Attachment Theory Flashcards
Origins
Attachment Theory originates from the ideas and writing of John Bowlby. His seminal works are trilogy: The Attachment and Loss: Attachment (1969), Separation (1973) and Loss (1980). These ideas were translated into a measurement tool, the Strange Situation Procedure, by Mary Ainsworth. She developed the concepts of Secure, Avoidant and Ambivalent Attachments. A fourth category, Disorganised Attachment has been devised by Mary Main and Jude Cassidy and in terms of psychopathology this is the most important category, as research shows this is the group that is most likely to develop psychopathology in childhood and in later life.
Ongoing refinement
Attachment Theory has been refined since its initial inception and now is not so specific as to define the primary attachment figures as the only attachment figure and is no longer considered a characteristic of the child (Bowlby’s original idea) but a characteristic of the nature of the relationship between the caregiver and the child. One can consider the attachment figures of a child to be in a hierarchy depending on whom the child prefers to go to when in need of comfort or protection. This will usually depend on;
the quality of the relationship,
the amount of time spent in the relationship,
the proximity in time of the relationship (e.g. child may go to Dad after being in Dad’s care for a day when
usually the primary attachment figure is the mum)
the characteristics of the relationship in relation to the comfort or protection sought e.g. child may go to
Dad if accidentally cut (because Dad feels safest in that context as Dad doesn’t mind blood) but may go
to Mum if feels sick because she feels nicest to cuddle into.
the “goodness of fit”
A number of classificatory models of attachment have been proposed. Adult models of attachment have followed two main lines of thinking. One is focussed largely on the concept of internalized working models of attachment (or attachment states of mind, {Main, 1996) in the context of specific relationships or relationship stresses. This model infers attachment states of mind from a thorough interview in which the individual is asked to talk about early attachments. Self-report measures of attachment generally focus on adult relationships, and derive more from a personality psychology perspective than the developmental perspective of Main and colleagues (Fortuna and Roisman, 2008). The personality psychology perspective describes four attachment categories: secure, dismissing, preoccupied and fearful. Self report measures ask individuals to describe their feelings about intimate relationships, for example, whether they seek intimate relationships, can trust their partners, and whether they are comfortable with some level of dependence.
Insecure attachment
Babies who do not develop a secure attachment may:
have trouble interacting with their mother (they may not want to be with their mother, or may be upset when with them);
be withdrawn or become passive; or develop skills later than other babies. Toddlers and pre-schoolers of depressed mothers may:
be less independent
be less likely to interact with others
have more trouble accepting discipline; be more aggressive and destructive; or not do as well in school.
School age children of depressed mothers may:
have behavioural problems;
have learning difficulties;
have a higher risk of attention deficit and hyperactivity disorder;
not do as well in school; or
have a higher risk of anxiety, depression and other mental health problems.
Assessment
In assessing attachment:
A. Factors obtained in the history can cover a number of areas:
For the child
Any significant separations or disruptions from parents/primary carers? What was the quality of care received from primary carer?
What is the child’s experience of care?
How old is the child?
What stage of development is he/she at?
What is the nature of the child’s interaction with primary carer?
How does child relate to other adults?
How does child relate to other children?
How does child respond when separated from carer? (Before, during, after) How does child respond when reunited with carer? (Before, during, after)
For the parent and others important factors are those that are likely to have affected the parents’ internal representations of being a parent or factors that have significantly affected their behaviour and emotional availability.
What was their experience of being parented?
Any history of or current mental illness?
Have parents experienced any significant losses?
Is there substance abuse?
Is there a history of or current domestic violence?
What is the parent’s capacity to reflect on the child’s experience?
How does parent act on separation from the child?
How does parent act on reunion with the child?
Are there any other significant people in the child’s life?
Has the child been in an out of home placement?
B. Observational measures of The Dyadic Relationship
There are a number of ways of assessing this, each with their strengths and weaknesses. Some take much longer than others and require specialised training to formally ‘code’. These more complex measures are of limited use in everyday clinical practice but nevertheless it is important to know about them because they may need to be used occasionally, they are discussed in the literature and they embody many fundamental principles.
For example:
1. The Strange Situation Procedure
(Ainsworth) In this procedure of the strange situation the child is observed playing for 20 minutes while caregivers and strangers enter and leave the room, recreating the flow of the familiar and unfamiliar presence in most children’s lives. The situation varies in stressfulness and the child’s responses are observed. The child experiences the following situations:
Parent and infant are introduced to the experimental room.
Parent and infant are alone. Parent does not participate while infant explores.
Stranger enters, converses with parent, then approaches infant. Parent leaves inconspicuously.
First separation episode: Stranger’s behavior is geared to that of infant.
First reunion episode: Parent greets and comforts infant, then leaves again.
Second separation episode: Infant is alone.
Continuation of second separation episode: Stranger enters and gears behavior to that of infant.
Second reunion episode: Parent enters, greets infant, and picks up infant; stranger leaves inconspicuously.
Four aspects of the child’s behaviour are observed:
The amount of exploration (e.g. playing with new toys) the child engages in throughout. The child’s reactions to the departure of its caregiver.
The stranger anxiety (when the baby is alone with the stranger).
The child’s reunion behaviour with its caregiver.
On the basis of their behaviours, the children were categorized into three groups, with a fourth added later – secure, avoidant-insecure, resistant insecure and disorganised insecure. Each of these groups reflects a different kind of attachment relationship with the caregiver.
2. Crowell Procedure
This procedure provides a method of observing caregiver-child interactions in a clinical setting. It involves a series of eight episodes designed to elicit behaviours that allow the clinician to focus on the relationship between a child and his or her caregiver in a setting that is unstructured enough to allow for “real-life” or spontaneous interactions. This procedure requires 45 to 60 minutes to complete. The eight episodes include free-play, clean-up, a bubble blowing episode, four increasingly difficult problem-solving tasks, and a separation/reunion episode. These episodes allow the clinician to see how comfortable and familiar the dyad is with each other, how the dyad negotiates transitions, the dyad’s ability to problem solve together, their use of shared affect (positive and negative) to communicate, and attachment behaviours.
3. Face-to-face or videotaped interaction
Simple observations of the mother infant dyad
The focus is always on each aspect as it relates to ‘the other’ i.e. for baby as it relates to parent and vice versa. For example, an observer may note that the mother and infant both are both dressed in a ‘pretty’ way, or one appears well fed but the other does not. Absent behaviours or interactions are recorded in addition to those that are present.
Behaviour:
In relation to one another such as body position in relation to own body parts and in relation to the ‘other’, muscle tone and any changes in this, activity including in particular if this is towards or away from each other and at what times movement occurs, contact, and the quality of this, infant state (e.g. tiredness). Do they mirror each other’s behaviour?
Visual Interaction:
Do infant and parent look at each other, how often, in what situations/prompts? What is the other persons response, do they have a ‘light in their eyes’ does this change when they are looking at the other? How long do they sustain eye contact? When do they look away?
Vocal Interactions:
Amount, tone, prosody, developmental level, reciprocity, relationship to affective state and position to other.
Affect Tone:
What is the affective tone of the interaction, how is this evidenced in facial expression, movements, and proximity.
Depth of Interaction:
What is the intensity of the interaction?
Parental Reflective Capacity:
To what extent does the parent have this capacity? Is it consistent or do current factors appear to influence this?
Infant reactivity:
How does the infant respond to their parent? How does this compare to their responses to others significant people in her/his life and how does it compare to their reaction to the observer and to other professionals?
Risk: Is anything observed that raises concerns for the safety of the baby, e.g. dangerous environment, significant parental lack of awareness of infant, or misinterpretation of cues? Anger in parent directed toward the child
