Exploring the role of OXTR gene methylation in attachment development: A longitudinal study.

The current study explored longitudinally whether oxytocin receptor gene methylation (OXTRm) changes moderated the association between parental sensitivity changes and children's attachment changes over three waves. Six hundred six Flemish children (10-12 years, 42.8%-44.8% boys) completed attachment measures and provided salivary OXTRm data on seven CpG sites. Their parents reported their sensitive parenting. Results suggest that OXTRm changes hardly link to attachment (in)security changes after the age of 10. Some support was found for interaction effects between parental sensitivity changes and OXTRm changes on attachment changes over time. Effects suggest that for children with increased OXTRm in the promotor region and decreased methylation in the inhibitor region over time, increased parental sensitivity was associated with increased secure attachment and decreased insecure attachment over time.

Oxytocin and state attachment responses to secure base support after stress in middle childhood.

We tried to replicate the finding that receiving care increases children's oxytocin and secure state attachment levels, and tested whether secure trait attachment moderates the oxytocin and state attachment response to care. 109 children (9-11 years old; M = 9.59; SD = 0.63; 34.9% boys) participated in a within-subject experiment. After stress induction (Trier Social Stress Test), children first remained alone and then received maternal secure base support. Salivary oxytocin was measured eight times. Secure trait and state attachment were measured with questionnaires, and Secure Base Script knowledge was assessed. Oxytocin levels increased after receiving secure base support from mother after having been alone. Secure state attachment changed less. Trait attachment and Secure Base Script knowledge did not moderate oxytocin or state attachment responses to support. This might mean that, regardless of the attachment history, in-the-moment positive attachment experiences might have a beneficial effect on trait attachment development in middle childhood.

A qualitative exploration of depressed female Iranian adolescents' attachment narratives.

It is assumed that depressed and suicidal adolescents struggle with issues reflecting insecure attachment. However, less is known about which insecure attachment-related themes characterize depression and suicidality in adolescents. To explore this further, semi-structured in-depth interview were conducted with 18 Iranian female adolescents (Mage = 16.6 ± 0.70), with depression and/or suicidal ideation or suicide attempts, who self-reported being insecurely attached. Qualitative data were analysed using thematic analysis. Three main themes were identified from the data: (1) quality of parenting, (2) attachment representation, and (3) attachment behavior. The theme parenting quality included the subthemes "emotionally absent", "emotionally supportive", "psychologically controlling", "overprotective", "punitive", "aggressive", and "passive". The theme attachment representation comprised: "not accepting", "not feeling loved", "not feeling understood", "lack of intimacy", "unreliable", "reliable", "mixed emotions", "hatred", and "dismiss and devaluation". The theme attachment behavior included "aggression", "relational avoidance", and "emotional role reversal". Findings point to the possible usefulness of attachment-based interventions to treat suicidal adolescents and their families in Iran. However, the results also showed culture-specific themes, pointing at the father-daughter relationship's unique importance, which deserves special attention in attachment-based interventions.

Editorial Perspective: On the need for clarity about attachment terminology.

Part of the appeal of attachment language is that it feels near to our everyday experience, as terms like 'attachment', 'security' or 'disorganisation' feel readily recognisable. Yet, not one of these terms is used by academic attachment researchers in line with ordinary language. This has hindered the evidence-based use of attachment in practice, the feedback loop from practice to research and the dialogue between attachment researchers in developmental psychology and in social psychology. This paper pinpoints the difficulties arising from the existence of multiple versions of 'attachment theory' that use exactly the same terms, held by communities that assume that they are referring to the same thing and with little infrastructure to help them discover otherwise. When we talk past one another, the different communities with a stake in knowledge of attachment are obstructed from genuinely learning from one another, drawing on their respective strengths and pursuing collaborations. One factor contributing to this situation has been the use of attachment terminology with technical meanings, but often without setting out clear definitions. We here introduce a guide to attachment terminology used by the academic community, which has recently been published on the website of the Society for Emotion and Attachment Studies. The guide is meant for researchers, clinicians and everyone concerned with attachment to increase understanding of the technical meaning of important terminology used by researchers, and support the quality of discussions between researchers, and between researchers and clinicians and other publics.

Cumulative family stress and externalizing problems: Secure base script knowledge as a protective factor.

The current study examined whether secure base script knowledge can buffer against higher concurrent externalizing problems and against relative increases in externalizing problems associated with cumulative family stress. We conducted a one-year longitudinal study with two waves between 2017 and 2019 in which 272 Dutch-speaking Western European children from Flanders (47.8% boys, M age = 10.20 , SD age = 0.60 ) participated. Secure base script knowledge was associated with lower concurrent externalizing problems (f2  = 0.03). High levels of secure base script knowledge also buffered against relative increases in externalizing problems associated with cumulative family risk (f2  = 0.02). These findings suggest that secure base script knowledge can mitigate the negative effects of a stressful family environment on externalizing problems.

Exploring everyday state attachment dynamics in middle childhood.

The current study explored dynamics of secure state attachment expectations in everyday life in middle childhood, specifically state attachment carry-over and reactivity to experiences of caregiver support in the context of stress. In two independent samples (one community sample, N = 123; one adoption sample, N = 69), children (8-12 years) daily reported on their state attachment for respectively 14 and 7 consecutive days. Additionally, they reported daily on their experiences of distress and subsequent experiences of caregiver support. Results in both samples indicated that secure state attachment on a day-to-day basis is characterized by a significant positive carry-over effect, suggesting that state attachment fluctuations are (partially) self-predictive. In Study 1, experiencing no support following distress significantly related to intraindividual decreases in secure state attachment; in Study 2, experiencing effective support during distress related to intra-individual increases in secure state attachment. Taken together, the current studies provide novel and important insights into how state attachment temporally evolves on a day-to-day basis in middle childhood.

Roles of recalled parenting experiences and effortful control in adult daily emotion regulation.

Research suggests that both childhood experiences with one's parents and individual differences in effortful control contribute to adult emotion regulation (ER). However, it is unclear how they associate with specific ER processes. In this adult study, we examined the roles of recalled parenting experiences and effortful control in daily ER selection and implementation. Using ecological momentary assessment (EMA), we focused on ER strategies of reappraisal, suppression, and rumination. We hypothesized recalled parental warmth, rejection, and overcontrol to predict adult ER selection and effectiveness of ER implementation and effortful control to mediate these effects. One hundred twenty-two adults answered self-reported questionnaires on their childhood experiences with their parents and effortful control. In EMA, they reported ER and emotions seven times daily for seven days. Recalled parental warmth predicted less suppression and rumination, whereas recalled overcontrol, especially in fathers, predicted greater suppression and reappraisal. However, recalled parenting experiences did not predict the effectiveness of ER implementation, and no support was found for the mediating role of effortful control between recalled parenting experiences and ER. Our findings suggest that recalled parenting experiences may guide adult ER selection rather than shape ER implementation, and these links may be largely independent of their effortful control.

Multisystem physiological reactivity during help-seeking for attachment needs in school-aged children: differences as a function of attachment.

In this study, we sought to expand on what is currently known regarding autonomic nervous system (ANS) reactivity in middle childhood as a function of attachment. ANS activity includes multiple indices - respiratory sinus arrhythmia (RSA) is an index of parasympathetic nervous system activation (PNS) and electrodermal activity (EDA) is an index of sympathetic nervous system activation (SNS). Children (N = 103) completed Child Attachment Interviews and read vignettes describing situations aimed to activate attachment needs (NEED; e.g., getting hurt, which can elicit need for comfort or assistance) and help-seeking (HS; when children experience need and seek comfort from attachment figures), while SNS and PNS reactivity were monitored. Attachment was not associated with children's SNS or PNS reactivity during NEED, but attachment was associated with physiological reactivity during HS: Dismissing attachment was associated with greater SNS activation (higher EDA) and preoccupied attachment with PNS deactivation (lower RSA, greater vagal withdrawal) during HS.

Middle childhood attachment-based family therapy: Theory and model description.

In middle childhood, the first manifestations of mental health problems can emerge and become a precursor of mental health issues in adolescence. Given that weak parent-child attachment can contribute to this distress, it is possible that strengthening the attachment bond could reduce risk trajectory. Unfortunately, evidence-based attachment-focused interventions are lacking at this age. Attachment-based family therapy (ABFT) is a well-studied intervention for troubled adolescents and has the potential to be extended downward to children. However, ABFT for adolescents focuses on mentalization and trauma conversation strategies that may be developmentally advanced for children's capacities. Therefore, we modified the intervention strategies to be more developmentally sensitive to childhood. Middle childhood ABFT (MCABFT) builds on the theory that insecure attachment develops through a learning process that can be interrupted and reorganized to promote secure attachment development. MCABFT uses less conversation and more play and puts parents more at the center of the therapy compared with ABFT for adolescents. In this article, we describe MCABFT's theoretical and clinical model.

Perceived Parental Support and Psychological Control, DNA Methylation, and Loneliness: Longitudinal Associations Across Early Adolescence.

A broad range of factors have been associated with the development of adolescent loneliness. In the family context, a lack of parental support and high levels of parental psychological control have systematically been linked to loneliness. On the biological level, DNA methylation (which is an epigenetic process that suppresses gene expression) is believed to play a role in the development of loneliness. Specifically, high levels of DNA methylation in genes that play an important role in the functioning of the human stress response system are believed to elevate the risk of loneliness. Moreover, DNA methylation levels in these stress-related genes can be influenced by stressful environmental factors, suggesting a potential mediating role of DNA methylation in the association between parenting behaviors and loneliness. The current 3-year longitudinal study is the first study to examine the potential bidirectional longitudinal associations between loneliness, DNA methylation in stress-related genes, and both perceived parental support and psychological control. Furthermore, we explored the potential mediating role of DNA methylation in stress-related genes in the associations between perceived parenting and loneliness. The sample comprised 622 early adolescents (55% girls, Mage T1 = 10.77 years, SDage T1 = 0.48) who were followed from Grade 5 to 7. Parental support, psychological control, and loneliness were assessed annually by adolescent self-report questionnaires and DNA methylation was determined from saliva samples. Cross-Lagged Panel Models (CLPM) revealed that higher levels of loneliness predicted lower perceived parental support and higher perceived psychological control over time, as well as higher DNA methylation in some stress-related genes, that is, the glucocorticoid receptor gene (NR3C1) and the brain-derived neurotrophic factor (BDNF). In addition, higher NR3C1 methylation was predictive of lower perceived parental support and higher psychological control over time. No evidence was found for a mediating role of DNA methylation. Overall, our longitudinal findings challenge the current focus on DNA methylation and parenting behaviors as risk factors for adolescent loneliness. Instead, they suggest that the less considered direction of effects, which implies that loneliness predicts DNA methylation and aspects of parenting such as support and psychological control, should receive greater attention in future research.

Piloting attachment psychoeducation provided to parents of children with severe disabilities: Testing the feasibility of a digital micro-intervention.

BackgroundA digital micro-intervention offering attachment psychoeducational videos was explored regarding its feasibility in parents of children with severe disabilities. Method: A mixed-methods study (including daily diaries and one-time questionnaires) with 16 parents (75.0% female) of children with severe disabilities (up to 10 years of age) was done during a three-week intervention. Results: Parents were positive about the video series and almost no drop-out occurred. The videos stimulated their learning and thinking and offered parents some personal meaning. Preliminary efficacy tests showed no major changes in parents' parenting self-efficacy (PSE) or perceptions of statements on parent-child attachment. Conclusions: The study showed promising results regarding the micro-interventions' acceptability and implementation. The limited efficacy testing did not show major changes in parents' PSE. Further research is needed to investigate the differential relevance of the micro-intervention, based on parents' needs, as well as its optimal embeddedness in a broader intervention trajectory.

An empirical test of prototype and revisionist models of attachment stability and change from middle childhood to adolescence: A 6-year longitudinal study.

We examined the prototype v. revisionist models of attachment stability with a five-wave, 6-year, longitudinal study of attachment security from middle childhood to adolescence in a White Western European sample (N = 157; Wave 1 Mage  = 10.91, SD = 0.87; 52% female). Attachment was assessed using both questionnaire (Experiences in Close Relationships) and narrative-based measures (Attachment Script Assessment). In addition, a set of potential moderators of prototype-like stability were examined. Results indicated that data from both attachment assessments best fit the prototype model. Moderator analyses indicated that male sex significantly undermined the influence of an attachment prototype and parent-child conflict and parental divorce enhanced the influence of an attachment prototype on stability.

Dynamics of attachment and emotion regulation in daily life: uni- and bidirectional associations.

Attachment theory proposes that the activation of the attachment system enacts emotion regulation (ER) to maintain security or cope with insecurity. However, the effects of ER on attachment states and their bidirectional influences remain poorly understood. In this ecological momentary assessment study, we examined the dynamics between attachment and ER. We hypothesised that attachment states and ER influence each other through time. Specifically, we hypothesised bidirectional short-term cycles between state attachment security and reappraisal, state attachment anxiety and rumination, and state attachment avoidance and suppression. We also tested how trait attachment is related to state attachment and ER. One hundred twenty-two participants (Mage = 26.4) completed the Experiences in Close Relationship-Revised and reported state attachment and ER seven times daily for seven days. The results were only partly consistent with our cycle hypotheses yet revealed a cycle between low state attachment security and rumination that was attenuated by reappraisal. Moreover, rumination and suppression predicted increased insecure states, and reappraisal predicted increased secure and insecure states. Finally, trait attachment showed associations with state attachment and ER. Our study suggests regulatory dynamics between attachment and ER and opens important questions about their functional relationship in maintaining attachment-related behavioural patterns and emotional well-being.

Attachment and brooding rumination during children's transition to adolescence: the moderating role of effortful control.

Brooding rumination is a maladaptive form of emotion regulation and confers a risk for psychopathology. Insecure attachment and low cognitive self-regulation are important antecedents of brooding. Yet, little is known about the developmental interplay between these two systems. Thus, we tested how children's attachment and cognitive self-regulation, conceptualized as effortful control (EC), interact to predict brooding. The participants in the three-wave longitudinal study were n = 157 children (10 to 14 years) and their mothers. Children reported their attachment and brooding, and mothers reported children's EC. Results showed that children with low avoidance received benefit from high EC to decrease brooding, whereas children with high anxiety brooded irrespective of EC. Thus, high EC may foster constructive emotion regulation among securely attached children, whereas the beneficial effects of high EC on emotional functioning seem to be overridden by insecurity. The functional role of cognitive self-regulation on different attachment strategies is discussed.

Attachment development in children adopted from China:The role of pre-adoption care and sensitive adoptive parenting.

The current study examined the attachment development of 92 internationally adopted Chinese girls, focusing on the influence of type of pre-adoption care (institutional versus foster care) and sensitive adoptive parenting. Although the children were more often insecurely attached than non-adopted children 2 and 6 months after adoption (Times 1 and 2, N = 92), they had similar levels of secure base script knowledge (SBS knowledge) as a non-adopted comparison group at age 10 (Time 3, N = 87). Furthermore, concurrently observed sensitive parenting was positively associated with SBS knowledge. Finally, a significant interaction between type of pre-adoption care and early-childhood sensitive parenting indicated that the post-institutionalized children showed a stronger increase in security than the post-foster children when parents were more sensitive.

Attachment and the Development of Depressive Symptoms in Adolescence: The Role of Regulating Positive and Negative Affect.

Although widely accepted, attachment theory's hypothesis that insecure attachment is associated with the development of depressive symptoms through emotion regulation strategies has never been longitudinally tested in adolescence. Additionally, previous research only focused on strategies for regulating negative affect, whereas strategies for regulating positive affect may also serve as a mechanism linking insecure attachment to depressive symptoms. This study aimed to fill these research gaps by testing whether the association between attachment and change in depressive symptoms over time is explained by strategies for regulating negative and positive affect in adolescence. Adolescents (N = 1706; 53% girls; Mage = 12.78 years, SDage = 1.54 at Time 1) were tested three times, with a 1-year interval between measurement times. They reported on their attachment anxiety and avoidance at Time 1, depressive symptoms at Times 1 and 3, and regulation of negative affect (brooding and dampening) and positive affect (focusing and reflection) at Time 2. The results from multiple mediation analyses showed that more anxiously attached adolescents developed more depressive symptoms via increased brooding and dampening. More avoidantly attached adolescents developed more depressive symptoms via decreased focusing. These findings provide longitudinal support for attachment theory's emotion regulation hypothesis, and show that the regulation of both negative and positive affect is important.

Reactive attachment disorder symptoms and prosocial behavior in middle childhood: the role of Secure Base Script knowledge.

BACKGROUND: Children with attachment disorder show prosocial behavior problems. Children with a reactive attachment disorder show inhibited and emotionally withdrawn behavior. Consequently, these children typically display prosocial behavior problems. However, the underlying mechanism between reactive attachment disorder and prosocial behavior problems is still unclear and findings in literature are mixed. METHODS: The current study investigated the role of children's attachment representations in this association. Attachment representations reflect knowledge about a cognitive script regarding the attachment figure as a source for support (Secure Base Script). We tested whether secure base script knowledge 1) mediates or 2) moderates the link between reactive attachment disorder and prosocial behavior problems in 83 children (6-11 years; 83.1% boys) recruited from special education schools for children with behavioral problems. Children completed a pictorial Secure Base Script Test. Their reactive attachment disorder symptoms were assessed during an interview with the primary caregivers. Primary caregivers and teachers filled out a prosocial behavior questionnaire about the child. RESULTS: Results did not support the mediation hypothesis, but evidence for the moderation hypothesis was found. Secure base script knowledge attenuated the negative association between attachment disorder symptoms and prosocial behavior. CONCLUSIONS: These findings contribute to the discussion about the link between attachment representations and attachment disorders.

Investigating the interplay between parenting dimensions and styles, and the association with adolescent outcomes.

Research has indicated that a strictly dimensional or parental style approach does not capture the full complexity of parenting. To better understand this complexity, the current study combined these two approaches using a novel statistical technique, i.e., subspace K-means clustering. Four objectives were addressed. First, the study tried to identify meaningful groups of parents in longitudinal adolescent reports on parenting behaviour. Second, the dimensional structure of every cluster was inspected to uncover differences in parenting between and within clusters. Third, the parenting styles were compared on several adolescent characteristics. Fourth, to examine the impact of change in parenting style over time, we looked at the cluster membership over time. Longitudinal questionnaire data were collected at three annual waves, with 1,116 adolescents (mean age = 13.79 years) at wave 1. Based on five parenting dimensions (support and proactive, punitive, psychological and harsh control), subspace K-means clustering, analysed per wave separately, identified two clusters (authoritative and authoritarian parenting) in which parenting dimensions were interrelated differently. Authoritative parenting seemed to be beneficial for adolescent development (less externalising problem behaviour and higher self-concept). Longitudinal data revealed several parenting group trajectories which showed differential relations with adolescent outcomes. Change in membership from the authoritative cluster to the authoritarian cluster was associated with a decrease in self-concept and an increase in externalising problem behaviour, whereas changes from the authoritarian cluster to the authoritative cluster were associated with an increase in self-concept and a decrease in externalising problem behaviour.

Comfort provided by parents versus strangers after eliciting stress in children with severe or profound intellectual disabilities: does it make a difference?

The relationships between children with severe or profound intellectual disabilities (ID) and their parents may fulfil attachment functions, such as regulating emotional responses to stress. This study examined the extent to which children with severe or profound ID differentiate between their parents and a stranger as a resource for stress-regulation. A home-based experimental paradigm was conducted and video-recorded in 38 families. Children (1-8 years) were exposed to four naturalistic stressors followed by comfort, randomly provided by the parents or the stranger. Emotional behaviour (arousal and valence) and the skin conductance level were simultaneously recorded. With regard to both emotional behaviour and skin conductance, children significantly differentiated between their parents as attachment figures and the stranger during stress and comfort, despite their impairments on various developmental domains. Behavioural observation and physiology show complementary manifestations of parent-child attachment in this population.

Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation.

Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.

Los sistemas de asistencia de menores de todo el mundo demuestran cada vez más interés en adoptar estrategias clínicas empíricamente informadas para aumentar la eficacia de los tratamientos. Existen muchos tratamientos respaldados empíricamente, pero se sabe poco acerca de los elementos obstaculizadores y facilitadores para la implementación de dichos tratamientos en los sistemas de asistencia de menores. Este estudio analizó las experiencias de los prestadores de sistemas de asistencia de menores a la hora de implementar la terapia familiar basada en el apego en los servicios domiciliarios del sistema flamenco de asistencia de menores (en Bélgica). Se entrevistó a dieciséis prestadores de sistemas de asistencia de menores (doce terapeutas y cuatro supervisores) implicados en tres servicios domiciliarios. Se utilizó el "Marco Consolidado para la Investigación de Implementación" (Consolidated Framework for Implementation Research,CFIR) para guiar la recopilación, la codificación y el análisis de los datos de las entrevistas. Los resultados revelaron que el éxito de la implementación estuvo relacionado con la adecuación de la terapia familiar basada en el apego con la misión, la filosofía y las prácticas existentes de los sistemas de asistencia de menores. La confianza de los prestadores de sistemas de asistencia de menores en la compatibilidad entre la terapia familiar basada en el apego y los sistemas de asistencia de menores aumentó la inversión en los esfuerzos de implementación y en la perseverancia para superar dificultades y contratiempos. Algunos obstáculos estuvieron relacionados con el aprendizaje de la terapia familiar basada en el apego y algunos otros con dificultades a nivel de los sistemas, como la falta de liderazgo y apoyo, la mala coordinación con fuentes de derivaciones y con otros acompañantes en el cuidado de los jóvenes, y con la falta de apoyo a las políticas. Para diseminar satisfactoriamente los tratamientos respaldados empíricamente en el marco de los sistemas de asistencia de mejores es necesario abordar diferentes obstáculos en múltiples niveles sistémicos.