Preliminary Danish Norms for the Odense Child Trauma Screening (OCTS)

The Odense Child Trauma Screening (OCTS) is Danish story stem screening tool applicable for assessment of preschoolers and young children in risk of being traumatized. Having shown initial evidence of validation, Danish norms are needed to strengthen the clinical assessment with the OCTS by serving as a baseline comparison for assessment of potentially traumatized children. We tested 169 children from the Danish general population aged 4-8 with the OCTS and investigated sex and age differences in play-based behavior and narrative representations. Caregivers reported electronically on child demographic information, psychosocial functioning, and history of trauma exposure using The Strengths and Difficulties Questionnaire (SDQ) and The Diagnostic Infant and Preschool Assessment (DIPA) trauma list. Across the 145 scores of the OCTS coding scheme, significant sex and age differences were only found in five and sixteen scores respectively. In the five codes where significant sex differences were observed, boys' normative scores were higher. No significant sex differences were found in the partial story scores or the OCTS total score. Three significant age differences in partial story and OCTS total scores emerged with 4-year-olds scoring higher than 6-8-year-olds. We further found 13 significant age differences in code scores with higher scores among the youngest of the two groups in question suggesting that scores tend to decrease along older age. Few significant sex and age differences were found in children's OCTS play-based behavior and narrative representations. Indicative of few sex and age biases of the OCTS coding scheme and stories, results suggest that the OCTS can be applied across the intended target group of children aged 4 to 8 years. As higher scores were found in the younger age groups, clinicians should be attentive to age in certain codes of the OCTS coding scheme in their assessment of children in clinical practice. The preliminary normative scores must be interpreted and clinically applied with caution due to our non-representative sample and lack of analyses on factors potentially influencing children's responses to the OCTS (e.g., developmental, contextual, cultural factors).

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-024-00616-7.

An Online Attachment Style Recognition System Based on Voice and Machine Learning

Attachment styles are known to have significant associations with mental and physical health. Specifically, insecure attachment leads individuals to higher risk of suffering from mental disorders and chronic diseases. The aim of this study is to develop an attachment recognition model that can distinguish between secure and insecure attachment styles from voice recordings, exploring the importance of acoustic features while also evaluating gender differences. A total of 199 participants recorded their responses to four open questions intended to trigger their attachment system using a web-based interrogation system. The recordings were processed to obtain the standard acoustic feature set eGeMAPS, and recursive feature elimination was applied to select the relevant features. Different supervised machine learning models were trained to recognize attachment styles using both gender-dependent and gender-independent approaches. The gender-independent model achieved a test accuracy of 58.88%, whereas the gender-dependent models obtained 63.88% and 83.63% test accuracy for women and men respectively, indicating a strong influence of gender on attachment style recognition and the need to consider them separately in further studies. These results also demonstrate the potential of acoustic properties for remote assessment of attachment style, enabling fast and objective identification of this health risk factor, and thus supporting the implementation of large-scale mobile screening systems.

Relationship between attachment style of 4-7-year-old children and their behavior during dental visit

Background

The general health and quality of life are directly correlated with oral health. Oral health is one of the unique health concerns that apply to all children. Pediatric dentistry is built on effective communication with children, which is also a requirement for providing pediatric dental care. Many pediatric dentists find it difficult to anticipate children's behavior and how they will respond to therapeutic procedures. The purpose of this study was to evaluate children's attachment types in order to forecast their behavior during a dentist appointment.

Materials and Methods

The participants were 120 children between the ages of 4 and 7 who were reported to the Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Bareilly. The youngsters were evaluated by a dental graduate student. While they waited in the waiting area, the parents were asked to complete the Kinship Center Attachment Questionnaire regarding their kids. In the second visit, dental work was scheduled for the kids who had met the requirements for inclusion in the first visit. Another pediatric dentistry postgraduate student evaluated the children's conduct during the dental procedure using a predefined questionnaire and the Frankl scale. The Chi-squared test, t-test, Pearson's correlation coefficient, and linear regression were used to examine the data.

Results

According to the findings, 55.8% of the total children were cooperative, among which 59.1% were female and 52.0% were males. The average age of the kids was 6.2 ± 0.95. Moreover, 21.3% of kids had insecure attachment styles and 78.7% of kids had secure attachment types. The child-dentist communication and the insecure ambivalent attachment pattern were significantly correlated. As a result, our study demonstrated that children's safe attachment styles varied with age. Our results showed that there is an inverse relationship between children's collaboration and age, with cooperation rising as age increases.

Conclusions

According to the findings of this study and considering its limitations, in young ages, the attachment style of the mother plays an important role in behavior of children. The significant correlations existed between the insecure ambivalent attachment style and child-dentist communication, as well as the secure attachment type and mother-child separation.

Post-Traumatic Play in Child Victims of Adverse Childhood Experiences: A Pilot Study with the MCAST-Manchester Child Attachment Story Task and the Coding of PTCP Markers

Background: Play is among the most frequently observed distorted behaviors in victims of Adverse Childhood Experiences (ACEs). Terr's (1981) studies helped to describe this behavioral distortion as post-traumatic child's play (PTCP). This study aimed to evaluate whether child victims of Adverse Childhood Experiences (ACEs) engaging in semi-structured play present the markers of post-traumatic child's play (PTCP) during the administration of the Manchester Child Attachment Story Task (MCAST), whose playful stories activate the attachment system. Methods: The sample comprised 17 child victims of ACEs (mean age = 6.76). Children were evaluated using the Manchester Child Attachment Story Task. Results: The analysis of the play clearly revealed the presence of markers associated with the characteristics of the post-traumatic play described by Terr (1981), namely, repetition, revisiting, hyperarousal, and danger. In particular, the intrusiveness dimension was observed, which can be identified in the post-traumatic play by the presence of recurrent memories, dreams, and dissociative symptoms. Conclusions: Post-traumatic play is characterized by repetition, containing aspects, scenes, or sequences of the traumatic event, expressed explicitly or symbolically.

Mentalizing in mothers and children with type 1 diabetes

Studies suggest that the relationship between psychosocial well-being and type 1 diabetes (T1D) is bidirectional, with T1D typically having a negative influence on psychological functioning, which in turn negatively affects the course of T1D. Here, we investigate the potential role of the capacity for mentalizing, or reflective functioning, in children and their mothers in diabetes control. We tested differences in mentalizing as assessed by the Reflective Functioning Scale in two groups of mother-son dyads with good (GDC) versus poor (PDC) diabetes control. Fifty-five boys (8-12 years old) and their mothers were recruited from the Juvenile Diabetes Foundation in Santiago, Chile. The mothers were interviewed with the Parental Development Interview and the children with the Child Attachment Interview, and both were scored for reflective functioning by using the Reflective Functioning Scale. Self-report measures of stress and diabetes outcomes were completed by the mothers and children, and levels of glycated hemoglobin (HbA1c) were assessed as an index of diabetes control. The results showed that both maternal and child reflective functioning were higher in the GDC than the PDC group and were negatively correlated with HbA1c in the total sample. Our findings suggest an important role for mentalizing in diabetes outcomes, but further prospective research is needed.

Growing points in attachment disorganization: looking back to advance forward

In this special issue paper we reflect on the next generation of attachment research with a focus on disorganization, a central but still poorly understood topic in this area. We suggest that progress will be facilitated by a return to attachment theory's evolutionary roots, and to the emphasis on biological function that inspired Bowlby's original thinking. Increased interdisciplinary cross-fertilization and collaborations would enable novel and generative research on some of the long-standing questions surrounding attachment disorganization. Accordingly, we present an agenda for future research that encompasses contributions of modern ethology and neurobiology, novel hypotheses based on the concept of adaptive decanalization, connections with neurodevelopmental vulnerability and risk for mental disorders such as schizophrenia, and the possibility of sex differences in the behavioral manifestations of attachment disorganization. We believe that these avenues of theory and research offer exciting potential for innovative work in attachment disorganization in the years ahead.

Pathways From Childhood Sociomoral Sensitivity in Friendship, Insecurity, and Peer Rejection to Adult Friendship Quality

Across the life span, friendship is an important component of people's support networks. This article explores the developmental roots of adult friendship intimacy and satisfaction, taking into consideration the early interplay between sociomoral sensitivity in friendship, insecurity in peer contexts, and peer rejection. Data (N = 176) came from the longitudinal study "Individual Development and Social Structure." Respondents were surveyed repeatedly from age 7 to 37 years. Autoregressive cross-lagged panel models show that sociomoral sensitivity in friendship protects adolescents from peer rejection and is reciprocally associated with insecurity. Childhood and adolescent sociomoral sensitivity antecede early adult friendship intimacy, which, in turn, antecedes friendship satisfaction in mid-adulthood. The findings indicate a sequence of pathways from sociomoral sensitivity developed early in life to friendship quality in adulthood.

Role of attachment style in prediction of behavior of 3 to 6-year-old children

PURPOSE

Efficient communication with children is the basis of pediatric dentistry and is a prerequisite for provision of pediatric dental care. Prediction of the behavior of children and their reaction to therapeutic procedures is a challenge for many pediatric dentists. This study aimed to assess the attachment styles of children to predict their behavior during a dental visit.

METHODS

The participants included 117 healthy children aged 3 to 6 years presented to the Department of Pediatric Dentistry, Tehran University of Medical Sciences, in 2017-2018. A postgraduate dental student examined the children. The parents were requested to fill out the Kinship Center attachment questionnaire (KCAQ) regarding their children, while waiting in the waiting room. The children who met the inclusion criteria in the first visit were scheduled for a dental procedure in the second visit. Another postgraduate student of pediatric dentistry assessed the behavior of children during the dental procedure according to the designed questionnaire and based on the Frankl scale. A third examiner along with the second examiner evaluated the behavior of children on a random basis to determine the inter-examiner agreement. Data were analyzed using the Chi-squared test, t test, Pearson's correlation coefficient, and linear regression.

RESULTS

The results showed that 67.5% of the children were cooperative, including 54.7% of boys. The mean age of children was 5.1 ± 0.95 years. Also, 80.3% of children had secure and 19.7% had insecure attachment styles (11.97% insecure avoidant and 7.69% insecure ambivalent). A significant association existed between the insecure ambivalent attachment style and child-dentist communication. A significant inverse correlation was also noted between the total score of the questionnaire and parent-child separation in dental office.

CONCLUSIONS

The current findings revealed no significant difference in the attachment styles of cooperative and uncooperative children. Significant associations only existed between the insecure ambivalent attachment style and child-dentist communication, and also between mother-child separation and secure attachment style. Thus, the children's behavior in dental office cannot be predicted based on their attachment style.

Attachment to mothers and fathers during middle childhood: an evidence from Polish sample

Background

Middle childhood is a significant period of change both for a child’s cognition and social functioning. Considering that the primary developmental theme of attachment in middle childhood is the balance between child’s growing autonomy and the constant need of relatedness, cultural differences in developmental trends in the attachment might be considered as a function of individualism and collectivism orientations. However, little is known about whether the findings on predictors of individual differences in the attachment in middle childhood found in Western cultures, hold within the non-Western ones. Moreover, still little is known about differences between attachment to mothers and fathers in middle childhood. Hence, one goal of the present study was to investigate the role of a child’s age, sex, and emotionality in a middle-childhood attachment to mothers and fathers in the Polish sample. The second aim was to compare obtained results to the attachment research that focused on Western cultures.

Methods

The sample consisted of 132 children aged 8–12 years (51% boys). They completed the Kern’s Security Scale and the Coping Strategies Questionnaire. Mothers completed a child’s EAS-C and short sociodemographic questionnaire. Pearson’s correlations were conducted to test relationships between a child’s age, sex, emotionality, SES, and attachment-related variables. A paired-samples t-test was used to compare the intensity of preoccupied and avoidant coping strategies with parents in the whole sample. The effects of a child’s age, sex, temperament, and attachment figure were tested with separate repeated-measures ANOVA.

Results

Some of the results replicated prior studies conducted in Western cultures. Similarly to the individualistic cultures, older Polish children reported less preoccupied and more avoidant coping strategies with their parents than younger children. Second, older girls reported higher felt-security with their fathers than with mothers, which suggests some significant changes in attachment relationships regarding the child’s sex. However, as opposed to Western cultures, there were no links between the child’s sex and preoccupied and avoidant coping. Polish children also reported higher rates of preoccupied coping than the avoidant one. Finally, children with relatively lower emotionality reported higher attachment security with both parents than children with relatively higher emotionality.

Conclusions

The current study extends previous work on attachment in middle childhood, the area of rather sparse research, as compared to other developmental periods. The findings reveal the existence of both some specificity in the middle-child attachment in the Polish sample, as well as some culture-universal developmental trends. However, as many questions remain unanswered, they also highlight the strong need for future cross-cultural and comparative studies.

Children's emotion understanding in relation to attachment to mother and father

Although attachment plays a key role in children's socio-emotional development, little attention has been paid to the role of children's attachment to their father. This study examined whether insecure attachment to each parent was associated with reduced emotion understanding in children and whether children showed consistent attachments to their mother and father. We measured children's attachment to each parent using the Manchester Child Attachment Story Task and child emotion understanding using the Test of Emotion Comprehension (children's M_age  = 5.64 years, SD = 0.84). The results indicated that insecure father-child attachment and insecure mother-child attachment were each associated with lower emotion understanding in children after controlling for parent's depressive symptoms and children's age. There was significant concordance of child attachment to mother and father. The findings provide support for convergence of children's attachment across parents and suggest that father-child attachment is an important factor to consider when examining children's emotion understanding. Statement of contribution What is already known on this subject Secure mother-child attachment is positively associated with children's emotional competence. Children form similar representations of attachment to their mother and father. What the present study adds Both mother-child and father-child attachment are associated with children's emotion understanding. The study's findings highlight the importance of father-child attachment in their children's emotion understanding. The study provides support for concordance of children's attachment across parents.

Sex differences in attachment styles

Sex differences in attachment styles have been found in adulthood, emerge as early as middle childhood, and can be sizable when described at the appropriate level of analysis. However, they have received relatively little attention in mainstream attachment research. Here I review the evidence of sex differences in attachment, including what is currently known about developmental patterns and cross-cultural variation. I summarize existing evolutionary models of sex differences, and discuss evidence for a role of prenatal and postnatal sex hormones. I highlight current theoretical and empirical gaps in the literature, and call for more integrative research on this fascinating topic.

Assessing disorganized attachment representations: a systematic psychometric review and meta-analysis of the Manchester Child Attachment Story Task

Narrative story stem measures are increasingly popular for the assessment of attachment representations among early school-age children. Given their clinical and theoretical importance, disorganized representations are typically a focus of assessment procedures. The Manchester Child Attachment Story Task (MCAST) is one such measure. A systematic literature review and meta-analysis was conducted to evaluate the documented reliability and validity of the MCAST with a focus on assessing disorganized representations. Twenty-five studies were included in the review encompassing 1,876 children from nine countries. Results suggest that inter-rater reliability for the MCAST is acceptable and the prevalence of disorganization identified on the MCAST among various subgroups (e.g. community, clinical, adopted/maltreated) is comparable to prevalence estimates from other developmental periods using other assessment methods. In addition, prevalence of disorganization on the MCAST differed in hypothesized ways between the various subgroups. However, MCAST disorganization did not correlate in predictable ways with many constructs when relationships were examined within samples. Few studies examined the relationship of disorganization on the MCAST with parenting variables, aspects of adoption and maltreatment, and emotion regulation skills. Recommendations for further study of the MCAST and for how the tool might be integrated into clinical and developmental research are provided.

Does distance from the equator predict self-control? Lessons from the Human Penguin Project

We comment on the proposition "that lower temperatures and especially greater seasonal variation in temperature call for individuals and societies to adopt … a greater degree of self-control" (Van Lange et al., sect. 3, para. 4) for which we cannot find empirical support in a large data set with data-driven analyses. After providing greater nuance in our theoretical review, we suggest that Van Lange et al. revisit their model with an eye toward the social determinants of self-control.

Attachment representations of school-aged Korean children: comparing family drawing and narrative assessments in a clinical and a community sample

This study explored the links between two different methods of assessing children's attachment representations, a narrative task (the Manchester Attachment Story Task, MCAST) and a drawing task (the Family Drawing Task, FDT), in a clinical sample of 51 and a community sample of 45 Korean children aged 7-9. In both samples, attachment classifications derived from the MCAST were related to attachment classifications and global ratings derived from the FDT. In addition, rates of insecure attachment determined by MCAST classifications and by FDT global scales indicative of insecure attachment were higher in the clinical sample than the community sample. Variations in attachment patterns for these Korean samples are discussed in relation to Korean child-rearing customs. Results of this study contribute to the cross-cultural validation of both of these instruments, as well as extending our understanding of patterns of attachment in Korea from infancy to middle childhood.

Associations between early caregiving and rural, low-SES, African-American children's representations of attachment relationships

Little research has examined the legacy of early maternal care for later attachment representations among low-income and ethnic minority school-aged children. Using data from a sample of 276 rural, low-income, African-American families, this study examined associations between maternal care in infancy and children's representations of attachment figures in middle childhood. Maternal care was coded from 10-min home-based observations at 6, 15, and 24 months of age. Representations of attachment figures were assessed using the Manchester Child Attachment Story Task at 6 years of age. Sensitive maternal care in infancy was not significantly related to attachment security or episodic disorganized behaviors in children's representations. However, children exposed to more harsh-intrusive parenting during infancy displayed less secure representations of attachment figures in middle childhood and more episodic disorganized behaviors, even after controlling for numerous child and family contextual covariates. Findings inform conceptualizations of attachment formation among rural, low-income, African-American parent-child dyads.

The relationships between shyness and unsociability and peer difficulties

The main purpose of the study was to examine the moderating role of the insecure mother–child attachment in the relations between social withdraw and peer difficulties. Participants were 487 urban children (247 boys, 240 girls) in elementary schools in Shanghai, the People’s Republic of China. Data on attachment-relevant coping styles in insecure relationships with mother were collected from children’s self-reports. Information concerning social withdrawal (i.e., shyness and unsociability) and peer difficulties (i.e., peer victimization and rejection) was obtained from peer nomination. Among the results, both shyness and unsociability were positively related to peer victimization and rejection. However, several interaction effects were also observed. Both avoidant and ambivalent attachment served an exacerbating role for peer difficulties for shy and unsociable children, with these patterns differing by gender. Implications for the contributions of attachment to socially withdrawn children’s peer adjustment are discussed.

Mothers with intellectual disability, their experiences of maltreatment, and their children's attachment representations: a small-group matched comparison study

Maternal intellectual disability (ID) is regarded a risk factor in child development, but there is no scientific evidence on maternal ID in relation to children's attachment. Using a matched comparison design, a small group (n = 23) of mothers diagnosed with ID was studied to help fill this gap. Besides maternal ID, we examined the role of abuse/trauma/maltreatment (ATM) in the mothers' biographies, along with potential confounds. Comparison group mothers (n = 25) had normal variations in intelligence and matched mothers with ID on residential area, income, child age, and sex. History of maternal ATM was assessed using a semi-structured interview and was found to be significantly more likely in the ID group mothers' experience than the comparison group mothers. Children's (M age = 77 months) attachment representations were assessed with the Separation Anxiety Test. Among children of mothers with ID, a substantial minority (35%) had a secure and the vast majority (>80%) an organized attachment representation. Mothers with ID who had suffered elevated ATM were significantly more likely to have children who were scored high on disorganization and insecurity. We discuss possible implications of our findings for societal considerations regarding parenting and child attachment in the context of parental ID status.

Attachment and social competence: a study using MCAST in low-risk Italian preschoolers

The Manchester Child Attachment Story Task (MCAST) is a story stem method suitable for children aged about 4 to 8, aimed at assessing children's attachment representations with a doll-play format that is evaluated with a series of dimensional scales and classifications. Although this instrument has already been validated in previous studies, not all of the findings have been conclusive. The aims of the present study were (1) to examine the factor structure of the MCAST scales, and (2) to test the association between children's dichotomized MCAST classifications and factors with social competence, using the Social Competence and Behavior Evaluation Scale (SCBE) with a normative group of Italian preschoolers (age range 4.4 to 6.1). Results obtained from a sample of 64 children confirm the association of MCAST attachment classifications (security vs. insecurity and organization vs. disorganization) with both social skills and behavioral problems. Further independent studies on the variables analyzed are recommended for corroborating the findings obtained.

Adaptive insecure attachment and resource control strategies during middle childhood

By integrating the life history theory of attachment with resource control theory, the current study examines the hypothesis that insecure attachment styles reorganized in middle childhood are alternative adaptive strategies used to prepare for upcoming competition with the peer group. A sample of 654 children in the second through seventh grades in Shanghai, China, participated in this study. The children reported attachment relationships with their mother and the use of resource control strategies in the peer group. Boys had higher avoidant attachment scores than girls, whereas girls had higher ambivalent attachment scores than boys. Moreover, avoidant attachment was positively associated with the use of coercive strategies to control resources. Ambivalent attachment was associated with the use of both coercive and prosocial strategies to control resources. A number of other gender and developmental differences were also observed. The implications for the adaptiveness of insecure attachment in middle childhood are discussed.

Negative and atypical story content themes depicted by children with behaviour problems

BACKGROUND

Specific thematic content arising from children’s doll play is often considered to give clinically meaningful information regarding their mental state, but has received little systematic enquiry. This exploratory study examined the negative and atypical content themes in the attachment story narratives of children with behaviour problems, and their associations with child symptomatology and parental depressed mood.

METHOD

Videotaped mother-child attachment doll play completions of 77 children from a clinical sample were blind coded for negative content themes. Mothers completed questionnaires for maternal depression and child behaviour.

RESULTS

Children rating positive for behaviour disorder were more likely to represent maternal injury, role reversal and marked maternal sadness. Severe behavioural symptoms were associated with more pervasive negative themes. Half of the overall sample depicted child accidents and maternal unresponsiveness, whereas child aggression, child anger and maternal absence were rare. Girls with depressed mothers showed an absence of particular negative representations (e.g., child sadness) compared to boys.

CONCLUSIONS

Specific atypical themes are associated with the extent of child psychopathology and may be modified by exposure to maternal depressed mood. The methodological limitations in this exploratory study are also discussed.

No reliable gender differences in attachment across the lifespan

In middle childhood, boys show more avoidant attachments and girls more ambivalent attachments as a prelude to gender differentiation in reproductive strategies. However, we have failed to find systematic and method-independent gender differences in middle or late childhood attachments, nor in adult attachment representations. We conclude that Del Giudice's model rests on a brittle empirical basis.

METHODS & MEASURES: Psychometric properties of the Manchester Child Attachment Story Task: An Italian multicentre study

The paper describes a multicentre study of the psychometric properties of the Manchester Child Attachment Story Task in a sample of 230 Italian children aged 4 to 8 years. The task's internal consistency and inter-rater reliability were investigated; in addition, multiple discriminant analysis was used to explore the contribution of individual coding system scale scores to overall categorical attachment classification. The instrument showed acceptable psychometric properties, especially with respect to Disorganization and Coherence scales. However, our results also suggest that some subscales of the coding system could be modified in order to improve reliability. The implications of our results for future research and further test validation are discussed.