Upload
zelda
View
394
Download
28
Tags:
Embed Size (px)
DESCRIPTION
Attachment Theory and Psychopathology. What is Attachment?. Enduring emotional tie Internal working model Secure base for exploration Foundation for future relationships . Assessment of Attachment in Infancy. Strange Situation as standard setting for observing infant attachment - PowerPoint PPT Presentation
Citation preview
Attachment Theory and Psychopathology
What is Attachment?
• Enduring emotional tie• Internal working model• Secure base for exploration• Foundation for future relationships
Assessment of Attachment in Infancy
• Strange Situation as standard setting for observing infant attachment
• Variety of mildly stressful events including separations and reunions with mother– focus is on reunion behaviour
Categories of Infant Attachment
• Organized Attachment– Secure, Avoidant, & Ambivalent
• Disorganized Attachment
Secure Relationship
• Greets parent on reunion• Comfort seeking if upset• Comfort is effective in soothing• Security allows confidence in exploration• Balance of attachment and exploration
Avoidant Relationship
• Behaves independent of mom• Lack of greeting on reunion• Focus on exploration without reference
to mother - distraction from negative emotion
Resistant Relationship
• Lack of exploration• Typically distressed at separation• Anger or passivity interferes with
being comforted on reunion
Distribution of Organized Patterns
0
10
20
30
40
50
60
70
North America Germany Israel
Percent
Secure
Avoidant
Ambivalent
Clinical Implications
• Securely Attachment Infants:– more competent with peers– more competent problem solvers– less vulnerable to behaviour problems– more self confident
Clinical Implications
• Avoidant and Resistant attachment:– More hostile with peers– Peer victimization– More behaviour problems
Resistant - linked to anxiety disorder in adolescence
Disorganized Relationship
• First noticed in infants with a history of maltreatment
• Breakdown in the organization of the attachment system
• Theorized to relate to fear of the parent “fright without solution”
• 15% in non-clinical samples; as high as 80% in at-risk samples
Signs of Disorganization
• Approach parent in odd ways • Move away from parent when upset or
frightened• Freeze • Show fear of parent
Clinical Implications
• Poor regulation of negative emotions• Oppositional defiant behaviour• Hostile-aggressive behaviour• Coercive and punitive styles of interacting
with peers and family members• Dissociative Disorders
Attachment and Family Drawings
See overheads
Adult Attachment and Psychopathology
AAI Questions
• Description of childhood relationships• Five adjectives with episodic memories• Upset and separation experiences• Abuse and loss• Relationships since childhood• Relationship with own child
Organized Categories
• Autonomous (60% of population)– coherent with little self deception– values attachment relationships
• Dismissing (22% of population)– limits activation by idealization, lack of memory, or
devaluing attachment figures– emphasis on fun or material aspects of relationship limits
emotional aspects • Preoccupied (17% of population)
– entangled with parents - weak sense of self– memories, but difficulty providing objective overview
Strange Situation and AAI’s
Secure Autonomous
Avoidant Dismissing
Resistant Preoccupied
Clinical Implications
Depressive DisordersAnxiety Disorders
Borderline Personality Disorder
Depressive Disorders
• Rosenstein & Horowitz (1996)• 32 psychiatrically hospitalized adolescents• 31% were dismissing• 69% were preoccupied
Anxiety Disorders
• Fongay et al. (1996)• 66% Preoccupied• 18% Dismissing• 16% Autonomous
Borderline Personality Disorder
• Patrick et al. (1994)– 12 Borderline patients– 100% preoccupied
• Fonagy et al. (1996)– 36 Borderline patients– 75% preoccupied– 17% dismissing– 8% autonomous
Attachment Interventions
Van den Boom (1994)
Van den Boom (1994)
• Train caregivers in sensitive responsiveness (increase maternal sensitivity)
• To do this you need to:– Improve the mothers’ ability to monitor,
perceive, and respond to the infant’s signals and needs accurately
Supporting Secure Attachment
Intervention Study– 100 highly irritable infants– 3 home visits between 6 and 9 months focused
on enhancing sensitivity– ‘Intervention’ mothers more sensitive– 65% of intervention and 28% of control coded
as secure in strange situation