Reactive Attachment Disorder Symptoms and Prosocial Behavior in Middle Childhood: The Role of Secure Base Script Knowledge

Abstract

Background: Children with attachment disorder show prosocial behavior problems. Children with a reactive attachment disorder show inhibited and emotionally withdrawn behavior. Consequently, these children typically display prosocial behavior problems. However, the underlying mechanism between reactive attachment disorder and prosocial behavior problems is still unclear and findings in literature are mixed. Methods : The current study investigated the role of children’s attachment representations in this association. Attachment representations reflect knowledge about a cognitive script regarding the attachment figure as a source for support (Secure Base Script). We tested whether secure base script knowledge 1) mediates or 2) moderates the link between reactive attachment disorder and prosocial behavior problems in 83 children (6-11 years; 83.1% boys) recruited from special education schools for children with behavioral problems. Children completed a pictorial Secure Base Script Test. Their reactive attachment disorder symptoms were assessed during an interview with the primary caregivers. Primary caregivers and teachers filled out a prosocial behavior questionnaire about the child. Results : Results did not support the mediation hypothesis, but evidence for the moderation hypothesis was found. Secure base script knowledge attenuated the negative association between attachment disorder symptoms and prosocial behavior. Conclusions : These findings contribute to the discussion about the link between attachment representations and attachment disorders.

A Systematic Review of Representational and Behavioral Measures of Parent-Child Attachment Available for Middle Childhood

“…Therefore, we would not recommend that downward adaptations be done. One measure that theoretically relates to the secure base script, with less verbal demands than the ASA and Story Stem tasks, is a speeded task in which children are required to place pictures relating to an attachment narrative in an appropriate order (Cuyvers et al, 2020). This measure was developed to assess attachment security of children with special educational needs, and the approach might be useful to assess attachment in typically-developing children who are younger than 8.…”

Review of the Current Knowledge of Reactive Attachment Disorder

“…The current mediation hypothesis aims to discuss the relationship between a lack of emotional nurture and the development of RAD. This was described in a study by Cuyvers et al [14], which explored the relationship between the symptoms of RAD and insecure attachment. Parental factors were assessed and included attributes such as lack of support, lengthy periods of isolation between the parent and child, and mood disorders such as depression.…”