Mary Dozier

Psychophysiology in Attachment Interviews: Converging Evidence for Deactivating Strategies

By asking the subject to consider a host of potentially threatening attachment-related issues, the Adult Attachment Interview (AAI) allows an assessment of different strategies for regulating the attachment system. These strategies can be assessed along the 2 dimensions of security/anxiety and deactivation/hyperactivation. The greatest inferential leaps may be in characterizing strategies as deactivating. For example, individuals using deactivating strategies often report extremely positive relationships with parents, display restricted recall of attachment memories, and play down the significance of early attachment experiences. If these descriptive features are guided by a strategy that requires diverting attention from attachment information, subjects employing this strategy should experience conflict or inhibition during the Attachment Interview. In the present study, skin conductance levels were monitored for 50 college students during a baseline period and throughout the Attachment Interview. Subjects employing deactivating strategies showed marked increases in skin conductance levels from baseline to questions asking them to recall experiences of separation, rejection, and threat from parents. This finding supports the notion that individuals employing deactivating attachment strategies experience conflict or inhibition during the Attachment Interview.

Attachment organization and treatment use for adults with serious psychopathological disorders

Individual differences in attachment organization among adults with serious psychopathological disorders were related to strategies of treatment use. Forty young adults with serious psychopathological disorders were administered the Adult Attachment Interview (George, Kaplan, & Main, 1984), and their clinicians completed ratings of treatment use. Attachment organization was assessed using the Attachment Q-set (Kobak, 1989), yielding ratings of security/anxiety and avoidance/preoccupation. In preliminary analyses, diagnosis was found to be related to security, with greater security associated with affective rather than thought disorders. Gender was related to avoidance/preoccupation, with males having stronger avoidant tendencies than females. The effects of diagnosis and gender were partialled out of subsequent analyses. As predicted, greater security was associated with more compliance with treatment, as rated by clinicians. Stronger avoidant tendencies were associated with greater rejection of treatment providers, less self-disclosure, and poorer use of treatment. These findings suggest that attachment organization may be an important determinant of how individuals with serious psychopathological disorders approach attachment figures.

Foster Children’s Diurnal Production of Cortisol: An Exploratory Study

Young children in foster care have often experienced inadequate early care and separations from caregivers. Preclinical studies suggest that early inadequate care and separations are associated with long-term changes in regulation of the hypothalamic-pituitary-adrenal (HPA) axis. In this study, the daytime pattern of cortisol production was examined among 55 young children who had been placed into foster care and 104 children who had not. Saliva samples were taken at wake-up, in the afternoon, and bedtime for 2 days. Average salivary cortisol values for each time of day were computed. A group (foster vs. comparison) time (morning, afternoon, night) interaction emerged, reflecting less decline in levels across the day for foster than comparison children. Daytime patterns were categorized as typical, low, or high. Children who had been in foster care had higher incidences of atypical patterns of cortisol production than children who had not. These differences suggest that conditions associated with foster care interfere with children’s ability to regulate neuroendocrine functioning.

Effects of Therapeutic Interventions for Foster Children on Behavioral Problems, Caregiver Attachment, and Stress Regulatory Neural Systems

Abstract:  Young children in foster care are exposed to high levels of stress. These experiences place foster children at risk for poor social, academic, and mental heath outcomes. The role of adverse events in stimulating neurobiological stress responses presumably plays a role in shaping neural systems that contribute to these problems. Systematic and developmentally well‐timed interventions might have the potential to change developmental trajectories and promote resilience. Moreover, understanding how specific dimensions of early adversity affect underlying stress response systems and how alterations in these systems are related to later psychosocial outcomes might facilitate more precise and targeted interventions. Data are drawn from two ongoing randomized trials involving foster infants/toddlers and preschoolers. Consistent with prior animal models of early adversity, these studies have shown that early adversity—particularly neglect, younger age at first foster placement, and higher number of placements—is associated with altered hypothalamic‐pituitary‐adrenal (HPA) axis function. The interventions under investigation have produced evidence that it is possible to impact many areas that have been negatively affected by early stress, including HPA axis activity, behavior, and attachment to caregivers.

Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial

Young children who have experienced early adversity are at risk for developing disorganized attachments. The efficacy of Attachment and Biobehavioral Catch-up (ABC), an intervention targeting nurturing care among parents identified as being at risk for neglecting their young children, was evaluated through a randomized clinical trial. Attachment quality was assessed in the Strange Situation for 120 children between 11.7 and 31.9 months of age (M = 19.1, SD = 5.5). Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment.

Differential patterns of whole-genome DNA methylation in institutionalized children and children raised by their biological parents

Previous studies with nonhuman species have shown that animals exposed to early adversity show differential DNA methylation relative to comparison animals. The current study examined differential methylation among 14 children raised since birth in institutional care and 14 comparison children raised by their biological parents. Blood samples were taken from children in middle childhood. Analysis of whole-genome methylation patterns was performed using the Infinium HumanMethylation27 BeadChip assay (Illumina), which contains 27,578 CpG sites, covering approximately 14,000 gene promoters. Group differences were registered, which were characterized primarily by greater methylation in the institutionalized group relative to the comparison group, with most of these differences in genes involved in the control of immune response and cellular signaling systems, including a number of crucial players important for neural communication and brain development and functioning. The findings suggest that patterns of differential methylation seen in nonhuman species with altered maternal care are also characteristic of children who experience early maternal separation.

Discrepancies between self- and other-report of psychiatric symptomatology: Effects of dismissing attachment strategies

This study examined the relationship between psychiatric symptomatology and the representations of attachment relationships held by adults with serious psychopathological disorders. Psychiatric symtomatology was assessed by self-report and three sets of expert ratings. Seventy-six persons with serious psychopathological disorders were included as participants. As expected, persons relying on hyperactivating strategies of attachment reported generally more psychiatric symptoms than did those relying on deactivating strategies of attachment. However, the three sets of experts rated persons relying on deactivating strategies as more symptomatic than others. More specifically, interviewers who conducted Quality of Life Interviews rated dismissing subjects as exhibiting looser thinking than others. Interviewers who conducted Attachment Interviews rated dismissing subjects as experiencing more delusions, hallucinations, and suspiciousness, and case managers rated dismissing subjects as generally more psychotic. These findings suggest that, although greater preoccupation with attachment issues is associated with more acknowledgment of distress generally and symptoms specifically, greater reliance on deactivating strategies may be associated with greater symptomatology observed by others.

The Effect of Placement Instability on Adopted Children's Inhibitory Control Abilities and Oppositional Behavior.

This study assessed relations among placement instability, inhibitory control, and caregiver-rated child behavior. The sample included 33 adopted children who had experienced placement instability, 42 adopted children who had experienced 1 stable placement, and 27 children never placed in foster care. Five- and 6-year-old children completed the day-night task, which requires children to inhibit a prepotent response, and a control task that presents similar memory demands but does not require inhibition (C. L. Gerstadt, Y. J. Hong, & A. Diamond, 1994). Adopted children who had experienced placement instability performed worse on the inhibition task than did both other groups of children, when the authors controlled for age, verbal intelligence (as measured with the Wechsler Preschool and Primary Scale of Intelligence--Revised; D. Wechsler, 1989; or the Peabody Picture Vocabulary Test--Third Edition; L. M. Dunn & L. M. Dunn, 1997), and control task performance (p<.01). Children who had experienced placement instability were also rated on the Child Behavior Checklist as more oppositional than other children (p<.01; T. M. Achenbach & L. A. Rescorla, 2000). Inhibitory control did not mediate the association between placement instability and oppositional behavior (p>.05). These results suggest that placement instability may adversely affect the social-emotional development of adopted children.

A preliminary study of medial temporal lobe function in youths with a history of caregiver deprivation and emotional neglect

Previous research findings have linked caregiver deprivation and emotional neglect with sensitivity to threatening cues. The present preliminary study investigated whether dysfunctions of the medial temporal lobe could underlie these associations. Using fMRI, we measured medial temporal lobe responses to emotional faces (angry, fearful, happy, neutral) among 30 youths. Eleven of the youths had a history of caregiver deprivation and emotional neglect. Attention states (i.e., attention to anger, fear, or physical attributes, or passive viewing) were systematically manipulated. Relative to comparison youths, youths with a history of caregiver deprivation and emotional neglect showed significantly greater left amygdala and left anterior hippocampus activation during the processing of threatening information. To our knowledge, these findings are the first to demonstrate altered medial temporal lobe function during the processing of threat cues in youths with a history of caregiver deprivation and emotional neglect.

Interventions for foster parents: implications for developmental theory.

All children who enter foster care have experienced disruptions in their relationships with caregivers, and many have experienced maltreatment. Studying the effects of these adverse early experiences can inform developmental theory. In particular, insight can be provided regarding sensitive periods in the development of attachment and self-regulatory capabilities. The quality of surrogate caregivers varies as a function of both the intervention services provided and foster parent characteristics. Studying the effects of foster parent quality can suggest which aspects of child functioning are more or less canalized at various developmental periods. This paper considers salient developmental issues of infancy, preschool years, middle childhood, and adolescence and examines ways in which these issues may present special difficulties for foster children. Across development, foster care is associated with difficulties regulating behaviors, emotions, and physiology. Thus, conditions associated with foster care placement (e.g., disruptions in care, maltreatment) appear to affect very basic and fundamental regulatory processes. Interventions have been designed that target developmentally specific manifestations of regulatory difficulties. Although the literature regarding evidence-based interventions for foster parents is quite limited, preliminary findings provide some evidence that nurturing, responsive care can serve to partially remediate early deficits. These findings suggest that stable and nonfrightening care is essential for normal development. Nonetheless, even in the case of quite adverse early experience that results in problematic child outcomes, there is some evidence that the development of many systems remains relatively plastic.