High rate of insecure attachment patterns in preterm infants at early school age.

AIM: In preterm infants, insecure attachment is associated with behavioural and emotional problems but data on attachment beyond toddler age are scarce. This study assessed attachment security at 6-8 years in very and moderate or late preterm infants. The results were compared to a non-clinical full-term sample. METHODS: Attachment security of 38 very and 20 moderate or late preterm infants was assessed during a home visit with the German version of the Attachment Story Completion Task. Attachment patterns of 28 full-term controls were taken from a previous study. Primary outcomes were attachment security and attachment security score. Secondary outcomes for the preterm groups were infant behavioural problems, parental stress, perceived social support, maternal depressive symptoms, and infant development. RESULTS: Very preterm infants had the highest rate of insecure attachment (81%) compared to moderate or late preterm infants (60%) and full-term infants (47%); (p = 0.013). Attachment security scores differed significantly between very preterm and full-term infants (p = 0.001). Secondary outcomes were similar in very and moderate or late preterm cohorts. CONCLUSION: Prematurity was associated with an increased risk of insecure attachment at early school age. Interventions targeting attachment security are reasonable considering the high rate of behavioural problems following premature birth.

[Attachment and Externalizing Behavior Problems in Primary School Children with ADHD]. / Bindungsrepräsentation und externalisierende Verhaltensauffälligkeiten von Grundschulkindern mit ADHS.

Attachment and Externalizing Behavior Problems in Primary School Children with ADHD When examining children with ADHD, attachment research does not usually differentiate between the different clinical pictures within the disorder. This study examines attachment and ADHD in children who display a simple or unspecified form of ADHD, in order to be able to draw specific conclusions about this particular group. Attachment, ADHD symptoms as well as externalizing behavior problems were assessed from 93 children aged five to nine years, 48 of whom had an ADHD diagnosis. The distributions of attachment representations between children with ADHD and those without ADHD differ greatly. In addition, externalizing behavior problems differ between attachment classifications. Attachment seems to be an important factor in the etiology of ADHD, however, ADHD as well as externalizing behavior problems as a global construct are too unspecific to determine the influence of attachment on the disorder. Subsequent studies should first focus on specific symptom patterns within the clinical picture whereas clinical practice should consider the parent-child relation an important factor in the development as well as the treatment of ADHD.