Infant colic and HPA axis development across childhood

This study examines the long-term impact of infant colic on Hypothalamic-Pituitary-Adrenal (HPA) axis development and the moderating role of attachment security, in a low-risk Dutch sample of 193 children. We assessed infant colic at 6 weeks, circadian cortisol concentrations at ages 1, 2.5, 6, and 10 years, and attachment security at 1 year. Findings indicated that infant colic was associated with steeper diurnal cortisol slopes and slightly higher cortisol concentrations throughout childhood. Attachment security did not moderate these associations. This is the first study to reveal a link between infant colic and the development of the HPA axis in healthy children beyond infancy. These findings have important implications for understanding early risk and protective factors in the stress system's development.

Family Accommodation and Separation Anxiety: The Moderating Role of Child Attachment

Family accommodation, or changes in parental behavior aimed at avoiding or alleviating child anxiety-related distress, contributes to the severity of anxiety symptoms, and is most strongly associated with separation anxiety. This study examined whether child attachment security, characterized as the degree to which children perceive their parents to be reliable, available, and communicative, moderates the association between family accommodation and separation anxiety symptoms, and whether this moderation is specific to separation anxiety among other anxiety symptoms. In a sample of clinically anxious children (N = 243, 6-12 years), family accommodation was significantly positively associated with separation anxiety symptoms across levels of attachment security. Family accommodation was more strongly associated with parent-reported separation anxiety symptoms in children with lower attachment security compared with those with higher attachment security. No significant moderation effect emerged for other anxiety symptoms. Findings enhance understanding of the role of attachment within family accommodation of child anxiety.

Free from your experiences to grow: belief in free will moderates the relationship between attachment avoidance and personal growth initiative

BACKGROUND

Attachment theory proposes that attachment security facilitates personal growth. However, attachment security origins in relationship history, and thus, how people treat their experiences may influence the outcomes of attachment security. People differ in the degree in believing that human beings have free will, and belief in free will may influence the relationship between experiences and outcomes. The present cross-sectional study investigated the relationships between attachment security, belief in free will, and personal growth initiative.

METHODS

We used the cross-sectional data of 346 Chinese college students for data analysis, including correlational analyses, regression, and moderation analyses. The nine-item Chinese version of the Experiences in Close Relationships-Relationship Structures Scale, the sixteen-item Chinese version of the Personal Growth Initiative Scale-II, and the seven-item Free Will subscale of the Chinese version of the Free Will and Determinism Plus Scale were utilized.

RESULTS

Results showed attachment avoidance and belief in free will, not attachment anxiety, was associated with personal growth initiative. Belief in free will moderated the association between attachment avoidance and personal growth initiative. When the centered score of belief in free will was higher than 0.64, attachment avoidance was no longer associated with personal growth initiative. 85.84% of our data were below this Johnson-Neyman significance region, and 14.16% were above. In other words, only those who scored higher than 0.64 on free will beliefs were able to pursue personal growth despite their high attachment avoidance.

CONCLUSIONS

These findings suggest that when believing in free will, avoidantly attached people may believe in their ability to pursue personal growth and think their future has more possibilities, not influenced by other factors like social support, which they think they lack.

Compassionate goals, responsiveness, and well-being

Compassionate goals-intentions to be supportive and constructive and not harm relationship partners-predict responsiveness and well-being. However, not much is known about whether the effects of compassionate goals depend on attachment security, trust, or self-esteem. This article reviews recent studies examining this research question. These studies indicate that compassionate goals predict relationship processes (e.g., responsiveness, constructive approaches to relationship problems, self-disclosure) and well-being (e.g., growth-seeking) regardless of attachment security, trust, and self-esteem. Furthermore, compassionate goals also predict increased attachment security, trust, and self-esteem over time. These findings suggest that people with compassionate goals can cultivate responsive relationships and thrive through relationships even when they have insecurities related to low attachment security, low trust, or low self-esteem.

Attachment theory's core hypotheses in rural Andean Peru

This is the first study aiming to test two universality claims of attachment theory within a rural Andean sample from Cusco, Peru. A total of 69 mothers and their children (6 to 36 months) participated. Child attachment security was assessed with the Attachment Q-set (AQS), maternal sensitivity was measured during three naturalistic episodes (free interaction, bathing, and feeding) with the Ainsworth sensitivity scale and the Maternal Behavior Q-sort (MBQS), and a cumulative maternal risk variable was calculated. Results revealed that most children displayed less characteristic secure base behaviors in the interactions with their mothers, compared to other reference samples. Furthermore, an association between maternal sensitivity and child attachment security was found, and a negative relation between maternal sensitivity and the cumulative risk variable. These results support some of the attachment theory's universality claims, and suggest new avenues for research on assessment issues in rural samples in the Global South.

Children experiencing sadness: Coping strategies and attachment relationships

This study aimed to explore the events which are sources of sadness for children, and their coping strategies for overcoming their sadness according to their attachment security. We expected that distinct clusters would emerge, with securely attached children more likely showing constructive and successful coping strategies than insecurely attached children. Middle-class children (N = 191) aged 7-11 years old from four private elementary schools were asked to talk about a sad event they experienced using open-ended questions from the Sadness Interview. The answers were coded into different categories of sad events and associated coping strategies. Finally, children were assessed on their security attachment using the Security Scale. Cluster analyses identified a four-cluster solution. Children in the Clusters 1 and 2 were characterized by a perceived successful constructive coping strategy while describing minor events (in the first Cluster), and very painful events (in the second). Furthermore, in the third Cluster children overcame sad events using a perceived successful disengagement coping strategy, whereas children in the fourth Cluster are characterized by perceived unresolved sadness. ANCOVA testing showed that children in the first cluster had significantly higher attachment security compared to Clusters 3 and 4, which did not significantly differ from each other. The study of sadness in children may be particularly informative for clinicians and educators for understanding and supporting children's strategies of sadness management while considering the influence of their attachment relationships on their ability to cope with sadness.

Modifying insecure attachment style with cognitive bias modification

BACKGROUND AND OBJECTIVES

Attachment theory suggests that internal working models developed from early experiences with attachment figures biases cognitive appraisals a person makes of themselves and others. The current paper investigates whether attachment-related interpretative biases can be altered using Cognitive Bias Modification (CBM-I).

METHODS

Eighty anxiously attached participants were randomly assigned to receive either secure or insecure CBM-I training. To measure training effects on attachment-related interpretation bias, participants read scenarios involving attachment figures whereby the availability of the attachment figure was undetermined, followed by test sentences that assigned an attachment-secure or -insecure interpretation to the situations. Participants rated the similarity of these sentences to the previously read ambiguous situations.

RESULTS

Participants who received secure CBM-I training ascribed higher similarity ratings to secure sentence interpretations of ambiguous scenarios compared to insecure sentence interpretations. Attachment anxiety increased after CBM-I training for those who received insecure training, but did not differ for those who received secure training.

LIMITATIONS

This study was limited to healthy participants and did not include clinical participants. These findings need to be replicated by assessing the effects of CBM-I over an extended period.

CONCLUSIONS

CBM-I training may provide a viable means of modulating attachment anxiety. If validated with more potent strategies for secure attachment training, this approach could have significant implications for the treatment of affective disorders characterized by insecure attachments.

Parent-child relationship and child anger proneness in infancy and attachment security at toddler age: a short-term longitudinal study of mother- and father-child dyads

Early parent-child relationship and child negative emotionality have both been studied as contributors to attachment security, but few studies have examined whether negative emotionality can moderate effects of parent-child relationship on security and whether the process is comparable across mother- and father-child dyads and different security measures. In 102 community families, we observed parent-child shared positive affect and infants' anger proneness at 7 months, and attachment security at 15 months, using observer-rated Attachment Q-Set (AQS) and a continuous measure derived from Strange Situation Paradigm (SSP). For mother-child dyads, high shared positive affect and low anger proneness were associated with AQS security. Those effects were qualified by their interaction: Variations in shared positive affect were associated with security only for relatively more anger-prone children.  That effect reflected the diathesis-stress model. For father-child dyads, shared positive affect was associated with security. There were no effects for SSP security with either parent.

Non-verbal and verbal parental mentalization as predictors of infant attachment security: Contributions of parental embodied mentalizing and mind-mindedness and the mediating role of maternal sensitivity

Interest in studying the relative contributions of verbal (e.g., maternal mind-mindedness [MM]) and non-verbal dimensions (i.e., parental embodied mentalizing [PEM]) of parental mentalization to child socio-emotional development is relatively recent. To date, only one study has addressed this issue in relation to child attachment security, suggesting a complementary and unique contribution of each one. The purpose of the present study was to further examine the specific contribution of PEM to infant attachment security by considering MM. In addition, this study aimed to explore the mediating role of maternal sensitivity linking PEM, MM to infant attachment security within 110 mother-infant dyads at moderate psychosocial risk. The two dimensions of parental mentalization (PEM and MM) were assessed on the basis of observations made during a videorecorded sequence of mother-child interactions in a context of free play with and without toys when the infants were 8 months old. The Maternal Behavior Q-Sort was used to measure the mothers' sensitivity in a natural setting based on observations of daily mother-child interactions, also when the infants were about 8 months old. Attachment security was measured using The Strange Situation Procedure at infant age 16 months. The results showed positive correlations between maternal sensitivity and both verbal and non-verbal measures of parental mentalization. The mediation analyses first revealed that PEM had a significant indirect effect on attachment security, with sensitivity being identified as a mediator in this association. No indirect effect linking MM and attachment security via sensitivity was observed. These results highlight the contribution of PEM to maternal sensitivity and show maternal sensitivity to be a factor that partly explains the influence of PEM on attachment security in children.

Commentary on Guild et al. (2020): The Importance of Well-Designed Intervention Studies for Advancing Attachment Theory and its Clinical Applications

Guild and colleagues (this issue) report results of a long-term follow up after a randomized trial of the effectiveness of an attachment-theory-informed psychotherapeutic intervention for mothers with depression and their toddlers. Their paper shows the intervention can increase the likelihood of secure attachment in children of depressed mothers and that secure attachment explains more optimal social-emotional functioning in middle childhood in the treated group. This commentary discusses the contribution of the paper by Guild and colleagues and their broader body of work to our evolving understanding of developmental processes underpinning social-emotional competence in children of depressed parents, and to several ongoing controversies in the field: 1) the relevance of attachment-theory-informed interventions in the context of maternal depression; 2) the evidence gap regarding the efficacy and effectiveness of attachment-theory-informed interventions, particularly with respect to sustained benefits; 3) cost-benefits of early interventions; and 4) the need for theory driven research that explains how and under what circumstances attachment is related to later child outcomes.

Frontal EEG asymmetry in infants observing separation and comforting events: The role of infants' attachment relationship

The development of social-cognitive abilities in infancy is subject to an intricate interaction between maturation of neural systems and environmental input. We investigated the role of infants’ attachment relationship quality in shaping infants’ neural responses to observed social interactions. One-hundred thirty 10-month-old infants participated in an EEG session while they watched animations involving a distressing separation event that ended with either comforting or ignoring behavior. Frontal asymmetry (FA) in the alpha range - which is indicative of approach-withdrawal tendencies - was measured with EEG. Attachment quality was assessed using the Strange Situation procedure at 12 months. Overall, infants with disorganized attachment showed a lack of right-sided – withdrawal related – FA compared to secure and insecure infants. Furthermore, only avoidant infants exhibited reduced right-sided FA responses following the separation. Contrary to our expectations, the type of response (comforting vs. ignoring) did not elicit differences in FA patterns, and attachment quality did not moderate the effects of the type of response on frontal asymmetry. Implications for research on attachment-related biases in social information processing and on the neural underpinnings of prosocial behaviors are discussed.

Attachment security, verbal ability, and inhibitory control in middle childhood

BACKGROUND

The relationship between parent-child attachment and executive function (EF) in middle childhood remains relatively poorly studied. Very little is known about the role that the child's verbal ability might play in these relationships. Therefore, in the present study, we explored the concurrent links between perceived attachment security with parents and hot and cool inhibitory control (IC)-a core component of EF-as well as the potential mediating role of verbal ability in those links.

METHODS

The participants were 160 children aged 8 to 12 (51% girls). They completed the Attachment Security Scale, the computerised version of the go/no-go task, the delay discounting task, and the vocabulary subtest from the Wechsler Intelligence Scale for Children. Pearson's correlations were conducted to test relationships between the study variables. A hierarchical multiple linear regression analysis was performed to examine whether attachment security uniquely contributed to the outcomes after accounting for covariates. The indirect effects were tested using a non-parametric resampling bootstrap approach.

RESULTS

The results showed that, after accounting for the child's age and sex, there was a direct relationship between attachment security with the father and cool, but not hot, IC. However, there were no significant links between attachment security with the mother and both aspects of IC. We also found that children's verbal ability played a mediating role in the associations between both child-father and child-mother attachment security and hot, but not cool, IC above and beyond the child's age.

CONCLUSIONS

The current study extends previous work on executive functions in middle childhood. The results highlight the role of attachment in explaining individual differences in IC in middle childhood as well as the different mechanisms through which attachment with parents might explain cool vs. hot IC. The findings have potential implications for therapeutic interventions using the family context as a target to improve IC in middle childhood.

Attachment security and striatal functional connectivity in typically developing children

Attachment security is formed through interactions with a main caregiver during the first three years of life and reflects inter-individual differences in mental representations for the relationship. The striatum is known to be a key structure to initiate attachment behaviours and maintain attachment relationships as well as to modulate reward-related processing as part of the approach module in current neurobiological models of human attachment. Although findings have suggested critical roles of the striatum in inter-individual differences in attachment, most studies were based on a wide variety of tasks and very few have investigated these associations in intrinsic brain connectivity in typically developing children. In the present study, using resting-state functional magnetic resonance imaging, we examined the striatal functional connectivity according to children’s attachment security in 68 nine-year-olds (Secure attachment = 39, Insecure attachment = 29, mean age/SD = 9.62/0.69). Children with secure attachment demonstrated increased functional connectivity in the tempro-limbic region, compared to children with insecure attachment. In addition, the child-reported attachment security scores were negatively associated with the caudate-prefrontal connectivity, but positively with the putamen-visual area connectivity. These data demonstrate that inter-individual differences in attachment can be captured in striatal functional connectivity organization in the typical brain.

Within-Person Associations Between Attachment Security, Need Satisfaction and Psychological Adjustment in Daily Life of Older Adults

OBJECTIVES

Little is known about how attachment processes manifest within older adults in daily life and how these processes are associated with daily psychological adjustment. This study examined the within-person associations between states of attachment security and psychological adjustment. It is expected that this association is mediated by higher levels of satisfied needs in daily life.

METHODS

Microlongitudinal self-report data were collected in a sample of 136 older adults ranged in age from 60 to 90 years (ageM = 70.45 years) across 10 days with daily morning and afternoon measurement occasions.

RESULTS

Three main findings from multilevel analyses emerged. First, older adults showed significant within-person variation in attachment security, satisfaction of the needs for autonomy and competence, and psychological adjustment over time. Second, attachment security was positively associated with psychological adjustment within individuals. Third, both satisfaction of the needs for autonomy and competence mediated the within-person association between attachment security and psychological adjustment.

DISCUSSION

The results suggest that attachment security is associated with the experience of autonomy and competence in daily life of older adults which in turn is related with better psychological adjustment.

Effectiveness of a brief manualized intervention, Managing Cancer and Living Meaningfully (CALM), adapted to the Italian cancer care setting: Study protocol for a single-blinded randomized controlled trial

Patients with advanced cancer suffer from psychosocial distress that may impair quality of life and that may be ameliorated by psychotherapeutic treatment. We describe here the methodology of a randomized controlled trial (RCT) to assess the effectiveness of a novel, brief, semi-structured psychotherapeutic intervention to reduce distress and increase well-being in patients with advanced or metastatic cancer. The intervention, called Managing Cancer and Living Meaningfully (CALM), was originally developed in Canada and we are now testing its Italian adaptation (CALM-IT).

The study is a single-blinded phase III RCT with assessment at baseline, 3 and 6 months with two conditions: CALM-IT versus a nonspecific supportive intervention (SPI). Eligibility criteria include: ≥ 18 years of age; fluency in the Italian language; no cognitive deficit, and diagnosis of advanced or metastatic cancer with an expected survival of 12–18 months. CALM-IT includes up to 12 sessions, delivered over 6 months and covers 4 domains: i) Symptom Management and Communication with Health Care Providers; ii) Changes in Self and Relations with Close Others; iii) Sense of Meaning and Purpose; and iv) the Future and Mortality. The primary outcome is difference in severity of depressive symptoms between treatment arm and the primary endpoint is 6 months. The secondary endpoint is 3 months and secondary outcomes are: generalized anxiety, distress about dying and death, demoralization, spiritual well-being, attachment security, posttraumatic growth, communication with partners, quality of life, and satisfaction with clinical care.

If shown to be effective, CALM-IT can be implemented nationally to relieve distress and to promote psychological well-being in patients with advanced cancer.

Patterns of growth in executive functioning during school years: Contributions of early mother-child attachment security and maternal autonomy support

Executive functioning (EF) undergoes marked developmental improvements during the early school years. Given the crucial role of EF in learning and school adjustment, it is important to document the factors that bolster the development of executive competence, especially during a period of growth. Although substantial evidence suggests that parent-child relationships relate to EF, few longitudinal studies have examined the parental antecedents of EF developmental trajectories during the school years. Accordingly, this multiyear longitudinal study (N = 102) explored the respective roles of early mother-child attachment security and maternal autonomy support in the prediction of patterns of growth in working memory, cognitive flexibility, and planning skills across Grades 2 to 4. Multilevel growth curve analyses revealed a unique positive relation between attachment security and all EF skills, whereas autonomy support was mainly independently associated with initial planning performance. These findings provide further suggestion for a global contribution of secure attachment relationships to children's executive competence and highlight the importance of supporting children's autonomy to foster the emergence of more complex EF abilities such as planning. This study also supports the relevance of considering multiple aspects of parent-child relationships to delineate how early caregiving experiences contribute to children's EF development.

Child attachment security in gay father surrogacy families: Parents as safe havens and secure bases during middle childhood

Child attachment security and utilization of parents as safe havens and secure bases were compared in 33 surrogacy children with gay fathers and 37 donor-conceived children with lesbian mothers during middle childhood. Assessments included data coded from parent-child interactions, interviews, and questionnaires administered to children and both parents. Findings indicated that children of gay fathers perceived high attachment security and their scores did not differ from those of children with lesbian mothers or from normative scores of children with heterosexual parents. Children's greater attachment security was associated with higher levels of parental warmth, responsiveness, and willingness to serve as an attachment figure; lower levels of parental negative control and rejection; and the child's younger age. Finally, children used the primary attachment figure more as a safe haven and the secondary attachment more as a secure base, though they reported high levels of both types of support from both parents.

Preschoolers' secure base script representations predict teachers' ratings of social competence in two independent samples

Associations between attachment security, assessed as a secure base script (SBS), and teachers' social competence ratings were examined in two samples (one from the Midwest region and the other from the Southern region of the United States). Consistent with previous reports, significant associations between domains were obtained in both samples and after combining the two samples, r = .33, p < .001. The associations remained significant when child sex, age, and verbal intelligence were controlled. Findings are discussed with reference to relations between SBS scores and the covariates. Regarding sex differences, an existing literature suggests that girls, compared with boys, may be advantaged with respect to skills that could support higher scores on the task used to assess secure base scripts. In both samples, teachers rated girls as somewhat higher on scales of social competence and controlling for sex reduced the magnitude of associations between SBS and social competence, but the results remained significant in all tests.

Attachment security and existential distress among patients with advanced cancer

BACKGROUND

Felt security in close relationships may affect individual adaptation responses to existential threat in severe illness. We examined the contribution of attachment security to demoralization, a state of existential distress involving perceived pointlessness and meaninglessness in advanced cancer.

METHOD

A mixed cross-sectional sample of 382 patients with advanced cancer (mean age 59, 60% female) was recruited from outpatient oncology clinics. Participants completed self-report measures of attachment security, demoralization, depression, and physical symptom burden. We used multiple linear regression to analyze the association between attachment security and demoralization, controlling for demographic factors and symptom burden and tested whether attachment security moderated the association of symptom burden with demoralization. Separate analyses compared the contribution of the dimensions of attachment anxiety and attachment avoidance.

RESULTS

The prevalence of clinically relevant demoralization was 35%. Demoralization was associated with lower attachment security (β = -0.54, 95%CI: -0.62 to 0.46). This effect was empirically stronger for attachment anxiety (β = 0.52, 95%CI: 0.44 to 0.60) compared to attachment avoidance (β = 0.36, 95%CI: 0.27 to 0.45). Attachment security also significantly moderated the association of physical symptom burden with demoralization, such that with less attachment security, there was a stronger association between symptom burden and demoralization.

CONCLUSION

Attachment security may protect from demoralization in advanced cancer. Its relative lack, particularly on the dimension of attachment anxiety, may limit adaptive capacities to deal with illness burden and to sustain morale and purpose in life. An understanding of individual differences in attachment needs can inform existential interventions for severely ill individuals.

Your love makes me feel more secure: Boosting attachment security decreases materialistic values

Enhanced interpersonal security has been shown to diminish the desire for money and possessions. In the present study, we focus on attachment security to examine the relationship between attachment security and materialism. By employing the experience in close relationships - short scale and material values scale, we observed a positive relationship between attachment insecurity and materialism in Study 1. In Study 2, we primed participants' feeling of attachment security to further explore the impact of attachment security on materialistic values. The results showed that participants in the security-priming group exhibited lower levels of state materialism (Study 2a) and a longer time to respond to materialism-related words (Studies 2b and 2c) than participants in the neutral condition. However, attachment styles did not moderate the attachment security-materialism relationship. Our findings reveal that regardless of attachment style, boosting attachment security can effectively decrease materialism.

How do you make me feel better? Social cognitive emotion regulation and the default mode network

Socially-induced cognitive emotion regulation (Social-Reg) is crucial for emotional well-being and social functioning; however, its brain mechanisms remain poorly understood. Given that both social cognition and cognitive emotion regulation engage key regions of the default-mode network (DMN), we hypothesized that Social-Reg would rely on the DMN, and that its effectiveness would be associated with social functioning. During functional MRI, negative emotions were elicited by pictures, and - via short instructions - a psychotherapist either down-regulated participants' emotions by employing reappraisal (Reg), or asked them to simply look at the pictures (Look). Adult Attachment Scale was used to measure social functioning. Contrasting Reg versus Look, aversive emotions were successfully reduced during Social-Reg, with increased activations in the prefrontal and parietal cortices, precuneus and the left temporo-parietal junction. These activations covered key nodes of the DMN and were associated with Social-Reg success. Furthermore, participants' attachment security was positively correlated with both Social-Reg success and orbitofrontal cortex involvement during Social-Reg. In addition, specificity of the neural correlates of Social-Reg was confirmed by comparisons with participants' DMN activity at rest and their brain activations during a typical emotional self-regulation task based on the same experimental paradigm without a psychotherapist. Our results provide first evidence for the specific involvement of the DMN in Social-Reg, and the association of Social-Reg with individual differences in attachment security. The findings suggest that DMN dysfunction, found in many neuropsychiatric disorders, may impair the ability to benefit from Social-Reg.

Infant emotion regulation: relations to bedtime emotional availability, attachment security, and temperament

The present study examines the influences of mothers' emotional availability toward their infants during bedtime, infant attachment security, and interactions between bedtime parenting and attachment with infant temperamental negative affectivity, on infants' emotion regulation strategy use at 12 and 18 months. Infants' emotion regulation strategies were assessed during a frustration task that required infants to regulate their emotions in the absence of parental support. Whereas emotional availability was not directly related to infants' emotion regulation strategies, infant attachment security had direct relations with infants' orienting toward the environment and tension reduction behaviors. Both maternal emotional availability and security of the mother-infant attachment relationship interacted with infant temperamental negative affectivity to predict two strategies that were less adaptive in regulating frustration.

[The mediating role of family functioning in the relationship between family adversity and preschoolers' social adjustment]

Preschoolers' social adaptation is related to their degree of exposure to environnemental risks. However, the mechanisms through which the environmental risks operate their influence on social adaptation are still poorly documented. Thus, the first goal of this study is to investigate the main effect of family adversity on preschoolers' behavioral problems and attachment security. The second goal is to test the mediating effect of family functionning in the relationship between family adversity and behavioral problems or attachment security. Five hundred and seventy-two participants (n=572) were assessed on family adversity between the age of 5 and 42 months. Behavioral problems and family functionning were assesed at 42 months. Eighty of the participants were assessed on attachment security at the age of 48 months. The results show a main effect of family adversity on behavioral problems as well as a mediating effect of family functionning in the relationship of family adversity and behavioral problems. No significant effect was found for security of attachment.