M. Oosterman

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.

Attachment in foster children associated with caregivers' sensitivity and behavioral problems

This study focused on attachment of foster children by examining factors associated with attachment relationships of children raised from birth by the same parents. The sample included 61 children between 26 to 88 months of age and their foster caregivers. Attachment security and caregiver sensitivity were coded on the basis of, respectively, a home-observation (Attachment Q-Set) and a laboratory procedure (Three boxes). Other measures included caregiver reports of child externalizing and internalizing behavior problems and symptoms of attachment disorder, including inhibited and disinhibited attachment as well as secure base distortions. For a subsample of children, teacher ratings of behavior problems also were available. Foster parent sensitivity was positively associated with attachment security, but only if symptoms of disordered attachment were partialled out. Symptoms of inhibited and disinhibited attachment as well as secure base distortions were positively related to parent reports of externalizing and internalizing behavior problems whereas attachment security was negatively related to teacher reports of externalizing behavior problems. Attachment theoretical tenets appeared valid with foster parent-child relationships, except for children with symptoms of attachment disorder.

Children's physical health complaints after exposure to intimate partner violence

OBJECTIVES A clear association between exposure to intimate partner violence (IPV) and childrens physical health is still not well determined, because adverse effects might be explained by the confounding detrimental effects of other traumatic experiences. This study investigated whether children exposed to IPV have higher risks for physical health complaints compared to children in a general population sample. Second, health complaint differences were explored between IPV witnesses and those who in addition experienced other forms of abuse or neglect. DESIGN Risk estimates for 21 everyday physical health complaints were made for children exposed to IPV compared to a general population sample using odds ratios. METHODS Primary caregivers of 275 child witnesses of IPV (6-12 years of age) referred to several specialized mental health or child welfare institutes throughout the Netherlands (2004-2009) reported on childrens somatic complaints using 21 items of the Child Behaviour Checklist (CBCL; Achenbach & Rescorla, 2001) reflecting sleeping, eating, pain complaints, and self-harm. RESULTS Compared to a population sample (n= 903), child witnesses more often experienced health complaints, in particular, more eating, sleeping, and pain problems and more self-harm. Few differences in health complaints were found between child witnesses with and without additional adverse experiences of maltreatment. CONCLUSIONS The degree of physical health complaints in children exposed to IPV is considerable, whether or not they were also victims of other forms of abuse. Early attention to everyday health complaints in children exposed to IPV might prevent more serious health problems in adolescence and adulthood.

Disturbances in attachment: inhibited and disinhibited symptoms in foster children

BackgroundPrevious DSM-versions recognized an inhibited and a disinhibited subtype of the Reactive Attachment Disorder (RAD). The current DSM-5 distinguishes two different disorders, instead of two subtypes of RAD. This study examined whether a split-up of the subtypes is valid.MethodIn 126 foster children, attachment disorder symptoms were assessed with the Disturbances of Attachment Interview. Forms of pathogenic care were identified based on dossier analyses. Associations between symptoms of attachment disorder with internalizing and externalizing problems (Child Behavior Checklist and Teacher Report Form) were examined.ResultsOmnibus tests showed no significant association between type of symptoms and type of pathogenic care. Exploratory analyses did reveal an univariate association between disinhibited symptoms and history of physical abuse. Disinhibited symptoms were associated with more internalizing and externalizing problems (d’s < 0.50).ConclusionThe distinction of inhibited and disinhibited subtypes of RAD seems valid regarding their emotional and behavioral correlations. Whereas inhibited symptoms lack a correlation, disinhibited symptoms seem to have an externalizing and internalizing correlation.Trial registrationNTR1747

Children with disrupted attachment histories: Interventions and psychophysiological indices of effects

Diagnosis and treatment of children affected by disruptions of attachment (out of home placement, multiple changes of primary caregiver) is an area of considerable controversy. The possible contribution of psychobiological theories is discussed in three parts. The first part relates the attachment theoretical perspective to major psychobiological theories on the developmental associations of parent-child relationships and emotional response. The second part reviews studies of autonomic reactivity and HPA-axis activity with foster children, showing that foster children show more reactivity within physiological systems facilitating fight or flight behaviours rather than social engagement, especially foster children with atypical attachment behaviour. The third part is focused on treatment of children suffering from the consequences of disrupted attachment, based on a psychotherapy study with psychophysiological outcome measures. Implications are discussed for theory, diagnosis, and intervention.

The interrelationship between pregnancy-specific anxiety and general anxiety across pregnancy: a longitudinal study

Abstract Background: High levels of prenatal maternal anxiety – either pregnancy-specific anxiety or general anxiety – may have detrimental effects on both the mother and her child. It is currently unknown how these two different expressions of anxiety influence each other over time during pregnancy. Aims: This study aimed to describe the relationship between state, trait and pregnancy-specific anxiety levels across pregnancy. Methods: Longitudinal data from three data-waves of a large-scaled sample of nulliparous normal risk pregnant women were used to display associations over time by means of autoregressive and cross-lagged panel models. Results: Cross-lagged, cross-time pathways from pregnancy-specific anxiety to state as well as trait anxiety were positively significant, while vice versa the most consistent links were found from trait anxiety to pregnancy-specific anxiety. Conclusions: We conclude that pregnancy-specific anxiety and general anxiety appear to influence each other over time, resulting in heightened anxiety for some soon-to-be mothers.

Temperament, disordered attachment, and parental sensitivity in foster care: differential findings on attachment security for shy children

In a foster care sample, the moderating effect of temperamental shyness on the association between parental sensitivity and attachment quality was tested. The foster parents of 59 foster children (age M = 57 months, SD = 16.4) filled out the Child Behavior Questionnaire. To control for confounds, symptoms of inhibited and disinhibited disordered attachment were derived from the Disturbances of Attachment Interview. The Strange Situation Procedure as well as a 15 minute parent–child interaction task were administered. Analyses indicated an interaction effect between parental perceptions of shyness and parental sensitivity for attachment quality. Shy children who had more sensitive foster parents were more often securely attached. For less shy children, no differences in attachment security were found in relation to the foster parents’ sensitivity. These results are partially consistent with the differential susceptibility hypothesis. Shy children may benefit more from more sensitive foster parents when entering foster care.

PRENATAL CHANGES IN PARENTING SELF-EFFICACY: LINKAGES WITH ANXIETY AND DEPRESSIVE SYMPTOMS IN PRIMIPAROUS WOMEN

The aim of the study was to examine parenting self-efficacy in relation to depressive and anxiety symptoms during pregnancy. Five hundred thirty-three first-time pregnant women completed questionnaires at 12, 22, and 32 weeks of pregnancy that measure parenting self-efficacy, anxiety, and depressive symptoms. Parenting self-efficacy increased slightly but significantly over the course of pregnancy. Higher levels of depressive symptoms as well as state and trait anxiety symptoms were related to lower expectations of parenting self-efficacy at all time points, but only anxiety symptoms uniquely predicted parenting self-efficacy. Higher levels of anxiety symptoms in the first trimester predicted less positive change in parenting self-efficacy over the course of pregnancy, but depressive symptoms did not when anxiety levels were taken into account. The findings highlight the role of antenatal anxiety symptoms as a predictor of suboptimal preparation for the parenting role in first-time-expecting mothers. Possible explanations and implications for clinical practice are briefly discussed.

Changes in Parenting Self-Efficacy and Mood Symptoms in the Transition to Parenthood: A Bidirectional Association

SYNOPSIS Objective. Anxiety and depressive symptoms are assumed to relate to parenting self-efficacy in the context of changes and adaptations taking place in the transition to parenthood. The aim of this study was to elucidate the direction of effects. Design. Participants were 822 first-time expectant women who filled out questionnaires on depressive and anxiety symptoms and parenting self-efficacy at 32 weeks of pregnancy and at 3 and 12 months postpartum. Results. From 32 weeks of pregnancy to 3 months postpartum, parenting self-efficacy increased, whereas anxiety and depressive symptoms decreased. Multivariate response models showed that higher prenatal parenting self-efficacy was associated with more decreases in anxiety and depressive symptoms; lower prenatal mood symptoms were associated with more increases in parenting self-efficacy to 3 months postpartum. Higher postpartum parenting self-efficacy at 3 months predicted less increase in trait anxiety from 3 to 12 months postpartum. Conclusions. Parenting self-efficacy appears to be a result of mental health and a predictor for the course of mental health in first-time mothers. These results highlight the importance of focusing on both factors for intervention and prevention efforts.

Verbal persuasion and resilience of parenting self-efficacy: Preliminary findings of an experimental approach

Verbal persuasion may be the least preferable way to enhance parenting self-efficacy as it may undermine resilience against failures inevitable in parenting. To test this, 55 parents participated in two tasks. First, a cry interpretation task led a random half of the participants to believe they mastered this skill and would do well on the subsequent task, while the other half was told their skill was low. In the second task parents chose appropriate responses to stop infant crying which exposed them to randomly assigned success rates (20%, 40%, 50%, or 80%). Parenting self-efficacy was rated before and after the second task. Results showed that positive persuasion led to higher parenting self-efficacy than negative persuasion. Crucially, parents who received positive persuasion were vulnerable to decreases in self-efficacy due to failure. These findings are a preliminary suggestion that verbal persuasion may heighten parenting self-efficacy in the short-term, but undermine its long-term resilience.