Longitudinal Assessment of Sleep-Wake Regulation and Attachment Security with Parents

Exclusive breastfeeding mitigates the association between prenatal maternal pandemic-related stress and children sleep problems at 24 months of age

Infant sleep quality is increasingly regarded as an important factor for children long-term functioning and adaptation. The early roots of sleep disturbances are still poorly understood and likely involve a complex interplay between prenatal and postnatal factors. This study investigated whether exclusive breastfeeding during the first 6 months moderated the association between maternal prenatal pandemic-related stress (PRS) and sleep problems in 24-months children born during the COVID-19 pandemic. We also explored the potential contribution of maternal postnatal anxiety in these relations. Seventy-eight infants (50% males) and their mothers provided complete data from birth to 24 months. Between 12 and 48 h from birth, maternal PRS during pregnancy was retrospectively reported as well as maternal anxiety and exclusive breastfeeding. Maternal anxiety and exclusive breastfeeding were also reported at 3 and 6 months after childbirth. Children sleep disturbances were reported at 24 months. Bayesian analyses revealed that maternal PRS was positively associated with sleep problems in children who were not exclusively breastfed from birth to 6 months. Findings add to the growing literature on the lasting impact of early pre- and postnatal experiences on child well-being and development.

Attachment to Mother and Father, Sleep, and Well-Being in Late Middle Childhood

The security of attachment has been related to several advantageous developmental outcomes, such as good sleep quality and higher well-being indicators. However, few studies concern the associations between attachment dimensions to both parents, sleep, and well-being in late middle childhood. Our study aims to expand knowledge in this area, clarifying the above-mentioned associations by considering the secure base and safe haven dimensions of attachment. We also investigate the role of sleep as a mediator of the relationship between attachment and well-being. The 258 participants (49.2% girls, mean age = 11.19, SD = 0.85) completed self-report questionnaires regarding attachment (KSS), sleep (SSR), and well-being (CHIP-CE). The results show significant associations between attachment to both parents (0.40 ** ≤ r ≤ 0.61 **) and between attachment security, sleep (-0.21 ** ≤ r ≤ -0.35 **) and child well-being (0.42 ** ≤ r ≤ 0.47 **). Besides, sleep quality partially mediated the relations between all attachment dimensions to both parents and well-being. The results are discussed in light of attachment theory, focusing on the comparison between attachment to mother and father as a valid framework to unravel differences in child well-being, with sleep as a process that can help to explain the mechanisms through which attachment security enables subjective perceptions of well-being.

The mediating effect of attachment insecurity on circadian consequences of childhood trauma

Circadian preferences have been associated with mental health as well as social and physical health in recent years. However, factors associated with circadian preferences have not been fully elucidated. The main aim of this study is to investigate the associations of childhood trauma and attachment styles with circadian preferences. A total of 673 participants were evaluated using the Morningness-Eveningness Questionnaire (MEQ), the Childhood Trauma Questionnaire 28 (CTQ-28), and the Experiences in Close Relationships-Revised (ECR-R) questionnaire. The results indicated that 14.9% (n = 100) of the participants were morning type, 20.6% (n = 139) were evening type, and 64.5% (n = 434) were intermediate type. Both childhood trauma and attachment-related anxiety/avoidance scores were associated with being evening type (p < .01). Moreover, attachment-related anxiety and avoidance fully mediated the association between childhood trauma and circadian preferences. The present study showed that attachment styles might be associated with circadian preferences. Further studies are needed to replicate these results and to infer explanatory mechanisms for these cross-sectional associations.

Developmental trajectories of infant nighttime awakenings are associated with infant-mother and infant-father attachment security

This longitudinal study examined developmental trajectories of infant sleep problems from 3 to 24 months old and investigated associations with infant-parent attachment security and dependency. In a sample of 107 Israeli families, number and duration of infant nighttime awakenings were measured at 3, 6, 9, and 24 months old, using mothers' and fathers' reports on the Brief Infant Sleep Questionnaire (BISQ). Infant-parent attachment security and infant-parent dependency was assessed at 24 months old, using the observer Attachment Q-Sort procedure (AQS) with both parents. Latent growth curve models showed a non-linear decline in number and duration of infant nighttime awakenings over time. A higher number and longer duration of infant nighttime awakenings at 3 months were associated with higher infant-father attachment security at 24 months. In contrast, longer infant nighttime awakenings at 3 months were predictive of lower infant-mother attachment security at 24 months. A steeper decrease in duration of infant nighttime awakenings was associated with higher infant-father attachment security and lower infant-mother attachment security. As a potential mechanism, paternal involvement in nighttime caregiving was explored in relation to infant-father attachment security. Results of our post-hoc analyses revealed no significant associations between paternal involvement in nighttime caregiving and infant-father attachment security. Our results highlight the need to examine potential mechanisms explaining the divergent associations of infant sleep problems with infant-mother and infant-father attachment security in future research.

Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review

OBJECTIVE

Recent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD.

METHODS

We used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic-Pituitary-Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review.

RESULTS

The evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD.

CONCLUSION

The biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.

Infant crying problems and symptoms of sleeping problems predict attachment disorganization at 18 months

This longitudinal study examined the associations among infant crying, symptoms of sleeping problems, and attachment while considering the influence of maternal sensitivity and depressive symptoms. One hundred and five healthy full-term infants (42.9% female) were assessed for crying and symptoms of sleeping problems at 3 and 18 months via parental interview. Maternal sensitivity was measured through researcher observation, and attachment was measured at 18 months using the Strange Situation procedure. It was found that infant crying and symptoms of sleeping problems were not linked to the organized patterns of secure or insecure (avoidant versus resistant) attachment. However, when the disorganized attachment was considered, there were direct links found from infant crying and symptoms of sleeping problems at 3 months (β= .22, p< .05) and 18 months (β= .21, p< .05). Thus, crying and symptoms of sleeping problems as early as 3 months may indicate a disruption in the coherence of infants' relationship to their caretakers.

Viii. Attachment and sleep among toddlers: disentangling attachment security and dependency

Many scholars have proposed that parent-child attachment security should favor child sleep. Research has yet, however, to provide convincing support for this hypothesis. The current study used objective measures of sleep and attachment to assess the longitudinal links between mother-child attachment security and subsequent sleep, controlling for child dependency. Sixty-two middle-class families (30 girls) were met twice, when children were 15 months (Wave 1; W1) and 2 years of age (Wave 2; W2). At W1, mother-child attachment was assessed with the observer version of the Attachment Q-Sort. At W2, children wore an actigraph monitor for 72 hr. Results indicated that children more securely attached to their mothers subsequently slept more at night and had higher sleep efficiency, and these predictions were not confounded by child dependency. These findings suggest a unique role for secure attachment relationships in the development of young children's sleep regulation, while addressing methodological issues that have long precluded consensus in this literature.

Attachment in the making: mother and father sensitivity and infants' responses during the Still-Face Paradigm

This study examined the extent to which infant and parent response trajectories during the Still-Face Paradigm (SFP) in early infancy predicted later infant-mother and infant-father attachment. Families (N=135) participated in the SFP when infants were 3, 5, and 7 months of age and participated in the Strange Situation procedure when infants were 12 months of age (mothers) and 14 months of age (fathers). Multilevel models showed that parent sensitivity assessed during the SFP was related to infants' affective and behavioral response trajectories during the SFP and that sensitivity and infant response trajectories predicted attachment. Results from the current study support the notion that parent and infant responses in the SFP with mothers and fathers during Bowlby's attachment in the making phase provide insight into the developing parent-child attachment relationship.