Attachment across the lifespan: insights from adoptive families

Probing the content of affective semantic memory following caregiving-related early adversity

Cognitive science has demonstrated that we construct knowledge about the world by abstracting patterns from routinely encountered experiences and storing them as semantic memories. This preregistered study tested the hypothesis that caregiving-related early adversities (crEAs) shape affective semantic memories to reflect the content of those adverse interpersonal-affective experiences. We also tested the hypothesis that because affective semantic memories may continue to evolve in response to later-occurring positive experiences, child-perceived attachment security will inform their content. The sample comprised 160 children (ages 6-12 at Visit 1; 87F/73 M), 66% of whom experienced crEAs (n = 105). At Visit 1, crEA exposure prior to study enrollment was operationalized as parental-reports endorsing a history of crEAs (abuse/neglect, permanent/significant parent-child separation); while child-reports assessed concurrent attachment security. A false memory task was administered online ∼2.5 years later (Visit 2) to probe the content of affective semantic memories-specifically attachment schemas. Results showed that crEA exposure (vs. no exposure) was associated with a higher likelihood of falsely endorsing insecure (vs. secure) schema scenes. Attachment security moderated the association between crEA exposure and insecure schema-based false recognition. Findings suggest that interpersonal-affective semantic schemas include representations of parent-child interactions that may capture the quality of one's own attachment experiences and that these representations shape how children remember attachment-relevant narrative events. Findings are also consistent with the hypothesis that these affective semantic memories can be modified by later experiences. Moving forward, the approach taken in this study provides a means of operationalizing Bowlby's notion of internal working models within a cognitive neuroscience framework. RESEARCH HIGHLIGHTS: Affective semantic memories representing insecure schema knowledge (child needs + needs-not-met) may be more salient, elaborated, and persistent among youths exposed to early caregiving adversity. All youths, irrespective of early caregiving adversity exposure, may possess affective semantic memories that represent knowledge of secure schemas (child needs + needs-met). Establishing secure relationships with parents following early-occurring caregiving adversity may attenuate the expression of insecure semantic memories, suggesting potential malleability. Affective semantic memories include schema representations of parent-child interactions that may capture the quality of one's own attachment experiences and shape how youths remember attachment-relevant events.

Epigenetic aging studies of pair bonding in prairie voles

The quality of romantic relationships can predict health consequences related to aging. DNA methylation-based biomarkers of aging accurately estimate chronological age. We developed several highly accurate epigenetic aging clocks, based on highly conserved mammalian CpGs, for the socially monogamous prairie vole (Microtus ochrogaster). In addition, our dual-species human-vole clock accurately measured relative age and illustrates high species conservation of epigenetic aging effects. Next, we assessed how pair bonding impacts epigenetic aging. We did not find evidence that pair-bonded voles exhibit accelerated or decelerated epigenetic aging effects in blood, ear, liver, or brain tissue. Our epigenome wide association study identified CpGs in five genes strongly associated with pair bonding: Foxp4, Phf2, Mms22l, Foxb1, and Eif1ad. Overall, we present accurate DNA methylation-based estimators of age for a species of great interest to researchers studying monogamy in animals. We did not find any evidence that sex-naive animals age differently from pair-bonded animals.

Secure attachment priming inhibits the generalization of conditioned fear

BACKGROUND

Fear overgeneralization constitutes a susceptibility factor contributing to the development and maintenance of anxiety spectrum disorders. Extant research has demonstrated that exposure to positive and supportive social relationships attenuates fear acquisition and promotes the extinction of conditioned fear responses. However, the literature lacks investigation into the effect of secure attachment priming on inhibiting the generalization of conditioned fear.

METHODS

In this study, college students were recruited via online platforms to voluntarily engage in the experimental procedures, resulting in 57 subjects whose data were deemed suitable for analysis. The experimental protocol consisted of four consecutive phases: pre-acquisition, acquisition, priming, and generalization. The priming phase consisted of two experimental conditions: secure attachment priming (experimental group) and positive emotion priming (control group). This study adopted the perceptual discrimination fear conditioning paradigm, employing subjective expectancy of shock ratings and skin conductance responses as primary assessment indices. Individual difference variables were measured using corresponding psychological measurement scales.

RESULTS

In terms of generalization degree, a notable divergence surfaced in the skin conductance responses across various generalization materials between the secure attachment priming group and the control group. Similarly, during generalization extinction, a significant disparity emerged in the skin conductance responses across different generalization phases between the secure attachment priming group and the control group. In addition, individual differences analyses revealed that the inhibitory effect of secure attachment priming on fear generalization was not affected by intolerance of uncertainty and attachment orientations. Conversely, slope analyses confirmed that as intolerance of uncertainty increased, the inhibitory effect of positive emotion priming on fear generalization was attenuated.

CONCLUSION

The findings suggest that activating participants' representations of secure attachment via imagination effectively attenuates the generalization of perceptual fear at the physiological level. The inhibitory effect of secure attachment priming appears to be distinct from positive emotional modulation and remains unaffected by individual trait attachment styles. These results offer novel insights and avenues for the prevention and clinical intervention of anxiety spectrum disorders.

Associations of Duration of Preadoption Out-of-home Care, Genetic Risk for Schizophrenia Spectrum Disorders and Adoptive Family Functioning with Later Psychiatric Disorders of Adoptees

The objective was to examine the impacts of duration of preadoption out-of-home care and adoptive family functioning on later psychiatric morbidity of adoptees with high (HR) and low (LR) genetic risk for schizophrenia spectrum disorders. The study uses nationwide data from the Finnish Adoptive Family Study of Schizophrenia. The study population in this substudy consisted of 43 h adoptees and 128 LR adoptees. Of these adoptees, 90 had spent 0-6 months and 81 over 6 months in preadoption out-of-home care. The family functioning of adoptive families was assessed based on Global Family Ratings and psychiatric disorders on DSM-III-R criteria. The results showed that among the adoptees with over 6 months in preadoption out-of-home care, the likelihood for psychiatric disorders was significantly increased in HR adoptees compared to LR adoptees. In adoptees with 6 months or less in preadoption out-of-home care, an increased likelihood for psychiatric disorders was found among those living in adoptive families with dysfunctional processes. These findings indicate that especially for HR children, a well-functioning early caregiving environment is crucial in terms of subsequent mental wellbeing. The results emphasize that when adoption is necessary, early placement and well-functioning adoptive family environment are beneficial to children.

The role of developmental caregiving programming in modulating our affiliation tendency and the vulnerability to social anxiety and eating disorders

Attachment is the evolutionarily-established process through which humans create bonds with others to receive care from them. The phenomenon is as essential to our physical survival as it is to our psychological development. An increasing number of studies demonstrates that in sensitive periods during the early years of life, our brain circuitry is programmed in the interactions with our caregivers, with the imprinting of information over multiple attachment dimensions. Adopting a basic brain-computer analogy, we can think of this knowledge as the psycho-social firmware of our mind. According to a recently proposed extension of the classical three-dimensional view, one attachment dimension - somaticity - concerns the caregiver's task of reflecting and confirming the child's (internal) states - such as sensations, emotions, and representations - to support the child's ability to identify and define those entities autonomously. Relying on multidisciplinary evidence - from neuroscientific, developmental, evolutionary, and clinical sources - we suggest that somaticity (H1) has the adaptive function to modulate our tendency to comply and affiliate with a reference group but also (H2) increases the vulnerability to developing Social Anxiety (SA) and Eating Disorders (EDs). We evaluate H1-H2, (1) indicating the evolutionary role of somaticity in modulating our affiliation tendency to optimize the ancestral threat-opportunity balance coming from infectious diseases and (2) showing the deep connection between SA-EDs and the features most closely related to somaticity - interoception and parenting style. Finally, we discuss three relevant implications of H1-H2: (A) Bringing into research focus the adaptive role of our firmware knowledge system versus the hardware (neural substrate) and software (higher cognition) ones. (B) Complementing the well-grounded Objectification and Allocentric Lock Theories, allowing us to integrate multiple levels of explanation on the etiology of psychopathology. (C) Suggesting the design of new psychological treatments. While not aiming to prove H1-H2, our analysis supports them and encourages their direct testing.

The Foundations for Chronic Low Back Pain Management may Start in Early Life. Exploring the Role of Caregiver Parental Leave on Future Low Back Pain in the Offspring

Chronic low back pain is difficult to treat and despite increased spending on health services, clinical outcomes for people with low back pain have not improved. Innovative, large scale initiatives seem necessary to stem the cost of low back pain. Psychological health contributes to the development and persistence of chronic low back pain and psychological interventions are important in the management of low back pain. Given the contribution of psychological health to low back pain development and management, it raises the question; can we support psychological health in later life by bolstering emotional development in early life, and reduce the burden of this common condition? Positive early life experiences, including those induced by extended paid parental leave, could bolster emotional development and support the psychological health necessary to manage low back pain in later life. We present the current state of evidence demonstrating the potential value of increasing support for parent-child relationships in early life to reduce the burden of low back pain in future generations. The current evidence is limited to cross-sectional associations, but strong preclinical data clearly shows the potential negative impacts of maternal separation on rodent pup health that compels consideration in human populations. PERSPECTIVE: The benefits stemming from enhanced child development include stable emotional foundations, possibly improving psychological health and low back pain management in the future. This perspective raises questions for future studies - within the context of low back pain, what ingredients bolster stable psychological health? And are these ingredients influenced by parental leave?

Attachment-Related Differences in Emotion Regulation in Adults: A Systematic Review on Attachment Representations

In recent years, there has been an increase in the prevalence of mental disorders connected with affective dysregulation and insecure attachment. Therefore, it is even more important to understand the interplay between an individual's attachment representation and patterns of emotion regulation. To our knowledge, this is the first systematic review to examine this association. PsycInfo, PsyArticles, and PubMed were searched for studies that examined attachment-related differences in emotion regulation in adults. To examine the unconscious attachment representation, only studies using the Adult Attachment Interview or the Adult Attachment Projective Picture System were included. Thirty-seven peer-reviewed studies (with a total of 2006 subjects) matched the PICO criteria. Emotion regulation was measured via four objective approaches: autonomic nervous system, brain activity, biochemistry, or nonverbal behavior. Across all measurements, results reveal a significant correlation between attachment representation and emotion regulation. Secure attachment correlates consistently with balanced emotion regulation, whereas it is impaired in insecure and dysfunctional in unresolved attachment. Specifically, unresolved individuals display counterintuitive responses and fail to use attachment as a resource. Insecure-dismissing attachment is associated with an emotionally deactivating strategy, while on a physiological, biochemical, and nonverbal level, emotional stress is still present. There is still a lack of studies examining preoccupied individuals. In addition to interpreting the results, we also discuss the risk of bias, implications for psychotherapy and coaching, and an outlook for future research.

Attachment, Mentalizing and Trauma: Then (1992) and Now (2022)

This article reviews the current status of research on the relationship between attachment and trauma in developmental psychopathology. Beginning with a review of the major issues and the state-of-the-art in relation to current thinking in the field of attachment about the impact of trauma and the inter-generational transmission of trauma, the review then considers recent neurobiological work on mentalizing and trauma and suggests areas of new development and implications for clinical practice.

Exploring the relationship between adoption and psychological trauma for children who are adopted from care: A longitudinal case study perspective

Children who have been adopted from care are very likely to have experienced early adversity that may result in psychological trauma. A current debate in the field is whether adoption provides a pathway to healing for traumatised children, helping them to recover from past psychological harm, or creates trauma for children through the very nature of being an adopted child.

OBJECTIVE

This study aimed to use longitudinal data pertaining to children who had been adopted from care to examine the relationship between being adopted from care and psychological trauma.

PARTICIPANTS AND SETTING

Seventeen adopted children had been interviewed in their adoptive homes during the third wave of the Care Pathways and Outcomes study (McSherry et al., 2013), when they were aged between nine and 14 years old. Ten of these children were selected for specific consideration in this article. Checklists for early adversities and psychological trauma were used to support the creation of case studies that highlighted the extent of psychological trauma in the children's lives.

RESULTS

The adopted children either experienced possible pre-care psychological trauma, with the impact of this reducing over time, in utero developmental harm due to their mother's alcohol misuse during pregnancy, inherited an intellectual disability, with the resultant difficulties superseding any concern regarding possible pre-care psychological trauma, or possible psychological trauma when moving from an established foster placement to adoption. Recommendations for policy and practice are provided.

Adoption and trauma: Risks, recovery, and the lived experience of adoption

BACKGROUND

Although a very heterogeneous group, adopted persons may present developmental and mental health problems of varying severity. Pre-placement adversity and trauma have often been linked to these problems. It has been also suggested that adoption itself is a psychological trauma, predisposing the individual to emotional difficulties.

OBJECTIVES

This article examines the links between early adversity, trauma, and adoption. We begin by defining trauma and then describe the way in which pre-placement adversity can undermine neurobehavioral and interpersonal functioning, increasing the risk for long-term psychological difficulties. Next, we examine children's recovery when placed in a stable adoptive home. Finally, we explore adoption as a lived experience, highlighting contextual and developmental factors that facilitate the person's positive or negative attributions about being adopted, leading to varying patterns of emotional adjustment.

CONCLUSIONS

Although pre-placement adversity increases adopted individuals' risk for maladjustment, the human brain and behavior are malleable, and placement in a nurturing adoptive home often facilitates recovery from early adversity, with significant heterogeneity in the extent of recovery within and across domains of functioning. While there is no evidence that early adoption is a trauma for the individual, ongoing negative life circumstances, attachment difficulties, and developmentally-mediated attributions about adoption can undermine the person's self-esteem, identity, relationships, and sense of well-being. Conclusions and suggestions for future research are offered.

Emotional-behavioral problems, attachment and verbal skills in late-adopted adolescents: The role of pre-adoption adversities and adoption variables

BACKGROUND

There are few studies on late-adopted adolescents' outcomes -e.g., emotional-behavioral problems, attachment and cognitive status- and their possible predictive factors, none from Italy.

OBJECTIVE

This paper aimed to investigate emotional-behavioral problems, attachment representations, and verbal skills in late-adopted adolescents in Italy and to explore the predictive role of pre-adoption adversities and adoption variables for worse adoptees' outcomes.

PARTICIPANTS AND SETTING

The study included N = 79 late-adopted (mean age at adoption = 6 years) adolescents, between 11 and 18 years, placed via both intercountry and domestic adoption.

METHODS

Parents provided information about pre-adoption and adoption history and filled the Children's Behavior Checklist 6-18 for measuring participants' emotional-behavioral problems. Attachment representations were assessed through the Friend and Family Interview administered directly to adolescents, like the verbal comprehension index of the Wechsler Intelligence Scale for Children (4th edition) for measuring participants' verbal IQ.

RESULTS

Maltreatment and its interaction with multiple placements were the main predictors of other problems-i.e., social, thought, and identity difficulties (respectively, p = .007 and p = .029)-while intercountry adoption was the unique predictor of both externalizing and total problems (respectively, p = .047 and p = .015). However, domestic adoption was the most important predictor both for higher insecurity and disorganized attachment representations and lower verbal skills (all p < .044); even stronger if domestic adoption interacted with pre-adoptive institutionalization.

CONCLUSIONS

Pre-adoption adversities as well as domestic vs. intercountry adoption, but not the age at placement, contributed to adolescent adoptees' developmental outcomes.

Attachment Stories in Middle Childhood: Reliability and Validity of Clinical and Nonclinical Children's Narratives in a Structured Setting

Middle childhood is one of the most understudied periods of development and lacks a gold standard for measuring attachment representations. We investigated the reliability and validity of a Dutch version of the Story-Stem Battery coded using the Little Piggy Narrative (LPN) Coding System in a clinical (N = 162) and a nonclinical group (N = 98) of 4–10-year-old children. Their attachment stories were furthermore coded using the coherence scale. Factor analyses showed that the items of the LPN system formed four attachment scales and a separate scale reflecting distress/anxiety, with sufficient internal consistency for the scales and high interrater reliability (n = 20). Furthermore, we studied construct and discriminatory validity. The attachment scores correlated with coherence and child behavioral problems in the expected direction. Results showed age and gender differences, indicating that separate norm groups are necessary. In particular, disorganized attachment, coherence and distress/anxiety differ between clinical and nonclinical children across age and gender. Results for the other three organized attachment scales were more complex. For instance, older boys from the nonclinical group had higher scores on secure attachment than their clinical peers, while girls from the clinical and nonclinical groups did not differ, even though girls in the nonclinical group had higher secure attachment scores than boys. Results are discussed in light of attachment theory and developmental pathways in middle childhood, as well as their clinical implications.

The Neurobiology of Infant Attachment-Trauma and Disruption of Parent-Infant Interactions

Current clinical literature and supporting animal literature have shown that repeated and profound early-life adversity, especially when experienced within the caregiver-infant dyad, disrupts the trajectory of brain development to induce later-life expression of maladaptive behavior and pathology. What is less well understood is the immediate impact of repeated adversity during early life with the caregiver, especially since attachment to the caregiver occurs regardless of the quality of care the infant received including experiences of trauma. The focus of the present manuscript is to review the current literature on infant trauma within attachment, with an emphasis on animal research to define mechanisms and translate developmental child research. Across species, the effects of repeated trauma with the attachment figure, are subtle in early life, but the presence of acute stress can uncover some pathology, as was highlighted by Bowlby and Ainsworth in the 1950s. Through rodent neurobehavioral literature we discuss the important role of repeated elevations in stress hormone corticosterone (CORT) in infancy, especially if paired with the mother (not when pups are alone) as targeting the amygdala and causal in infant pathology. We also show that following induced alterations, at baseline infants appear stable, although acute stress hormone elevation uncovers pathology in brain circuits important in emotion, social behavior, and fear. We suggest that a comprehensive understanding of the role of stress hormones during infant typical development and elevated CORT disruption of this typical development will provide insight into age-specific identification of trauma effects, as well as a better understanding of early markers of later-life pathology.

Changes in objectively measured sleep among internationally adopted children in 1-year follow-up during the first years in new families

BACKGROUND

Psychosocial risks and environmental changes experienced by internationally adopted children may predict sleep problems, which are incidentally among the main concerns of adoptive parents. Several questionnaire studies have found sleep of internationally adopted children to be problematic, but none of those used an objective measure in a controlled study.

OBJECTIVE

To determine whether the objectively recorded sleep of internationally adopted children is worse than their controls who are living with their biological parents.

METHODS

To this case-control part of the Finnish Adoption Study, we recruited children who were adopted internationally to Finland between October 2012 and December 2016. Simultaneously, control children were recruited from 16 daycare centers. To assess sleep in children, actigraphy recordings were made twice, 1 year apart, between December 2013 and April 2018. In the adopted group, the first assessment took place 10 months after they had arrived in their families. The associations between adoption status and sleep parameters were analyzed using linear mixed modeling and adjusted for multiple potential confounders, including child age.

RESULTS

Seventy-eight internationally adopted children (boys 64%) aged 1-7 years and 99 controls (boys 53%) aged 2-6 years attended the first sleep recording. The recordings showed that the internationally adopted children slept longer (B = 0.48, 95% CI 0.23-0.73, P < 0.001) than the controls. There were no significant differences in sleep fragmentation or sleep efficiency between the groups. During the 1-year follow-up, the sleep patterns of the adopted children approached those of the controls.

CONCLUSIONS

The internationally adopted children spent more time in bed and slept more than their control children in both recordings. However, their sleep patterns were not very different from those of their peers and the differences appeared to vanish during the first years in their new family.

Object attachment as we grow older

Extreme object attachment in adults can form as a way to compensate for a lack of interpersonal attachment or as a symptom of hoarding disorder; however, normative levels of object attachment also exist across the lifespan. Although the importance of secure interpersonal attachment as a protective factor for older adults has been well established, research into object attachment in older adults is still a nascent field. As individuals age, they inevitably experience a series of cognitive, emotional, and physical changes that may influence their attachment to objects. Life events may impact the way that we view our possessions, particularly over time. Given individual differences, multiple pathways may affect normative object attachment as we age.

Do Infant Faces Maintain the Attention of Adults With High Avoidant Attachment?

We investigated whether adults have attentional bias toward infant faces, whether it is moderated by infant facial expression, and the predictive effect of the adult attachment state on it. One hundred unmarried nulliparous college students [50 men and 50 women; aged 17–24 years (M = 19.70, SD = 1.35)] were recruited. Each completed a self-report questionnaire—the Chinese version of the State Adult Attachment Measure (SAAM), and a dot-probe task with a stimulus presentation duration of 500 ms, which used 192 black-and-white photographs of 64 people (32 infants and 32 adults; each person displayed three expressions: happy, neutral, and sad) as the experimental stimuli. The results showed that, at the duration of 500 ms, individuals' attentional bias toward infant faces disappeared, regardless of the facial expression. However, when the interaction between avoidant attachment state and face was controlled, the attentional bias was significant again, and the avoidant attachment state negatively predicted individuals' attentional bias toward infant faces. This indicates that at the suprathreshold stage, there are individual differences in the attentional bias toward infant faces, and high avoidant attachment will weaken individuals' attentional bias toward infant faces. This study advances previous studies that focused only on individuals' attention to infant faces occurring at the early processing stage of attention. The results provide direction for interventions; specifically, changing the attachment state of avoidant individuals can affect their attention to infants, which may promote the establishment of parent–child relationships.

Aggressiveness in Adopted and Non-Adopted Teens: The Role of Parenting, Attachment Security, and Gender

The aim of this study was to examine the relationship among aggressiveness, parenting practices, and attachment security in adolescents, assessing maternal and paternal effects separately. Two different subsamples of adolescents between 12 and 16 years old participated in the study (n = 157): 67 adopted adolescents (61.2% girls) and 90 non-adopted adolescents (56.7% girls). Partial and full mediation models were analyzed in multi-group structural equation models (using maximum likelihood estimates), allocating non-adoptive and adoptive adolescents into two different groups. Results showed that whereas acceptance/involvement of each parent predicted attachment security towards the corresponding parental figure, only the father's coercion/imposition predicted aggressiveness, and only attachment security to the mother was a (negative) predictor of adolescent's aggressiveness. The partial mediation model provided the most parsimonious explanation for the data, showing no differences between adopted and non-adopted subsamples and supporting a good model fit for both boys and girls in a multi-group invariance analysis. The implications of these results are discussed in light of the protective effects of care relationships in early adolescence (vs. late adolescence) as well as the differential role of parent figures.

Enhancing diurnal cortisol regulation among young children adopted internationally: A randomized controlled trial of a parenting-based intervention

Children who have been adopted internationally commonly experience institutional care and other forms of adversity prior to adoption that can alter the functioning of the hypothalamic-pituitary-adrenal (HPA) axis. In particular, internationally adopted children tend to have blunted diurnal declines compared to children raised in their birth families. The Attachment and Biobehavioral Catch-Up (ABC) intervention was developed to enhance young children's biological and behavioral regulation by promoting sensitive parenting. The current study used a randomized controlled trial to assess whether ABC improved the diurnal functioning of the HPA axis among 85 children who had been adopted internationally when they were between the ages of 4 and 33 months (M = 16.12). Prior to the intervention, there were no significant differences in diurnal cortisol production between children whose parents were randomly assigned to receive ABC and children whose parents were randomly assigned to receive a control intervention. After the intervention, children whose parents had received the ABC intervention exhibited steeper declines in cortisol levels throughout the day than children whose parents had received the control intervention. These results indicate that the ABC intervention is effective in enhancing a healthy pattern of diurnal HPA axis regulation for young children who have been adopted internationally.