Attachment & human development

Question 1

Neurobiology of attachment – neurotransmitters

Answer 1

• olfactory system:
  
  • mediated by norepinephrine
  • olfactory bulbs –> locus ceruleus –> amygdala
  • dopamine, oxytocin involved in odor preference
• somatosensory system – enables positioning for nursing
• Maternal behavior = oxytocin & estrogen (both), dopamine
  
  • estrogen regulates # of CNS oxytocin receptors
  • ** distribution of receptors matters (e.g. have them in the reward centers)
• Caudate, nucleus accumbens, medial thalamus

Question 2

Oxytocin - functions

Answer 2

• increases:
  
  • social contact induction, partner preference formation, pair, social bondin, relaxation,sensory processing
• decreases:
  
  • agression, anxiety
• released w/ increased social support
• repeat trauma can inhibit oxytocin release
• ** Use as potential pharmacotherapy

Question 3

Precursors for the development of healthy attachment

Answer 3

• interaction with caretaker w/ appropriate intensity and #
  
  • attunement, 6-8 caretakers max
• imitative capacity & discriminative ability of infant
• strength of child’s needs and clarity of signals
• sensitive phase (1st 2-yrs of life)
• object permanence: ability of the infant to conceive of a person as having a permanent and independent existence even when that person is not present to the infant’s perception
• Predictability (even with blunted response) is necessariy for developing trust
  
  • unpredictability is very disruptive (even w/ proper emotional tones)

Question 4

Phases of attachment (4)

Answer 4

1. Indiscriminate sociability (0-2 mo): smiling, crying, cooing/babbling, listening, visual fixation and tracking, postural adjustment, clinging, non-nutritional sucking
2. Attachment in the making (2-7 mo): more control over interactions (reaching, grasping), differentiating b/t caregiver and others, differential smiling, crying, and movement, vocalizations/greetings, climbing/exploring
3. Clear cut attachments (7-24 mo): person permanence (internal image of 1º caregiver), goal-corrected control over attachment behavior (1º caregiver = secure base to return/cling to)
4. Goal coordinated partnerships (>24 mo): understanding difference b/t own’s goals/plans and caregivers goles/plans; can act upon those

Question 5

Stranger anxiety

Answer 5

• 6-8 months
• infant reacts with distress in presence of a stranger
• a reaction to a discrepancy in faces that the infant cannot reconcile
• (during phase 2 and 3)

Question 6

Separation anxiety (infants)

Answer 6

• 10-18 months
• child is placed in a strange environment w/o 1º caregiver
• causes distress to the child since they cannot get closer to the caretaker

Question 7

Patterns of attachment

Answer 7

• Secure (65-70%)
  
  • comforted, calmed when parent returns
• Insecure (30-35%)
  
  • avoidant (20%)
    
    • unemotional, disengaged when parent returns
  • ambivalent-resistant (10%)
    
    • anger when parent returns
  • disorganized-disoriented (5%)
    
    • chaotic behavior, not responsive

Question 8

Attunement

Answer 8

• synchronous and interactive communication
• reading and responding to each other’s cues
• occurs through implicit learning
• reading of non-verbal, social-emotional language
• can help prevent mismatch b/t need and provision of nurturing
• Intentional attunement: a phenomenal state which generates a familiarity with other’s intentions through internalized sensations

Question 9

Phases of response to separation

Answer 9

• Protest
• Despair
• Detachment
• Depression
• Reorganization
• Emotional blunting

Question 10

Reactive attachment disorder

Answer 10

• consistent patter of inhibited, emotionally withdrawn behavior toward adult caregivers
  
  • e.g. not seeking or responding to comfort
• social and emotional disturbances
• experience of insufficient care
  
  • social neglect, deprivation, no primary caregiver,
• Persistent for present for 12+ months

Question 11

Disinhibited Social Engagement Disorder

Answer 11

• child actively approaces and interacts w/ unfamiliar adults,
  
  • behaves in inappropriately familiar ways, not checking back with adult caregiver
• hx of extremes of insufficeint care (as in RAD)
• Persistent if present 12+ months

Question 12

High risk signs for infants

Answer 12

• weak crying response
• extreme resistance to cuddling
• poor sucking response
• no reciprocal smile response
• failure to respond w/ recognition to primary caregiver
• delay in developmental milestones