Longitudinal association between infant disorganized attachment and childhood posttraumatic stress symptoms

Abstract

The purpose of this study was to evaluate whether children with a history of disorganized attachment in infancy were more likely than children without a history of disorganized attachment to exhibit symptoms of posttraumatic stress disorder (PTSD) at school age following trauma exposure. The sample consisted of 78 8.5-year-old children from a larger, ongoing prospective study evaluating the effects of intrauterine cocaine exposure (IUCE) on children's growth and development from birth to adolescence. At the 12-month visit, children's attachment status was scored from videotapes of infant-caregiver dyads in Ainsworth's strange situation. At the 8.5-year visit, children were administered the Violence Exposure Scale-Revised, a child-report trauma exposure inventory, and the Diagnostic Interview for Children and Adolescents by an experienced clinical psychologist masked to children's attachment status and IUCE status. Sixteen of the 78 children (21%) were classified as insecure-disorganized/insecure-other at 12 months. Poisson regressions covarying IUCE, gender, and continuity of maternal care indicated that disorganized attachment status at 12 months, compared with nondisorganized attachment status, significantly predicted both higher avoidance cluster PTSD symptoms and higher reexperiencing cluster PTSD symptoms. These findings suggest that the quality of early dyadic relationships may be linked to differences in children's later development of posttraumatic stress symptoms following a traumatic event.

Unresolved Attachment Status and Trauma-Related Symptomatology in Maltreated Adolescents: An Examination of Cognitive Mediators

“…Attachment disorganization, as represented by an AAP classification of "Unresolved", showed a statistically significant, moderate association with symptomatology in this sample. This finding is consistent with previous research linking attachment disorganization and trauma-related symptoms in various samples [17,21,42]. Attachment status was also meaningfully linked to cognitive efficiency, with unresolved adolescents showing more impairment in working memory specifically than their organized counterparts.…”

“…In their prospective study of 168 children into early adulthood, Ogawa et al [17] found that both disorganized and avoidant patterns of attachment predicted dissociative symptoms in their sample, although the disorganized pattern showed more consistent association with dissociation, one of the core features of Post-Traumatic Stress Disorder, particularly in late adolescence/early adulthood. Another longitudinal study, by McDonald and co-authors [21], examined the association between attachment status at 12 months and post-traumatic stress disorder symptoms roughly 7 years later. The authors found that disorganized attachment uniquely predicted avoidance-related post-traumatic symptoms in their sample.…”

Italian translation and cross-cultural comparison with the Childhood Attachment and Relational Trauma Screen (CARTS)

“…Further novel to the current study was an assessment of the concurrent validity of the CARTS in relation to experiences of attachment in adult romantic relationships, where the literature suggests that experiences of childhood attachment predict future adult romantic attachment (Hesse & Main, 2000; Kochendorfer & Kerns, 2017; MacDonald et al, 2008). In the present study, select correlations between CARTS Mother ratings and responses to the ECR-R were significant, in particular in the association with concurrent anxious romantic attachment.…”

An Attachment Perspective on Borderline Personality Disorder: Advances in Gene–Environment Considerations

“…The fearful disorganized behaviors also typically appear following one of the brief separations, during that moment of reunion when the securely attached child approaches readily and is comforted promptly. Attachment disorganization in the early infant-mother relationship has been associated prospectively in longitudinal work and meta-analytic summaries of the findings with later childhood problem behaviors, especially aggression [13], post-traumatic stress disorder (PTSD) symptoms in the school years [14], and dissociation problems in adolescence [15].…”