Marian J. Bakermans-Kranenburg

Threat-Related Attentional Bias in Anxious and Nonanxious Individuals: A Meta-Analytic Study

This meta-analysis of 172 studies (N = 2,263 anxious,N = 1,768 nonanxious) examined the boundary conditions of threat-related attentional biases in anxiety. Overall, the results show that the bias is reliably demonstrated with different experimental paradigms and under a variety of experimental conditions, but that it is only an effect size of d = 0.45. Although processes requiring conscious perception of threat contribute to the bias, a significant bias is also observed with stimuli outside awareness. The bias is of comparable magnitude across different types of anxious populations (individuals with different clinical disorders, high-anxious nonclinical individuals, anxious children and adults) and is not observed in nonanxious individuals. Empirical and clinical implications as well as future directions for research are discussed.

Less Is More: Meta-Analyses of Sensitivity and Attachment Interventions in Early Childhood

Is early preventive intervention effective in enhancing parental sensitivity and infant attachment security, and if so, what type of intervention is most successful? Seventy studies were traced, producing 88 intervention effects on sensitivity (n = 7,636) and/or attachment (n = 1,503). Randomized interventions appeared rather effective in changing insensitive parenting (d = 0.33) and infant attachment insecurity (d = 0.20). The most effective interventions used a moderate number of sessions and a clear-cut behavioral focus in families with, as well as without, multiple problems. Interventions that were more effective in enhancing parental sensitivity were also more effective in enhancing attachment security, which supports the notion of a causal role of sensitivity in shaping attachment.

For Better and For Worse Differential Susceptibility to Environmental Influences

Evidence that adverse rearing environments exert negative effects particularly on children presumed “vulnerable” for temperamental or genetic reasons may actually reflect something else: heightened susceptibility to the negative effects of risky environments and to the beneficial effects of supportive environments. Building on Belskys (1997, 2005) evolutionary-inspired proposition that some children are more affected—both for better and for worse—by their rearing experiences than are others, we consider recent work on child vulnerability, including that involving measured genes, along with evidence showing that putatively vulnerable children are especially susceptible to both positive and negative rearing effects. We also consider methodological issues and unanswered questions in the differential-susceptibility equation.

Differential susceptibility to the environment: an evolutionary--neurodevelopmental theory.

Two extant evolutionary models, biological sensitivity to context theory (BSCT) and differential susceptibility theory (DST), converge on the hypothesis that some individuals are more susceptible than others to both negative (risk-promoting) and positive (development-enhancing) environmental conditions. These models contrast with the currently dominant perspective on personal vulnerability and environmental risk: diathesis stress/dual risk. We review challenges to this perspective based on emerging theory and data from the evolutionary, developmental, and health sciences. These challenges signify the need for a paradigm shift in conceptualizing Person x Environment interactions in development. In this context we advance an evolutionary--neurodevelopmental theory, based on DST and BSCT, of the role of neurobiological susceptibility to the environment in regulating environmental effects on adaptation, development, and health. We then outline current thinking about neurogenomic and endophenotypic mechanisms that may underpin neurobiological susceptibility, summarize extant empirical research on differential susceptibility, and evaluate the evolutionary bases and implications of BSCT and DST. Finally, we discuss applied issues including methodological and statistical considerations in conducting differential susceptibility research; issues of ecological, cultural, and racial--ethnic variation in neurobiological susceptibility; and implications of differential susceptibility for designing social programs. We conclude that the differential susceptibility paradigm has far-reaching implications for understanding whether and how much child and adult development responds, for better and for worse, to the gamut of species-typical environmental conditions.

A Global Perspective on Child Sexual Abuse: Meta-Analysis of Prevalence Around the World

Our comprehensive meta-analysis combined prevalence figures of childhood sexual abuse (CSA) reported in 217 publications published between 1980 and 2008, including 331 independent samples with a total of 9,911,748 participants. The overall estimated CSA prevalence was 127/1000 in self-report studies and 4/1000 in informant studies. Self-reported CSA was more common among female (180/1000) than among male participants (76/1000). Lowest rates for both girls (113/1000) and boys (41/1000) were found in Asia, and highest rates were found for girls in Australia (215/1000) and for boys in Africa (193/1000). The results of our meta-analysis confirm that CSA is a global problem of considerable extent, but also show that methodological issues drastically influence the self-reported prevalence of CSA.

Attachment Representations in Mothers, Fathers, Adolescents, and Clinical Groups: A Meta-Analytic Search for Normative Data

This meta-analysis on 33 studies, including more than 2,000 Adult Attachment Interview (AAI) classifications, presents distributions of AAI classifications in samples of nonclinical fathers and mothers, in adolescents, in samples from different cultures, and in clinical groups. Fathers, adolescents, and participants from different countries show about the same distribution of AAI classifications as nonclinical mothers do. The distribution of nonclinical mothers is as follows: 24% dismissing, 58% autonomous, and 18% preoccupied mothers. About 19% of the nonclinical mothers are unresolved with respect to loss or trauma of other kinds. Mothers from low socioeconomic status show more often dismissing attachment representations and unresolved loss or trauma. Autonomous women and autonomous men are more often married to each other than can be expected by chance, and the same goes for unresolved men and women. Clinical participants show highly deviating distributions of AAI classifications, with a strong overrepresentation of insecure attachment representations, but systematic relations between clinical diagnosis and type of insecurity are absent.

The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study.

This study addresses the extent to which insecure and disorganized attachments increase risk for externalizing problems using meta-analysis. From 69 samples (N = 5,947), the association between insecurity and externalizing problems was significant, d = 0.31 (95% CI: 0.23, 0.40). Larger effects were found for boys (d = 0.35), clinical samples (d = 0.49), and from observation-based outcome assessments (d = 0.58). Larger effects were found for attachment assessments other than the Strange Situation. Overall, disorganized children appeared at elevated risk (d = 0.34, 95% CI: 0.18, 0.50), with weaker effects for avoidance (d = 0.12, 95% CI: 0.03, 0.21) and resistance (d = 0.11, 95% CI: -0.04, 0.26). The results are discussed in terms of the potential significance of attachment for mental health.

The first 10,000 Adult Attachment Interviews: distributions of adult attachment representations in clinical and non-clinical groups

More than 200 adult attachment representation studies, presenting more than 10,500 Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) classifications, have been conducted in the past 25 years. In a series of analyses on the distributions of the AAI classifications in various cultural and age groups, fathers, and high-risk and clinical samples, we used the distribution of the combined samples of North American non-clinical mothers (23% dismissing, 58% secure, 19% preoccupied attachment representations, and 18% additionally coded for unresolved loss or other trauma) to examine deviations from this normative pattern, through multinomial tests and analyses of correspondence. The analyses were restricted to AAI classifications coded according to the Main, Goldwyn, and Hesse (2003) system. We did not find gender differences in the use of dismissing versus preoccupied attachment strategies, and the AAI distributions were largely independent of language and country of origin. Clinical subjects showed more insecure and unresolved attachment representations than the norm groups. Disorders with an internalizing dimension (e.g., borderline personality disorders) were associated with more preoccupied and unresolved attachments, whereas disorders with an externalizing dimension (e.g., antisocial personality disorders) displayed more dismissing as well as preoccupied attachments. Depressive symptomatology was associated with insecurity but not with unresolved loss or trauma, whereas adults with abuse experiences or PTSD were mostly unresolved. In order to find more reliable associations with clinical symptoms and disorders, future AAI studies may make more fruitful use of continuous AAI scales in addition to the conventionally used categorical classifications.

Oxytocin receptor (OXTR) and serotonin transporter (5-HTT) genes associated with observed parenting

Both oxytocin and serotonin modulate affiliative responses to partners and offspring. Animal studies suggest a crucial role of oxytocin in mammalian parturition and lactation but also in parenting and social interactions with offspring. The serotonergic system may also be important through its influence on mood and the release of oxytocin. We examined the role of serotonin transporter (5-HTT) and oxytocin receptor (OXTR) genes in explaining differences in sensitive parenting in a community sample of 159 Caucasian, middle-class mothers with their 2-year-old toddlers at risk for externalizing behavior problems, taking into account maternal educational level, maternal depression and the quality of the marital relationship. Independent genetic effects of 5-HTTLPR SCL6A4 and OXTR rs53576 on observed maternal sensitivity were found. Controlling for differences in maternal education, depression and marital discord, parents with the possibly less efficient variants of the serotonergic (5-HTT ss) and oxytonergic (AA/AG) system genes showed lower levels of sensitive responsiveness to their toddlers. Two-way and three-way interactions with marital discord or depression were not significant. This first study on the role of both OXTR and 5-HTT genes in human parenting points to molecular genetic differences that may be implicated in the production of oxytocin explaining differences in sensitive parenting.

Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses

The current meta-analytic study examined the differential impact of maltreatment and various socioeconomic risks on attachment security and disorganization. Fifty-five studies with 4,792 children were traced, yielding 59 samples with nonmaltreated high-risk children (n = 4,336) and 10 samples with maltreated children (n = 456). We tested whether proportions of secure versus insecure (avoidant, resistant, and disorganized) and organized versus disorganized attachments varied as a function of risks. Results showed that children living under high-risk conditions (including maltreatment studies) showed fewer secure (d = 0.67) and more disorganized (d = 0.77) attachments than children living in low-risk families. Large effects sizes were found for the set of maltreatment studies: maltreated children were less secure (d = 2.10) and more disorganized (d = 2.19) than other high-risk children (d = 0.48 and d = 0.48, respectively). However, children exposed to five socioeconomic risks (k = 8 studies, d = 1.20) were not significantly less likely to be disorganized than maltreated children. Overall, these meta-analyses show the destructive impact of maltreatment for attachment security as well as disorganization, but the accumulation of socioeconomic risks appears to have a similar impact on attachment disorganization.