Attachment and parenting in adult patients with anxiety disorders

An intergenerational study of parental bonding on perceptions of parental and spousal criticism and marital relationship quality in Singapore

Criticism is a form of interpersonal social rejection and destructive conflict behavior which has been associated with poor relationship outcomes in both parent-child and marital relationships. However, the role of the individual's perceptions of parental and spousal criticism in influencing the perceptions of criticism of other members in the family unit has not been examined. This study investigated the associations between parental bonding and perceptions of parental and spousal criticism across generations in Singapore. In all, 134 Singaporean married parent dyads (G2) and one child (G3) of each dyad were recruited. G2 parent participants completed the Perceived Criticism measure for their parents (G1) and spouses, the Parental Bonding Instrument and the Quality of Marriage Index. G3 children participants completed the Perceived Criticism measure for their parents (G2). Path analysis found that G2 perceptions of parental bonding were significant predictors of G2's perceptions of G1 parental criticism, which significantly predicted both G2's perceptions of spousal criticism and G3's perceptions of G2 parental criticism. Perceptions of spousal criticism were also found to predict marital relationship quality in G2 participants. Findings highlight the intergenerational transmission of perceptions of criticism across relationships in the family unit, providing support that parenting practices and communication patterns in one generation can predict those in the next generation in the Singaporean context. Future studies can look to replicate the findings in other cultures and include further investigations into sibling relationships as well.

The relationship between parental bonding and mood, anxiety and related disorders in adulthood: A systematic review and meta-analysis

BACKGROUND

A strong bond between parents and their children is essential in promoting healthy psychological development. Poor quality parent-child relationships can render children vulnerable to various adverse outcomes. Although extensive research has highlighted the association between abnormal parent-child bonding and mood and anxiety-related psychopathology in offspring, no systematic review or meta-analysis has assessed this relationship in adults.

METHODS

A literature search was conducted in five databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science) on January 4th, 2021. Studies that assessed the relationship between parental bonding and the presence of a mood or anxiety disorder in adults were eligible for inclusion.

RESULTS

Fifty-seven studies were included in the systematic review (n = 44 in the meta-analysis). Quantitative results indicated that individuals with major depression, panic disorder, or persistent depressive disorder reported lower parental care and higher overprotection compared to individuals without psychiatric diagnoses. Qualitative results indicated that individuals with diagnoses of mood or anxiety disorders tended to report higher parental abuse than controls.

LIMITATIONS

The measures of parental bonding used by the included studies are retrospective and subject to biases. All studies had a case-control design and thus, causal-relationships cannot be drawn from the results.

CONCLUSIONS

Our findings suggest that poor-quality parental bonding early in life may place offspring at greater risk for mood and anxiety disorders during adulthood. Future research should extend these results by confirming the relationship between parental bonding and other psychiatric disorders, as well as identifying which factors mediate the relationship between abnormal parental bonding and psychiatric disorders.

The Relationship Between Children and Their Maternal Uncles: A Unique Parenting Mode in Mosuo Culture

The relationship between children and their maternal uncles in contemporary Mosuo culture reveals a unique parenting mode in a matrilineal society. This study compared the responses of Mosuo and Han participants from questionnaires on the parent–child and maternal uncle–child relationship. More specifically, Study 1 used Inventory of Parent and Peer Attachment (IPPA) to assess the reactions of the two groups to the relationship between children and their mothers, fathers, and maternal uncles. The results show that while Han people display a higher level of attachment toward their fathers than their maternal uncles, Mosuo people do not exhibit a significant difference in this aspect. Study 2 used a scenario-based method to compare how adults and teenagers perceive the rights and responsibilities of fathers/maternal uncles toward their children/nephews or nieces. The results show that Han adults attribute more rights and responsibilities to their own children than nephews/nieces, while their Mosuo counterparts have the reverse pattern and assign stronger responsibilities to their nephews/nieces than their own children. Both groups perceive the fathers to be the bearer of rights and responsibilities, although this perception was weaker among Mosuo. This paper concludes that in the Mosuo society, fathers have a relatively weak social role as a result of their unique matrilineal social structure.

Recalled Parental Bonding Interacts with Oxytocin Receptor Gene Polymorphism in Modulating Anxiety and Avoidance in Adult Relationships

Early interactions with significant individuals affect social experience throughout the course of a lifetime, as a repeated and prolonged perception of different levels of care, independence, or control influences the modulation of emotional regulatory processes. As many factors play a role in shaping the expectations and features of social interaction, in this study, we considered the influence of parental bonding and genetic allelic variation of oxytocin receptor gene polymorphism (rs53576) over levels of experienced anxiety and avoidance in 313 young adults belonging to two different cultural contexts, namely Italy and Singapore. Results highlighted a major effect of maternal characteristics, care, and overprotection, with differences between the two cultural groups. Additionally, the interaction between rs53576 and maternal overprotection suggested different environmental susceptibility in the Italian sample and the Singaporean one. Implications for clinical work and future steps are described in the Conclusion.

Psychological Health Issues Subsequent to SARS-Cov 2 Restrictive Measures: The Role of Parental Bonding and Attachment Style

Background: The novel coronavirus 2019 (COVID-19) has caused severe panic among people worldwide. In Italy, a nationwide state of alert was declared on January 31st, leading to the confinement of the entire population from March 11 to May 18, 2020. Isolation and quarantine measures cause psychological problems, especially for individuals who are recognized as being vulnerable. Parental bonding and attachment styles play a role in the programming of the stress response system. Here, we hypothesize that the response to restricted social contact and mobility due to the pandemic has detrimental effects on mental-psychological health and that this relationship is, at least in part, modulated by parental bonding and attachment relationships that are experienced at an early age. Methods: A sample of 68 volunteer University students was screened for psychopathological symptoms (SCL-90-R and STAI-Y), stress perception (PSS), attachment style (RQ), and parental care and overcontrol (PBI) 6 months before the confinement. In the same subjects, psychopathological symptoms and stress perception were measured again during confinement. Results: Overall, psychological health and stress management deteriorated across the entire sample during confinement. Specifically, a significant increase in phobic anxiety, depression, psychological distress, and perceived stress was observed. Notably, parental bonding and attachment styles modulated the psychological status during the lockdown. Individuals with secure attachment and high levels of parental care (high care) showed increased levels of state anxiety and perceived stress in phase 2, compared with phase 1. In contrast, individuals with insecure attachment and low levels of parental care (low care) already showed a high rate of state anxiety and perceived stress in phase 1 that did not increase further during phase 2. Conclusion: The general deterioration of psychological health in the entire sample demonstrates the pervasiveness of this stressor, a decline that is partially modulated by attachment style and parental bonding. These results implicated disparate sensitivities to environmental changes in the high- and low care groups during the lockdown, the former of which shows the greatest flexibility in the response to environment, suggesting adequate and functional response to stress in high care individuals, which is not observable in the low care group.

Antecedents of fathers' perception of child behavior at child age 12 months

This study investigates whether fathers' adverse childhood experiences (ACE) and attachment style reported during pregnancy predict fathers' perception of child behavior assessed 12 months postpartum, expressed by the Parenting Stress Index (PSI), Child Domain. Prospective fathers (N = 835) were recruited to "The Little in Norway (LiN) study" (Moe & Smith) at nine well-baby clinics in Norway, with data collection composed of five time points during pregnancy and two time points postpartum (6 and 12 months). The main analyses included linear regression, path-analysis modeling, and intraclass correlation based on mixed effects modeling. First, linear regression analyses showed that neither fathers' ACE nor attachment style significantly predicted perceived child behavior postpartum directly. Furthermore, path analyses showed that ACE and less secure attachment style (especially avoidant attachment) measured early in pregnancy strongly predicted negatively perceived child behavior, mediated by fathers' mental health symptoms during pregnancy and partner disharmony postpartum. Second, intraclass correlation analyses showed that fathers' perceived child behavior showed substantial stability between 6 and 12 months postpartum. Family interventions beginning in pregnancy may be most beneficial given that fathers' early experiences and perceptions of attachment in pregnancy were associated with later partner disharmony and stress.

Oxytocin receptor gene and parental bonding modulate prefrontal responses to cries: a NIRS Study

The ability to interpret and regulate emotions relies on experiences of emotional socialization, obtained firstly through the interaction with the parents, and on genetic features that affect how individuals take on social situations. Evidence from the genetic field states that specific allelic variations of the oxytocin receptor gene polymorphisms regulate physiological modulation of human behavior, especially concerning responses to social cues and affiliative behaviors. Starting from this gene-by-environment interaction frame, we assessed 102 young adults for OXTr rs53576 and rs2254298, recalled parental bonding (using the Parental Bonding Instrument), and recorded participants' neural responses to social stressors using Near InfraRed Spectroscopy (NIRS). The results highlight that higher genetic susceptibility (G/G homozygous) to familiar context and positive early life interactions modulate more optimal neural responses to general social cues, in terms of promptness to action. With regards to the dimensions of parental bonding, we found lateralized effects, with greater activation in the right prefrontal cortex for Care subscales, and on the left side of the prefrontal cortex for Overprotection. Results provide evidence to understand the neurological mechanisms behind the negative impact of poor parenting practices on the child.

Genes and environment in attachment

In the last two decades, there has been increasing research interest in disentangling the contribution of genetic and environmental factors to individual differences in attachment, and in identifying the genes involved in shaping attachment. Twin studies suggest that as attachment changes during the course of development, genetic factors may play a progressively more important role, while shared environmental effects might decrease. However, most of this literature is limited by low power, measurement issues, and cross-sectional design. The findings of molecular genetic studies are, overall, inconclusive. The literature on main genetic effects and gene-by-environment interactions on attachment is filled with inconsistent and unreplicated findings. Also, most studies are underpowered. Challenges for future research are to identify the unshared environmental mechanisms involved in shaping attachment, and to better elucidate the genes involved and their interaction with the environment. Some pioneer studies suggested that the incorporation of epigenetic processes into G × E interaction models might represent a promising future way for investigating the complex, dynamic interplay between genes, environment, and attachment.

Attachment in Patients with Bipolar and Unipolar Depression: A Comparison with Clinical and Non-clinical Controls

Background

A link between depression and insecure attachment has long been postulated. Although many studies examined the relationship between depressive symptoms and attachment, relatively few studies were performed on patients diagnosed with depression. Also, research on patients with bipolar disorder is scarce.

Objective

We aimed at testing the association between attachment insecurity and unipolar and bipolar depression.

Methods

We studied 21 patients with bipolar disorder, current episode depressed, and three age- and sex-matched groups, each consisting of 21 individuals: patients with major depressive disorder, recurrent episode; patients with epilepsy; non-clinical participants. The Experience in Close Relationships questionnaire was used to assess adult attachment style.

Results

Patients with both bipolar and unipolar depression displayed significantly higher scores on attachment-related avoidance as compared with patients with epilepsy and non-clinical participants. Also, patients with bipolar depression scored significantly higher on attachment-related anxiety than all other groups. In both psychiatric groups, attachment dimensions were not significantly correlated with global clinical severity or severity of depression.

Conclusion

Despite some study limitations, our results are consistent with some previous studies and provide support to Bowlby's seminal hypothesis that attachment insecurity may predispose to depression. Attachment theory may provide a valuable theoretical framework for future research and for guiding treatment.

The influence of perceived parenting styles on socio-emotional development from pre-puberty into puberty

The relative impact of parenting on socio-emotional development of children has rarely been examined in a longitudinal context. This study examined the association between perceived parenting styles and socio-emotional functioning from childhood to adolescence. We hypothesized that optimal parenting associated with improvement in socio-emotional functioning from childhood into early adulthood, especially for those with more behavioral problems in childhood. Children between ages 7 and 9 years were recruited for the Singapore Cohort Study of Risk Factors for Myopia (SCORM). Nine years later, 700 out of 1052 subjects were followed up (67%). During childhood, parents completed the Child Behavior Checklist (CBCL), while young adults completed the Youth Self-Report (YSR) and Parental Bonding Instrument (PBI). Perceived optimal parental care resulted in less internalizing and externalizing problems in early adulthood in comparison to non-optimal parental care styles. Perceived optimal paternal parenting, but not maternal parenting, in interaction with childhood externalizing problems predicted externalizing symptoms in early adulthood. No significant interactions were found between perceived parenting styles and internalizing problems. In conclusion, perceived parental care associates with the quality of socio-emotional development, while optimal parenting by the father is especially important for children with more externalizing problems in childhood.

Exploring the Link among State of Mind Concerning Childhood Attachment, Attachment in Close Relationships, Parental Bonding, and Psychopathological Symptoms in Substance Users

Background: In the present study, we have explored the link among styles of attachment and psychopathology in drug users. We know that insecure attachment predisposes the individuals the development of drug-addiction and psychopathological symptoms. However, we do not know which attachment is more frequent in drug users and which is related to particular psychopathological symptoms. The aim of the present work is to explore the relationship between childhood attachment state of mind, attachment in close relationships, parental bonding and psychopathology in sample of Italian substance users.

Methods: We explored, in a sample of 70 drug users and drug-addicted patients, the childhood attachment state of mind measured by the Adult Attachment Interview, the attachment in close relationships by the Relationship Questionnaire and parental bonding measured by the Parental Bonding Instrument. The Symptom Check-List-90-R (SCL-90-R) measured psychopathological symptoms.

Results: We found that parental bonding, rather than state of mind concerning childhood attachment or attachment in close relationships, is related to the psychopathological manifestation of anxiety, hostility, depression, and paranoid ideation in the sample. The latter occurs frequently in our sample, independent of state of mind concerning child attachment, attachment in close relationships, and parental bonding, suggesting its role either as a factor that favors a bad image of the participants’ own relationships or as a direct effect of consuming drugs.

Conclusion: These results have clinical implications on suggesting ways of interventions that prevent drug-addiction, which should include the evaluation of attachment in the prodromic phases of substance use onset or rehabilitation programs to prevent and manage psychotic-like symptoms.

Genetic predispositions and parental bonding interact to shape adults' physiological responses to social distress

Parental bonding and oxytocin receptor (OXTR) gene genotype each influences social abilities in adulthood. Here, we hypothesized an interaction between the two - environmental experience (parental bonding history) and genetic factors (OXTR gene genotype) - in shaping adults' social sensitivity (physiological response to distress). We assessed heart rate and peripheral temperature (tip of the nose) in 42 male adults during presentation of distress vocalizations (distress cries belonging to female human infants and adults as well as bonobo). The two physiological responses index, respectively, state of arousal and readiness to action. Participants' parental bonding in childhood was assessed through the self-report Parental Bonding Instrument. To assess participants' genetic predispositions, buccal mucosa cell samples were collected, and region rs2254298 of the oxytocin receptor gene was analyzed: previous OXTR gene findings point to associations between the G allele and better sociality (protective factor) and the A allele and poorer sociality (risk factor). We found a gene * environment interaction for susceptibility to social distress: Participants with a genetic risk factor (A carriers) with a history of high paternal overprotection showed higher heart rate increase than those without this risk factor (G/G genotype) to social distress.Also, a significant effect of the interaction between paternal care and genotype on nose temperature changes was found. This susceptibility appears to represent an indirect pathway through which genes and experiences interact to shape mature social sensitivity in males.

The Family-Couple-Parenting Questionnaire: Development of a Measure for Long-Term Couples and Young Adults

This work describes the construction of family-couple-parenting (FCP) questionnaire, a new measure of three aspects related to the developmental path toward parenting choices, within the perspective of the family life cycle and attachment theory. Two studies are reported. Study 1 reports the development of the FCP questionnaire and its psychometric properties. Study 2 assesses the FCP's nomological validity by investigating group differences on FCP factors and links between FCP factors and romantic attachment (experience in close relationships-revised) and recalled parental bonding (parental bonding instrument). Participants were 791 Italian participants: 405 young adults (203 students, 202 workers) and 193 couples (91 childless-by-choice, 102 parents-to-be). The results suggest that the FCP's stable psychometric structure and strong theoretical basis make FCP a useful instrument for research related to the path to parenthood.

Interpersonal trauma, attachment insecurity and anxiety in an inpatient psychiatric population

Current research suggests that interpersonal trauma has an impact on insecure attachment and anxiety. Some research further suggests that attachment may play a mediating role between traumatic events and psychopathology. The purpose of this study was to examine the relationship between the experience of interpersonal trauma, attachment anxiety, attachment avoidance and clinical anxiety severity among adult psychiatric inpatients who reported having experienced interpersonal trauma after the age of 16. It was hypothesized that attachment anxiety and attachment avoidance would mediate the relationship between interpersonal trauma and clinical anxiety level. This study used archival data on 414 adult psychiatric inpatients in a large city in the Southwest U.S. Results suggest that interpersonal trauma was correlated to attachment avoidance but not to attachment anxiety and that attachment avoidance partially mediated the relation of interpersonal trauma to anxiety. The attachment framework appositely explains how a negative model of other contributes to the relation between experiences of interpersonal trauma and anxiety in adulthood.

Development of a structure-validated Family Relationship Questionnaire (FRQ) with Chinese university students

Consistent results have shown a relationship between the psychological world of children and their perceived parental bonding or family attachment style, but to date there is no single measure covering both styles. The authors designed a statement matrix with 116 items for this purpose and compared it with the Parental Bonding Instrument (PBI) in a study with 718 university students. After exploratory and confirmatory factor analyses, five factors (scales)--namely, Paternal/Maternal Encouragement (5 items each), Paternal/Maternal Abuse (5 items each), Paternal/Maternal Freedom Release (5 items each), General Attachment (5 items), and Paternal/Maternal Dominance (4 items each)--were defined to form a Family Relationship Questionnaire (FRQ). The internal alphas of the factors ranged from .64 to .83, and their congruency coefficients were .93 to .98 in samples regarding father and mother. Women scored significantly higher on FRQ General Attachment and Maternal Encouragement and lower on Paternal Abuse than men did; only children scored significantly higher on Paternal and Maternal Encouragements than children with siblings did. Women also scored significantly higher on PBI Paternal Autonomy Denial; only children scored significantly higher on Paternal and Maternal Cares and Maternal Autonomy Denial. All intercorrelations between FRQ scales were low to medium, and some correlations between FRQ and PBI scales were medium to high. This study demonstrates that the FRQ has a structure of five factors with satisfactory discriminant and convergent validities, which might help to characterize family relationships in healthy and clinical populations.