Martin Schröder1, Janine Lüdtke2, Elodie Fux2, Yonca Izat3, Margarete Bolten2, Gabriele Gloger-Tippelt4, Gerhard J Suess5, Marc Schmid2. 1. Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland; University of Lüneburg, Faculty of Education, Institute of Social work and Social Education, Universitätsallee 1, 21339, Lüneburg, Germany. Electronic address: Martin.Schroeder@upk.ch. 2. Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland. 3. Vivantes Clinic Friedrichshain, Child and Adolescent Psychiatry Berlin, Child and Adolescent Psychiatry, Psychotherapy, Psychosomatic, Zadekstrasse 53, 12351, Berlin, Germany. 4. Heinrich Heine University Düsseldorf, Universitätsstraße 1, 40225, Düsseldorf, Germany. 5. Hamburg University of Applied Sciences, Faculty Business & Social Sciences, Department Social Work, Alexanderstraße 1, 20099, Hamburg, Germany.
Abstract
INTRODUCTION: Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9. METHODS: A total of 135 children aged between 5 and 9 years (M=7.17 years, SD=1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development. RESULTS: The prevalence of AR in children with AD was 28.6% for the 'secure' form of AR, 17.1% for the 'insecure-avoidant' form, 25.7% for the 'insecure-ambivalent' form, and 28.6% for the 'disorganized' form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills. CONCLUSIONS: Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models.
INTRODUCTION: Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9. METHODS: A total of 135 children aged between 5 and 9 years (M=7.17 years, SD=1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development. RESULTS: The prevalence of AR in children with AD was 28.6% for the 'secure' form of AR, 17.1% for the 'insecure-avoidant' form, 25.7% for the 'insecure-ambivalent' form, and 28.6% for the 'disorganized' form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills. CONCLUSIONS: Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models.
Authors: David Bürgin; Nina Kind; Martin Schröder; Vera Clemens; Jörg M Fegert; Anne Eckert; Anna Buchheim; Aoife O'Donovan; Cyril Boonmann; Marc Schmid Journal: Front Psychiatry Date: 2020-12-21 Impact factor: 4.157
Authors: Astrid R Seim; Thomas Jozefiak; Lars Wichstrøm; Stian Lydersen; Nanna S Kayed Journal: Eur Child Adolesc Psychiatry Date: 2020-11-13 Impact factor: 4.785