Attachment Disorder Flashcards
Stages of Attachment?
- Asocial stage
0-6 weeks
Smiling and crying not directed at specific people - Indiscriminate Attachment
6 weeks to 7 months
Attention sought from different individuals
can tell ppl apart
No fear to strangers - Specific Attachments
7-11 months
Strong attachment to one individual
Separation and stranger anxiety
Fear of strangers - Multiple Attachments
show interest to grandparents, parents and familiar ppl.
Attachment Styles?
4 main attachment styles to “strange stitutaion”:
Secure
Insecure avoidant- no interest mo leaves and hapily play
Insecure ambivalentدمدمی/resistant-intense distress with no mom
Disorganized
Avoidant attached adolescents?
Avoid intimacy, dependence, disclosure
Hard to engage
View relationships as unimportant
Don’t feel a huge need for other people
Seen as cold –reported as lacking empathy or remorse
Are indifferent to other’s views –assume others dislike them
Linked with higher incidence of somatising illness & hard drug use
Ambivalent attached adolescents?
Disruptive, ‘attention seeking’, difficult to manage
Insecure and coercive
Can alternate between friendly charm and hostile aggression
Display antisocial behaviour, impulsivity, poor concentration
Feel a growing sense of unfairness and injustice –lots of complaining
Dysregulated emotions
Key terms associated with attachment?
Secure base
The attachment figure/relationship provides a safe space (literally or symbolically) from which to explore the world
Safe haven
The attachment figure/relationship is a safe place (literally or symbolically) to retreat to at times of danger or anxiety
Attunement
Process between caregiver and infant in which they are able to ‘tune in’ to each other’s physical and emotional states
Through a process of co-regulation the infant learns to manage stress and anxiety
Where the child’s stress is met by a stressed adult who is unable to respond sensitively and effectively to the child’s needs, co-dysregulation may occur in which both care giver and infant distress escalates
Symptoms of Disordered Attachment?
Behavioural signs e.g.
Lack of self control/impulsiveness
Lack of normal fear
Aggression towards others
Lying/being deceitful
Inappropriate sexual behaviour
Cruelty to animals
Sleep disturbance
Cognitive functioning
Emotional functioning
Social functioning
Physical aspects
Cognitive functioning
Given the need of a ‘secure base’ in order to explore and learn, children with attachment disorders having lacked such security have clear cognitive difficulties
e.g.
Lack of cause and effect thinking
Learning disorders
Language disorders
Distorted self image
Grandiose sense of self importance
‘Black and white’ and ‘All or nothing’ styles of thinking
Emotional functioning?
Core emotions are intense, feelings of anger, fear, pain and shame.
Often appear disheartened and depressed with mood swings.
Struggle to express emotions.
Social functioning?
Superficially engaging – lacks genuine trust, intimacy and affection
Lack of eye contact for closeness
Indiscriminately affectionate with strangers
Lack of peer relationships
Cannot tolerate limits and external control
Blames others for mistakes
Victimises others
Victimised by others
Lacks trust in others
Exploitative, bossy
Physical aspects?
Poor hygiene
Chronic body tension
Accident prone
High pain tolerance/over reaction to minor injury
Tactilely defensive
Causes of disrupted attachment?
Unplanned pregnancy
Consideration of termination
Post natal depression/psychosis
Physical/emotional neglect or abuse
Separation from primary caregiver
Parental conflict
Maternal addiction to drugs or alcohol
Frequent moves or placements
Traumatic experiences
Unresponsive baby
Undiagnosed, painful illnesses such as ear infections/colic
The caregiver and child not being attuned
Poor parenting skills
Parental difficulties with attachment
Management of Disordered Attachment?
Clear assessment of both attachment and family system and their relevance to current problems and concerns
The young person needs to be able to make sense of their history and current functioning
Reactive Attachment Disorder (RAD)?
grossly pathological care
Subtypes of RAD?
Inhibited
* Refers to children who continually fail to
initiate and respond to social interactions in a developmentally appropriate way
* Interactions are often met with a variety of
approaches – avoidance, resisting com-fort, hypervigilant or highly ambivalent
**Disinhibited** * Refers to a child who has an inability to display appropriate selective attachments * Also known as Disinhibited Social Engagement Disorder (DSED) * More enduring over time than the inhibited type
Signs of RAD?
- Noticeable neglectful behaviour by the primary caregiver
Not comforting the baby or child in distress
Not responding to needs such as hunger or a dirty nappy - Inappropriate interaction noticed between the baby or child and the primary caregiver
- Lack of smiling or responsiveness in the baby or child
Does not seek attention or comfort, or resorts to extreme measures to gain attention
Rejection of demonstrations of comfort
Avoidance of touch or gestures of affection - Lack of distress in situations which would be expected to cause distress
- Indiscriminate, excessive friendliness towards healthcare workers
- Inconsolable crying
- Emotional and behavioural difficulties
