TY - JOUR

T1 - Attachment disorder and attachment theory – Two sides of one medal or two different coins?

AU - Schröder, Martin

AU - Lüdtke, Janine

AU - Fux, Elodie

AU - Izat, Yonca

AU - Bolten, Margarete

AU - Gloger-Tippelt, Gabriele

AU - Suess, Gerhard J.

AU - Schmid, Marc

N1 - This study was funded by a grant to Marc Schmid for young researchers of the University of Basel, Switzerland ( DMS2133 ).

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Introduction: Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9. Methods: A total of 135 children aged between 5 and 9 years (M = 7.17 years, SD = 1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development. Results: The prevalence of AR in children with AD was 28.6% for the ‘secure’ form of AR, 17.1% for the ‘insecure-avoidant’ form, 25.7% for the ‘insecure-ambivalent’ form, and 28.6% for the ‘disorganized’ form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills. Conclusions: Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models.

AB - Introduction: Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9. Methods: A total of 135 children aged between 5 and 9 years (M = 7.17 years, SD = 1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development. Results: The prevalence of AR in children with AD was 28.6% for the ‘secure’ form of AR, 17.1% for the ‘insecure-avoidant’ form, 25.7% for the ‘insecure-ambivalent’ form, and 28.6% for the ‘disorganized’ form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills. Conclusions: Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models.

KW - Attachment representations (AR)

KW - Attachment theory

KW - Reactive attachment disorder (RAD)

KW - Research Domain Criteria (RDoC)

KW - Story stem method

KW - Social Work and Social Pedagogics

UR - http://www.scopus.com/inward/record.url?scp=85074430171&partnerID=8YFLogxK

U2 - 10.1016/j.comppsych.2019.152139

DO - 10.1016/j.comppsych.2019.152139

M3 - Journal articles

C2 - 31706154

AN - SCOPUS:85074430171

VL - 95

JO - Comprehensive Psychiatry

JF - Comprehensive Psychiatry

SN - 0010-440X

M1 - 152139

ER -