i processi decisionali circa la protezione e l’affidamento dei minori. L’articolo è diviso in due parti. Nella prima ci occupiamo dei problemi relativi all’utilizzo di teoria e ricerca sull’attaccamento nel contesto del Tribunale per i minorenni e ne discutiamo le ragioni. A questo proposito, esaminiamo le applicazioni della teoria che si ispirano al principio elettivo del superiore interesse del minore, discutiamo i fraintendimenti a riguardo e identifichiamo i fattori che ne hanno ostacolato un’accurata implementazione. Nella seconda parte, forniamo indicazioni per una sua adeguata e corretta applicazione. A tal fine, siamo partiti da tre principi di riferimento: il bisogno del bambino di caregiver familiari e non abusanti, il valore della continuità di cure sufficientemente buone e i benefici delle reti di relazioni di attaccamento. Discutiamo, inoltre, di quanto le valutazioni sulla qualità dell’attaccamento e sul comportamento di cura siano adeguate a ispirare i processi decisionali forensi rivolti ai minori. Concludiamo che la valutazione dei comportamenti di cura dovrebbe ricoprire un ruolo centrale. Nonostante non ci sia fra noi completo consenso riguardo all’utilizzo delle valutazioni sulla qualità dell’attaccamento nelle decisioni attinenti all’affidamento e alla protezione del minore, tali valutazioni si rivelano, al momento, le più adatte a individuare obiettivi e modalità degli interventi di sostegno. Infine, offriamo indicazioni per organizzare le future collaborazioni di ricerca interdisciplinare

Attachment goes to court: child protection and custody issues

Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child’s need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments of attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration