C. Schuengel

Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae

During the past 10 years nearly 80 studies on disorganized attachment involving more than 6,000 infant-parent dyads have been carried out. The current series of meta-analyses have established the reliability and discriminant validity of disorganized infant attachment. Although disorganized attachment behavior is necessarily difficult to observe and often subtle, many researchers have managed to become reliable coders. Furthermore, disorganized attachment shows modest short- and long-term stability, in particular in middle class environments, and it is not just a concomitant of constitutional, temperamental, or physical child problems. The predictive validity of disorganized attachment is established in terms of problematic stress management, the elevated risk of externalizing problem behavior, and even the tendency of disorganized infants to show dissociative behavior later in life. In normal, middle class families, about 15% of the infants develop disorganized attachment behavior. In other social contexts and in clinical groups this percentage may become twice or even three times higher (e.g., in the case of maltreatment). Although the importance of disorganized attachment for developmental psychopathology is evident, the search for the mechanisms leading to disorganization has just started. Frightening parental behavior may play an important role but it does not seem to be the only causal factor involved in the emergence of disorganized attachment.

THE MEASUREMENT OF DISSOCIATION IN NORMAL AND CLINICAL POPULATIONS: META-ANALYTIC VALIDATION OF THE DISSOCIATIVE EXPERIENCES SCALE (DES)

The Dissociative Experiences Scale (DES) hos now been used in over 100 studies on dissociation. This article reports on a series of meta-analyses to test some of the theoretical assumptions underlying the DES and to examine the instruments reliability and validity. Studies wilh the DES were identised through Psychlit, Medline, Social Sciences Citation Index, and Current Contents. Across sludies in similar domains (e.g., studies on multiple personality disorders) combined effect sizes were computed using the Rosenthal-Mullen approach. The DES showed excellent convergent validity wilh other dissociative experiences questionnaires and inter- view schedules (combined effect size: d = 1.82; N = 5,916). The DES also showed impressive pre- dictive validity, in particular concerning dissociative disorders (Multiple Personality Disorder: combined effect size d = 1.05; N = l, 705) and traumatic experiences (post-traumatic stress dis- order: combined effect size d = 0.75; N = 1,099; and abuse: combined effect size d = 0.52; N = 2,108). However, the discriminant validity was less well established. The DES is sensitive to response and experimenter biases. It is recommended to average DES-scores over more points in time and over morejudges. The DES seems to measure the current view on past dissociative expe- riences. The model of dissociation as a form of autohypnosis failed to receive support from the data. A developmental model to Interpret dissociation is proposed.

Frightening Maternal Behavior Linking Unresolved Loss and Disorganized Infant Attachment

Main and Hesses (1990) model in which frightening (threatening, frightened, or dissociated) parental behavior explains why infants of parents with unresolved loss develop disorganized attachment relationships was tested. Unresolved loss using the Adult Attachment Interview in a nonclinical middle-class sample of 85 mothers who had experienced the loss of someone important was assessed. Disorganized attachment was examined in the Strange Situation. Parental behavior was recorded during 22-hr home visits. The model applied to mothers with currently insecure attachment representations. Secure mothers with unresolved loss displayed less frightening behavior than other mothers, and unresolved loss in secure mothers did not predict disorganized attachment of their infants. Frightening behavior predicted infant disorganized attachment irrespective of maternal security.

Bullying and victimization among school-age children: Stability and links to proactive and reactive aggression

The main aim of the study relates to the links between bullying and victimization on the one hand and reactive and proactive aggression on the other. In addition, we also investigated stability and incidence of bullying and victimization. At age 7, 236 children were rated on bullying and victimization using peer reports. At age 8, 242 children were rated again. Two hundred and fifteen children (114 girls and 101 boys) were present at both time points. Reactive and proactive aggression was assessed by teachers. The results showed that bullies and bully/victims were both reactively and proactively aggressive, while victims were only reactively aggressive. A moderate degree of stability of bullying and victimization was found, with bullying being more stable than victimization. Boys were more often bullies than girls and more stable than girls in victimization. Stable victims and stable bully/victims were more reactively aggressive than their unstable counterparts. The relevance of the outcomes to preventing future maladjustment and suggestions for further research are discussed.

Activities and participation of 9- to 13-year-old children with cerebral palsy

Objective: To describe the activities and participation of children with cerebral palsy and to examine the relationship with personal factors and disease characteristics. Design: Cross-sectional study. Setting: Department of Rehabilitation Medicine of a University Medical Center in The Netherlands. Subjects: One hundred and ten children: 70 boys, 40 girls, mean (SD) age 11 years and 3 months (20 months). Outcome measures: Activities and participation, described in the domains of mobility, self-care, domestic life, social life and communication, measured with the Gross Motor Function Measure, the Pediatric Evaluation of Disability Inventory and the Vineland Adaptive Behavior Scales. Results: Multiple linear regression models showed that the Gross Motor Function Classification System (GMFCS) was strongly associated with mobility (explained variance 87-92%), self-care and domestic life. Apart from the GMFCS, cognitive impairment and limb distribution were less important but also significantly associated with self-care and domestic life (explained variance 65-81%). Cognitive impairment and epilepsy were the most important factors associated with social life and communication (explained variance 54-75%). Conclusion: Activities and participation can, to a large extent, be explained by only a few associated factors.

The Contribution of Organized Youth Sport to Antisocial and Prosocial Behavior in Adolescent Athletes

In this study, we investigated the contribution of organized youth sport to antisocial and prosocial behavior in adolescent athletes. The sample consisted of N=260 male and female soccer players and competitive swimmers, 12 to 18 years of age. Multilevel regression analysis revealed that 8% of the variance in antisocial behavior and 7% of the variance in prosocial behavior could be attributed to characteristics of the sporting environment. Results suggested that coaches who maintain good relationships with their athletes reduce antisocial behavior, and that exposure to relatively high levels of sociomoral reasoning within the immediate context of sporting activities promotes prosocial behavior. These results point to specific aspects of adolescents’ participation in sport that can be used to realize the educational potential of organized youth sport.

In Search of Shared and Nonshared Environmental Factors in Security of Attachment: A Behavior-Genetic Study of the Association between Sensitivity and Attachment Security.

The current article presents results from a twin study of genetic and environmental components of maternal sensitivity and infant attachment and their association. The sample consisted of 136 twin pairs from 2 sites: Leiden, the Netherlands, and London, UK. Maternal sensitivity was assessed in the home at 9-10 months, and infant attachment security was observed in the laboratory at 12 months. The study yielded little evidence that genetic factors are involved in variations between twins in maternal sensitivity ratings but did find that shared variance in maternal sensitivity was able to account for some of the similarity between twins in attachment security. Weak nonshared associations between sensitivity and attachment appeared to suppress the magnitude of the correlation between attachment and sensitivity in twin children. The results could indicate that the attachment security of one twin may depend on the relationship the parent has with the other twin. The results are brought to bear on the validity of attachment theory as a theory of primarily shared environmental effects in childrens development and the continuing challenge posed to attachment theory by within-family differences in socioemotional processes.

Autonomic reactivity in relation to attachment and early adversity among foster children

This study examined whether the quality of relationships with foster caregivers was associated with autonomic nervous system reactivity of children during separation and reunion with their foster caregiver. Moreover, effects of early adversity were examined in relation to attachment and autonomic nervous system reactivity. The sample included 60 children between 26 and 88 months of age, who participated with their primary foster caregivers in the Strange Situation. Respiratory sinus arrhythmia and preejection period were measured as indicators of parasympathetic and sympathetic nervous system reactivity, respectively. Attachment quality (ordered/disordered and secure/insecure attachment), was coded on the basis of childrens behavior in the Strange Situation using the Cassidy and Marvin coding system. Children with a background of neglect and those with disordered (disorganized-controlling or insecure-other) attachment showed most sympathetic reactivity during the procedure. Moreover, children with disordered attachment showed less vagal regulation (respiratory sinus arrhythmia decreases on separation and increases on reunion) than children with ordered attachment. The findings show that the quality of relationships with current caregivers, and to a lesser extent specific experiences of neglect, may have an impact on childrens abilities to regulate emotions in the context of environmental stress and challenges.

Parents' reactions to the diagnosis of cerebral palsy: associations between resolution, age and severity of disability

BACKGROUND For parents, receiving a diagnosis, typically in early childhood, that their child has cerebral palsy may conjure up high distress and anxiety. Resolution of these initial reactions may help parents to focus on the challenges and needs of their children. AIMS of the study were to test whether parents of older children displayed resolution more often than parents of younger children, and whether parents of children with less severe cerebral palsy also showed more resolution. METHOD Resolution of reactions to diagnosis was assessed with the Reaction to Diagnosis Interview, in a clinic-based sample of 255 parents of children with cerebral palsy aged between 1.4 and 17.3 years. Physicians rated motor ability using the Gross Motor Function Classification System. RESULTS Overall, the responses of 81.6% of the parents were predominantly indicative of resolution. Unresolved reactions were significantly more often found among parents of younger children and parents of children with more severe motor disabilities. Among parents of teenage children, resolution was more often apparent from a focus on action to better the lives of their children, whereas in parents of younger children, it was more apparent from their focus on constructive thoughts and information seeking. CONCLUSIONS Given time, the large majority of parents may resolve their reactions to the diagnosis that their child has cerebral palsy. Parents of the most severely affected children may need specific support which, given the age trends, might be aimed at different resolution processes for parents of younger and older children.

Social Functioning and Communication in Children with Cerebral Palsy: Association with Disease Characteristics and Personal and Environmental Factors.

Aim  The objective of this longitudinal study was to describe the course of social functioning and communication in children with cerebral palsy (CP) over a 3‐year period, its difference with the normative course, and its relationship with disease characteristics and personal and environmental factors.