Henrik Daae Zachrisson

Feelings of insecurity: Review of attachment and eating disorders

OBJECTIVE Attachment theory has received increasing attention from clinicians and researchers in the field of eating disorders. This paper is an updated review on theoretical approaches in the field, and of studies employing the Adult Attachment Interview. METHOD We searched the major databases such as PsycInfo and Science Direct for empirical and theoretical studies on attachment and eating disorders, and these are reviewed. RESULTS Theoretical approaches on attachment and eating disorders highlight either retrospective, general risk or attachment theoretical statements. There is greater prevalence of insecure attachment in the eating disordered population than in non-clinical samples. However, there is no sufficient evidence to conclude about specific mechanisms for this connection. DISCUSSION The theoretical approaches vary in their theoretical grounding, specificity and empirical support. AAI-based research on attachment and eating disorders is still at an early stage. More advanced studies are required for the field to move forward.

Predicting Language Development at Age 18 Months: Data from the Norwegian Mother and Child Cohort Study

Objectives: This study investigated predictors of delayed language development at 18 months of age in a large population cohort of Norwegian toddlers. Methods: Data were analyzed on 42,107 toddlers. Language outcome at age 18 months was measured using a standard parent report instrument, the Ages and Stages Questionnaire, communication scale. Confirmatory factor analysis was conducted on the Ages and Stages Questionnaire items. A theoretically derived set of child, family, and environmental risk factors were used to predict delayed language development at age 18 months using Generalized Estimating Equation. Results: A number of child factors, including being a boy, low birth weight or gestational age, or a multiple birth child were all significantly associated with low scores on the language outcome at age 18 months. Maternal distress/depression and low maternal education, having older siblings, or a non-Norwegian language background also predicted low scores on the language outcome at age 18 months. Overall, estimated variance in language outcome explained by the model was 4% to 7%. Conclusions: A combination of early neurobiological and genetic factors (e.g., male gender, birth weight, and prematurity) and concurrent family variables (e.g., maternal distress/depression) were associated with slower language development at age 18 months. This finding replicated previous research conducted on slightly older language-delayed 2 year olds but also detected the importance of factors related to family resources for the first time in this younger age group. Despite this finding, most of the variability in language performance in this cohort of 18 month olds remained unexplained by the comprehensive set of purported risk factors.

Attachment in anorexia nervosa: An exploration of associations with eating disorder psychopathology and psychiatric symptoms

Previous research on attachment and eating disorder has to a great extent presupposed direct links between states of mind with respect to attachment and eating disorder diagnoses. The authors provide a brief review stating that no such association can be found in current literature. The authors suggest that the association might exist on the level of eating disorder pathology and psychiatric symptoms, rather than diagnostic level. Based on 20 Adult Attachment Interviews coded with the Dynamic-Maturational method from patients diagnosed with anorexia, the authors explore the associations between attachment and diagnostic subgroups, eating disorder psychopathology (Eating Disorder Inventory — 2nd edition), and psychiatric symptoms. All patients were coded within the range of insecure attachment. State of mind with respect to attachment did not differentiate between diagnostic subgroup and eating disorder pathology. Individuals classified as dismissing reported higher levels of anxiety-related distress than those classified as preoccupied or mixed dismissing/preoccupied. A high frequency of unresolved traumas and losses was found. The findings support previous reports of high frequencies of insecure attachment and unresolved traumas in anorexic patients. The high level of anxiety-related stress in the dismissing group lead the author to suggest that attachment plays a role in the patient’s handling of distress following the eating disorder, rather than in the disorder itself.

Time trends in obesity and eating disorders

OBJECTIVE Obesity is a well-known risk factor for eating disorders, and has been increasing in the normal population over the last decades. This study examines whether the increase in obesity is followed by an increase in prevalence of eating disorders in the general female population. METHOD We compared the prevalence of eating disorders and obesity in two nationally representative surveys in Norway in 1991 (n = 1,537) and 2004 (n = 1,467). Eating disorder diagnoses were obtained using the self-report questionnaire survey for eating disorders (SEDs) at both time points. RESULTS The prevalence of overweight and obesity has doubled from 1991 to 2004, whereas the prevalence of eating disorders has been stable. Obesity was strongly associated with eating disorders both in 1991 and 2004. CONCLUSION Despite the strong association between obesity and eating disorders, the increase in obesity is not followed by an increase in eating disorders.

Attention problems and language development in preterm low-birth-weight children: Cross-lagged relations from 18 to 36 months

BackgroundResearch has highlighted a series of persistent deficits in cognitive ability in preterm low-birth-weight children. Language and attention problems are among these deficits, although the nature of the relation between attention and language in early development is not well known. This study represents a preliminary attempt to shed light on the relations between attention problems and language development in preterm low-birth-weight children.MethodsThe aim of this study was to analyse reciprocal influences between language and attention problems from 18 to 36 months. We used maternal reports on attention problems and language ability referring to a sample of 1288 premature low-birth-weight infants, collected as part of the Norwegian Mother and Child Cohort Study (MoBa). A sample of children born full-term was used as the control group (N = 37010). Cross-lagged panel analyses were carried out to study reciprocal influences between attention problems and language.ResultsLanguage ability at 18 months did not significantly predict attention problems at 36 months, adjusting for attention problems at 18 months. Attention problems at 18 months significantly predicted changes in language ability from 18 to 36 months, pointing to a precursor role of attention in relation to language in children born preterm. Gender, age corrected for prematurity, and mothers education emerged as important covariates.ConclusionsPreliminary evidence was found for a precursor role of early attention problems in relation to language in prematurity. This finding can contribute to a better understanding of the developmental pathways of attention and language and lead to better management of unfavourable outcomes associated with co-morbid attention and language difficulties.

Concordance between Hopkins Symptom Checklist (HSCL-10) and Pakistan Anxiety and Depression Questionnaire (PADQ), in a rural self-motivated population in Pakistan.

BackgroundThere have been no previous studies conducted in Pakistan comparing the concordance of any well established Western anxiety/depression screening instrument with an indigenous scale, in a community based setting.MethodsParticipants (n = 1040) in the present study were recruited from the six villages of our interest from the district Gujarat of Pakistan, using a convenient sampling technique. Interview versions of the Hopkins Symptom Checklist 10-item version (HSCL-10) and the Pakistani Anxiety and Depression Questionnaire (PADQ) were used to observe the pattern of anxiety and depression among the participants.ResultsThe internal consistency of HSCL-10 and PADQ were 0.86 and 0.84 respectively. Exploratory factor analysis found evidence for both a one-dimensional (distress) and a two-dimensional (anxiety and depression) solution for the HSCL-10, but only a one-dimensional (distress) solution for the PADQ. The HSCL-10 and PADQ found to be moderately to highly correlated (r = 0.62, p < 0.0001, 0.73 after correction for attenuation).ConclusionHSCL-10 has shown good screening abilities in a rural setting in Pakistan, and moderate to good concordance with an indigenous instrument measuring psychological distress. The HSCL-10 can therefore be used as a screening instrument, both in clinical and epidemiological settings in Pakistan, and for Pakistani immigrants living in Western societies.

Normative development of physical aggression from 8 to 26 months.

This study investigated the normative use and developmental course of physical aggression (PA), defined as use of physical force such as hitting, biting, and kicking, from 8 to 26 months and predictors thereof. We used data from the Behavior Outlook Norwegian Developmental Study, comprising 1,159 children (559 girls and 600 boys). Both mothers and fathers reported frequently about their childs use of PA in personal and telephone interviews. Mean number of reports per child was 7.16 (SD 1.70), with 90% having at least 6 reports. We employed Rasch scaling to construct a single linear PA measure and multilevel growth curve modeling to address the research questions. The results confirm that the development of PA is nonlinear, with a peak in frequency at about 20-22 months, which is followed by a decline toward 26 months. There is both within- and between-child variance in the development of PA. Higher levels of PA were predicted by the presence of a same-age sibling, maternal and paternal mental distress, and difficult child temperament (high activity level and distress due to limitations), whereas the main effect of gender was only trend-significant. Growth of PA across this developmental period was predicted by the presence of a same-age sibling and high activity level. The results both support and transcend previous research within this field.

Family Income Dynamics, Early Childhood Education and Care, and Early Child Behavior Problems in Norway.

The sociopolitical context of Norway includes low poverty rates and universal access to subsidized and regulated Early Childhood Education and Care (ECEC). In this context, the association between family income dynamics and changes in early child behavior problems was investigated, as well as whether high-quality ECEC buffers children from the effects of income dynamics. In a population-based sample (N = 75,296), within-family changes in income-to-needs predicted changes in externalizing and internalizing problems (from ages 18 to 36 months), particularly for lower income children. For internalizing problems, ECEC buffered the effect of income-to-needs changes. These findings lend further support to the potential benefits of ECEC for children from lower income families.

Does universally accessible child care protect children from late talking? Results from a Norwegian population-based prospective study

This study examines the association between type of child care arrangement at age 1, 1.5 and 3 years and late talking (LT). The data were from 19,919 children in the population-based prospective Norwegian Mother and Child Cohort Study (MoBa) and included information about child care arrangement, LT and a variety of covariates. Attendance at universally accessible child care at 1.5 and 3 years of age was related to a reduced risk for LT, even after controlling for covariates, including early social communication skills before entering child care. However, type of child care at one year of age did not predict LT. Children attending centre care full-time at age three years showed less LT than children attending centre care part-time, whereas no such relationship was found for children at age 1.5 years or for children attending family day care. The results indicate that high-quality universal child care protects children from LT.

Maternal perinatal and concurrent depressive symptoms and child behavior problems: a sibling comparison study

Background Previous studies have found significant associations between maternal prenatal and postpartum depression and child behavior problems (CBP). The present study investigates whether associations remain in a prospective, longitudinal design adjusted for familial confounding. Methods The sample comprised 11,599 families including 17,830 siblings from the Norwegian Mother and Child Cohort study. Mothers reported depressive symptoms at gestational weeks 17 and 30, as well as 6 months, 1.5, 3, and 5 years postpartum. Fathers’ depression was measured at gestational week 17. At the last three time‐points, child internalizing and externalizing problems were concurrently assessed. We performed multilevel analyses for internalizing and externalizing problems separately, using parental depression as predictors. Analyses were repeated using a sibling comparison design to adjust for familial confounding. Results All parental depressive time‐points were significantly and positively associated with child internalizing and externalizing problems. After sibling comparison, however, only concurrent maternal depression was significantly associated with internalizing [estimate = 2.82 (1.91–3.73, 95% CI)] and externalizing problems [estimate = 2.40 (1.56–3.23, 95% CI)]. The effect of concurrent maternal depression on internalizing problems increased with child age. Conclusions Our findings do not support the notion that perinatal maternal depression is particularly detrimental to childrens psychological development, as the most robust effects were found for maternal depression occurring during preschool years.