Attachment goes to court: child protection and custody issues

Evaluating the use of the AMBIANCE-Brief measure in clinical settings: Assessing acceptability, feasibility, and utility of the AMBIANCE-Brief

Community agencies and practitioners around the globe seek opportunities to learn various assessment tools and interventions rooted in attachment theory. However, information regarding the feasibility of implementation and sustainability of these tools once participants have been trained to use them, is limited. This study investigated the perceived acceptability, feasibility, utility, relevance, fidelity, and sustainability of the Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) among practitioners who had taken a training. Practitioners (N = 59) who attended a virtual AMBIANCE-Brief training originating from Canada between June 2020 and November 2021 completed an online follow-up survey. Practitioners reported that they primarily used the AMBIANCE-Brief for case conceptualization (68%). Additionally, 95% agreed that the AMBIANCE-Brief was relevant to their clinical practice, 98% agreed it was useful for their clinical work, 76% agreed that it was feasible to implement into their clinical work, and 59% found it easy to incorporate into their treatment planning with clients. Findings suggest that the AMBIANCE-Brief may be acceptable, feasible, and useful for practitioners. Avenues for continuing to evaluate the AMBIANCE-Brief include cross-cultural validity, coder drift, and booster sessions. Additional work clarifying how practitioners integrate the measure into practice would be valuable.

The predictive validity of the strange situation procedure: Evidence from registered analyses of two landmark longitudinal studies

Meta-analyses demonstrate that the quality of early attachment is modestly associated with peer social competence (r = .19) and externalizing behavior (r = -.15), but weakly associated with internalizing symptoms (r = -.07) across early development (Groh et al., Child Development Perspectives, 11(1), 70-76, 2017). Nonetheless, these reviews suffer from limitations that undermine confidence in reported estimates, including evidence for publication bias and the lack of comprehensive assessments of outcome measures from longitudinal studies in the literature. Moreover, theoretical claims regarding the specificity of the predictive significance of early attachment variation for socioemotional versus academic outcomes had not been evaluated when the analyses for this report were registered (but see Dagan et al., Child Development, 1-20, 2023; Deneault et al., Developmental Review, 70, 101093, 2023). To address these limitations, we conducted a set of registered analyses to evaluate the predictive validity of infant attachment in two landmark studies of the Strange Situation: the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) and the NICHD Study of Early Child Care and Youth Development (SECCYD). Across-time composite assessments reflecting teacher report, mother report, and self-reports of each outcome measure were created. Bivariate associations between infant attachment security and socioemotional outcomes in the MLSRA were comparable to, or slightly weaker than, those reported in the recent meta-analyses, whereas those in the SECCYD were weaker for these outcomes. Controlling for four demographic covariates, partial correlation coefficients between infant attachment and all socioemotional outcomes were r ≤ .10 to .15 in both samples. Compositing Strange Situations at ages 12 and 18 months did not substantively alter the predictive validity of the measure in the MLSRA, though a composite measure of three different early attachment measures in the SECCYD did increase predictive validity coefficients. Associations between infant attachment security and academic skills were unexpectedly comparable to (SECCYD) or larger than (MLSRA) those observed with respect to socioemotional outcomes.

Editorial Perspective: What can we learn from hunter-gatherers about children's mental health? An evolutionary perspective

Humans lived as hunter-gatherers for more than 95% of our evolutionary history, thus studying contemporary hunter-gatherer populations offers insight into the conditions children may be psychologically adapted to. Here, we contrast hunter-gatherer childhoods with those of WEIRD (Western Educated Industrialised Rich Democratic) societies and consider the implications for children's mental health. Hunter-gatherer infants receive continuous physical contact and more sensitive and responsive caregiving than is typical of WEIRD societies, due to the extensive involvement of alloparents (non-parental caregivers) who generally provide 40-50% of their care. Alongside positive attachment outcomes, alloparenting likely reduces the harms of family adversity and risk of abuse/neglect. From late infancy, hunter-gatherers spend their time in mixed-age 'playgroups' where they learn via active play and exploration without adult supervision. This contrasts with WEIRD norms surrounding the need for adult supervision of children, as well as with the passive teacher-led classrooms, which could potentially lead to suboptimal learning outcomes and pose difficulties to children with ADHD. Based on this preliminary comparison, we consider practical solutions to potential harms arising from discordance between what children are adapted to and exposed to. These include infant massage and babywearing; increased sibling and extra-familial involvement in childcare; and educational adjustments.

In defense of unresolved attachment: re-modelling intergenerational transmission of attachment

Intergenerational transmission of attachment is one of the core hypotheses of attachment theory. How parents or other caregivers look back on their childhood attachment experiences is suggested to shape their infants' attachments. In the current paper, we show that a new twist to correspondence analysis (Canonical Correlation Analysis [CCA]) of cross-tabulated attachment classifications with oblique rotation Correspondence Analysis (CA) may uncover the latent structure of intergenerational transmission showing the unique role of parental Unresolved representations in predicting infant Disorganized attachments. Our model of intergenerational transmission of attachment supports predicted associations between parental and infant attachments. Despite growing skepticism about the validity of parental Unresolved trauma and infant Disorganized attachment, we come to an evidence-based statistical defense of these generative clinical components of attachment theory awaiting a substantive experimentum crucis.

Accessibility of child protection investigations during pandemic: A qualitative analysis of court proceedings

BACKGROUND

Qualitative research using published court records to examine contextual factors that contribute to child protection decisions in cases involving parents with intellectual disabilities is limited, particularly during the COVID-19 pandemic.

METHOD

The present study conducted qualitative content analysis on 10 published Ontario court cases to study child protection decision-making between 2019 and 2021.

RESULTS

The findings corroborated previous literature with nine out of 10 cases resulting in loss of child custody. Four major themes emerged from content analysis: (1) Impact of COVID-19 pandemic on cases; (2) Systemic barriers to accessibility; (3) Attitudes and bias toward parents with intellectual disabilities; and (4) Ultimate reliance on intellectual disability status for final custody decision.

CONCLUSIONS

Conducting content analysis on published court cases is useful in learning about accessibility barriers for parents with intellectual disabilities and may help in understanding the impact of the COVID-19 pandemic on the child protection system.

eCONNECT Parent Group: An Online Attachment-Based Intervention to Reduce Attachment Insecurity, Behavioral Problems, and Emotional Dysregulation in Adolescence

During adolescence, a secure parent-adolescent relationship promotes youths' adjustment and psychological well-being. In this scenario, several studies have demonstrated the effectiveness of the CONNECT program, a 10-session, attachment-based parenting intervention that helps parents understand and reframe their parent-adolescent interactions, reducing adolescents' insecure attachment and behavioral problems. Furthermore, recent years have witnessed a significant increase in the implementation of effective online versions of psychological interventions, emphasizing the opportunity for more agile and easier dissemination of evidence-based protocols. Therefore, this study aims to identify changes in adolescents' attachment insecurity, behavioral problems, and parent-child affect regulation strategies, providing preliminary findings on an online, 10-session, attachment-based parenting intervention (eCONNECT). A total of 24 parents (20 mothers, 4 fathers; Mage = 49.33, SD = 5.32) of adolescents (Mage = 13.83 years, SD = 1.76, 45.8% girls) were assessed on their adolescents' attachment insecurity (avoidance and anxiety) and behavioral problems (externalizing and internalizing), and on their affect regulation strategies in the parent-child interaction (adaptive reflection, suppression, and affect dysregulation) at three time points: before intervention (t0), after intervention (t1), and at a 2-month follow-up (t2). Mixed-effects regression models highlighted a reduction in adolescents' internalizing problems (d = 0.11), externalizing problems (d = 0.29), and attachment avoidance (d = 0.26) after the intervention. Moreover, the reduction in externalizing problems and attachment avoidance remained stable at follow-up. Additionally, our findings highlighted a reduction in parent-child affect dysregulation. Results add preliminary evidence on the implementation suitability of an online attachment-based parenting intervention to change at-risk adolescents' developmental trajectories by reducing attachment insecurity, behavioral problems, and parent-child affect regulation.

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). VIPP-SD combines support of parental sensitive responsiveness with coaching parents in sensitive limit setting. Here, we present meta-analyses of 25 RCTs conducted with more than 2,000 parents and caregivers. Parents or children had various risks. We examined its effectiveness in promoting parental cognitions and behavior regarding sensitive parenting and limit setting, in promoting secure child-parent attachment, and reducing externalizing child behavior. Web of Science, MEDLINE, PubMed, and recent reviews were searched for relevant trials (until May 10, 2021). Multilevel meta-analysis with META, METAFOR, and DMETAR in R took account of the 3-level structure of the datasets (studies, participants, measures). The meta-analyses showed substantial combined effect sizes for parenting behavior (r = .18) and attitudes (r = .16), and for child attachment security (r = .23), but not for child externalizing behavior (r = .07). In the subset of studies examining effects on both parenting and attachment, the association between effect sizes for parenting and for attachment amounted to r = .48. We consider the way in which VIPP-SD uses video-feedback an active intervention component. Whether VIPP-SD indeed stimulates secure attachment through enhanced positive parenting remains an outstanding question for further experimental study and individual participant data meta-analysis.

The Role of Forensic Veterinary Toxicology in Pet Custody Cases

Forensic veterinary toxicology has become a popular branch of toxicology, dealing with animal cruelty (e.g., malicious poisoning), regulatory issues (e.g., contamination of the feed supply chain), insurance litigation or wildlife poisoning. The current study highlights the importance of the toxicological aspects of animal health-related disagreements in a pet custody case following a divorce. In this study, the custody case of three dogs and a cat was concluded with the aid of toxicological test results that were obtained from the pets' blood samples for the first time in Turkey. The results confirmed the presence of benzoylecgonine in one of the blood samples, as alleged by one of the owners. The study also aims to raise the veterinarians', as well as the judicial system members', awareness of drug abuse in pets.

A "transmission gap" between research and practice? A Q-methodology study of perceptions of the application of attachment theory among clinicians working with children and among attachment researchers

Clinical practitioners are frequently encouraged, through literature, training, and policy, to learn, understand, refer to and use their knowledge of attachment theory and research when working to meet the needs of children and families. However, there has been very little empirical study of how practitioners understand and perceive the relevance of attachment concepts and methods. Q-methodology was used to examine the perceptions of attachment knowledge and its applications for practice among 30 UK clinicians working with children and an international group of 31 attachment researchers. Factor analysis revealed three perspectives, described as: i) pragmatic, developmental, and uncertain, ii) academic, and iii) autodidactic and therapeutic. Participants agreed on core tenants of theory, their aspirations for clinical practice and the inaccessibility of current assessment measures for practitioners. Yet they diverged on their understandings of attachment insecurity, disorganisation, and the implications of both for various aspects of child development.

A mixed method study to explore the maternal impact and outcomes of a specialist Building Attachment and Bonds Service (The BABS Study)

Our intent was to explore if maternal anxiety, depression, reflective functioning and level of attachment significantly changed after the Building Bonds and Attachment Service (BABS) Intervention. We measured outcomes for 46 at risk mothers via HADS; MAAS; MPAS and P-PRFQ. Our findings, triangulated with 32 semi structured interviews identified that BABS intervention made a significant difference to participants who were admitted during the antenatal period (Pregnant group: depression 9.63[CI:7.63-11.63; p < 0.001]; anxiety 9.40[CI: 7.56-11.24]; p < 0.001]; reflective functioning 30.78[CI:24.84-36.72; p < 0.001] and maternal attachment 8.78[CI:4.08-13.48]; p 0.001). Suicidal contemplation was prevented for two women. Our conclusions explained the service made a significant difference to the lives of mothers between baseline and post intervention for pregnant mothers with anxiety and depression who struggled to bond with their baby. Appropriate referral may help to increase accessibility to those who may benefit most. Further research needs to test if this care model would be acceptable to culturally diverse populations.

Child Welfare Reform: A Scoping Review

While there have been ongoing calls to reform child welfare so that it better meets children's and families' needs, to date there have been no comprehensive summaries of child welfare reform strategies. For this systematic scoping review, we summarized authors' recommendations for improving child welfare. We conducted a systematic search (2010 to 2021) and included published reviews that addressed authors' recommendations for improving child welfare for children, youth, and families coming into contact with child welfare in high-income countries. A total of 4758 records was identified by the systematic search, 685 full-text articles were screened for eligibility, and 433 reviews were found to be eligible for this scoping review. Reviews were theoretically divided, with some review authors recommending reform efforts at the macro level (e.g., addressing poverty) and others recommending reform efforts at the practice level (e.g., implementing evidence-based parenting programs). Reform efforts across socioecological levels were summarized in this scoping review. An important next step is to formulate what policy solutions are likely to lead to the greatest improvement in safety and well-being for children and families involved in child welfare.

International perspective on guidelines and policies for child custody and child maltreatment risk evaluations: A preliminary comparative analysis across selected countries in Europe and North America

Little knowledge exists on how evaluators in child custody and child maltreatment cases are informed by guidelines, the kinds of qualifications required and the types of training provided in different countries. The purpose of this paper is to provide an international preliminary comparison on how child custody and child maltreatment risk assessments are conducted in selected Western countries, and how the assessments are informed by best practice guidelines. Another aim is to increase knowledge on how the guidelines and best-practice standards could be developed further to reflect recent research findings. A total number of 18 guidelines were included in the analyses: four from Canada, five from the United States, three from the United Kingdom, three from the Netherlands, two from Finland, and one from Germany. We conducted a content analysis of the included guidelines in the database, focusing on how the guidelines address the best interest of the child criteria, guidelines for conducting the assessments, considerations for evaluative criteria, and specific guidance for conducting specific assessment procedures (e.g., interviews and observations). Findings show that the qualifications of and training provided to evaluators in child custody and child maltreatment risk evaluations are largely heterogeneous across the countries represented. Guidelines differ in whether and how they highlight the importance of evidence-based practices and scientifically validated assessment measures. Implications are drawn from the review and contextualized by international expert authors in the fields of forensic psychology, and family law. After the content analysis, discussion sessions within the expert group were held. The authors provide both commentaries and suggestions to improve the development of standard methods for conducting both child custody and child maltreatment risk evaluations and to consider a more transparent and judicious use of social science research to guide methods and the recommendations offered within these assessments.

Major depression as a predictor of the intergenerational transmission of attachment security: Findings from a pregnancy cohort study

OBJECTIVE

Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant-parent attachment classification at 12 months postpartum.

METHODS

Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant-parent attachment was measured using the Strange Situation Procedure at 12 months.

RESULTS

Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample.

CONCLUSION

While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.

Attachment Theory: A Barrier for Indigenous Children Involved with Child Protection

Background: Attachment theory is an established theoretical understanding of the intimate relationships between parental figures and children. The theory frames the ways in which a child can be supported to develop within a secure base that prepares them for adulthood, including entering into and sustaining intimate relationships. The theory, built on the work of John Bowlby following World War II, has extensive literature supporting its application across multiple cultures and nations, although its roots are heavily tied to Eurocentric familial understandings. However, the theory has also been heavily criticized as not being appropriate for child intervention decision-making. Further, its application to Indigenous caregiving systems is also under question. Yet courts rely heavily on applying the theory to questions of sustaining Indigenous children in non-Indigenous care when return to biological parents is deemed impossible. Methods: This article draws upon the consistent arguments used in leading Canadian child welfare legal decisions and case examples to show how Attachment Theory is applied relative to Indigenous children and families. Results: Attachment Theory drawing upon Eurocentric framing, and as applied in Canadian child protection systems, as seen in precedent court decisions, is given priority over living in culture. This occurs even though the research reviewed has shown that the traditional dyadic version of the theory is not valid for Indigenous peoples. Conclusions: While all children will attach to a caregiver or caregiving system, such as kinship or community, leading legal decisions in Canada tend to rely on Eurocentric versions of the theory, which is contrary to the best interests of Indigenous children. Child protection needs to reconsider how attachment can be used from appropriate cultural lenses that involve the communal or extended caregiving systems common to many Canadian Indigenous communities. Child protection should also recognize that there is not a pan-Indigenous definition of attachment and child-rearing, so efforts to build working relationships with various Indigenous communities will be needed to accomplish culturally informed caregiving plans. In addition, continued advocacy in Canada is needed to have child protection decision-making conducted by the Indigenous communities, as opposed to Eurocentric provincial or territorial agencies.

Concepts travel faster than thought: an empirical study of the use of attachment classifications in child protection investigations

Scholarly discussion suggests prevalent, overconfident use of attachment classifications in child protection (CP) investigations but no systematic research has examined actual prevalence, the methods used to derive such classifications, or their interpretations. We aimed to cover this gap using survey data from a nationally representative sample of Swedish CP workers (N = 191). Three key findings emerged. First, the vast majority formed an opinion about young children's attachment quality in all or most investigations. Second, most did not employ systematic assessments, and none employed well-validated attachment methods. Third, there was overconfidence in the perceived implications of attachment classifications. For example, many believed that insecure attachment is a valid indicator of insufficient care. Our findings illustrate a wide researcher-practitioner gap. This gap is presumably due to inherent difficulties translating group-based research to the level of the individual, poor dissemination of attachment theory and research, and infrastructural pressures adversely influencing the quality of CP investigations.

Still Mother after All These Years: Infants Still Prefer Mothers over Fathers (If They Have the Choice)

Fathering and mothering have changed in many ways within the last decades. Earlier studies showed a clear hierarchy in infant attachment figures with a preference for mothers. This study examined whether infants in the 21st century still prefer mothers over fathers in their expression of attachment behaviors, whether differences in parental involvement still exist, and whether this will result in differences in attachment security to mother and father. A total of 50 German families with infants between 10 and 19 months were observed in an experimental setting and during home visits. Parents reported on their involvement. The results revealed a clear hierarchy with regard to the duration of attachment behaviors directed towards mothers, followed by fathers and strangers. Mothers reported to be more involved in child care on weekdays compared to fathers. Involvement was not associated with attachment variables. Attachment security to mother and father was positively related and did not differ significantly. Infants in the 21st century in a Western country still prefer mothers over fathers in their expression of attachment behaviors. Mothers were more involved in child care than fathers. However, these differences did not result in differences in attachment security to mother and father.

Admissibility of attachment theory, research and assessments in child custody decision-making? Yes and No!

Attachment theory, research, and assessments have become increasingly applied to settle child custody cases. We discuss such applications in relation to admissibility criteria for scientific evidence and testimony proposed by Faigman et al. (2014). We argue that attachment theory and research can provide valid "framework evidence"; group-based attachment research has yielded general principles suitable as a frame of reference for pertinent court decisions. In particular, child custody decision-making should generally be guided by research indicating that children benefit from attachment networks. In contrast, assessments of attachment quality fall short of providing valid "diagnostic evidence"; information that a specific individual/dyad is a "true" instance of a general group-level principle. In particular, such assessments do not yield valid information about whether a particular caregiver has better caregiving skills than another caregiver and will better support child development. We conclude that attachment theory and research should be admissible for framework but not for diagnostic testimony.

Living arrangements after parental separation have minimal impact on mental health at age 7 years

AIM

This study compared mental health after parental separation in 7-year-old children living in joint physical custody with sole physical custody family arrangements.

METHODS

The study population included 39 661 children from the Danish National Birth Cohort, living in a nuclear family at age 6 months. Child mental health was measured at age 7 years with maternal reports of the Strength and Difficulties Questionnaire (SDQ) operationalised as a high total score. Associations between living arrangements and mental health were analysed using logistic regression models, taking into account early childhood indicators of family relations, parental mental health and socioeconomic conditions.

RESULTS

There were no statistically significant differences between the living arrangements after parental separation with joint physical custody having an odds ratio (OR) of 1.37 (95% CI 1.10-1.70), sole physical custody without a new partner OR 1.33 (95% CI 1.19-1.47) and OR 1.55 (95% CI 1.30-1.84) for sole physical custody with new partner, with children in a nuclear family as reference.

CONCLUSION

This study indicates that living arrangements after parental separation have a minimal influence on child mental health at age 7 years.

Six attachment discourses: convergence, divergence and relay

Attachment concepts are used in diverging ways, which has caused confusion in communication among researchers, among practitioners, and between researchers and practitioners, and hinders their potential for collaboration. In this essay we explore how attachment concepts may vary in meaning across six different domains: popular discourses, developmental science, social psychological science, psychiatric diagnosis, psychotherapy, and child welfare practice. We attempt to typify these forms of attachment discourse by highlighting points of convergence, divergence, and relay between the different domains. Our general conclusions are that diversity in the use of attachment concepts across different domains of application has been largely unrecognised, and that recognition of these differences would reduce confusion, help identify sites where infrastructure needs to be developed to support coordination, and strengthen opportunities for collaboration to mutual benefit. We suggest that academic attachment discourse would benefit from clarification of core terminology, including: "attachment", "internal working model", "trauma", and "dysregulation".

Replication crisis lost in translation? On translational caution and premature applications of attachment theory

In the biomedical, behavioral and neurobiological sciences reproducibility and replicability of research results have become a major issue. The question is whether attachment research is also plagued by lack of replicability, and if so whether one can speak of a crisis? Furthermore, discussions about the applicability of attachment research findings to policy and (clinical) practice have recently been intensified. The subsequent question arises whether one could even speak of a "translational crisis". In this paper assumptions and conditions of replicability and applicability will be outlined. Some examples of attachment findings lost or found in translation to policy and practice (e.g. on infant crying and parental insensitive responsiveness) will be used to illustrate the challenges and chances of bridging the gap between attachment science and practice.

The God, the blood, and the fuzzy: reflections on Cornerstones and two target articles

In response to Cornerstones of attachment research and the target articles, I reflect on three questions. First, what is "attachment"? Although a natural kind, I argue against an essentialist understanding (i.e. in terms of necessary/sufficient conditions for class membership). Instead, the attachment concept must be allowed to have fuzzy boundaries, partly because of how attachments transform in both phylogeny and ontogeny. Second, how to think about the normative (species-typical) features of the theory vis-à-vis dyadic/individual differences in attachment? Whereas the former are foundational, I argue that the latter largely reflect surface variation. Despite this, the lion's share of attachment research has horned in on variation and its measurement, to some detriment to the theory's potential and applications. Finally, what is encouraging and discouraging about recent developments? While applauding large-scale cooperative endeavors (e.g. individual participant meta-analyses, consensus statements) I caution the field not to lose sight of the value of smaller-scale, creative explorations of uncharted territories.