Erik Hesse

Disorganized Infant, Child, and Adult Attachment: Collapse in Behavioral and Attentional Strategies:

This presentation focuses on the disorganized/disoriented (Group D) categories of infant, child, and adult attachment. The infant D category is assigned on the basis of interruptions and anomalies in organization and orientation observed during Ainsworths strange situation procedure. In neurologically normal low-risk samples, D attachment is not substantially related to descriptions of infant temperament, and usually appears with respect to only one parent. At six, former D infants are often found to be role-inverting (D-Controlling) towards the parent, while drawings and separation-related narratives (D-Fearful) suggest continuing states of fear and disorganization. In adults, marked lapses in reasoning and discourse surrounding the discussion of loss or abuse during the Adult Attachment Interview (AAI) causes a transcript to be assigned to Unresolved/disorganized (U/d) adult attachment status, which predicts infant D attachment. Bowlbys theory is extended, with the proposal that certain forms of frightening parental behavior will arouse contradictory biologically channeled propensities to approach and to take flight from the parent. Maltreated infants are therefore highly likely to be disorganized. Also identified are subtler forms of frightening parental behavior (including dissociative behavior and anomalous forms of frightened behavior) that appear to lead to infant disorganization. This suggests that infant D attachment may at times represent a second-generation effect of the parents own continuing unresolved responses to trauma. Infant D attachment predicts disruptive/aggressive and dissociative disorders in childhood and adolescence, while U/d adult attachment appears frequently in psychiatric and criminal populations. Clinical implications are discussed.

Examining the role of parental frightened/frightening subtypes in predicting disorganized attachment within a brief observational procedure

Following Main and Hesses hypothesis, several investigators have affirmed that frightened/frightening (FR) as well as particular atypical maternal behaviors are associated with infant disorganized and adult unresolved attachment. Here, for the first time, FR behavior was observed in (a) middle-class father-infant (n = 25) and independent mother-infant dyads (n = 50) and (b) a brief laboratory play session. In addition, relations between disorganization, unresolved attachment, and the six FR system subscales were explored. Paternal and maternal overall FR behavior was related to infant disorganization (n = 75, phi = .61, p < .001), and for a subsample where Adult Attachment Interviews were available (n = 32), to unresolved adult attachment (phi = .59, p < .001). At the subscale level, disorganized-FR behaviors were related to infant disorganization, but only for mother-infant dyads. Across the whole sample, both dissociative-FR and threatening-FR subscales were associated with infant disorganization. The dissociative-FR subscale emerged as the central predictor of infant disorganization and was the only subscale significantly related to unresolved attachment. The appearance of FR behavior in this 18-min play procedure suggests that FR probably occurs more frequently than previously suspected. The possible role of dissociative processes in unresolved adult attachment, disorganized attachment, and FR parental behavior is discussed.

Disorganized attachment in infancy: a review of the phenomenon and its implications for clinicians and policy-makers.

ABSTRACT Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static “trait” of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.

Prior participation in the strange situation and overstress jointly facilitate disorganized behaviours: implications for theory, research and practice

ABSTRACT We seek to understand why a relatively high percentage (39%; vs the meta-analytic average, 15–18%) of disorganized/disoriented (D) classifications has accrued in the low-risk Uppsala Longitudinal Study (ULS) study, using experienced D coders. Prior research indicates that D behaviours do not always indicate attachment disorganization stemming from a history of frightening caregiving. We examined the role of two other presumed factors: participation in a previous strange situation and overstress. Our findings indicate that both factors were highly prevalent in the ULS sample and that they jointly predicted higher rates of D. First, participation in a previous strange situation was associated with significantly higher distress displays during the second visit than occurred among previously untested children, suggesting that prior participation in the strange situation had a sensitizing effect on child distress during the second visit. Second, unless separations were cut short in lieu of high distress during the second visit, re-tested children were disproportionately likely (ca 60%) to be classified D. We argue that these findings have important implications for theory, research, and practice. In particular, we conclude that practitioners must refrain from misattributing the appearance of any D behaviors observed to a history of maltreatment.

Unresolved loss, a risk factor for offspring, predicts event-related potential responses to death-related imagery.

This study investigates whether individual differences in attachment status can be detected by electrophysiological responses to loss-themed pictures. The Adult Attachment Interview (AAI) was used to identify discourse/reasoning lapses during the discussion of loss experiences via death that place speakers in the Unresolved/disorganized AAI category. In parents, Unresolved AAI status has been associated with Disorganized infant Strange Situation response, a known risk factor for psychopathology (e.g., internalizing/externalizing/dissociation). This association has been related to anomalous frightening (FR) parental behavior in the infant’s presence, behavior presumed to be instigated by vulnerability to trauma-related fright. Here, psychophysiological methods were utilized to examine whether Unresolved AAI status could be detected in brain responses to subtle/symbolic reminders of loss. One year after AAI administration, 31 undergraduate women who had experienced loss (16 Unresolved) underwent continuous electroencephalogram (EEG) recording during a picture-viewing, valence-rating task. Picture onset-locked event-related potentials (ERPs) revealed millisecond responses to 4 picture categories: pleasant people, pleasant nature, cemetery (symbolic death), and gruesome death (dead or dying people). Participants’ valence ratings did not differ between groups across picture categories. However, the N2 ERP, implicated in detecting stimulus salience, was selectively greater in Unresolved participants viewing cemetery scenes; it was in fact as high as the N2 for gruesome death images observed throughout the sample. Additionally, Unresolved participants exhibited a right-hemispheric P3 asymmetry across picture categories, suggestive of continuously heightened vigilance/arousal. Together, these results suggest that Unresolved AAI status is associated with greater neurophysiological sensitivity to subtle reminders of loss that may disrupt ongoing mental function.

Parental loss of family members within two years of offspring birth predicts elevated absorption scores in college

ABSTRACT Liotti proposed that interactions during infancy with a parent suffering unresolved loss could lead to vulnerabilities to altered states of consciousness. Hesse and van IJzendoorn provided initial support for Liotti’s hypothesis, finding elevated scores on Tellegen’s Absorption Scale - a normative form of dissociation - for undergraduates reporting that their parents had experienced the loss of family members within two years of their birth. Here, we replicated the above findings in a large undergraduate sample (N = 927). Additionally, we investigated mother’s and father’s losses separately. Perinatal losses, including miscarriage, were also considered. Participants reporting that the mother or both parents had experienced loss within two years of their birth scored significantly higher on absorption than those reporting only perinatal, only father, or no losses. While not applicable to the assessment of individuals, the brief loss questionnaire utilized here could provide a useful addition to selected large-scale studies.