An exploratory study of the association between reactive attachment disorder and attachment narratives in early school‐age children

Minnis, Helen; Green, Jonathan; O’Connor, Thomas G.; Liew, Ashley; Glaser, Danya; Taylor, Emma; Follan, Michael; Young, David; Barnes, J. C.; Gillberg, Christopher; Pelosi, Anthony; Arthur, J.; Burston, Amanda; Connolly, Brenda; Sadiq, Fareeha Amber

doi:10.1111/j.1469-7610.2009.02075.x

Cited by 101 publications

(128 citation statements)

References 50 publications

(65 reference statements)

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“…During the home visit demographic data were collected, and parents completed three questionnaires: the Strengths and Difficulties Questionnaire (SDQ) investigating a wide range of child psychiatric symptoms (Goodman, Ford, Simmons, Gatward, & Meltzer, 2003), the Relationships Problems Questionnaire (RPQ) investigating RAD symptoms (Angold et al, 1995;Minnis et al, 2009) and the 'Life Change Scale' to monitor current or recent life stresses (Foxman, 2004). Parents were then interviewed using two semi-structured measures: the Development and Well-Being Assessment (DAWBA) (Goodman, Ford, Richards, & et al, 2000) to investigate psychopathology and the Child and Adolescent Psychiatric Assessment, RAD module (CAPA-RAD) to investigate RAD (Minnis, Pelosi, Taylor, O'Connor, & Barnes, 2006). The child's medical status, including any current medication, was noted.…”

Section: Methodsmentioning

confidence: 99%

Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness

Kočovská

Puckering

Follan

et al. 2012

Research in Developmental Disabilities

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We aimed to explore the extent of neurodevelopmental difficulties in severely maltreated adopted children. We recruited 34 adopted children, referred with symptoms of indiscriminate friendliness and a history of severe maltreatment in their early childhood and 32 typically developing comparison children without such a history, living in biological families. All 66 children, aged 5-12 years, underwent a detailed neuropsychiatric assessment.The overwhelming majority of the adopted/indiscriminately friendly group had a range of psychiatric diagnoses, including Attention Deficit Hyperactivity Disorder (ADHD), PostTraumatic Stress Disorder (PTSD) and Reactive Attachment Disorder (RAD) and one third exhibited the disorganised pattern of attachment. The mean IQ was 15 points lower than the comparison group and the majority of the adopted group had suspected language disorder and/or delay. Our findings show that school-aged adopted children with a history of severe maltreatment can have very complex and sometimes disabling neuropsychiatric problems.

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Section: Methodsmentioning

confidence: 99%

Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness

Kočovská

Puckering

Follan

et al. 2012

Research in Developmental Disabilities

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“…Thirty-three studies were published between 1988 and 2011, of which the majority were undertaken in the USA (n = 18 24,47,93,94,[96][97][98][99][100][102][103][104]106,111,113,115,116,118,121 ), with the rest spread across the UK (n = 4 50,52,[107][108][109] ), Canada (n = 4 25,105,110,119 ), Germany (n = 2 101,122 ), the Netherlands (n = 2 117,120 ), Romania (n = 1 94 ) and Spain (n = 1 114 ). Table 1 and Box 1.…”

Section: Resultsmentioning

confidence: 99%

“…47, 52,[95][96][97]104,108,110,111,113,114,116 It was not possible to assert that any instrument had good enough validity and reliability to be used alongside our reference standard, the SSP.…”

Section: Discussion and Summary Of Findingsmentioning

confidence: 99%

“…25,[93][94][95]102,108,115,118,122 Only three of these reported data that enabled calculations of concurrent validity sensitivity and specificity scores: two for attachment patterns 93,94 ( Table 7) and one for attachment disorders 95 ( Table 8). …”

Section: Psychometric Propertiesmentioning

confidence: 99%

“…24,25,47,50,52,[93][94][95][96][99][100][101][102][104][105][106][107][108][111][112][113][114][115][116][117][118][119][120][121][122] In those studies providing demographic detail, parental age ranged from 12 to 70 years and ethnicity was predominantly white or Caucasian.…”

Section: Population Characteristicsmentioning

confidence: 99%

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Clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems: a systematic review and meta-analysis

Wright

Barry

Hughes

et al. 2015

Health Technol Assess

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Background and objectivesServices have variable practices for identifying and providing interventions for ‘severe attachment problems’ (disorganised attachment patterns and attachment disorders). Several government reports have highlighted the need for better parenting interventions in at-risk groups. This report was commissioned to evaluate the clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems (the main review). One supplementary review explored the evaluation of assessment tools and a second reviewed 10-year outcome data to better inform health economic aspects of the main review.Data sourcesA total of 29 electronic databases were searched with additional mechanisms for identifying a wide pool of references using the Cochrane methodology. Examples of databases searched include PsycINFO (1806 to January week 1, 2012), MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations (1946 to December week 4, 2011) and EMBASE (1974 to week 1, 2012). Searches were carried out between 6 and 12 January 2012.Review methodsPapers identified were screened and data were extracted by two independent reviewers, with disagreements arbitrated by a third independent reviewer. Quality assessment tools were used, including quality assessment of diagnostic accuracy studies – version 2 and the Cochrane risk of bias tool. Meta-analysis of randomised controlled trials (RCTs) of parenting interventions was undertaken. A health economics analysis was conducted.ResultsThe initial search returned 10,167 citations. This yielded 29 RCTs in the main review of parenting interventions to improve attachment patterns, and one involving children with reactive attachment disorder. A meta-analysis of eight studies seeking to improve outcome in at-risk populations showed statistically significant improvement in disorganised attachment. The interventions saw less disorganised attachment at outcome than the control (odds ratio 0.47, 95% confidence interval 0.34 to 0.65;p < 0.00001). Much of this focused around interventions improving maternal sensitivity, with or without video feedback. In our first supplementary review, 35 papers evaluated an attachment assessment tool demonstrating validity or psychometric data. Only five reported test–retest data. Twenty-six studies reported inter-rater reliability, with 24 reporting a level of 0.7 or above. Cronbach’s alphas were reported in 12 studies for the comparative tests (11 with α > 0.7) and four studies for the reference tests (four with α > 0.7). Three carried out concurrent validity comparing the Strange Situation Procedure (SSP) with another assessment tool. These had good sensitivity but poor specificity. The Disturbances of Attachment Interview had good sensitivity and specificity with the research diagnostic criteria (RDC) for attachment disorders. In our supplementary review of 10-year outcomes in cohorts using a baseline reference standard, two studies were found with disorganised attachment at baseline, with one finding raised psychopathology in adolescence. Budget impact analysis of costs was estimated because a decision model could not be justifiably populated. This, alongside other findings, informed research priorities.LimitationsThere are relatively few UK-based clinical trials. A 10-year follow-up, while necessary for our health economists for long-term sequelae, yielded a limited number of papers.ConclusionsMaternal sensitivity interventions show good outcomes in at-risk populations, but require further research with complex children. The SSP and RDC for attachment disorders remain the reference standards for identification until more concurrent and predictive validity research is conducted. A birth cohort with sequential attachment measures and outcomes across different domains is recommended with further, methodologically sound randomised controlled intervention trials. The main area identified for future work was a need for good-quality RCTs in at-risk groups such as those entering foster care or adoption.Study registrationThis study is registered as PROSPERO CRD42011001395.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Reactive Attachment Disorder and Severe Attachment Disturbances

O’Connor

Spagnola

Byrne³

2012

Handbook of Evidence‐Based Practice in Clinical Psychology

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An exploratory study of the association between reactive attachment disorder and attachment narratives in early school‐age children

Cited by 101 publications

References 50 publications

Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness

Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness

Clinical effectiveness and cost-effectiveness of parenting interventions for children with severe attachment problems: a systematic review and meta-analysis

Reactive Attachment Disorder and Severe Attachment Disturbances

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