Fix my child: The importance of including siblings in clinical assessments.

AIMS: This study examined concordance in the attachment strategies of school-aged siblings with reference to environmental risk in terms of poverty and maltreatment. It also investigated the effect of child maltreatment and maternal mental illness on children's psychosocial functioning in terms of the Dynamic-Maturational Model of Attachment and Adaptation (DMM) including unresolved trauma and the DMM Depressed modifier. METHODS: The attachment strategies of 30 sibling pairs, aged 5-14 years, were assessed using the School-age Assessment of Attachment (SAA). Unlike most previous studies, this study included siblings from large families of two to six children. RESULTS: The main finding was that as environmental risk increases, the diversity of sibling attachment strategies decreases with greater recourse to the DMM Type A3-6 and A/C strategies. Unlike previous studies, the highest level of concordance was found in sibling pairs with the opposite gender. Boys whose mothers had a history of mental illness were significantly more likely than girls to be assessed with the DMM-depression modifier. CONCLUSION: As danger increases, children in the same family experience more of the same childhood. Further research should focus on single case, intra-familial studies to build a systemic model of the shared environment. Research should also evaluate the effects of environmental risk compared with size of the sibling group on children's attachment strategies. The clinical implications point to the importance of assessing all children in the family using a model built around functional formulation rather than diagnosing the symptoms of a particular child.

The Meaning of the Child Interview: A new procedure for assessing and understanding parent-child relationships of 'at-risk' families.

Reder and Duncan's well-known studies of the 1990s on fatal child abuse drew attention to how parental scripts regarding their children could dangerously distort relationships in ways that were sometimes fatal to children. This article reports on a new system for assessing the 'meaning of the child to the parent', called the Meaning of the Child Interview (MotC). Parents are interviewed using the established Parent Development Interview, or equivalent, and the transcript of the interview is then analysed according to parental sensitivity and likely risk to the child. The MotC constructs were developed from those used in observed parent-child interaction (specifically, the CARE-Index) and the form of discourse analysis used in the Dynamic Maturational Model - Adult Attachment Interview, allowing a more systemic and inter-subjective understanding of parenting representations than often put forward. This article discusses the theoretical background to the MotC, gives a brief review of similar measures and then introduces the coding system and patterns of caregiving. The validity of the MotC is addressed elsewhere.

Assessing attachment in the school years: the application of the Dynamic Maturational Model of Attachment to the coding of a child attachment interview with community and looked-after children.

BACKGROUND: This article reports on the analysis of a Child Attachment Interview using the Dynamic Maturational Model (DMM) of attachment coding system developed by Crittenden for use with the Adult Attachment Interview (AAI). The aim of the study was to see if the two coders could classify the child interviews using the DMM-AAI approach and produce the range of DMM attachment strategies to be expected from previous research and the literature. METHODS: Two coders independently classified interviews with 41 children aged between 6 and 13 years with an average age of 9.8 years. In total, 24 of the children were from a local authority middle school (the community children) and 17 were in foster care (looked-after children). RESULTS: The full array of DMM strategies was identified, with significant differences between the community and looked-after children in terms of attachment security and lack of resolution of loss and trauma. There was 100% agreement between coders on secure versus insecure attachment patterns, a Kappa of .910 for the full range of DMM attachment strategies and Kappas of between .655 and .773 for unresolved loss, trauma and depression. Discussion focuses on the strengths and deficits of the use of the DMM compared with other published work on child attachment interviews, the use of interviews to assess post-traumatic stress disorder in children and the implications of defensive attachment strategies for services offered to looked-after children.

DMM assessments of attachment and adaptation: Procedures, validity and utility.

This article gives a brief over view of the Dynamic-Maturational Model of attachment and adaptation (DMM; Crittenden, 2008) together with the various DMM assessments of attachment that have been developed for specific stages of development. Each assessment is discussed in terms of procedure, outcomes, validity, advantages and limitations, comparable procedures and areas for further research and validation. The aims are twofold: to provide an introduction to DMM theory and its application that underlie the articles in this issue of CCPP; and to provide researchers and clinicians with a guide to DMM assessments.