CAMHS Flashcards
How many stages of attachment are there?
4 stages
- Association stage
- Stage of indiscriminate attachment
- Stage of specific attachments
- Stage of multiple attachments
What age range is the indiscriminate attachment age?
6weeks- 6/7 months
What age range is association stage?
0-6 weeks
What age range is multiple attachment stage?
~ 8 months
What age range is specific attachments stage?
~ 7 months
What is the association stage?
Social and non-social stimuli will produce favourable response
What is specific attachment stage?
Protest only when separated from primary caregivers. Fear strangers
What is indiscriminate attachment stage?
Infants enjoy human company but tend to be indiscriminate
Stage of multiple attachments?
Attached to many people
Categories of attachment?
2 categories one with 2 sub categories
- Secure attachment
- Anxious/insecure attachment:
- Avoidant
- Ambivalent - Disorganized
What is secure attachment and percentage of children who have it?
-Confident baby, rarely cries, readily explores (70%)
What is anxious attachment: avoidant and the percentage of babies which have it?
-Avoidant (20%)
Avoids/ignores parent and strangers
What is anxious attachment: ambivalent and percentage of babies which have it?
10%
Ambivalent in the presence of parent but wary of strangers
Test responses of secure attachment?
- Distressed when mother leaves
- Avoidant of stranger when alone but friendly when mother present
- Positive and happy when mother returns
- Will use mother as a safe base to explore their environment
Test responses of ambivalent attachment?
- Infant shows signs of distress when mother leaves
- Infant avoids stranger: shows fear of stranger
- Child approaches mother but resists contact, may even push her away
- Infant cries more and explores less than other 2 types
Avoidant attachment responses in test ?
- Infant shows no sign of distress when mother leaves
- Infant is okay with stranger and plays normally when stranger present
- Infant shows little interest when mother returns
- Mother and stranger able to comfort infant equally
Characteristics of Type A Insecure avoidant?
- Avoid intimacy, dependence, disclosure
- Hard to engage
- View relationships as unimportant
- Don’t feel huge need for people
- Seen as cold- reported as lacking empathy/remorse
- Indifferent to other’s views: assume others dislike them
- Linked with higher incidence of somatising illness and hard drug use
Characteristics of Insecure ambivalent Type C?
- View of self = low value, ineffective, independent
- View of others: insensitive, unpredictable, unreliable
- 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
Behavioural symptoms of disordered attachment?
Lack of self-control/impulsiveness Lack of normal fear Self-destructive behaviours Destruction of property Aggression Constantly irresponsible Inappropriately demanding or clingy or has a pseudo maturity Stealing Lying/deceit Hoarding Inappropriate sexual behaviour Cruelty to animals Sleep disturbance Abnormal eating habits (hordes/gorges/refusal to eat/hides food) Enuresis and encopresis Hyperactivity Preoccupation with fire or gore Persistent nonsense questions/incessant chatter Poor hygiene Difficulties with change Difficulties with emotional change
Cognitive functioning symptoms of disordered attachment?
o Lack of cause and effect thinking o Learning disorders o Language disorders o Distorted self-image o Grandiose self of sense importance o ‘Black and white’ and ‘All or nothing’ thinking styles
Emotional symptoms of disordered attachment?
Core emotions are intense, feelings of anger, fear, pain, and shame Often appear disheartened and depressed with mood swings Struggle to express emotions Lack of affection Intense displays of rage Sadness, depression, helplessness Inappropriate expressions of emotions Mood swings Low self esteem
Social symptoms of disorganized attachment?
o Superficially engaging lacks genuine trust, intimacy, and affection
o Lack of eye contact for closeness
o Lack of per relationships
o Indiscriminately affectionate with strangers
o Cannot tolerate limits and external control
o Blames others for mistakes
o Victimises others
o Victimised by others
o Lacks trust in others
o Exploitative, bossy
Physical aspects of disordered attachment?
Poor hygiene Chronic body tension Accident prone High pain tolerance/ over reaction to minor injury Tactilely defensive
Signs of RAD?
- Noticeable neglectful behaviour from primary caregiver: not comforting baby/child in distress or not responding to needs like hunger etc
- Inappropriate interaction noticed between baby and primary caregiver
- Lack of smiling or responsiveness in baby or child
- Lack of distress in situations which should be expected to cause distress
- Inconsolable crying
- Indiscriminate excessive friendliness towards healthcare workers
- Emotional and behavioural difficulties
Presentation of conductive disorder?
- Aggression to people or animals
- Destruction of property
- Deceitfulness or theft
- Serious violation of rules
- Aggression:
Threatens/bullies or intimidates others
Often initiates fights
Physical weapon use
Physically cruel
Stolen
Forced someone into sexual activity - Destruction of property
