[Practitioners in Psychotherapy can Improve their Competences in Assessing Attachment in Middle Childhood: Psychometric Quality of an Attachment Screening Tool Relevant forTherapy]. / Stärkung bindungsdiagnostischer Kompetenz von Praktiker/innen in der Psychotherapie: Güte eines therapiebezogenen Bindungsinstrumentes für die mittlere Kindheit.

Attachment narratives are increasingly used as a diagnostic tool in the therapeutic work with children in middle childhood. This, however, demands extensive procedures to ensure its adequate analysis and reliability.Thus, a new diagnostic instrument has been developed. It is a short version of the coding procedure used in the German Attachment Story Completion Task (GASCT) andmakes use of the idea of traffic lights. It can be understood quite intuitively and can be applied time-economically in practice. Instead of a qualitative classification into four attachment groups it results in a five-graded clinical assessment of the child's attachment security towards his or her attachment figures. This can be compared to the attachment security score of the GASCT. Psychometric qualities of the "Attachment Story Completion Light" were analyzed in a sample of 50 patients of a child and adolescent psychiatric hospital aged between four and eight years. Reliability was high, validity of the new instrument was also satisfying, regarding it's association with the original GASCT. For applying the new attachment screening tool a supervised training is required.The tool will enable practitioners to better recognize strengths and difficulties in the attachment representations of children and to plan adequate individualized therapy. As a rating identifying developmental risks, the instrument can help to clarify therapeutic procedures as well as service delivery for child and family.

Attachment disorder and attachment theory - Two sides of one medal or two different coins?

INTRODUCTION: Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9. METHODS: A total of 135 children aged between 5 and 9 years (M=7.17 years, SD=1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development. RESULTS: The prevalence of AR in children with AD was 28.6% for the 'secure' form of AR, 17.1% for the 'insecure-avoidant' form, 25.7% for the 'insecure-ambivalent' form, and 28.6% for the 'disorganized' form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills. CONCLUSIONS: Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models.

Narratives of attachment in middle childhood: do gender, age, and risk-status matter for the quality of attachment?

Attachment in middle childhood increasingly attracts the interest of developmental psychologists and clinicians. Recent studies using attachment narratives elicited by story stems reported gender-specific aspects of attachment development, potentially evoked by developmental tasks during this period of the life span. There is evidence that children with risk factors present more insecure and disorganized attachment narratives compared to children without risk. Yet, there is little research concerning the joint effects of gender, risk, and age for attachment classifications. The paper presents a pooled analysis of 22 samples (eight risk samples) including 887 children (411 girls), aged between 4.5 and 8.5 years who were assessed with the same "German Attachment Story Completion Procedure" (GASCP). Girls were 1.8 times more likely to present secure and 0.4 times less likely to present disorganized narratives compared to boys when controlling for risk status and age. Children from risk samples were more likely (odd ratio 5.4) to display disorganized and less likely to show a secure attachment (odd ratio 0.3) compared to those from no-risk samples in multilevel logistic regressions. Remarkably, the effect of risk was not moderated by age and gender, and gender effects were not moderated by age.

[Assessment methods and preventive measures focusing on relationships]. / Beziehungsorientierte Diagnostik und Intervention im Kindesalter--Einführung in das Themenheft.

In this contribution relationship-oriented assessment methods and preventive measures during infancy and childhood are founded in an ecological and differential understanding of development in context. Using selected developmental milestones it is demonstrated that relationships as a social context play an important role particularly during early infancy. Criteria for describing well functioning and maladaptive relationships can be derived from theoretical presumptions, empirical longitudinal studies and health related clinical judgements. These criteria may serve as guidelines for interventions, especially in cases of children with a clinical diagnosis of child neglect. Possible procedures to assess the quality of relationships are discussed using methods from contributions in this issue of the journal as examples. Diagnostic and preventive procedures are seen as mutually interacting within continuous feedback loops, where assessment procedures serve to both give evidence for the efficacy of interventions and for specifying further preventive methods.

[Attachment behavior with respect to mothers and fathers and attachment representations in five and seven-year-old children]. / Bindungsverhalten zu Mutter und Vater und Bindungsrepräsentation bei Kindern im Alter von fünf und sieben Jahren.

During preschool and early school age attachment quality can be assessed by different means: at the behavioral level by the Strange Situation (SS), at the representational level by semiprojective methods using story stems or pictures. Both methods gain access to different levels of a theoretically assumed inner working model of attachment, in which attachment at the behavioral level is supposed to be person specific, attachment at the representational level generalized. This study aimed at analyzing whether attachment behavior to mother and father is associated, and how it is linked to the generalized attachment representation. It was also examined whether in the case of no association between mother and father attachment behavior towards the major attachment figure is linked to the attachment representation. In the Duesseldorf study 67 children aged 5 years were observed in the SS with mother, 31 of them also in the SS with father. At the age of 6.5 years an attachment story completion task was conducted. When person specific attachment to mother and father was congruent (SS secure n=6, or insecure n=8) the attachment representation was consistent as well, when father and mother attachment were discrepant no association with attachment representation could be found. The findings did not confirm a stronger influence of the major attachment figure on the formation of the attachment representation.

Attachment representations in 6-year-olds: related longitudinally to the quality of attachment in infancy and mothers' attachment representations.

A new method to assess attachment representations in children by applying a story completion procedure in doll play (SCPDP) is presented. Transmission and continuity of attachment were tested in 28 German families by using the Strange Situation procedure (SS) with the mother and her infant, the Adult Attachment Interview (AAI) with the mother when the child is 5 years old, and the attachment representations (SCPDP) of the 6-year-olds. Relying on the twofold distinction (secure/insecure), results revealed a significant continuity of attachment from 1 to 6 years of age, and a correspondence between maternal AAI and child's attachment quality in SS, as well as a correspondence between maternal AAI and the 6-year-olds' attachment representations. Using configural frequency analysis, we found continuity in patterns of security and insecurity when looking across the measures of infant and pre-school attachment and maternal adult attachment. Processes underlying the high match of mothers' and children's attachment representations are discussed.