Middle Childhood Support-Seeking Behavior During Stress: Links With Self-Reported Attachment and Future Depressive Symptoms

The effects of maternal competence and situational stress level on children's help-seeking expectations across 4 to 6 years of age

Help-seeking is a crucial problem-solving strategy for young children. However, it is not yet clear how children weigh different cues to make help-seeking decisions across preschool years, especially in caregiver-child interactions. The current study used a social expectation task to examine the effects of maternal competence and situational stress level on 4- to 6-year-old children's help-seeking expectations from a third-party perspective. Children's expectations of whether to seek help were measured. A total fo 135 Han Chinese children aged 4 to 6 years from an eastern city of China participated in this study. We found that 4- to 6-year-olds expected to seek more help from a competent mother than from an incompetent mother in low-stress conditions. When the stress level was high, however, they expected to seek help regardless of maternal competence levels. These results suggest that the interaction between the situational stress level and maternal competence determines young children's help-seeking expectations across preschool years. They further suggest that young children seek help from mothers in an active and discriminatory way.

Attachment expectations moderate links between social support and maternal adjustment from 6 to 18 months postpartum

Significant links exist between one's perception of available social support and mental health outcomes, including during the transition to motherhood. Yet, attachment theory posits that individuals do not benefit equally from social support. As such, we examined the influence of attachment representations (i.e., secure base script knowledge) as they potentially moderate links between social support and psychological distress in a 1-year longitudinal study of an ethnically diverse (56% White) sample of infant-mother dyads. We hypothesized that higher social support would predict lower maternal psychological distress and this relation would be strongest in those with higher secure base script knowledge. Results indicated that maternal perceptions of social support were significantly negatively correlated with psychological distress. Analyses revealed that secure base script scores significantly moderated these associations. Interestingly, for those high in script knowledge, low social support predicted greater psychological distress. For those low in script knowledge, social support was unrelated to psychological distress. This pattern suggested that those who expect care (i.e., high secure base script knowledge) but receive minimal support (i.e., low perceived social support) find motherhood uniquely dysregulating. Practitioners may do well to examine individuals' attachment expectations in relation to their current social support.

Do parental attachment and prosocial behavior moderate the impairment from depression symptoms in adolescents who seek mental health care?

We investigated parental attachment and prosocial behavior as social protective indicators in adolescents (age 11-17) with symptoms of depression in a clinical setting. Specifically, we tested the moderating effect of these factors on the relation between symptoms of depression and their impairment on daily life. The Development and Well-Being Assessment, as completed by children, mothers, and fathers, was used, and hierarchical multiple regression analyses were conducted for these three perspectives. From the adolescents' reports we only found a significant effect of symptoms on impairment indicating that a higher number of symptoms were related to higher impairment. For the mothers and fathers, a higher score on the adolescents' prosocial behavior was related to a lower impairment from depression symptoms on the daily life of the adolescent and the family. Only for the mothers did a higher score on prosocial behavior buffered the effect of symptoms on impairment, while a higher parental attachment score was associated with a lower impairment. Further, when examining maternal and paternal attachment separately, we found that, only the mothers, reported less impairment from the symptoms when they perceived that the adolescent was attached to the father, and paternal attachment even buffered the effect of symptoms on impairment. To conclude, our results indicate that social protective factors, from the parent's perspective, are likely to have a beneficial effect in clinical practice and should be taken into account when examining impairment scores. Future studies should investigate whether additional protective indicators from the adolescents' perspective, such as quality of parental attachment or family climate, may have a positive impact on their daily functioning.

Middle childhood attachment-based family therapy: Theory and model description

In middle childhood, the first manifestations of mental health problems can emerge and become a precursor of mental health issues in adolescence. Given that weak parent-child attachment can contribute to this distress, it is possible that strengthening the attachment bond could reduce risk trajectory. Unfortunately, evidence-based attachment-focused interventions are lacking at this age. Attachment-based family therapy (ABFT) is a well-studied intervention for troubled adolescents and has the potential to be extended downward to children. However, ABFT for adolescents focuses on mentalization and trauma conversation strategies that may be developmentally advanced for children's capacities. Therefore, we modified the intervention strategies to be more developmentally sensitive to childhood. Middle childhood ABFT (MCABFT) builds on the theory that insecure attachment develops through a learning process that can be interrupted and reorganized to promote secure attachment development. MCABFT uses less conversation and more play and puts parents more at the center of the therapy compared with ABFT for adolescents. In this article, we describe MCABFT's theoretical and clinical model.

Depression in middle childhood: secure base script as a cognitive diathesis in the relationship between daily stress and depressive symptoms

A better understanding of protective factors against childhood depression may allow for the mitigation of severe and chronic symptoms and the timely implementation of intervention strategies. This study investigated the protective effect of having a secure base script on depressive symptoms when children face daily stressors. To test this hypothesis, moderation analyses were performed in a cross-sectional study with 378 children (48.5% boys, 51.5%) aged 8-12 years (M = 10.20; SD = 0.57). The results provided some support for the moderation effect when secure base script knowledge was investigated as a categorical variable in middle childhood. However, the results did not support the moderation effect when investigating secure base script as a continuous variable. Therefore, future investigations may need to address whether a categorical approach could better elucidate the protective role of secure base script knowledge in childhood depression.

In safe hands: Attachment figures' safety properties and the link with attachment style

According to the Learning Theory of Attachment, naturalistic learning experiences about others' responsiveness during distress are an underlying mechanism in the development of attachment. Previous studies have demonstrated attachment figures' unique safety-inducing effects in highly controlled conditioning procedures. Yet, neither have studies examined the presumed influence of safety learning on state attachment, nor have they examined how attachment figures' safety-inducing effects relate to attachment styles. To address these gaps, a differential fear conditioning paradigm was used in which pictures of participants' attachment figure and two control stimuli served as safety cues (CS-). US-expectancy and distress ratings were measured as indicators of fear responding. Results indicate that attachment figures evoked enhanced safety responding compared to control safety cues at the start of acquisition, which was maintained throughout acquisition and when presented together with a danger cue. Attachment figures' safety-inducing effects were reduced in individuals with higher attachment avoidance, although attachment style did not affect the rate of new safety learning. Finally, safe experiences with the attachment figure in the fear conditioning procedure resulted in diminished anxious state attachment. Adding to previous work, these findings underscore the importance of learning processes for attachment development and attachment figures' provision of safety.

The interactive effects of family violence and peer support on adolescent depressive symptoms: The mediating role of cognitive vulnerabilities

BACKGROUND

Family violence as an inducing factor of depressive symptoms has been confirmed in previous studies. However, the mechanisms underlying this association are not well understood, particularly in Chinese adolescents. Guided by the social-ecological diathesis-stress model, this three-wave longitudinal study aimed to examine the effects of an individual's cognitive vulnerabilities (rejection-sensitivity anxiety and negative cognitive error) and positive societal contexts (peer support) on the link between family violence and depressive symptoms in Chinese society.

METHODS

A total of 859 Chinese adolescents (44.35 % female; M_age = 12.73, SD = 0.43 at baseline) completed self-reporting surveys that assessed variables associated with study and peer-nominated peer support.

RESULTS

The results showed that family violence increased the incidence of depressive symptoms in adolescents after two years, resulting in rejection-sensitivity anxiety and negative cognitive error. Surprisingly, higher self-reported peer support, although not peer-nominated support, exacerbated rather than mitigated this indirect effect, supporting the reverse stress-buffering model and extending the healthy context paradox.

LIMITATIONS

Most of the measures were based on participants' self-reports.

CONCLUSIONS

These results emphasize the importance of individual cognition and societal contexts in adolescents with traumatic experiences and provide empirical evidence for the intervention and clinical treatment of depressive symptoms.

Parental support and insecure attachment development: the cortisol stress response as a moderator

The current study investigated whether variations at the level of the cortisol stress response moderate the association between parental support and attachment development. To test this hypothesis, we conducted a one-year longitudinal study with two waves in which 101 children (56% girls, M_age = 11.15, SD_age = 0.70) participated. Attachment anxiety and avoidance were measured at baseline (Wave 1) and one year later (Wave 2). Parental support and children's cortisol stress response during the Trier Social Stress Test were measured at Wave 2. Children's cortisol stress response was found to moderate the association between parental support and relative change in anxious attachment. A strong cortisol stress response weakened the associated between parental support and relative change in anxious attachment. No moderation effects were found for relative change in avoidant attachment.

Association between attachment and hoarding behavior: Mediation of anthropomorphism and moderation of hoarding beliefs among Chinese adolescents

The impact of insecure attachment on hoarding behavior (HB) has been supported by empirical evidence. However, scant literature has focused on how anthropomorphism (attributing human-like traits, characteristics, or emotions to nonhuman objects) and hoarding beliefs (motivations for ownership) affect the relationship between insecure attachment and HB, especially among Chinese adolescents. Using a cross-sectional study, we reserved 903 participants (561 males, 342 females, M = 20.20, SD = 1.85, age range = 18-24 years) to complete self-report questionnaires about close relationships, anthropomorphism, saving beliefs, and saving inventory to investigate the mediating role of anthropomorphism and the moderating role of hoarding beliefs in the relationship between insecure attachment and HB. Attachment anxiety and avoidance had a positive relationship with HB, and anthropomorphism is a mediating factor in the association between attachment anxiety and HB. In addition, hoarding beliefs moderated the relationship between attachment anxiety and HB. This study further elaborated on the relationships between insecure attachment, anthropomorphism, hoarding beliefs, and HB, which might shed some light on adolescent clinical interventions.

ConNEcT: An R package to build contingency measure-based networks on binary time series

Dynamic networks are valuable tools to depict and investigate the concurrent and temporal interdependencies of various variables across time. Although several software packages for computing and drawing dynamic networks have been developed, software that allows investigating the pairwise associations between a set of binary intensive longitudinal variables is still missing. To fill this gap, this paper introduces an R package that yields contingency measure-based networks (ConNEcT). ConNEcT implements different contingency measures: proportion of agreement, corrected and classic Jaccard index, phi correlation coefficient, Cohen's kappa, odds ratio, and log odds ratio. Moreover, users can easily add alternative measures, if needed. Importantly, ConNEcT also allows conducting non-parametric significance tests on the obtained contingency values that correct for the inherent serial dependence in the time series, through a permutation approach or model-based simulation. In this paper, we provide an overview of all available ConNEcT features and showcase their usage. Addressing a major question that users are likely to have, we also discuss similarities and differences of the included contingency measures.

A Learning Theory Approach to Attachment Theory: Exploring Clinical Applications

Although clinicians typically acknowledge the importance of insecure attachment as one factor that can contribute to children's psychopathology, translating attachment theory into clinical practice has proved a challenge. By specifying some of the mechanisms through which the child's attachment develops and changes, learning theory can enhance attachment based approaches to therapy. Specifically, interventions building on operant (parent management training) and classical (exposure therapy) learning can be used to stimulate new learning that increases the child's security and confidence in the parent's availability and responsiveness. To explore the clinical application and utility of a Learning Theory of Attachment (LTA), we focus on two attachment-focused interventions: Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and Middle Childhood Attachment-based Family Therapy (MCAT). VIPP-SD is an evidence-based parent management training designed to promote sensitive parenting and secure attachment in early childhood. MCAT is a recently developed intervention that uses exposure to stimulate secure attachment in middle childhood. LTA sheds light on the mechanisms set in train by VIPP-SD and MCAT facilitating the induction of professionals in clinical applications.

State Attachment Variability: Between- and within-Person Level Associations with Trait Attachment and Psychological Problems

Research suggests that inter-individual differences in the degree of state attachment variability are related to differences in trait attachment and psychological problems between children. In this study, we tested whether such associations are also relevant at a within-person level, and if so, whether intra-individual fluctuations in the degree of variability were predictive of or predicted by intra-individual fluctuations in trait attachment and psychological problems. Children (N = 152; M_age = 10.41 years, SD_age = 0.60 at time 1) were tested three times over a period of one year. At each timepoint, children reported on their expectations of maternal support in different distressing situations. Additionally, we administered measures of trait attachment to children and psychological problems to children and their mothers. We used Random-Intercept Cross-Lagged Panel Models to distinguish between-person from within-person associations between these constructs over time. The results revealed that the degree of state attachment variability was mainly relevant to understand differences between children in trait attachment and psychological problems: children who overall showed more state attachment variability were overall less securely attached at a trait-level and reported more psychological problems. Although evidence for within-person associations was less robust, there was some indication that the degree of state attachment variability might be related to the development of trust and psychological problems at a within-person level.

An empirical test of prototype and revisionist models of attachment stability and change from middle childhood to adolescence: A 6-year longitudinal study

We examined the prototype v. revisionist models of attachment stability with a five-wave, 6-year, longitudinal study of attachment security from middle childhood to adolescence in a White Western European sample (N = 157; Wave 1 M_age  = 10.91, SD = 0.87; 52% female). Attachment was assessed using both questionnaire (Experiences in Close Relationships) and narrative-based measures (Attachment Script Assessment). In addition, a set of potential moderators of prototype-like stability were examined. Results indicated that data from both attachment assessments best fit the prototype model. Moderator analyses indicated that male sex significantly undermined the influence of an attachment prototype and parent-child conflict and parental divorce enhanced the influence of an attachment prototype on stability.

A Lifespan Development Theory of Insecure Attachment and Internalizing Symptoms: Integrating Meta-Analytic Evidence via a Testable Evolutionary Mis/Match Hypothesis

Attachment scholars have long argued that insecure attachment patterns are associated with vulnerability to internalizing symptoms, such as depression and anxiety symptoms. However, accumulating evidence from the past four decades, summarized in four large meta-analyses evaluating the link between insecure attachment subtypes and internalizing symptoms, provide divergent evidence for this claim. This divergent evidence may be accounted for, at least in part, by the developmental period under examination. Specifically, children with histories of deactivating (i.e., insecure/avoidant) but not hyperactivating (i.e., insecure/resistant) attachment patterns in infancy and early childhood showed elevated internalizing symptoms. In contrast, adolescents and adults with hyperactivating (i.e., insecure/preoccupied) but not deactivating (i.e., insecure/dismissing) attachment classifications showed elevated internalizing symptoms. In this paper, we summarize findings from four large meta-analyses and highlight the divergent meta-analytic findings that emerge across different developmental periods. We first present several potential methodological issues that may have contributed to these divergent findings. Then, we leverage clinical, developmental, and evolutionary perspectives to propose a testable lifespan development theory of attachment and internalizing symptoms that integrates findings across meta-analyses. According to this theory, subtypes of insecure attachment patterns may be differentially linked to internalizing symptoms depending on their mis/match with the developmentally appropriate orientation tendency toward caregivers (in childhood) or away from them (i.e., toward greater independence in post-childhood). Lastly, we offer future research directions to test this theory.

Effects of Father and Mother Attachment on Depressive Symptoms in Middle Childhood and Adolescence: The Mediating Role of Emotion Regulation

Background: Attachment and emotion regulation play a decisive role in the developmental pathways of adaptation or maladaptation. This study tested concurrent and longitudinal associations between the attachment to mother and father, sadness regulation, and depressive symptoms. Methods: A total of 1110 participants from middle childhood to adolescence completed measures of attachment, emotion regulation, and depressive symptomatology. In total, 307 of them participated in the longitudinal assessment. Results: Results revealed attachment affects emotion regulation strategies and depressive symptoms. Furthermore, we found linear effects of the cumulative number of secure attachment relationships on adaptive and maladaptive deactivating sadness regulation, as well as on depressive symptoms. Longitudinal analysis showed the significant mediating role of sadness regulation in the relationship between attachment and depressive symptoms. Conclusions: Adaptive and maladaptive deactivating sadness regulation explain the longitudinal effects of attachment on depressive symptoms. Insecurely attached children and adolescents use maladaptive and adaptive sadness regulation strategies, but differ in their hierarchy of strategy use.

Mood Variability Among Early Adolescents in Times of Social Constraints: A Daily Diary Study During the COVID-19 Pandemic

The COVID-19 pandemic and associated governmental regulations have drastically changed the daily social lives of children, adolescents, and adults. Changes in the social context may particularly affect children who are in the transition to adolescents (henceforth referred to as early adolescents) as adolescence is a crucial period for peer interactions and development of independence and autonomy. Yet, the impact of the pandemic and associated governmental regulations on early adolescents' emotional well-being has yet to be clarified. In the current study, we explored daily fluctuations in mood in 54 early adolescents (M age = 11.07) during the first few months (April 2020-June 2020) of the COVID-19 pandemic. Moreover, the role of parents and peers on adolescents' mood variability was investigated. Adolescents rated their mood (i.e., happiness, anger, sadness, anxiety) and peer interactions once a day during four separate weeks across different weeks of containment measures in the Netherlands. Moreover, adolescents reported on their experienced attachment to parents and peers and internalizing problems during baseline and the final measurement, respectively. Results showed relatively stable levels of mood during the first few months of the COVID-19 pandemic. However, individual differences in mood variability during the first assessment week were negatively associated with the experienced level of attachment to both parents and peers. Moreover, heightened levels of mood variability did not mediate the link between attachment and internalizing problems. Lastly, the quality of offline contact, but not online contact, was negatively related to adolescents' mood variability. Overall, this study suggests that mood of early adolescents did not heavily fluctuated across the first few months of the COVID-19 pandemic. Our findings add to the growing body of literature aiming to understand how adolescent's life are affected by the COVID-19 crisis and illustrates that social connectedness to parents or peers may facilitate resilience to distress and daily mood fluctuation in early adolescents.

Attachment and the Development of Depressive Symptoms in Adolescence: The Role of Regulating Positive and Negative Affect

Although widely accepted, attachment theory's hypothesis that insecure attachment is associated with the development of depressive symptoms through emotion regulation strategies has never been longitudinally tested in adolescence. Additionally, previous research only focused on strategies for regulating negative affect, whereas strategies for regulating positive affect may also serve as a mechanism linking insecure attachment to depressive symptoms. This study aimed to fill these research gaps by testing whether the association between attachment and change in depressive symptoms over time is explained by strategies for regulating negative and positive affect in adolescence. Adolescents (N = 1706; 53% girls; Mage = 12.78 years, SDage = 1.54 at Time 1) were tested three times, with a 1-year interval between measurement times. They reported on their attachment anxiety and avoidance at Time 1, depressive symptoms at Times 1 and 3, and regulation of negative affect (brooding and dampening) and positive affect (focusing and reflection) at Time 2. The results from multiple mediation analyses showed that more anxiously attached adolescents developed more depressive symptoms via increased brooding and dampening. More avoidantly attached adolescents developed more depressive symptoms via decreased focusing. These findings provide longitudinal support for attachment theory's emotion regulation hypothesis, and show that the regulation of both negative and positive affect is important.

The School Attachment Monitor-A novel computational tool for assessment of attachment in middle childhood

Background

Attachment research has been limited by the lack of quick and easy measures. We report development and validation of the School Attachment Monitor (SAM), a novel measure for largescale assessment of attachment in children aged 5–9, in the general population. SAM offers automatic presentation, on computer, of story-stems based on the Manchester Child Attachment Story Task (MCAST), without the need for trained administrators. SAM is delivered by novel software which interacts with child participants, starting with warm-up activities to familiarise them with the task. Children’s story completion is video recorded and augmented by ‘smart dolls’ that the child can hold and manipulate, with movement sensors for data collection. The design of SAM was informed by children of users’ age range to establish their task understanding and incorporate their innovative ideas for improving SAM software.

Methods

130 5–9 year old children were recruited from mainstream primary schools. In Phase 1, sixty-one children completed both SAM and MCAST. Inter-rater reliability and rating concordance was compared between SAM and MCAST. In Phase 2, a further 44 children completed SAM complete and, including those children completing SAM in Phase 1 (total n = 105), a machine learning algorithm was developed using a “majority vote” procedure where, for each child, 500 non-overlapping video frames contribute to the decision.

Results

Using manual rating, SAM-MCAST concordance was excellent (89% secure versus insecure; 97% organised versus disorganised; 86% four-way). Comparison of human ratings of SAM versus the machine learning algorithm showed over 80% concordance.

Conclusions

We have developed a new tool for measuring attachment at the population level, which has good reliability compared to a validated attachment measure and has the potential for automatic rating–opening the door to measurement of attachment in large populations.

The Developmental Process of Peer Support Networks: The Role of Friendship

This study investigated the characteristics and development of peer support networks in an effort to unravel the role of friendship in this developmental process. The relationships between friendship networks and peer support networks were explored, and the influence of dyadic and triadic friendships on the development of peer support relationships was examined. Two waves of data were collected among a sample of adolescents in six Chinese junior high schools (n = 913 students from 28 classrooms; mean age = 14.13 years; 50.49% boys), and classroom friendship networks and peer support networks were analyzed. The results showed that peer support networks were sparse, hierarchical, and sex-segregated. Furthermore, peer support networks and friendship networks partially overlapped. Friends tended to have similar support-seeking and support-providing ties. Longitudinal multiplex social network analysis revealed that peer support networks changed moderately over time, and friendships played various roles in the development of peer support networks. Dyadic friendships improved the formation of peer support ties. A mutual friend improved the formation of support relationships between two students when the mutual friend chose the two students as friends, but a mutual friend also hindered or had no effects on the formation of support relationships in other cases. The implications for educators to improve peer support networks are presented, and directions for future research are discussed.

Mood Variability Among Early Adolescents in Times of Social Constraints: A Daily Diary Study During the COVID-19 Pandemic

The COVID-19 pandemic and associated governmental regulations have drastically changed the daily social lives of children, adolescents, and adults. Changes in the social context may particularly affect children who are in the transition to adolescents (henceforth referred to as early adolescents) as adolescence is a crucial period for peer interactions and development of independence and autonomy. Yet, the impact of the pandemic and associated governmental regulations on early adolescents' emotional well-being has yet to be clarified. In the current study, we explored daily fluctuations in mood in 54 early adolescents (M _age = 11.07) during the first few months (April 2020-June 2020) of the COVID-19 pandemic. Moreover, the role of parents and peers on adolescents' mood variability was investigated. Adolescents rated their mood (i.e., happiness, anger, sadness, anxiety) and peer interactions once a day during four separate weeks across different weeks of containment measures in the Netherlands. Moreover, adolescents reported on their experienced attachment to parents and peers and internalizing problems during baseline and the final measurement, respectively. Results showed relatively stable levels of mood during the first few months of the COVID-19 pandemic. However, individual differences in mood variability during the first assessment week were negatively associated with the experienced level of attachment to both parents and peers. Moreover, heightened levels of mood variability did not mediate the link between attachment and internalizing problems. Lastly, the quality of offline contact, but not online contact, was negatively related to adolescents' mood variability. Overall, this study suggests that mood of early adolescents did not heavily fluctuated across the first few months of the COVID-19 pandemic. Our findings add to the growing body of literature aiming to understand how adolescent's life are affected by the COVID-19 crisis and illustrates that social connectedness to parents or peers may facilitate resilience to distress and daily mood fluctuation in early adolescents.

Current Perspectives on the Management of Reactive Attachment Disorder in Early Education

Children with Reactive Attachment Disorder (RAD) have special educational needs that are challenging for teachers in early education. In the current contribution, we will discuss a large body of research suggesting that stimulating these children's attachment development is feasible for teachers and potentially a successful strategy to ensure that these children thrive better in the classroom and socially. The current overview discusses research and theory on RAD and RAD treatment and results in the formulation of specific recommendations for the successful management of children with RAD in the classroom.

Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation

Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.

Reactive attachment disorder symptoms and prosocial behavior in middle childhood: the role of Secure Base Script knowledge

BACKGROUND

Children with attachment disorder show prosocial behavior problems. Children with a reactive attachment disorder show inhibited and emotionally withdrawn behavior. Consequently, these children typically display prosocial behavior problems. However, the underlying mechanism between reactive attachment disorder and prosocial behavior problems is still unclear and findings in literature are mixed.

METHODS

The current study investigated the role of children's attachment representations in this association. Attachment representations reflect knowledge about a cognitive script regarding the attachment figure as a source for support (Secure Base Script). We tested whether secure base script knowledge 1) mediates or 2) moderates the link between reactive attachment disorder and prosocial behavior problems in 83 children (6-11 years; 83.1% boys) recruited from special education schools for children with behavioral problems. Children completed a pictorial Secure Base Script Test. Their reactive attachment disorder symptoms were assessed during an interview with the primary caregivers. Primary caregivers and teachers filled out a prosocial behavior questionnaire about the child.

RESULTS

Results did not support the mediation hypothesis, but evidence for the moderation hypothesis was found. Secure base script knowledge attenuated the negative association between attachment disorder symptoms and prosocial behavior.

CONCLUSIONS

These findings contribute to the discussion about the link between attachment representations and attachment disorders.

Charting the physiological time course of help-seeking during late childhood: Patterns of individual difference

In this study, we explored whether variability in children's physiological reactivity-respiratory sinus arrhythmia and electrodermal activity-predict concurrent and subsequent levels of children's observed help-seeking (HS) from their mothers during a failure task. In addition, we tested whether children's perceptions of maternal positivity pre-task (CPMP) and children's fearful temperament moderate these effects. In a community sample of 101 mother-child dyads, children (8-12 years of age) underwent a repeated failure task while their respiratory sinus arrythmia and electrodermal activity were monitored; their HS behaviors were later coded. Multilevel path analyses indicated that high-fearful children increased their HS at the same time as and following increased physiological reactivity regardless of CPMP pre-task. Low-fearful children showed increases in HS at the same time as and following increased physiological reactivity only when they perceived their mothers' affect to be positive. This study demonstrates children's individual differences in the physiological underpinning of time-linked HS behaviors.

Children's Attention to Mother and Adolescent Stress Moderate the Attachment-Depressive Symptoms Link

The breadth of children’s attentional field around their mother determines whether securely or insecurely attached children are at risk to develop depressive symptoms when confronted with distress in adolescence. To test this effect longitudinally, we measured children’s (M_age = 10.93; N = 109) baseline attentional breadth around their mother, attachment status (combining attachment coherence, secure base script knowledge, and self-reported trust), and self-reported depressive symptoms. One and two years later, we measured self-reported distress and depressive symptoms. We tested three-way interactions between attentional breadth × attachment × distress on changes in depressive symptoms. This three-way interaction was marginally significantly linked with changes in depressive symptoms from baseline to year 1, and significantly with changes in depressive symptoms from baseline to year 2. Results pointed to the protective role of a narrow attentional field around the mother in middle childhood for securely attached children who are confronted with distress later in life.

A learning theory of attachment: Unraveling the black box of attachment development

Attachment is an inborn behavioral system that is biologically driven and essential for survival. During child development, individual differences in (in)secure attachment emerge. The development of different attachment behaviors has been traditionally explained as a process during which experiences with (lack of) responsive and supportive care are internalized into working models of attachment. However, this idea has been criticized for being vague and even untestable. With the aim of unraveling this black box, we propose to integrate evidence from conditioning research with attachment theory to formulate a Learning Theory of Attachment. In this review, we explain how the development of individual differences in attachment security at least partly follows the principles of classical and operant conditioning. We combine observed associations between attachment and neurocognitive and endocrinological (cortisol, oxytocin, and dopamine) processes with insights in conditioning dynamics to explain the development of attachment. This may contribute to the explanation of empirical observations in attachment research that are insufficiently accounted for by traditional attachment theory.

Game Face expressions and performance on competitive tasks

Facial expressions influence both affective and cardiovascular responses to stress. However, previous research focuses primarily on positive expressions and is limited regarding additional facial expressions utilized on a day-to-day basis. This study examined an expression that is colloquially called a "Game Face": which refers to a serious, focused or determined facial expression. The current study examined whether Game Face expressions would influence psychophysiological response (e.g., heart rate and skin conductance) and performance. In an investigation of physical performance (Study 1), participants (N = 62) were asked to complete the cold-pressor task. Study 2 tested cognitive performance utilizing a puzzle task. Participants (N = 62) were divided into two groups and were asked to complete a puzzle. In both studies, one group was asked to make a Game Face, and the other was given no instruction related to facial expression. Results show no significant differences in performance on the physical task. In terms of cognitive performance, results reveal significantly better performance in the Game Face group. Additionally, assessments of skin conductance show that participants, who employed the Game Face during the cognitive task, displayed significant decreases from baseline following the puzzle manipulation. These results are promising regarding performance on a cognitive task and sympathetic nervous system activation, in concert with making a Game Face.

Combining oxytocin and cognitive bias modification training in a randomized controlled trial: Effects on trust in maternal support

BACKGROUND AND OBJECTIVES

Research on the social effects of intranasal oxytocin in children is scarce. Oxytocin has been proposed to have clearer beneficial effects when added to social learning paradigms. The current study tested this proposition in middle childhood by assessing effects of cognitive bias modification (CBM) training and oxytocin on trust in maternal support.

METHODS

Children (N = 100, 8-12 years) were randomly assigned to one of two training conditions: CBM training aimed at increasing trust or neutral placebo training. Within each training condition, half the participants received oxytocin and half a placebo. Main and interaction effects were assessed on measures of trust-related interpretation bias and trust. We explored whether child characteristics moderated intervention effects.

RESULTS

Children in the CBM training were faster to interpret maternal behaviour securely versus insecurely. Effects did not generalize to interpretation bias measures or trust. There were no main or interaction effects of oxytocin. Exploratory moderation analyses indicated that combining CBM training with oxytocin had less positive effects on trust for children with more internalizing problems.

LIMITATIONS

As this was the first study combining CBM and oxytocin, replication of the results is needed.

CONCLUSIONS

This study combined a social learning paradigm with oxytocin in children. CBM training was effective at an automatic level of processing. Oxytocin did not enhance CBM effects or independently exert effects. Research in larger samples specifying when oxytocin might have beneficial effects is necessary before oxytocin can be used as intervention option in children.

Unraveling middle childhood attachment-related behavior sequences using a micro-coding approach

Attachment theory states that children learn to trust in their parent's availability and support if they repeatedly experience that their parents respond sensitively to their needs during distress. Attachment is thus developed and shaped by day-to-day interactions, while at the same time, each interaction is a momentary expression of the attachment relation. How attachment-related behaviors of mother and child follow upon each other during interactions in middle childhood, and how these sequences differ in function of attachment quality, has hardly been studied up to now. To fill this gap, we analyzed the micro-coded interaction of 55 mother-child dyads (27 girls, 28 boys, mean age: 10.3) after a standardized stress-induction. Results reveal that all mother-child dyads show a loop between positive mother and child behaviors. This pattern is complemented with a loop of negative mother and child behaviors in low-trust and more avoidantly attached children: these children tend to handle negative mother behavior less well as they show more negative behavior and less positive behavior in response to negative maternal behavior. More anxiously attached children also show less positive behavior, but react positively on collaborative interactions. The micro-coded interactions thus reveal important insights that inform practitioners and advance attachment theory.

Comfort provided by parents versus strangers after eliciting stress in children with severe or profound intellectual disabilities: does it make a difference?

The relationships between children with severe or profound intellectual disabilities (ID) and their parents may fulfil attachment functions, such as regulating emotional responses to stress. This study examined the extent to which children with severe or profound ID differentiate between their parents and a stranger as a resource for stress-regulation. A home-based experimental paradigm was conducted and video-recorded in 38 families. Children (1-8 years) were exposed to four naturalistic stressors followed by comfort, randomly provided by the parents or the stranger. Emotional behaviour (arousal and valence) and the skin conductance level were simultaneously recorded. With regard to both emotional behaviour and skin conductance, children significantly differentiated between their parents as attachment figures and the stranger during stress and comfort, despite their impairments on various developmental domains. Behavioural observation and physiology show complementary manifestations of parent-child attachment in this population.

From trust in caregivers' support to exploration: The role of openness to negative affect and self-regulation

Attachment theory assumes that trust in caregivers' support and exploration are closely related. Little research tried to investigate this link, nor focuses on mechanisms that might explain this association. The present studies examined whether trust is related to exploration through a serial indirect effect of openness to negative affect and self-regulation. In Study 1, 212 children, aged 8-13, completed questionnaires assessing trust, openness to negative affect, self-regulation and exploration. The results showed that trust predicted exploration, but only to the extent to which openness to negative affect and self-regulation were involved too. Study 2 refined these findings (n = 59, aged 9-12) using a behavioral measure of openness to negative affect and exploration, and with mother-reported self-regulation. Replicating this serial indirect effect of openness to negative affect and self-regulation with multiple informants and methods, the present studies advance our understanding of how trust might foster exploration in preadolescence.

The Influence of Psychological Stress, Depressive Symptoms, and Cortisol on Body Mass and Central Adiposity in 10- to-12-Year-Old Children

PURPOSE

The purpose of this study was to examine the influence of psychological stress and depressive symptoms on body mass and central adiposity in 10-to-12-year-old children and to determine the mediating role of cortisol in the relationships among psychological stress, depressive symptoms, body mass, or central adiposity.

DESIGN AND METHODS

The convenience sample included 147 children (84 females; 63 males) who were recruited from one middle school and three elementary schools in a rural area of a southeastern state. Height, weight, waist circumference (WC), and salivary cortisol were measured. Children completed the Rating Scale for Pubertal Development for screening, Children's Depression Inventory, and the Feel Bad Scale. Bivariate correlation, multiple regression analyses, and univariate regression techniques were used in data analyses.

RESULTS

A positive relationship between psychological stress and depressive symptoms (r = 0.559, p < .001) was found. Depressive symptoms explained a significant amount of the variance in body mass index (BMI) (β = 0.37, p ≤.001) and central adiposity (β = 0.40, p ≤ .001) when sex, race/ethnicity, puberty, and socioeconomic status were controlled. No statistically significant relationships were found between psychological stress and cortisol or between depressive symptoms and cortisol.

CONCLUSIONS

Depressive symptoms were reported by normoweight, overweight, and obese children. Depressive symptoms accounted for variance in body mass and central adiposity. Practice Implications In addition to regular screening of BMI and WC, nurses and other health care professionals need to consider psychological factors that contribute to childhood obesity.

What role do family composition and functioning play in emotional and behavioural problems among adolescent boys and girls?

OBJECTIVES

The aim was to explore the associations of family composition, family support and communication with emotional and behavioural problems among adolescents as well as a possible moderating effect of gender on these associations.

METHODS

Data from the Health Behaviour in School-aged Children study conducted in 2014 in Slovakia were used. The final sample consisted of 2908 students (mean age 14.36; 49.7% boys). We explored the association using generalized linear models.

RESULTS

We found that non-intact family was significantly associated with a higher score in emotional and behavioural problems. Family support and communication were found to be significantly associated with a lower score in emotional and behavioural problems. Significant interactions of gender and family communication with emotional and behavioural problems were found, showing that family communication decreased emotional and behavioural problems only in girls.

CONCLUSIONS

Family composition, family support and communication play an important role in the occurrence of emotional and behavioural problems in adolescence. Family communication lowers these problems only in girls. Prevention and intervention programmes could be focused on parent-child communication strategies with the importance of differences in the needs of boys and girls.

Affective family interactions and their associations with adolescent depression: A dynamic network approach

The prevalence of depression rises steeply during adolescence. Family processes have been identified as one of the important factors that contribute to affect (dys)regulation during adolescence. In this study, we explored the affect expressed by mothers, fathers, and adolescents during a problem-solving interaction and investigated whether the patterns of the affective interactions differed between families with depressed adolescents and families with nondepressed adolescents. A network approach was used to depict the frequencies of different affects, concurrent expressions of affect, and the temporal sequencing of affective behaviors among family members. The findings show that families of depressed adolescents express more anger than families of nondepressed adolescents during the interaction. These expressions of anger co-occur and interact across time more often in families with a depressed adolescent than in other families, creating a more self-sustaining network of angry negative affect in depressed families. Moreover, parents' angry and adolescents' dysphoric affect follow each other more often in depressed families. Taken together, these patterns reveal a particular family dynamic that may contribute to vulnerability to, or maintenance of, adolescent depressive disorders. Our findings underline the importance of studying affective family interactions to understand adolescent depression.

Young children with significant developmental delay differentiate home observed attachment behaviour towards their parents

BACKGROUND

The hallmark of attachment is that contact, proximity and relief from stress are sought from specific individuals, laying important groundwork for healthy socioemotional functioning. This study investigated the extent to which differentiated attachment behaviour can be observed in young children with significant developmental delay (DD).

METHOD

Video-taped observations of the parent-child and stranger-child interaction were conducted at home and complemented with questionnaires in 20 families with a child with significant DD (age 2-7 years with an average DD of 49 months).

RESULTS

Children displayed more intense and persistent contact-seeking, contact-maintaining and resistant behaviour in the episodes with their parent compared to the episodes with the stranger. Parent-reported secure attachment behaviour was slightly more characteristic towards mother compared to father.

CONCLUSIONS

Even children with significant DD develop differentiated attachment behaviour. Detailed observations may support parents in identifying the interactions that make the attachment relationship with their child special.

Depressive symptoms and self-harm among youngsters referred to child welfare: The role of trust in caregiver support and communication

Depressive symptoms and self-harm, i.e. non-suicidal self-injury and suicidal behaviors, are highly prevalent in youngsters involved in Child Welfare System (CWS) services. Little research investigates, however, why these CWS youngsters are at risk. We explored whether trust in caregiver support and communication about experiences with primary caregivers, are associated with CWS youngsters' depressive symptoms and/or self-harm. An anonymous online survey of 271 CWS youngsters (10-21 years of age, 57.2% female) was used to assess trust and communication, and depressive symptoms/self-harm. Results showed significant negative associations between self-reported trust in maternal and paternal support, and depressive symptoms/self-harm. Communication about experiences with one's biological mother mediated the relationship between trust in maternal support and depressive symptoms/self-harm. Furthermore, the presence of an additional trustworthy caregiver buffered the impact of low trust in maternal or paternal support on depressive symptoms/self-harm. Implications for interventions targeting CWS youngsters' depressive symptoms and self-harm are discussed.

NR3C1 methylation as a moderator of the effects of maternal support and stress on insecure attachment development

We examined the prediction that the interaction between Glucocorticoid Receptor Gene (NR3C1) methylation, stress, and experienced maternal support predicts anxious and avoidant attachment development. This was tested in a general population sample of 487 children and adolescents (44% boys, Mage = 11.84, SDage = 2.4). These children were followed over a period of 18 months. In line with the prediction, we found that NR3C1 methylation moderates the effect of maternal support during stress on anxious attachment development 18 months later. More stressed children who experienced less maternal support reported increased anxious attachment when their NR3C1 gene was highly methylated. This effect could not be explained by children's level of psychopathology. No effects were found for attachment avoidance. These data provide the first prospective evidence that epigenetic processes are involved in attachment development. (PsycINFO Database Record

Interdependence of attachment styles and relationship quality in parent-adolescent dyads

The current study examined how attachment styles of parents and adolescents may jointly influence the quality of their relationship. Parent-adolescent (N_dyads = 77) pairs were recruited from a Midwestern town in the United States. The mean of adolescents' age was 16.25. Both members reported their attachment styles, relationship closeness, and relationship discord. The Actor-Partner Interdependence Model (APIM) showed that both members' attachment avoidance was associated with self-report lower levels of closeness. Parents' attachment anxiety was related to relationship discord. Parents with higher avoidant attachment reported lower closeness when adolescents were higher in avoidant attachment. Higher parents' anxious attachment was related to higher relationship closeness when adolescents were higher on anxious attachment. Such an association was negative when adolescents had lower anxious attachment. Higher parents' anxious attachment was related to greater discord when adolescents were lower on anxiety attachment. This study reveals the complex dyadic dynamics of relationship quality in parent-adolescent pairs.

Do changes in affect moderate the association between attachment anxiety and body dissatisfaction in children? An experimental study by means of the Trier Social Stress Test

OBJECTIVE

Previous studies have already found a positive association between attachment and disordered eating attitudes and behaviors in children and adolescents. However, to our knowledge, no experimental studies have examined whether changes in negative and/or positive affect moderate the association between attachment anxiety and body dissatisfaction in children.

METHOD

A controlled laboratory setting was used to investigate whether changes in state negative and/or positive affect moderate the association between attachment anxiety and body satisfaction in a sample of 81 children (M_age=11.74). The changes in state affect were caused by the exposure to a performance-related stressor using the Trier Social Stress Test for Children.

RESULTS

Children with high levels of attachment anxiety reported a decrease in body satisfaction, but only if the TSST-C led to a decrease in their positive affect.

DISCUSSION

Early detection and intervention programs may benefit from addressing insecure attachment and maladaptive emotion regulation in children.

The effects of Cognitive Bias Modification training and oxytocin administration on trust in maternal support: study protocol for a randomized controlled trial

BACKGROUND

Lack of trust in parental support is a transdiagnostic risk factor for the development of psychological problems throughout the lifespan. Research suggests that children's cognitive attachment representations and related information processing biases could be an important target for interventions aiming to build trust in the parent-child relationship. A paradigm that can alter these biases and increase trust is that of Cognitive Bias Modification (CBM), during which a target processing bias is systematically trained. Trust-related CBM training effects could possibly be enhanced by oxytocin, a neuropeptide that has been proposed to play an important role in social information processing and social relationships. The present article describes the study protocol for a double-blind randomized controlled trial (RCT) aimed at testing the individual and combined effects of CBM training and oxytocin administration on trust in maternal support.

METHODS/DESIGN

One hundred children (aged 8-12 years) are randomly assigned to one of four intervention conditions. Participants inhale a nasal spray that either contains oxytocin (OT) or a placebo. Additionally, they receive either a CBM training aimed at positively modifying trust-related information processing bias or a neutral placebo training aimed to have no trust-related effects. Main and interaction effects of the interventions are assessed on three levels of trust-related outcome measures: trust-related interpretation bias; self-reported trust; and mother-child interactional behavior. Importantly, side-effects of a single administration of OT in middle childhood are monitored closely to provide further information on the safety of OT administration in this age group.

DISCUSSION

The present RCT is the first study to combine CBM training with oxytocin to test for individual and combined effects on trust in mother. If effective, CBM training and oxytocin could be easily applicable and nonintrusive additions to interventions that target trust in the context of the parent-child relationship.

TRIAL REGISTRATION

ClinicalTrials.gov, ID: NCT02737254 . Registered on 23 March 2016.