Precursors and Effects of Self-reported Parental Reflective Functioning: Links to Parental Attachment Representations and Behavioral Sensitivity.

Parental reflective functioning is thought to provide a missing link between caregivers' own attachment histories and their ensuing parenting behaviors. The current study sought to extend research on this association involving 115 parents, both mothers and fathers, of 5-to-6-year-old preschoolers using the German version of the Parental Reflective Functioning Questionnaire (PRFQ). Our study was the first to combine Adult Attachment Interview classifications of parental attachment, behavioral observations of parental sensitivity and PRFQ ratings while drawing on a sizable father subsample. We found theoretically consistent significant relations between all measures, while our results particularly highlighted the role of dismissing attachment for decreases in parenting quality on both cognitive and behavioral levels as the dismissing status differentially affected specific components of self-reported parental reflective functioning and observed sensitivity. Interestingly, these patterns were largely comparable in mothers and fathers. Exploratory mediation analyses further suggested that decreased parental reflective functioning may partially mediate the relationship between parents' dismissing attachment and decreased parental sensitivity. Thus, for prevention and intervention programs targeting parental sensitivity and thus children's long term healthy mental development, the interplay between parental reflective functioning and parents' own attachment history emerges as a key mechanism. Finally, our study served as a further validation of the PRFQ given the caveat that the pre-mentalizing subscale may need further revision in the German version.

Deactivating attachment strategies associate with early processing of facial emotion and familiarity in middle childhood: an ERP study.

Neurophysiological evidence suggests associations between attachment and the neural processing of emotion expressions. This study asks whether this relationship is also evident in middle childhood, and how it is affected by facial familiarity. Attachment strategies (deactivation, hyperactivation) were assessed in 51 children (9 - 11 years) using a story stem completion task. Event-related potentials (ERPs) were recorded during children's passive viewing of mother and stranger emotional faces (angry/happy). At the stage of facial information encoding (N250), attachment deactivation was associated with a pattern pointing to increased vigilance towards angry faces. Further, the attention-driven LPP was increased to happy mother faces as highly salient stimuli overall, but not in children scoring high on deactivation. These children did not discriminate between mothers' facial emotions and showed a general attentional withdrawal from facial stimuli. While our results on attachment deactivation support a two-stage processing model, no effect of hyperactivation was found.

Family risk and early attachment development: The differential role of parental sensitivity.

Family risks are known to be detrimental to children's attachment development. This study investigated whether parental sensitivity plays different roles in early attachment development in the context of risk: Sensitivity was hypothesized to mediate risk effects on attachment, as well as a moderator that shapes the relation between risk and attachment. Multiple family risks, parental sensitivity (defined as responsivity and supportive presence), and children's attachment security of 197 infants and toddlers (Mage  = 15.25 months) and their caregivers were assessed in a prospective study with a cohort-sequential-design in Germany. Caregivers' sensitivity served as a mediator of risk effects on attachment as well as a moderator that buffers adverse consequences of risk. Early sensitivity might be relevant in setting the stage for attachment development supporting resilience.

A los riesgos familiares se les conoce como perjudiciales para el desarrollo de la afectividad en los niños. Este estudio investigó si la sensibilidad del progenitor juega diferentes papeles en el temprano desarrollo de la afectividad en el contexto de riesgo: La hipótesis es que la sensibilidad sirve de intermediaria de los efectos del riesgo sobre la afectividad, y también como una moderadora que moldea la relación entre el riesgo y la afectividad. Los riesgos familiares múltiples, la sensibilidad del progenitor (definida como la presencia de receptividad y apoyo) y la seguridad de la afectividad del niño en 197 infantes y niños pequeñitos (M = 15.25 meses) y de quienes les cuidaban fueron evaluadas en un estudio de probabilidad con un diseño secuencial de grupo en Alemania. La sensibilidad de quien presta el cuidado sirvió como mediadora de los efectos del riesgo sobre la afectividad, así como también de moderadora que amortigua las consecuencias adversas del riesgo. La temprana sensibilidad pudiera ser relevante para sentar las bases de la fortaleza de resistencia de apoyo al desarrollo de la afectividad.

Les risques de la famille sont connus comme étant préjudiciables au développement de l'attachement des enfants. Cette étude s'est attachée à étudier si la sensibilité parentale joue des rôles différents dans le développement précoce de l'attachement dans le contexte de risque: on a pris comme hypothèse que la sensibilité a servi de médiatrice aux effets de risque sur l'attachement, et a également servi de modératrice qui forme la relation entre le risqué et l'attachement. Les risques familiaux multiples, la sensibilité parentale (définie comme réceptivité et présence de soutien), et la sécurité de l'attachement de 197 nourrissons et jeunes enfants (M = 15,25 mois) et des personnes prenant soin d'eux ont été évalués dans une étude prospective avec un plan séquentiel-cohorte, en Allemagne. La sensibilité de la personne prenant soin de l'enfant a servi de médiateur pour les effets de risque sur l'attachement ainsi que de modérateur qui amorti les conséquences adverses de risque. La sensibilité précoce peut s'avérer pertinente dans la préparation du terrain pour le développement de l'attachement qui souvient la résilience.

Inhibited symptoms of Attachment Disorder in children from institutional and foster care samples.

The main objective of the article was to study the prevalence of symptoms of the inhibited attachment disorder depending on type and quality of the caregiving environment. Analyses were based on data of a sample of institutionalized children from Georgia (N = 16), and two samples of foster children from Georgia (N = 27) and Germany (N = 55). Inhibited attachment disorder symptoms were assessed by the Disturbances of Attachment Interview (DAI) and the Rating of Inhibited Attachment Behavior (RInAB). Further assessments included behavior problems in children, quality of caregiving behavior in foster parents/caregivers, and presence of preferred caregiver in the institution. Regarding inhibited attachment behavior, expected differences between institutional (high scores) and foster samples (low scores) found for both measures (RInAB and DAI), and convergent validity between these measures was found in the institutional sample, but not in the foster samples. There were also indications of construct validity (regarding preferred caregiver in institution and caregiver supportive presence). The findings also suggest methodological issues brought about by skewed distributions of positive and negative measures in high-risk and low-risk samples, respectively.

[Symptoms of Attachment Disorder, Behavioral Regulation and Physiological Stress in Institutionalized Children]. / Bindungsstörungssymptome, Verhaltensregulation und physiologische Belastung bei Heimkindern.

Symptoms of Attachment Disorder, Behavioral Regulation and Physiological Stress in Institutionalized Children The aim of the study was to investigate the influence of attachment status (availability of a specific caregiver) and caregiving quality on behavioral and physiological adaptation and attachment disorder in institutionalized children. In a sample of children from a Georgian children's home, attachment disorder symptoms were assessed by interview and attachment and exploration behavior as well as self-regulatory behavior were assessed by observation in the natural group setting as well in structured dyadic situations. The child circadian cortisol level was determined to assess physiological adaption. Quality of caregiving was assessed in terms of sensitivity by observation. While attachment status affected the occurrence of attachment disorder symptoms and physiological stress, patterns of regulation in terms of attachment-exploration-balance and self-regulatory behavior were predicted by caregiver sensitivity.

Disorganized attachment in infancy: a review of the phenomenon and its implications for clinicians and policy-makers.

Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static "trait" of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.

[Attachment Representation and Emotion Regulation in Patients with Burnout Syndrome]. / Repräsentationen früher Bindungsbeziehungen und Emotionsregulation bei Patienten mit Burnout-Syndrom.

OBJECTIVE: Burnout describes a syndrome of exhaustion resulting from insufficient coping with work-related distress. We investigated if patients that are being clinically treated for burnout show insecure and unresolved attachment representation more often compared with healthy controls. METHODS: 50 out of 60 consecutive burnout patients participated in the study. Mental representation of attachment was measured by using the Adult Attachment Interview. Additionally, we administered the Self Report Questionnaire to Assess Emotional Experience and Emotion Regulation and several burnout specific questionnaires. A population sample was used as control group. RESULTS: Burnout patients were classified as insecurely attached significantly more often than controls. Unresolved attachment status concerning loss or trauma was found significantly more often within the burnout sample. Patients with insecure attachment representation reported a lower subjective significance of work. Patients with avoidant insecure attachment showed more depersonalisation. Patients with unresolved loss/trauma reported less social support. They showed more passive-negative emotion experience and emotion regulation characterized by externalization. CONCLUSION: The results of the study suggest that an insecure or unresolved attachment representation might constitute an intrapersonal risk factor for the development of burnout syndrome.

[Growing up under adversity in Germany : Design and methods of a developmental study on risk and protective mechanisms in families with diverse psychosocial risk]. / Aufwachsen unter familiärer Belastung in Deutschland : Design und Methoden einer entwicklungspsychologischen Studie zu Risiko- und Schutzmechanismen bei Familien mit unterschiedlicher psychosozialer Belastung.

Family adversity comprises many risk factors for parents and children. The German early intervention approach Frühe Hilfen aims at providing enduring, effective, and scientifically validated prevention and intervention for effective child protection against those risks. The study on risk and protective mechanisms in the development of families with diverse psychosocial risks aims at identifying those mechanisms that cause and stabilize or moderate and diminish maltreatment and neglect, as well as cognitive, social, and emotional developmental deviations in risk families, specifically in the current German social and child protection system. The study examines the development of competence and early behavior problems in a sample of infants and toddlers and the interaction quality with their caregivers by applying a longitudinal sequential-cohort design. The assessments include developmental tests, systematic observations, and questionnaire data. First results suggest stable risk group membership and moderate stability of single risk factors.

[Early Intervention and Cognitive Development: A Longitudinal Study with Psychologically Stressed Mother-Child-Dyad during Early Childhood]. / Frühe Hilfen und kindliche kognitive Entwicklung: Eine längsschnittliche Pilotuntersuchung psychosozial belasteter Mutter-Kind-Paare in der frühen Kindheit.

Early intervention programs aiming at developing parents' relationship and parenting skills and supporting young families have become increasingly established in Germany throughout the last decade. The present longitudinal study analyzed 53 children and their mothers receiving early intervention due to their psychosocially highly challenging life situations and personal circumstances. The children were examined at birth and at an age of twelve months as well as between ages two and four. The results revealed that the child's cognitive development could be predicted by both maternal sensitivity and mother's psychosocial stress. However, the amount, type, and intensity of early intervention did not have any effect on the child's development. In terms of the effectiveness of early interventions the results implicate that interventions seems to be offered in an unspecific manner and does not contribute to an improvement of the child's developmental status.

[The Relationship Between Attachment Representations of Foster Parents and Foster Children and the Role of the Child's Sex]. / Der Zusammenhang von Bindungsrepräsentationen zwischen Pflegeeltern und Pflegekindern unter Berücksichtigung von Geschlechterunterschieden.

Children who have been placed in foster care after having experienced difficult family situations need to experience secure relationships. The development of a secure attachment model is regarded as a key protective factor for a healthy development. The present study examines predictors of attachment representations in a sample of 37 foster children aged three to eight years. Children's attachment representations were assessed using the Attachment Story Completion Task, and foster parents' attachment representations with the Adult Attachment Interview. Female foster children scored higher in secure attachment representations than males. Attachment representations of male foster children were positively influenced by a secure attachment representation of their primary foster parent and slightly by the duration of placement in the foster family as well as their age of placement but differently than expected. These results suggest that male foster children may be more vulnerable in their development of attachment representations and that foster parents' state of mind regarding attachment as well as the duration of the placement seem to have an impact on the development of attachment patterns in their foster children. This should be considered in the choice and counseling of foster parents.

[Accessing Disturbances of Attachment Symptoms Using Interview Technique]. / Interviewtechnik zur Erfassung von Bindungsstörungssymptomen.

Disturbances of attachment represent a clinically significant disorder and seriously impair social behavioural functioning. To date there has been little research and valid diagnostic methods are lacking. In the present study a German Version of the Disturbances of Attachment Interview developed by Smyke and Zeanah (1999) was used to assess disturbances of attachment in a sample of foster children and the validity of the translation is investigated. Furthermore, the Strengths and Difficulties Questionnaire (Goodman, 1997) was used to examine the discriminative validity. The results show a satisfying reliability and the scales of attachment disorders declare the main of the variance. There is a weak association between the disinhibited scale and hyperactivity in the SDQ. Overall the disinhibited disorder can be distinguished from other behaviour patterns. Regarding the inhibited scale there are associations with all SDQ scales and the inhibited category seems harder to distinguish from other deviant developmental issues. The method is evaluated as a qualified approach to the diagnosis of attachment disorders in the context of a multimethodical approach. Furthermore, the findings suggest further examination of the construct of attachment disturbances.

[Assessment of parental stress using the "Eltern-Belastungs-Screening zur Kindeswohlgefährdung" (EBSK) - association with emotional and behavioral problems in children]. / Die Erfassung elterlicher Belastung mit dem Eltern- Belastungs-Screening zur Kindeswohlgefährdung (EBSK). Zusammenhänge zu Erlebens - und Verhaltensauffälligkeiten beim Kind.

Parental stress is increased in clinical contexts (e.g., child psychiatry) and correlates with behavioral and emotional problems of children. In addition, parental stress can result in a biased parental perception of child's behavior and emotions. These interrelations were examined in a normal (N = 320) and a clinical (N = 75) sample. The "Eltern-Belastungs-Screening zur Kindeswohlgefährdung" (EBSK; Deegener, Spangler, Körner & Becker, 2009) was used for the assessment of parental stress. As expected, increased EBSK scores were overrepresented in the clinical sample. In both samples stressed parents reported having children with more behavioral and emotional problems. Children of stressed parents in turn reported significantly less problems than their parents did. The rating of independent third persons, e.g. teachers, was not available and should be added in future research. Restrictions in methodology and conclusions for practice are discussed.

Predictors of the rate and course of reactive attachment disorder and disinhibited social engagement disorder symptoms in foster children during the first year of placement.

BACKGROUND: Due to adverse care experiences, foster children are at risk for developing symptoms of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED). OBJECTIVE: This study investigated the factors influencing rate and course of RAD and DSED symptoms during the first year of placement in long-term foster care. PARTICIPANTS AND SETTING: The sample consisted of 55 foster children aged 1 to 6 years. Measurements were taken at placement as well as 6 and 12 months after placement. METHODS: RAD and DSED symptoms were assessed with the Disturbance of Attachment Interview (DAI). DSED symptoms were also assessed by observation with the Rating of Infant Stranger Engagement (RISE). Foster parents and caseworkers reported on children's preplacement experiences and placement characteristics. RESULTS: RAD symptoms were rare at Wave 1 (5.5 %) and remitted in most children within the first six months of placement, t(54) = 3.06, p = .003. A total of 30.9 % of the foster children presented DSED symptoms according to the DAI, but only 5.5 % of the children according to the RISE. Foster parents reported symptom reduction, t(54) = 3.71, p = .003, while observational data indicated symptom stability. Prior placement in emergency foster care was associated with lower levels of RAD at Wave 1, F(1.62, 80.88) = 7.80, p = .002, while later placed children presented more RAD and DSED symptoms (RRAD2 = 0.07, RDSED2 = 0.08, RRISE2 = 0.12). Psychopathology of the biological parents (RRAD2 = 0.07, RDSED2 = 0.08) and visitation with the biological parents (RRISE2 = 0.14) predicted symptom stability. CONCLUSION: A substantial number of foster children present persistent DSED symptoms indicating a need for evidenced based interventions.

Individual dispositions as precursors of differences in attachment quality: why maternal sensitivity is nevertheless important.

This paper explores the interplay of maternal sensitivity (or, more generally, the quality of the caregiving social environment) and infant individual dispositions in predicting infant-mother attachment. After a brief theoretical introduction, the focus turns to studies conducted during the 1980s that predicted attachment security vs. insecurity at 12 months from newborns' ability to regulate orientation and arousal. A re-analysis of two longitudinal studies, formerly coded only with the ABC system, subsequently revealed that disorganized (vs. organized) attachment was predictable from newborns' regulatory abilities, whereas secure (vs. insecure) attachment was predictable from the quality of maternal care. This suggested that the two dichotomies represented distinct dimensions and that - in low risk samples - disorganized SSP behavior may be associated with infant behavioral dispositions. More recent attempts to predict disorganized attachment from infant genetic (as opposed to newborn behavioral) dispositions yielded inconsistent results when only main effects models were examined. A set of subsequent studies examining the interplay of genetic and caregiving influences in the prediction of disorganized attachment suggested that maternal sensitivity is of particular importance in cases of genetic risk.

Attachment disorder symptoms in foster children: development and associations with attachment security.

BACKGROUND: Children in foster care constitute a risk population for developing symptoms of attachment disorders. However, little is known about the longitudinal course of attachment disorders and their association with attachment security in foster children. METHOD: This longitudinal study assessed attachment disorder symptoms in a sample of foster children (n = 55) aged 12 to 82 months. Foster parents with a newly placed foster child were assessed at three points during the first year of placement. At all assessment points, the Disturbance of Attachment Interview (DAI; Smyke and Zeanah in Disturbances of attachment interview, Tulane University, New Orleans, 1999) and the Attachment Q-sort (AQS; Waters and Deane in Monogr Soc Res Child Dev 50:41-65, 1985 German version as reported (Schölmerich and Leyendecker in Deutsche Übersetzung des attachment behavior Q-Set, revision 3.2. Unpublished manual, Ruhr University Bochum, Bochum, 1999) were used to investigate the interplay between disorder symptoms and attachment security. RESULTS: The results revealed that the symptoms of attachment disorders decreased. The decrease was more pronounced for the inhibited than for the disinhibited symptoms with marked changes in the first 6 months of placement. There was a noticeable gender difference in the development with boys showing a more pronounced decrease in inhibited attachment disorder symptoms and a stronger increase of attachment security. After 12 months, no significant gender effects were found. Regarding the association between symptoms of attachment disorders and attachment security, a significant negative correlation between the inhibited attachment disorder symptoms and attachment security was found 12 months after placement. CONCLUSIONS: Attachment disorder symptoms decreased in the stable foster care environment. Thus, foster care seems to be an effective placement option regarding children's attachment development.

Longitudinal Influences of DRD4 Polymorphism and Early Maternal Caregiving on Personality Development and Problem Behavior in Middle Childhood and Adolescence.

Most studies examining gene-environment effects on self-regulation focus on outcomes early childhood or adulthood. However, only a few studies investigate longitudinal effects during middle childhood and adolescence and compare two domains of early caregiving. In a longitudinal follow-up with a sample of N = 87, we studied the effects of differences in the DRD4 tandem repeat polymorphisms and two domains of early maternal caregiving quality on children's personality development using Block's California Child Q-Set (CCQ) at age six and age 12 and on problem behavior at ages six and seven. Early maternal regulation quality predicted later ego-resiliency and aggressiveness. In addition, significant gene-environment interactions revealed that children with the 7+ DRD4 tandem repeat polymorphism and poor maternal regulation quality in infancy showed lower scores in ego-resiliency and higher scores in ego-undercontrol and CCQ aggressiveness. In contrast, children who had experienced effective maternal regulation in infancy showed a comparable level in personality traits and problem behavior as the DRD4 7- group independent of the levels of maternal regulatory behavior. Similarly, longitudinal caregiving × DRD4 interactions were found for behavior problems in middle childhood, especially for oppositional-aggression, inattentive-hyperactivity, and social competence. Early caregiving effects were only found for maternal regulation quality, but not for maternal responsiveness. Effective early maternal regulation in infancy can moderate the negative effect of DRD4 7+ on children's self-regulation in middle childhood and adolescence. However, maternal responsiveness has no comparable effects. It seems relevant to consider several dimensions of early caregiving and to also measure the environment in more detail in gene-environment studies.

Dopamine D4 receptor exon III polymorphism, adverse life events and personality traits in a nonclinical German adult sample.

Personality and temperament embrace a wide area of both psychological and behavioral processes which are also based on disposition. A functional polymorphism in exon III of the dopamine D4 receptor gene (DRD4) has been a highly suspect genetic marker for personality in spite of ambiguous results. The present study aimed to further elucidate the relationship between DRD4, negative life events and personality in a representative nonclinical sample. Hundred sixty-seven Germans completed the NEO Five-Factor Inventory, the Tridimensional Personality Questionnaire and the California Adult Q-Sort. A factor analysis revealed 3 factors: emotional stability, social orientation and impulsivity. DNA from buccal cells was genotyped for the DRD4 variable-number tandem-repeat exon III polymorphism with respect to presence versus absence of the DRD4 7-repeat allele. Adverse life events were assessed by means of the Adverse Life Events Scale. Men carrying the DRD4 7-repeat allele were more impulsive than those without. Male 7-repeat carriers were more emotionally instable than others, but only when they experienced a large amount of negative life events. No genotype-personality relationships were found for women. The results indicate gender-specific influences of the DRD4 gene on human behavior and invite researchers to further investigate gene-environment correlations on personality traits.

The influence of attachment representation on parental perception and interpretation of infant emotions: A multilevel approach.

The aim of the study was to investigate parental perception and interpretation of infant emotional expression depending on their attachment representation. Forty-six parents' responses to infant pictures depicting positive, neutral, and negative emotions were assessed on the level of affective judgments (valence, arousal), mimic responses (facial muscle activity), and of the eyelid reflex (using the startle paradigm). Results revealed small differences between parents of different attachment representations with respect to their subjective evaluations. However, secure parents, as compared to insecure ones, showed a positive bias in their mimic responses to infant pictures. The modulation of the startle response indicated a negative evaluation of negative infant emotion expressions in dismissing parents, while an augmentation of the startle response to negative infant emotions could not be observed in secure and preoccupied parents. The findings highlight the role of attachment experiences for emotional information processing in parents and its consequences for parental behavior.

Adult attachment and gene polymorphisms of the dopamine D4 receptor and serotonin transporter (5-HTT).

Recently, the Dopamine D4 Receptor Gene (DRD4) and the Serotonin Transporter Gene (5-HTT) have been found to be candidate genes for infant attachment disorganization. The present study aimed to explore the relationship of these genes to adult attachment representations. The Adult Attachment Interview was used to assess attachment representations in 167 German adults. DNA from buccal cells was genotyped for the DRD4 VNTR Exon III and 5-HTT LPR polymorphisms with respect to the presence of the 7repeat allele and the short allele, respectively. DRD4 7repeat allele carriers were significantly more likely to be securely attached than those without 7repeat but only for subjects with unloving caregiver recollections. No association between the 5-HTT LPR polymorphism and adult attachment was found. These findings encourage further investigations to explore endophenotypical and mediating psychological processes between the DRD4 Gene and secure attachment patterns.

Brain activity during emotion perception: the role of attachment representation.

To examine emotional face processing in mothers of different attachment representations, event-related potentials were recorded from 16 mothers during presentation of infant emotion faces with positive, negative or neutral emotional expressions within a three-stimulus oddball paradigm, and frontal asymmetries were assessed. Insecure mothers, as compared to secure ones, showed a more pronounced negativity in the face-sensitive N170 component and a smaller N200 amplitude. Regarding the P300 component, secure mothers showed a stronger response to face stimuli than insecure mothers. No differences were found for frontal asymmetry scores. The results indicate that attachment differences may be related to neuropsychological functioning.