Maternal postpartum anxiety and the development of infant attachment: The effect of body sensations on infant attachment

BACKGROUND

Knowledge about the influences of maternal postpartum anxiety disorders (PAD) on infant development is limited. Aim of this present study is to evaluate the influence of PAD on infant attachment.

METHODS

In a longitudinal study, self-reported anxiety symptoms of N = 70 mothers (N = 28 with PAD diagnosed according to the DSM-IV, N = 42 controls) were examined in the postpartum period and one year later. Infants' attachment was observed in the Strange Situation Test (SST) at the age of 12-24 months.

RESULTS

Results indicate a strong relationship between PAD and infant attachment: infants of mothers with PAD were significantly more likely to be classified as insecure or disorganized than infants of control mothers. Logistic regression analysis led to a significant model with 76.8 % correct classification of infant attachment dependent on the maternal fear of anxiety associated body sensations (OR = 4.848) in the postpartum period. Including maternal sensitivity and interaction behavior, only maternal intrusiveness was additionally associated with infant attachment (ρ = 0.273, p < .05; OR = 45.021, p = .153).

LIMITATIONS

Participants were highly educated. Different anxiety disorders included led to a heterogenous sample. Generalization is diminished. Maternal sensitivity was measured on a global scale, and body tension was self-reported.

CONCLUSIONS

PAD plays a crucial role in the development of infant attachment. Interaction-focused interventions, helping mothers to decrease intrusiveness, and body-focused interventions, helping mothers to deal with their fear of anxiety symptoms, might be promising pathways to buffer the influence of PAD on infant attachment.

Randomized controlled trial of the Circle of Security-Intensive intervention for mothers with postpartum depression: maternal unresolved attachment moderates changes in sensitivity

Postpartum depression is related to inadequately sensitive caregiving, putting infants at risk for insecure attachment. Therefore, promoting sensitive maternal caregiving and secure child attachment is particularly important in postpartum depressed mothers and their infants. In this randomized-controlled-trial, we evaluated the efficacy of the Circle of Security-Intensive (COS-I)-intervention in supporting maternal sensitivity and mother-infant-attachment compared to treatment-as-usual (TAU) with unresolved-maternal attachment as a moderator of treatment effect. Eligible mothers with infants (N=72) 4-9 months-old were randomly assigned to treatment (n=36 dyads). Infant attachment was rated at follow-up (child age 16-18 months) (Strange-Situation-procedure). Maternal sensitivity was measured at baseline and follow-up (Mini-Maternal-Behavior-Q-sort). Maternal-unresolved-attachment was assessed at baseline (Adult-Attachment-Interview). We found no significant differences between treatments in infant attachment nor changes in mothers' sensitivity. However, in COS-I, unresolved-mothers exhibited significantly more change in sensitivity than non-unresolved-mothers, whereas in TAU, the opposite was true. These findings may help to optimize clinical use of COS-I.

Adolescents’ nonverbal emotional expressions during negotiation of a disagreement with their mothers: An attachment approach

The present study investigates the influence of attachment representation on adolescents’ nonverbal behaviour during an observed mother-adolescent interaction task. In a follow-up of the Regensburg longitudinal study, 43 (of the original 51 participating families) 16-year-old adolescents and their mothers were observed in a short revealed differences task. Ekman and Friesen’s (1978) facial expression descriptions were used in the second-by-second analysis of the adolescents’ facial expressions. The analysis assessed emotional states (anger, sadness, surprise, uneasiness, joy, smiling), manipulators or adapters as signs of tension (biting of lips, biting nails), emblems, and eye contact. Concurrently, adolescents were given the Adult Attachment Interview to assess their attachment representations using Kobak’s Adult-Attachment-Interview Q-sort. Results showed a significant relationship between adolescent attachment representation and adolescent nonverbal facial expression during the interaction task. Attachment security was related to open and positive expression of emotion, whereas dismissive attachment style was associated with communication inhibiting behaviour. The results are congruent with attachment theory claiming that coherent emotional appraisals of one’s own attachment history is a prerequisite to open emotional expression and communication of one’s feelings to others.

Is attachment at ages 1, 6 and 16 related to autonomy and relatedness behavior of adolescents in interaction towards their mothers?

This study investigates whether attachment quality at ages 1, 6 and 16 is related to autonomy and relatedness behavior in adolescence. In a follow-up of the Regensburg Longitudinal Study, forty-three 16-year-old adolescents and their mothers were assessed in a revealed differences task and a planning a vacation task. Attachment was assessed during infancy using the Ainsworth Strange Situation and at age six with the reunion procedure. Adolescent attachment representation was assessed using the Adult Attachment Interview. Results provided no evidence for significant continuity between infant or childhood attachment behavior and adolescent attachment representation. Instability of attachment organization, however, was linked to a higher number of experienced risk factors. Substantial relations between adolescent attachment representation and adolescent autonomy and relatedness behavior were found in both interaction tasks with their mothers. Further, significant relations between attachment qualities at ages 1 and 6 and adolescent interaction behavior during the planning a vacation task at age 16 were found. Thus, independent of attachment stability or instability, both early attachment in infancy and childhood and concurrent attachment representation were significantly related to autonomy and relatedness behavior in adolescence.

Bindungsrepräsentation und Coping im Jugend- und jungen Erwachsenenalter

Zusammenfassung. Zu insgesamt fünf längsschnittlichen Erhebungszeitpunkten wurde an 103 Personen der Zusammenhang zwischen deren Bindungsrepräsentation und deren Bewältigungsverhalten im Umgang mit alltäglichen Belastungen untersucht. Sowohl im Jugendalter als auch im jungen Erwachsenenalter wurden Unterschiede in der Art der Problembewältigung in Abhängigkeit von der Bindungsrepräsentation gefunden. In Übereinstimmung mit der Bindungstheorie und neueren Konzepten der Emotionsregulation setzten sich jene Personen, denen im jungen Erwachsenenalter eine sichere Bindungsrepräsentation zuerkannt wurde, sowohl in der Adoleszenz als auch im Alter von 21 Jahren aktiver mit ihren Problemen auseinander und banden ihr soziales Netzwerk in die Problembewältigung ein. Probanden mit unsicher-distanzierter Bindungsrepräsentation neigten demgegenüber eher zu passiver Verschlossenheit, die letztlich in sozialem Rückzug mündete, während Probanden mit unsicher-verwickelter Bindungsrepräsentation unklares Verhalten zeigten und zwischen der Suche nach Hilfe und sozialem Rückzug schwankten.

Stability of attachment representations during adolescence: the influence of ego-identity status

The purpose of this study was to examine two core assumptions of attachment theory. First, internal working models of attachment should increase in stability during the course of development. Second, attachment is related to the adaptive solution of stage-salient issues, in adolescence, specifically to identity formation. Adolescence as a developmental period of change and reorganization might lead to changes in attachment representations by re-evaluating one's life experiences in the course of general identity development. In a longitudinal study, the stability of attachment representations (assessed by the Adult Attachment Interview) between ages 16 and 18 was examined. In addition, the concurrent and longitudinal associations of identity status at age 16 with attachment representations at ages 16 and 18 were tested. Results showed high stability of attachment representation during that age period. Secure attachment representation was positively associated with the identity status achievement, whereas a dismissing status was positively associated with identity diffusion. Longitudinally, identity diffusion at age 16 predicted attachment representation at age 18 even after controlling for earlier attachment representation.

Attachment representation and cortisol response to the adult attachment interview in idiopathic spasmodic torticollis

OBJECTIVE

The study investigates individual differences in the mental representation of attachment and their impact on the cortisol response to psychosocial stress in idiopathic spasmodic torticollis (IST). It was hypothesized (a) that in IST insecure attachment is more prevalent than in a non-clinical control group and (b) that subjects with dismissing attachment respond with higher physiological arousal to a specific stimulus activating the attachment behavioural system than subjects with secure attachment.

METHOD

20 patients with IST and 20 healthy controls matched for age and sex underwent the Adult Attachment Interview, an hour-long, semiclinical interview on attachment experiences. During the interview salivary cortisol levels were monitored. The subjects' mental state with regard to attachment was classified using the attachment Q-sort method. Anxiety and depression were measured as potential covariates of the adrenocortical stress response.

RESULTS

Compared to the non-clinical group, dismissing attachment was strongly overrepresented in IST. In IST, but not in the healthy control group, dismissing attachment correlated with an elevated cortisol response to the interview.

CONCLUSION

In clinical, but not in non-clinical samples dismissing attachment may be associated with increased vulnerability to psychosocial stress. The factors contributing to this interaction are not yet fully elucidated.

Alexithymia and attachment representation in idiopathic spasmodic torticollis

We investigated alexithymia and the mental representation of attachment in idiopathic spasmodic torticollis (IST). It was hypothesized a) that alexithymia in IST is more prevalent than in a nonclinical control group and b) that significant correlations emerge between alexithymia and a dismissing attachment representation. Twenty patients with IST and 20 healthy controls matched for age and sex were administered the Toronto Alexithymia Scale (TAS-20) and the Adult Attachment Interview (AAI). Attachment was classified using the Attachment Interview Q-sort. IST patients scored significantly higher on the measure of alexithymia than subjects in the comparison group. In IST a dismissing attachment representation was significantly more frequent than in the control group. Across the total sample, externally oriented thinking correlated positively with dismissing attachment, and both externally oriented thinking and difficulty communicating feelings (two of the three subscales of the TAS-20) correlated inversely with secure attachment. Alexithymia is more prevalent in IST than in normals. As was hypothesized, alexithymia in adults is significantly interrelated with the mental representation of attachment.