Prediction of behavior problems in 4-year-olds born prematurely

Maternal History of Childhood Maltreatment and Children's Cognitive and Social Development

A growing literature provides evidence of long-term effects of childhood sexual trauma (CST), however the intergenerational consequences of CST are not well understood. In the current study we examine the adjustment of children whose mothers reported a history of CST compared to children whose mothers did not report childhood trauma across multiple domains of functioning. Data for these analyses were obtained from a longitudinal study of low-income, rural families. Propensity score matching (PSM) methodology was used to create a contrast group matched on maternal family of origin variables in an effort to isolate and examine the long-term associations of maternal CST history beyond the effects of other childhood adversities such as poverty (total N = 204). After controlling for numerous child and primary caregiver covariates, findings indicate that a maternal history of CST is related to higher levels of teacher reports of behavioral problems and academic skills in the classroom setting in Kindergarten and First grade. This study adds to the growing literature on the effects of maternal CST on offspring development. Implications for interventions with children with mothers reporting a history of CST and directions for future study are proposed.

ATTACHMENT IN INFANTS WITH CLEFT LIP AND/OR PALATE: MARGINAL SECURITY AND ITS CHANGES OVER TIME

This study examines the attachment quality and how this changed over time among infants who had cleft lip and palate (CLP), by conducting a prospective longitudinal study addressing the effects of this type of perinatal event on the parent-infant relationship and the emotional development of the infants. At 12 months of age, the Strange Situation Paradigm (SSP; M. Ainsworth, M.C. Blehar, E. Waters, & T. Wall, 1978) was administered to a sample of 38 CLP infants (born between 2003 and 2010) and 17 healthy controls. At 4 years of age, the Attachment Story Completion Task (ASCT; I. Bretherton, D. Ridgeway, & J. Cassidy, 1990) was administered to 32 individuals from the CLP sample and 14 from the control group. As reported in the literature, CLP infants display secure attachment behaviors as frequently as do control infants (55%). However, a more detailed analysis of the attachment scales revealed that CLP infants show more avoidance and less proximity seeking. In addition, a closer examination of the subcategories of attachment styles revealed that most CLP infants (71%) displayed distal attachment strategies such as the B1/B2 or A1/A2 subcategories. At 4 years old, CLP infants clearly displayed more deactivation and less security than did the control sample. Moreover, when detailing the evolution of attachment individually, almost 60% of the CLP children showing distal strategies at 12 months became deactivated or disorganized when they reached 4 years. Indeed, subtle differences in attachment behaviors at 12 months old-which can be considered marginally secure at that age-may reveal attachment vulnerabilities, which seem to be more apparent over the course of development.

Mapping the Early Language Environment Using All-Day Recordings and Automated Analysis

PURPOSE

This research provided a first-generation standardization of automated language environment estimates, validated these estimates against standard language assessments, and extended on previous research reporting language behavior differences across socioeconomic groups.

METHOD

Typically developing children between 2 to 48 months of age completed monthly, daylong recordings in their natural language environments over a span of approximately 6-38 months. The resulting data set contained 3,213 12-hr recordings automatically analyzed by using the Language Environment Analysis (LENA) System to generate estimates of (a) the number of adult words in the child's environment, (b) the amount of caregiver-child interaction, and (c) the frequency of child vocal output.

RESULTS

Child vocalization frequency and turn-taking increased with age, whereas adult word counts were age independent after early infancy. Child vocalization and conversational turn estimates predicted 7%-16% of the variance observed in child language assessment scores. Lower socioeconomic status (SES) children produced fewer vocalizations, engaged in fewer adult-child interactions, and were exposed to fewer daily adult words compared with their higher socioeconomic status peers, but within-group variability was high.

CONCLUSIONS

The results offer new insight into the landscape of the early language environment, with clinical implications for identification of children at-risk for impoverished language environments.

Family environment and behavior problems in children, adolescents, and adults with fragile X syndrome

We examine how the family environment is associated with aspects of the Fragile X syndrome phenotype during childhood, adolescence, and adulthood. Mothers of children (n  =  48), adolescents (n  =  85), and adults (n  =  34) with Fragile X syndrome participated in a multisite study. For children and adults with Fragile X syndrome, the presence of warmth and positivity and the absence of criticism were associated with fewer behavior problems. Although a higher level of criticism was significantly associated with greater behavior problems, there were only trend-level associations between levels of warmth and positivity and behavior problems during the adolescent years. The provision of family psychoeducation programs, which can reduce parental criticism, would likely benefit both the individual with Fragile X syndrome and the family.

Comparison of problem behaviours in atypically developing infants and toddlers as assessed with the baby and infant screen for children with aUtIsm traits (BISCUIT)

OBJECTIVE

Compares infants and toddlers with intellectual and developmental conditions in regard to the presence of challenging behaviour.

METHODS

Parents and caregivers to 140 children ranging from 17-35 months with five different conditions (Down syndrome (n = 23), developmental delay (n = 18), prematurity (n = 56), Cerebral Palsy (n = 15) and Seizure disorder (n = 28)) were administered the BISCUIT-Part 3. An ANOVA on overall scores and a MANOVA on the sub-scale scores were conducted to determine if groups differed significantly.

RESULTS

Results found no significant differences on total scores or differences on the sub-scales of the BISCUIT-Part 3: Aggressive/Destructive, Stereotypic and Self-Injurious. Some trends in individual item endorsement were found.

CONCLUSIONS

It is possible that differences among individuals with these disorders are not apparent until later in life. These results emphasize the importance of monitoring challenging behaviours in all at-risk infants and toddlers to ensure that early interventions to treat these challenging behaviours are possible.

The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study

This study addresses the extent to which insecure and disorganized attachments increase risk for externalizing problems using meta-analysis. From 69 samples (N = 5,947), the association between insecurity and externalizing problems was significant, d = 0.31 (95% CI: 0.23, 0.40). Larger effects were found for boys (d = 0.35), clinical samples (d = 0.49), and from observation-based outcome assessments (d = 0.58). Larger effects were found for attachment assessments other than the Strange Situation. Overall, disorganized children appeared at elevated risk (d = 0.34, 95% CI: 0.18, 0.50), with weaker effects for avoidance (d = 0.12, 95% CI: 0.03, 0.21) and resistance (d = 0.11, 95% CI: -0.04, 0.26). The results are discussed in terms of the potential significance of attachment for mental health.

The development of effortful control in children born preterm

This prospective longitudinal study examined emerging effortful control skills at 24- and 36-months postterm in 172 children born preterm (<36 weeks gestation). Infant (neonatal health risks), family (sociodemographic risks), and maternal risk factors (depressive symptoms, anger expressions during play interactions) were assessed at six time points across 3 years. In addition, children's emerging effortful control skills, cognitive development, and mother-reported behavior and attention problems were assessed at 24 and 36 months. Analyses documented links between effortful control skills, cognitive skills, and concurrent attention problems in children born preterm. The study also found that preterm children's effortful control skills improved over time. In addition, neonatal health risks, family sociodemographic risks, and angry parenting interactions were associated with less optimal effortful control skills.

Infant-mother attachment and behavior problems in healthy and chronically ill preschoolers

Analysis of longitudinal data for 145 children [51 healthy, 40 with cystic fibrosis (CF), and 54 with congenital heart disease (CHD)] was conducted: (a) to ascertain whether behavioral problems evident in older medically compromised children would be reported as early as 2–3 years-of-age; and (b) to test theoretical predictions concerning the role of infant-mother attachment in the etiology of behavior problems. As predicted, children with a medical diagnosis received higher scores from parents on the Child Behavior Checklist (CBCL), primarily on the Internalizing scale. Reports of somatic symptoms did not account for this effect. Contrary to predictions, children with CHD were reported to have more behavior problems than those with CF. Secure attachment was associated with lower CBCL scores for internalizing problems regardless of medical status. The increase in behavior problem reports associated with insecure attachment was shown to reflect an effect of avoidance rather than insecurity per se. The importance of distinguishing effects of different types of insecurity and the need for meta-analytic strategies to do so is emphasized.

Behavior problems at 3 and 6 years: Prevalence and continuity in full-terms and preterms

Results are reported for a 3-year prospective longitudinal study of behavior problems in a group of children born at very low birthweight (<1,500 g) and a full-term control. Behavior problems were assessed with the Behavior Screening Questionnaire (BSQ) at 3 years and with the Child Behavior Checklist (CBCL) and the hyperactivity index from the Conners parent and teacher scales at 6 years. The findings indicate that the preterms manifested more behavior problems than full-terms at both ages and that the overall prevalence of clinically significant problems increased with age. Although cross-age continuity on parent rating scales was similar and modest for both groups (r = .24–.35), the persistence of significant problems was quite high (50%). Early BSQ scores predicted later externalizing problems, even after the effects of prematurity, socioeconomic status, and family stress were removed, but not later internalizing problems. The latter were more strongly influenced by low SES and family stress. Findings for the full-terms, who had received the CBCL as well as the BSQ at 3 years, suggest that these two instruments may tap somewhat different dimensions of behavior disturbance at age 3.

The role of maternal responsivity in the development of children with intellectual disabilities

There is growing evidence that cumulative exposure to highly responsive parenting styles throughout the early childhood period may provide a variety of important child benefits in terms of language, cognitive, social, and emotional development. We view maternal responsivity as a dynamic construct of central importance to the development of children with intellectual disabilities just as it is for typically developing children. In this study, we selectively review the theoretical and conceptual evidence for the effects of responsivity on development, discuss factors known to influence responsivity including the nature of a child's disability, and review intervention approaches intended to enhance maternal responsivity. We conclude with a set of recommendations for future research.

Kognitive Entwicklung und sozial-emotionale Kompetenzen bei Frühgeborenen mit unterschiedlichen Bindungsrepräsentationen

Zusammenfassung. Es wurde geprüft, ob sich frühgeborene und termingeborene Kinder im Vorschulalter in ihrer kognitiven Entwicklung und ihren sozial-emotionalen Kompetenzen unterscheiden. Insgesamt wurden 29 Kinder im Alter zwischen fünf und sechs Jahren im Hinblick auf die Faktoren “Geburtszeitpunkt” (Frühgeborene < 2000 g vs. Termingeborene > 2600 g) und “Bindungsqualität” (sicher vs. unsicher gebunden) untersucht. Die Bindungsqualität wurde auf der Repräsentationsebene durch das Geschichtenergänzungsverfahren zur Bindung (GEV-B) erfasst. Die kognitive Leistung und sozial-emotionale Entwicklung wurde mit dem Entwicklungstest ET 6-6 sowie die emotionale Kompetenz durch den Untertest “Fotoalbum” des WET und die sozial-emotionalen Kompetenzen durch einen Erzieherbeobachtungsbogen erhoben. Frühgeborene erzielten signifikant niedrigere Werte in den Dimensionen der kognitiven Entwicklung des ET 6-6 als termingeborene Kinder. Außerdem bewerteten Erzieher das Sozialverhalten der Frühgeborenen tendenziell als weniger kompetent verglichen mit dem Verhalten der Termingeborenen. Im Untertest “Fotoalbum” des WET konnten unsicher gebundene Kinder im Vergleich zu sicher gebundenen Kindern emotionale Gesichtsausdrücke tendenziell schlechter erkennen. Diese Ergebnisse sprechen dafür, dass sich der Faktor “Frühgeburt” insbesondere auf die kognitive Leistung auswirkt.

Multiple determinants of externalizing behavior in 5-year-olds: a longitudinal model

In a community sample of 116 children, assessments of parent-child interaction, parent-child attachment, and various parental, child, and contextual characteristics at 15 and 28 months and at age 5 were used to predict externalizing behavior at age 5, as rated by parents and teachers. Hierarchical multiple regression analysis and path analysis yielded a significant longitudinal model for the prediction of age 5 externalizing behavior, with independent contributions from the following predictors: child sex, partner support reported by the caregiver, disorganized infant-parent attachment at 15 months, child anger proneness at 28 months, and one of the two parent-child interaction factors observed at 28 months, namely negative parent-child interactions. The other, i.e., a lack of effective guidance, predicted externalizing problems only in highly anger-prone children. Furthermore, mediated pathways of influence were found for the parent-child interaction at 15 months (via disorganized attachment) and parental ego-resiliency (via negative parent-child interaction at 28 months).

Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology

We review recent research on the presentation, nosology and epidemiology of behavioral and emotional psychiatric disorders in preschool children (children ages 2 through 5 years old), focusing on the five most common groups of childhood psychiatric disorders: attention deficit hyperactivity disorders, oppositional defiant and conduct disorders, anxiety disorders, and depressive disorders. We review the various approaches to classifying behavioral and emotional dysregulation in preschoolers and determining the boundaries between normative variation and clinically significant presentations. While highlighting the limitations of the current DSM-IV diagnostic criteria for identifying preschool psychopathology and reviewing alternative diagnostic approaches, we also present evidence supporting the reliability and validity of developmentally appropriate criteria for diagnosing psychiatric disorders in children as young as two years old. Despite the relative lack of research on preschool psychopathology compared with studies of the epidemiology of psychiatric disorders in older children, the current evidence now shows quite convincingly that the rates of the common child psychiatric disorders and the patterns of comorbidity among them in preschoolers are similar to those seen in later childhood. We review the implications of these conclusions for research on the etiology, nosology, and development of early onset of psychiatric disorders, and for targeted treatment, early intervention and prevention with young children.

Maternal resolution of child diagnosis: stability and relations with child attachment across the toddler to preschooler transition

In this longitudinal study, the authors investigated individual differences in how families adapt to a child's congenital disorder. Family impact, maternal grief resolution, and child attachment were assessed among 74 mothers and their toddlers with a neurological disorder or disfigurement. Fifty dyads were reevaluated 16 months later. For children with neurological compared with disfigurement diagnoses, there was a greater likelihood of negative impact on family, unresolved maternal grief, and insecure attachment at Time 1. Children classified as secure were significantly more likely to have mothers classified as resolved regarding their reactions to their children's diagnosis. Maternal grief resolution was significantly stable (77%) over time and mediated the relation between type of diagnosis and child security. With time, negative impact of child condition on the family decreased and percentage of children classified as secure increased, suggesting that on average families improved. Results suggest that helping parents come to terms emotionally and cognitively with their child's condition may be a useful focus for intervention.

Parenting stress in infancy and psychosocial adjustment in toddlerhood: a longitudinal study of children with craniofacial anomalies

OBJECTIVE

To evaluate the association between parenting stress during infancy and child psychosocial adjustment during toddlerhood, within a sample of children with craniofacial anomalies (CFAs).

DESIGN

Retrospective chart review.

SETTING

Urban medical center department of reconstructive plastic surgery.

PARTICIPANTS

Parents of 47 children aged birth to 24 months at time 1 and 24 to 46 months at time 2.

MAIN OUTCOME MEASURES

Parenting Stress Index/Short Form completed at times 1 and 2; Child Behavior Checklist completed at time 2.

RESULTS

Relative to norms, more parents of children with CFAs experienced serious levels of parenting stress at times 1 and 2; however, fewer children with CFAs experienced serious levels of adjustment problems. Parenting stress during infancy predicted psychosocial adjustment in toddlerhood but was mediated by parenting stress in toddlerhood. Parents high on stress at both assessments showed clinical levels of total parenting stress and parent-child dysfunctional interaction when their children were infants; their toddlers showed higher levels of maladjustment than those with parents elevated on parenting stress during only infancy.

CONCLUSIONS

Elevated levels of parenting stress during infancy may be stable through toddlerhood for families having a child with a CFA. The relation between parenting stress and child adjustment is likely to be reciprocal. These findings should be replicated with a larger sample and multiple informants.

Children at risk for learning disorders: multiple perspectives

This study examined the contribution of a multidimensional model of risk factors in explaining adaptive functioning among 5- to 6.5-year-old kindergartners with mild developmental delays who were considered at risk for developing learning disorders. Risk factors included (a) child characteristics, (b) maternal and familial ecological variables, and (c) the child's attachment style as perceived by the mother. The sample included 145 Israeli mother-child dyads: 70 mothers and their children at risk for developing learning disorders (51 boys, 19 girls) and 75 mothers and their typically developing children (46 boys, 29 girls) from the same general education kindergartens. Data were collected from children's self-reports, mothers' narratives, and teachers' ratings. Path analysis examined the multidimensional risk model for the two groups. The study indicated a high fit between the theoretical model and the empirical findings and showed a different pattern of relations between the model's components for the two populations studied.

The impact of premature birth on fear of personal death and attachment of styles in adolescence

The differences between adolescents born pre-term (n = 50) and a matched sample of adolescents born full-term were examined in relation to fear of personal death, attachment styles, and the relation between the two variables. Findings revealed that adolescents born pre-term showed a higher level of fear of personal death and a lower frequency of secure attachment style than adolescents born full-term. In addition, secure full-term born adolescents exhibited a lower level of fear of personal death compared with insecure adolescents; whereas among those born pre-term, attachment styles did not affect the level of fear of personal death. Results are discussed in terms of the long-term impact of premature birth on affect regulation in adolescence.

A therapeutic nursery evaluation study

The object of this prospective study was to evaluate the effectiveness of a therapeutic nursery program for troubled preschoolers attending the Preschool Day Treatment Center of The Menninger Clinic. Thirty-eight seriously disturbed preschoolers were assessed both at admission and at 9 months or at discharge (if before 9 months) in a pre-post design. Commonly used assessment instruments were collected by independent research clinicians. Significant gains were found in both internalizing and externalizing behaviors on the Child Behavior Checklist (CBCL). The Kohn Social Competence Scale showed significant improvement in learning, pleasurable play activities, and peer interactions. The socialization domain on the Vineland Adaptive Behavior Scale also indicated improvement beyond expectable maturation. In the Behavioral Observations test, both the capacities of the child and the qualities of the relationship were shown to be improved. As measured by the Epidemiologic Studies of Depression Scale (CES-D), mothers also became less depressed. Overall, the researchers conclude that a therapeutic nursery with a comprehensive program is an effective way to help seriously troubled preschoolers make gains in behavior, as well as in social and emotional growth.

Biological, psychological and social processes in the conduct disorders

BACKGROUND

This paper reviews recent evidence on the causes and maintenance of aggressive and disruptive behaviours in childhood and adolescence. It considers the relative merits of several different ways of conceptualising such problems, in relation to the contribution of biological, psychological and social factors.

METHOD

It focuses on conduct problems appearing in young childhood, which greatly increase the likelihood of persistent antisocial behaviours in adolescence and adult life in association with wider interpersonal and social role impairments. It considers the contribution of individual factors, including impaired verbal skills, deficits in executive functions, and an imbalance between behavioural activation and inhibition systems. These are viewed in interaction with commonly associated environmental disadvantages such as hostile or intrusive parenting. The roles of attributional biases, unrealistic self-evaluations, and insecure attachment are considered in relation to affect regulation, and effective social action. The contributions of the wider social environments of peers, neighbourhood and socio-economic conditions are evaluated.

CONCLUSIONS

The paper concludes that, although considerable progress has been made over the past ten years, there is a need to further refine our conceptualisation of the behaviours to be explained, to develop a coherent theory of the causal and maintaining processes, and to carry out prospective studies with adequate numbers of high risk children.

Behavior in term, small for gestational age preschoolers

AIMS

To evaluate whether being born small for gestational age (SGA) was associated with an increased frequency of preschool behavioral problems.

STUDY DESIGN

Follow-up study at 5 years of age.

SUBJECTS

A population based cohort of 318 term infants who were SGA, defined as having a birthweight less than the 15th percentile for gestational age, and without major handicap such as cerebral palsy or mental retardation, and a random control sample of 307 appropriate for gestational age (AGA) infants.

OUTCOME MEASURES

The Personality Inventory for Children and the Yale Children's Inventory (completed by the mothers), and child behavior during psychometric testing.

RESULTS

Behavior problems was not more common among the SGA children. The results were not confounded by a wide range of parental demographic and child rearing factors, including maternal non-verbal problem solving abilities, child rearing style, and maternal psychological distress. However, the parental factors explained 13% of the variance in a summary score of child behavior compared to 1% explained by SGA vs. AGA status. The SGA children were not more sensitive to the negative impacts of parental risk factors than AGA controls. The study does not address the outcome of severely growth-retarded SGA infants.

CONCLUSION

Being born moderately SGA is not a significant risk factor for preschool behavior problems.

Behaviour problems in extremely low birthweight children at 5 and 8 years of age

This study explored the prevalence and stability of behaviour problems and their prediction from neonatal, medical and family context factors in a group of extremely low birthweight (ELBW) infants assessed at 5 and 8 years of age. Behaviour problems were identified on the basis of several measures: the Total Behaviour Problem Scale and the Adaptive Function Scale of the Child Behaviour Checklist, and the Hyperactivity Index and Hyperactivity Scale from the Conners' Rating Scale. In this group of ELBW infants, the prevalence of behaviour difficulties was somewhat lower than that reported in other studies, and varied according to the measure and informant (parent vs. teacher) used. Also, there was little continuity between those children identified by their parents at 5 years of age as having behaviour problems and those children identified by parent and/or teacher report at 8 years of age. Most of the children identified with behaviour difficulties at 8 years were also reported to have academic difficulties. None of the neonatal or medical factors predicted behaviour difficulties at 8 years of age. In contrast, two family context factors, maternal level of education and family stress, were related to behaviour difficulties at 8 years. These findings indicate that ELBW and the often associated medical complications may not necessarily predispose infants to develop subsequent behaviour difficulties later on in childhood.

Key issues in the development of aggression and violence from childhood to early adulthood

Different manifestations of aggression from childhood to early adulthood are reviewed to establish how early manifestations are related to later manifestations. Similarities and differences in manifestations of aggression between the two genders are noted. Developmental sequences and pathways from minor aggression to violence are highlighted. Long-term escalation is contrasted with short-term escalation at older ages. Although studies have emphasized high stability of aggression over time, data show that a substantial proportion of aggressive youth desist over time. Temperamental, emotional, and cognitive aspects of aggression are reviewed, either as precursors or co-occurring conditions to aggression. Selected processes in the realms of the family, peers, and neighborhoods are highlighted that are known to be associated with juvenile aggression. Cumulative, long-term causes are contrasted with short-term causes, and causes associated with desistance in aggression are reviewed.

Behavioral problems in low-birthweight preschoolers

Preschool behavior of a population-based sample of 144 5-year-old children with birthweights less than 2000g (LBW) was compared with a random sample of 163 normal-birthweight term controls. The Personality Inventory for Children and the Yale Children's Inventory were completed by the mothers, and child behavior during psychometric testing was assessed. Nineteen per cent of the LBW children compared to 4% of controls had behavioral problems as defined by abnormal scores on more than three behavioral measures. The LBW children were more often socially insecure, anxious and difficult to manage, but inattention and hyperactivity were not prominent. The LBW children were not more sensitive to the negative impact of parental risk factors than normal-birthweight children.

Behavior problems in preschool children: a review of recent research

Research on the prevalence, course, and correlates of behavior problems in preschool children was examined. Prospective epidemiological studies and follow-up studies of clinical/high risk samples indicate that serious externalizing problems identified early often persist. Negative, inconsistent parental behavior and high levels of family adversity are associated with the emergence of problems in early childhood and predict their persistence to school age. Studies are examined from a developmental perspective and integrated with research on optimal parent-child relationships. The severity of initial problems and family context are related to different developmental outcomes.

Predicting behavior problems in children with epilepsy: child factors, disease factors, family stress, and child-mother interaction

This study examines the relative role of parent-child relationships, family stress, and disease factors in predicting behavior problems in children with epilepsy. It extends existing literature on parent-child relationships and behavior problems by examining children with biological risk. Child-mother interaction was observed for 51 children with epilepsy ages 7-13 years and related to teacher- and parent-reported behavior problems. Child's self-reliance correlated with parent-reported problems; expression of affect related to teacher-reported externalizing problems. A child self-reliance factor accounted for behavior problems after partialing age, gender, IQ, epilepsy variables, and family stress. The term child gender x quality of mother-child interaction predicted teacher-reported externalizing problems, with mother-child interaction correlated with behavior problems for boys. Child-parent relationships predict the development of behavior problems over and above the influence of disease-related factors, even for children at considerable biological risk.

Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom

This study of 62 low-income families examined the relation between maternal and infant measures assessed at 18 months infant age and child behavior problems at age 5 as rated by preschool teachers. The infancy assessments included measures of mother-infant interaction, maternal psychosocial problems, infant cognitive development, and infant attachment security, including the disorganized/disoriented classification. The strongest single predictor of deviant levels of hostile behavior toward peers in the classroom was earlier disorganized/disoriented attachment status, with 71% of hostile preschoolers classified as disorganized in their attachment relationships in infancy. Maternal psychosocial problems independently predicted hostile aggression in preschool and combined additively with infant attachment security in prediction. Results are discussed in relation to the asymmetry of forward and backward prediction that characterized the findings and in relation to the potential significance of disorganized attachment behavior as a precursor to later maladaptation.

Recent developments in attachment theory and research

The history and development of attachment theory are reviewed. Research has focused on four major patterns of attachment in infancy: one pattern of secure attachment and three patterns of insecure attachment (avoidant, resistant, and disorganized). These patterns have been shown to reflect different histories of parent-child interaction and affected subsequent development up to age eight. More recently, methods have been developed for identifying similar patterns of attachment in preschoolers, five to seven year olds and adults. Future research is likely to focus on the development of attachment patterns and their transmission from one generation to another. New data on the relationship between attachment and behaviour problems has generated mutual respect and collaboration between clinicians and researchers.