Francesca Lionetti

Attachment in institutionalized children: a review and meta-analysis.

In this article we review the literature on attachment patterns in institutionalized children and then perform a meta-analysis on data from 10 attachment studies involving 399 children in institutional settings. We computed the overall attachment distribution of secure, insecure, and disorganized rates and explored the effect of a set of moderating variables (i.e., country of institutionalization, attachment assessment procedure, age at entry, and age at assessment). To overcome bias related to the small number of studies, we conducted both classical and Bayesian meta-analysis and obtained comparable results. Distribution of childrens attachment patterns was: 18% secure, 28% insecure, and 54% disorganized/cannot classify. Compared to their family-reared peers, children living in an institution were found to be at greater risk for insecure and disorganized attachment, with a similar medium effect size for both distributions (d=0.77 and d=0.76, respectively). The following moderating variables were associated with insecure attachment: representational assessment procedures (d=0.63) and Eastern European countries of origin (d=1.13). Moderators for disorganized attachment were: Eastern European countries of origin (d=1.12), age at institution entry before the first birthday (d=0.93), and age at assessment under three years of age (d=0.91). Implications for child development and policies are discussed.

Attachment and social competence: a study using MCAST in low-risk Italian preschoolers.

The Manchester Child Attachment Story Task (MCAST) is a story stem method suitable for children aged about 4 to 8, aimed at assessing childrens attachment representations with a doll-play format that is evaluated with a series of dimensional scales and classifications. Although this instrument has already been validated in previous studies, not all of the findings have been conclusive. The aims of the present study were (1) to examine the factor structure of the MCAST scales, and (2) to test the association between childrens dichotomized MCAST classifications and factors with social competence, using the Social Competence and Behavior Evaluation Scale (SCBE) with a normative group of Italian preschoolers (age range 4.4 to 6.1). Results obtained from a sample of 64 children confirm the association of MCAST attachment classifications (security vs. insecurity and organization vs. disorganization) with both social skills and behavioral problems. Further independent studies on the variables analyzed are recommended for corroborating the findings obtained.

Parenting Stress: The Roles of Attachment States of Mind and Parenting Alliance in the Context of Adoption

SYNOPSIS Objective. To examine whether parent’s attachment states of mind and parenting alliance contribute to parental stress in the potentially demanding context of adoption. Design. Fifty mother–father pairs (n = 100) completed the Adult Attachment Interview within six months of adoption to investigate attachment states of mind. The Parenting Stress Index-Short Form (PSI/SF) and the Parenting Alliance Measure questionnaires were administered two years after adoption to evaluate stress and the parenting alliance. Results. Multivariate regression models showed that unresolved attachment predicted stress to a greater extent than insecure attachment and, together with low parenting alliance, significantly contributed to explaining levels of stress perceived by parents. In mothers, but not in fathers, parenting alliance moderated the effect of an unresolved state of mind on parenting stress. Conclusion. Unresolved attachment states of mind and the parenting alliance singly, and even more so jointly, influence stress experienced by parents. Understanding of the family’s adjustment to adoption may benefit from an in-depth analysis of the role of individual and dyadic variables involved in childrearing.

What promotes secure attachment in early adoption? The protective roles of infants' temperament and adoptive parents' attachment.

Life before adoption is characterized by the lack of sensitive and stable caregiving, putting infants at risk for non-secure attachment patterns. What leads to adoptees’ attachment security in their adoptive families has not been conclusively determined. We investigated the roles of children’s temperament and adoptive parents’ attachment on adoptees’ attachment security. The variables were studied in a sample of 30 early-placed adoptees (age at adoption placement M = 5.37 months, SD = 4.43) and their adoptive mothers and fathers. Attachment patterns were investigated by means of the Strange Situation Procedure and the Adult Attachment Interview, and temperament via the Infant Behavior Questionnaire. Results showed that mothers’ secure attachment, but not fathers’ attachment or adoptees’ temperament, increased the chance of secure attachment in adoptees. Temperament moderated the mother–child attachment match.

Environmental Sensitivity in Children: Development of the Highly Sensitive Child Scale and Identification of Sensitivity Groups.

A large number of studies document that children differ in the degree they are shaped by their developmental context with some being more sensitive to environmental influences than others. Multiple theories suggest that Environmental Sensitivity is a common trait predicting the response to negative as well as positive exposures. However, most research to date has relied on more or less proximal markers of Environmental Sensitivity. In this paper we introduce a new questionnaire—the Highly Sensitive Child (HSC) scale—as a promising self-report measure of Environmental Sensitivity. After describing the development of the short 12-item HSC scale for children and adolescents, we report on the psychometric properties of the scale, including confirmatory factor analysis and test–retest reliability. After considering bivariate and multivariate associations with well-established temperament and personality traits, we apply Latent Class Analysis to test for the existence of hypothesized sensitivity groups. Analyses are conducted across 5 studies featuring 4 different U.K.-based samples ranging in age from 8–19 years and with a total sample size of N = 3,581. Results suggest the 12-item HSC scale is a psychometrically robust measure that performs well in both children and adolescents. Besides being relatively independent from other common traits, the Latent Class Analysis suggests that there are 3 distinct groups with different levels of Environmental Sensitivity—low (approx. 25–35%), medium (approx. 41–47%), and high (20–35%). Finally, we provide exploratory cut-off scores for the categorization of children into these different groups which may be useful for both researchers and practitioners.

Maternal-fetal attachment and its correlates in a sample of Italian women: a study using the Prenatal Attachment Inventory

Background: Maternal–fetal attachment (MFA) is considered to be related to the quality of subsequent maternal care of the infant and maternal health behaviour during pregnancy. Objective: The aims of the present study were to investigate the internal structure of a questionnaire used for assessing MFA, the Prenatal Attachment Inventory (PAI), and to address the role of gestational age, couple adjustment and depressive symptomatology on MFA, on a sample of women from suburban areas. Method: A cross-sectional study using self-report questionnaires was conducted to address these two aims on 130 women attending prenatal care services. Results: A five-factor solution emerged for the PAI questionnaire. MFA levels were comparable to those found in previous studies using PAI, whereas depressive symptoms were higher than those reported in previous studies with normative pregnant women. Couple adjustment and gestational age significantly increased MFA. Among the MFA dimensions, Affect and Interaction were mainly affected by gestational age; Maternal–fetal differentiation was associated with gestational age and couple adjustment. Depressive symptoms were associated with an increase in Fantasy and Sensitivity factor scores. Conclusion: Prenatal attachment increased as gestational age advanced and as mothers perceived greater levels of couple adjustment, which promoted MFA strength, positive affect and MFA interaction and differentiation. The internal structure of PAI and its association with specific correlates are discussed.

Mothers who murdered their child: an attachment-based study on filicide

The current study examined whether attachment theory could contribute to identifying risk factors involved in filicide. Participants were 121 women: mothers from the normative population (NPM, n=61), mothers with mental illness (MIM, n=37), and filicidal mothers, i.e., mothers who had murdered their child (FM, n=23). Descriptive variables were collected and the Adult Attachment Interview was used to assess mental representations of attachment relationships using the traditional coding system and the Hostile/Helpless (HH) attachment state of mind coding. Unresolved, Insecure, Entangled, and Helpless representations of attachment relationships were overrepresented in the FM group. When a constellation of descriptive and attachment-based risk factors was taken into account, the HH attachment state of mind was found to contribute significantly to distinguishing between MIM and FM groups. As predicted, when the Bayesian Information Criterion was applied to multinomial regression models, descriptive variables were shown to be less able alone than in association with attachment-based classifications to disentangle the increased risk for committing filicide.

Evidence of factorial validity of parental knowledge, control and solicitation, and adolescent disclosure scales : When the ordered nature of Likert scales matters

For evaluating monitoring and parent-adolescent communication, a set of scales addressing parental knowledge, control and solicitation, and adolescent disclosure was proposed by Kerr and Stattin (2000). Although these scales have been widely disseminated, their psychometric proprieties have often been found to be unsatisfactory, raising questions about their validity. The current study examines whether their poor psychometric properties, which are mainly attributed to the relatively poor conceptual quality of the items, could have been caused by the use of less-than-optimal analytical estimation methods. A cross-validation approach is used on a sample of 1071 adolescents. Maximum likelihood (ML) is compared with the diagonal weighted least squares (DWLS) method, which is suitable for Likert scales. The results of the DWLS approach lead to a more optimal fit than that obtained using ML estimation. The DWLS methodology may represent a useful option for researchers using these scales because it corrects for their unreliability.

A matter of attachment? How adoptive parents foster post-institutionalized children’s social and emotional adjustment

ABSTRACT The current study investigates the contribution of children’s age at adoption (M = 46.52 months, SD = 11.52 months) and parents’ attachment on post-institutionalized children’s attachment and social–emotional adjustment. A total of 132 subjects, 48 post-institutionalized children aged 3–5 years, and their adoptive parents, took part in the study. One year from adoption, children’s attachment distribution was as follows: 31% secure, 42% disorganized, and 27% insecure. Parents’ secure attachment increased children’s probability of presenting a secure attachment pattern; specifically, mothers’ attachment patterns were most strongly associated with those of their adopted children, with fathers’ making an additional contribution. Two years from adoption, secure children showed more adequate social competences than their insecure and disorganized peers and presented better emotional comprehension. The effect of age at adoption was delimited to a marginal association with behavioral problems. This pattern of associations suggests that attachment – both of adoptive parents and of children – substantially fosters social–emotional adjustment of post-institutionalized children who have experienced a period in emotionally neglecting environments beyond their first year of life, regardless of their age at adoption. Implications for policies and practices are discussed.

Vantage Sensitivity: A Framework for Individual Differences in Response to Psychological Intervention

PurposePeople differ significantly in their response to psychological intervention, with some benefitting more from treatment than others. According to the recently proposed theoretical framework of vantage sensitivity, some of this variability may be due to individual differences in environmental sensitivity, the inherent ability to register, and process external stimuli. In this paper, we apply the vantage sensitivity framework to the field of psychiatry and clinical psychology, proposing that some people are more responsive to the positive effects of psychological intervention due to heightened sensitivity.MethodsAfter presenting theoretical frameworks related to environmental sensitivity, we review a selection of recent studies reporting individual differences in the positive response to psychological intervention.ResultsA growing number of studies report that some people benefit more from psychological intervention than others as a function of genetic, physiological, and psychological characteristics. These studies support the vantage sensitivity proposition that treatment response is influenced by factors associated with heightened sensitivity to environmental influences. More recently, studies have also shown that sensitivity can be measured with a short questionnaire which appears to predict the response to psychological intervention.ConclusionsVantage sensitivity is a framework with significant relevance for our understanding of widely observed heterogeneity in treatment response. It suggests that variability in response to treatment is partly influenced by people’s differing capacity for environmental sensitivity, which can be measured with a short questionnaire. Application of the vantage sensitivity framework to psychiatry and clinical psychology may improve our knowledge regarding when, how, and for whom interventions work.