Daryn H. David

Attachment and emotion in school-aged children.

One of the primary functions of the attachment behavioral system is to regulate emotional experience under conditions of threat. Although research supports this association among infants and adults, few studies examine the relation between emotion and attachment in middle childhood. This study examined the concurrent associations among childrens attachment organization and three indices of emotion reactivity/regulation: self- and parent-assessments of emotion, neuroendocrine reactivity, and fear-potentiated startle response. Ninety-seven 8- to 12-year-old children completed the Child Attachment Interview (CAI) and a fear-potentiated startle paradigm on separate occasions, with salivary cortisol assessed before and after each assessment. Greater attachment security was related to greater child-reported positive trait- and state-level emotion, lower pre-CAI cortisol levels, higher initial startle magnitude during threat, and a faster decrease in startle magnitude during threat. The findings provide initial support that attachment security is related to select measures of emotion, though different methods of assessment yielded discrepant findings. The findings are discussed in terms of their contribution to theory and research examining attachment and emotion.

Supported Parenting to Meet the Needs and Concerns of Mothers with Severe Mental Illness

Women with serious mental illness (SMI) often parent without adequate support from psychiatric and behavioral health providers. The lack of such services is significant, given that women with SMI have children at the same rate as or higher rates than women without psychiatric disabilities. In this call to action, we argue that the need to develop supported parenting initiatives for women with SMI is necessary and long overdue. First, we describe numerous social and systemic barriers in the United States that have hindered the development of parenting supports for women with SMI over the last century. We next describe recent qualitative and quantitative findings regarding the parenting needs and strengths of these mothers. Finally, we conclude with suggestions for future research, program development, and systems-level policy changes to support mothers with SMI in parenting most effectively.

Exclusion and micro-rejection: event-related potential response predicts mitigated distress.

We studied time-based neural activity with event-related potentials (ERPs) in young adults during a computer-simulated ball-toss game. Experiencing fair play initially, participants were ultimately excluded by other players. Dense-array ERPs showed time-dependent associations between slow-wave activity (580–900 ms) in left prefrontal/medial frontal cortical regions for exclusion events and self-reported distress. More subtle ‘micro-rejections’ during fair play showed a similar distress to ERP association (420–580 ms). In both cases, greater positive amplitude neural activity was associated with less post-exclusion distress. Findings suggest that rapidly occurring neural responses to social exclusion events are linked to individual differences in ostracism-related distress. Relations emerged even during fair play, providing a window into the neural basis of more subtle social-cognitive perceptual processes.

Attachment dismissal predicts frontal slow-wave ERPs during rejection by unfamiliar peers.

Attachment representations are thought to provide a cognitive-affective template, guiding the way individuals interact with unfamiliar social partners. To examine the neural correlates of this process, we sampled event-related potentials (ERPs) during exclusion by unfamiliar peers to differentiate insecure-dismissing from securely attached youth, as indexed by the child attachment interview. Thirteen secure and 10 dismissing 11- to 15-year-olds were ostensibly connected with two peers via the Internet to play a computerized ball-toss game. Actually, peers were computer generated, first distributing the ball evenly, but eventually excluding participants. Afterward children rated their distress. As in previous studies, distress was related to a negative left frontal slow wave (500-900 ms) during rejection, a waveform implicated in negative appraisals and less approach motivation. Though attachment classifications were comparable in frontal ERPs and distress, an attachment-related dismissal dimension predicted a negative left frontal slow wave during rejection, suggesting that high dismissal potentially involves elevated anticipation of rejection. As expected, dismissal and self-reported distress were uncorrelated. Yet, a new approach to quantifying the dissociation between self-reports and rejection-related ERPs revealed that dismissal predicted underreporting of distress relative to ERPs. Our findings imply that evaluations and regulatory strategies linked to attachment generalize to distressing social contexts in early adolescence.

Dismissing Children’s Perceptions of Their Emotional Experience and Parental Care: Preliminary Evidence of Positive Bias

The tendency to perceive caregivers in highly positive terms and to perceive the self as strong and problem-free are two facets of the positive bias characteristic of a dismissing attachment classification in adulthood. However, this link has not yet been examined in children. We evaluated the association between dismissing attachment and positive bias in school-aged children’s reports of their own emotional experience and their parental care, hypothesizing that: (1) compared to secure children, dismissing children would underreport their subjective distress relative to physiological indicators of distress, and (2) dismissing children would report that their parents were warmer/more caring than would secure children. Ninety-seven children between the ages of 8 and 12 completed the Child Attachment Interview, reports of maternal and paternal care, and a psychophysiological threat paradigm. Compared to secure children, dismissing children reported less distress than their startle responses during threat would suggest. In other words, dismissing children showed a greater divergence between subjective and physiological emotional response. Dismissing children rated their parents as warmer and more caring as compared to secure children’s ratings. Results provide support for the association between dismissing attachment and inflated positivity on child-report measures of parental care and emotional experience. Implications of the study’s findings for attachment theory are discussed.

Attachment Theory and Research as a Guide to Psychotherapy Practice

This article evaluates relevant links between theory and research on attachment relationships; cognitive structures including schemas and internal working models; aspects of the client-therapist relationship; and psychotherapeutic intervention models, arguing that attachment theory can be employed to more fully understand psychotherapeutic processes and change. First we review relevant background literature on attachment theory, delineating distinctions between attachment and other relevant theoretical formulations. Then we discuss aspects of the client-therapist relationship which may be affected by attachment, providing a brief overview of extant research on attachment and psychotherapy. Finally, we discuss the ways in which attachment theory has been employed in the design of psychotherapy models, specifically focusing on two treatment models which illustrate diversity in attachment-based treatment. Throughout we argue that the recent addition of reflective function, which is the capacity to understand the ways in which mental states underlie behavior in self and others, both enhances attachment theory and elucidates the connections between psychotherapeutic process and the development of self-regulatory insight during childhood through sensitive parental caregiving.

Safety, Trust, and Treatment: Mental Health Service Delivery for Women Who Are Homeless

Women with serious mental illnesses who are homeless and have histories of substance abuse, poverty, social dislocation, ruptured relationships, and/or experiences of abuse and trauma can encounter barriers to fully engaging in formal treatment and related services. Many local public mental health systems are often ill-equipped to accommodate these womens unique behavioral and physical service needs. This article proposes an innovative approach to providing mental health services that are sensitive to the intersecting identities and associated difficulties these women experience. Based on our evaluation of a federally funded program for homeless women with behavioral and mental health concerns, we highlight four key principles that can optimize and promote the recovery outcomes of these women: (1) peer support, (2) flexible services and resources, (3) supportive program leadership, and (4) gender-sensitive services provided by women. We provide case vignettes highlighting how each of these treatment principles fosters trust and helps to create safe psychological and physical spaces for women clients. We conclude with clinical and programmatic recommendations for implementing these principles in non-traditional behavioral health care settings.