ATTACHMENT THEORY-2024.pptxAttachment disorders

2024 Raymundo Hombrebueno Pawid, Jr, RPsy, RPm, LPT Benguet State University 1
Attachment
Theory

2024
https://positivepsychology.com/attachment-theory/#classroom-
attachment-theory
2
According to Bowlby and Ainsworth, attachments
with the primary caregiver develop during the
first 18 months or so of the child’s life, starting
with instinctual behaviors like crying and clinging
(Kennedy & Kennedy, 2004).
These behaviors are quickly directed at one or a
few caregivers in particular, and by 7 or 8 months
old, children usually start protesting against the
caregiver(s) leaving and grieve for their absence.

Once children reach the toddler stage,
they begin forming an internal working
model of their attachment relationships.
This internal working model provides the
framework for the child’s beliefs about
their own self-worth and how much they
can depend on others to meet their
needs.
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attachment-theory
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https://www.simplypsychology.org/internal-working-models-of-attachment.html

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https://www.google.com/url
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Introduction
• Attachment disorders are the psychological result of
significant social neglect, that is, the absence of adequate
social and emotional caregiving during childhood,
disrupting the normative bond between children and their
caregivers.
• According to DSM-5:
1.Reactive Attachment Disorder (RAD) and
2.Disinhibited Social Engagement Disorder (DSED)
https://emedicine.medscape.com/article/915447- Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD

Symptoms of RAD may include the
following:
•A child who rarely or minimally seeks comfort
when distressed
•A child who rarely or minimally responds to
comfort when distressed
•Minimal social and emotional responses to others
•Episodes of unexplained irritability, sadness or
tearfulness
•Limited expressions of positive affect or joy
• Evidence of inadequate basic emotional and
social caretaking
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https://emedicine.medscape.com/article/915447-overview?form=fpf Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki,
DIAGNOSIS:
•consistent pattern of inhibited,
emotionally withdrawn behavior
toward adult caregivers
•persistent social and emotional
disturbance
•pattern of extremes of insufficient
care
•The disturbance is evident before
age 5 years
•The child has a developmental age
of at least 9 months
•criteria for autism spectrum
disorder are not met

Symptoms of DSED may include the
following:
•Lack of reticence in approaching and interacting with
unfamiliar adults
•Overly familiar verbal or physical behaviors such as
hugging strangers, or sitting on the laps of unfamiliar
adults
•Willingness to approach a complete stranger for
comfort or food, to be picked up, or to receive a toy
•Diminished or absent checking back with adult
caretaker when in unfamiliar situations
•Evidence of inadequate social and emotional
caretaking, sometimes with a history of repeated
changes in the primary caretaker
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DIAGNOSIS:
•pattern of behavior in which a
child actively approaches and
interacts with unfamiliar adults in
an impulsive, incautious, and
overfamiliar way
•behaviors described in the first
criterion are not limited to
impulsivity but also include socially
disinhibited behavior
•pattern of extremes of insufficient
care
•care described in the third
criterion is presumed to be
responsible for the disturbed
behavior described in the first
criterion
•child has a developmental age of
at least 9 months

Complications of attachment disorders may include the
following:
•Defiant behavior
•Refusal to cooperate
•Pervasive anger and resentment
•Cognitive delays
•Language delays
•Stereotypies
•Conduct disorder
•Difficulties in social settings
•Academic difficulties
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Principles of treatment for RAD and DSED include the following:
•Most of the treatment is provided by modifying the behavior of the
primary caregivers (eg, parents or substitute parents) in their
everyday interactions with the child
•Referral to a mental health professional who is aware of the
emotional needs of children, the phenomenology of attachment
disruptions, and the need to repair and recreate the sense of
security in the child may be critical
•Pharmacologic treatment may be helpful for comorbid disorders
such as depression, but not for the attachment disorders
themselves
•There is no specific indication for inpatient treatment; however, the
occasional child may need to be hospitalized for a time so that
issues such as mistrust or lack of emotional involvement with
others can be addressed
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Management

Therapeutic ingredients that appear to promote
attachment when provided by caregivers
include the following:
•Security (sense of psychological safety)
•Stability (permanence of the attachment figure)
•Sensitivity (emotional availability)
Over the course of treatment, occasional
regressive behaviors should be expected and
tolerated.
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Management

Internal Working Models Of
Attachment
By
Saul Mcleod, PhD
Updated on
November 29, 2023
2024
https://www.simplypsychology.org/internal-working-models-of-
attachment.html
13
Key Takeaways
•Attachment theory posits that individuals develop
internal working models of attachment based on their
early experiences with caregivers and operate outside of
awareness (Bowlby, 1969/1982).
•According to Bowlby (1969), the primary caregiver acts as
a prototype for future relationships via the internal
working model.
•These models consist of mental representations of the
self, others, and relationships that guide thoughts,
feelings, and behaviors in attachment-relevant situations
throughout life (Bretherton & Munholland, 1999).

Internal Working Models Of
Attachment
By
Saul Mcleod, PhD
Updated on
November 29, 2023
2024 https://www.simplypsychology.org/internal-working-models-of-attachment.html 14
Key Takeaways
•Internal working models of attachment
significantly impact social cognition,
emotion regulation, relationship
dynamics, and psychological well-being
(Mikulincer & Shaver, 2016).
•Recognizing the power of working
models provides insight into individual
differences in relational functioning and
points toward avenues for therapeutic
change.

Background On Attachment Theory
2024 https://www.simplypsychology.org/internal-working-models-of-attachment.html 15
John Bowlby originally conceived of attachment
theory to explain the intense distress experienced by
infants when separated from their caregivers.
He proposed that humans have an innate attachment
behavioral system that motivates them to seek
proximity, contact, and comfort from significant
others (attachment figures) under conditions of threat
or distress (Bowlby, 1969/1982).

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Origins
This system evolved to promote survival by keeping
vulnerable infants close to nurturing caregivers who provide
protection, support, and care.
Individual differences in attachment security emerge based
on the sensitivity and responsiveness of the caregiver.
John Bowlby (1969/1982) theorized that these early
attachment experiences form the foundation for mental
representations called internal working models. These models
consist of cognitive-affective schemas about the self as
worthy/unworthy of care and others as reliable/unreliable
sources of support.
https://www.simplypsychology.org/internal-working-models-of-attachment.html

20XX presentation title 17
The social and emotional responses of the primary caregiver (usually
a parent) provide the infant with information about the world and
other people and how they view themselves as individuals.
For example, the extent to which an individual perceives
himself/herself as being worthy of love and care, and information
regarding the availability and reliability of others (Bowlby, 1969).
Bowlby referred to this knowledge as an internal working model
(IWM), which begins as a mental and emotional representation of the
infant’s first attachment relationship and forms the basis of an
individual’s attachment style.

2024 https://www.verywellmind.com/what-is-attachment-theory-2795337 18

Psychologist Mary Ainsworth devised an
assessment technique called the Strange
Situation Classification (SSC) to investigate
how attachments might vary between
children
The Strange Situation was devised by
Ainsworth and Wittig (1969) and was
based on Ainsworth’s previous Uganda
(1967) and later Baltimore studies
(Ainsworth et al., 1971, 1978)
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https://www.simplypsychology.org/mary-ainsworth.html

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The room was set up with a clear 9 x 9-foot floor space
divided into 16 squares for recording location and
movement.
One end housed a chair laden with toys, while the other
had chairs for the mother and a stranger. The baby was
placed centrally, free to move around. The mother and
stranger were pre-instructed on their roles.
The child is observed playing for 20 minutes while
caregivers and strangers enter and leave the room,
recreating the flow of the familiar and unfamiliar presence
in most children’s lives.
Ainsworth & Bell observed from the other side of a one-
way mirror, so the children did not know they were being
observed.

The strange situation

Scoring
Observers noted the child’s willingness to explore, separation
anxiety, stranger anxiety, and reunion behavior.
Two observers narrated continuous accounts into a two-
channel tape recorder that also captured a timer’s click every
15 seconds.
This is the standard procedure now, although, for the initial
14 participants, only one observer narrated as the other took
notes due to the lack of a two-channel recorder.
For the latter 33 participants, Bell was the sole observer. The
observations were later transcribed, consolidated, and coded.

These four classes of behavior
were scored for interaction with
the mother in episodes 2, 3, 5, and
8, and for interaction with the
stranger in episodes 3, 4, and 7.

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https://www.simplypsychology.org/mary-
ainsworth.html
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1.Proximity and contact seeking:
Behaviors involve active efforts such as purposeful
approaching, climbing, gesturing (like reaching or leaning),
partial approaches, and directed cries.The criteria include
the child’s initiative, persistence, and effectiveness in
gaining (or regaining) contact or proximity. The score
reflects the intensity and nature of the child’s efforts across
different episodes.

1.Contact maintaining:
Behaviors relevant after the baby has made
physical contact, either self-initiated or
otherwise.They encompass clinging, embracing,
resisting release through intensified clinging or
turning back and reaching if contact is lost, and
vocal protestations.

20XX presentation title 26
1.Avoidance of proximity and contact:
Interaction-avoiding behaviors apply in situations that typically
incite approach or interaction, such as an adult entering or trying
to attract the baby’s attention.The behaviors indicative of
avoidance include increasing distance, turning away, averting gaze,
hiding the face, or ignoring the person, especially when the person
is attempting to engage the child’s attention.
Unlike the resistance variable, which is often associated with
anger, avoidance may have a neutral tone or reflect apprehension.
It may be seen as a defensive behavior that conceals feelings,
possibly including resentment. The coding for this variable
distinguishes between the child’s interactions with the mother and
a stranger.

1.Resistance to contact and comfort:
Assesses the child’s resistant behavior towards someone who
attempts to interact or come into proximity.
Contact- and interaction-resisting behaviors include angry,
conflicting attempts to repel the adult, wriggling to get down
if picked up, or rejecting toys used by the adult to interact.
Other indications could be angry screams, thrashing about,
pouting, irritable fussing, or showing petulance.
These resistant behaviors may alternate with efforts to
maintain contact with the person being rejected.

1.Search behavior:
During episodes 4, 6, and 7, search behaviors were recorded.
These included following the mother to the door, attempting
to open it, banging on it, keeping the focus on the door or
glancing towards it, approaching the mother’s empty chair,
or observing it.
These behaviors indicated the infant’s active search or
orientation towards the last seen location of the absent
mother (usually the door) or a place associated with her in
the unfamiliar setting (her chair).

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ainsworth.html

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Behavioral categories allow the researcher to focus on the behaviors to observe
clearly. For example, smiling, crying, or the baby moving towards or away from
the mother.
This allows the observers to tally observations into pre-arranged groupings. It
also makes the observations replicable, so the results have greater reliability.
Other behaviors observed included:
•Exploratory behaviors
e.g., moving around the room, playing with toys, looking around the room.
•Search behaviors
e.g., following mother to the door, banging on the door, orienting to the door,
looking at the door, going to mother’s empty chair, looking at mother’s empty
chair.
•Affect Displays negative
e.g., crying, smiling.

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Observation reliability was assessed by independent
codings of the narrated reports by the two authors in four
dual-observed cases.
Correlation coefficients of 0.99 for each locomotor,
manipulatory, and visual exploration, and 0.98 for
crying, were achieved.

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RESULTS [ATTACHMENT STYLES]

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ainsworth.html

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Ainsworth (1970) identified three main attachment styles,
1. Secure (Type B)
2. Insecure avoidant (Type A), and
3. Insecure ambivalent/resistant (Type C).
A fourth attachment style, known as (4) Disorganized, was
later identified (Main, & Solomon, 1990).
RESULTS [ATTACHMENT STYLES]
ainsworth.html

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Securely attached children comprised most of the sample in Ainsworth’s (1971, 1978) studies.
Infants with this type of attachment explore their environment (explorative behavior) and are
moderately distressed when their mother leaves the room (separation anxiety).
They also show moderate stranger anxiety and some distress when they are approached by a
stranger. They seek contact with their mother when she returns.
Such children feel confident that the attachment figure will be available to meet their needs. They
use the attachment figure as a safe base to explore the environment and seek the attachment figure
in times of distress (Main, & Cassidy, 1988).
Securely attached infants are easily soothed by the attachment figure when upset. Infants develop
a secure attachment when the caregiver is sensitive to their signals, and responds appropriately to
their needs
SECURE
ATTACHMENT
According to Bowlby (1980), an individual who has
experienced a secure attachment “is likely to possess a
representational model of attachment figures(s) as being
available, responsive, and helpful” (Bowlby, 1980, p. 242).
ainsworth.html

Infants with an insecure-avoidant attachment are
unconcerned by their mother’s absence when she
leaves the room (no separation anxiety).
Insecure
Avoidant
They show little interest when reunited with the mother (i.e., she returns to the
room). Infants are strongly avoidant of the mother and stranger, showing no
motivation to interact with either adult. They do not seek contact with the
attachment figure when distressed. The stranger is treated similarly to the mother
(does not seek contact).
They are very independent of the attachment figure, both physically and
emotionally (Behrens, Hesse, & Main, 2007). Insecure avoidant children do not
orientate to their attachment figure while investigating the environment.
Such children will likely have insensitive caregivers who ignore their emotional
needs (Ainsworth, 1979).
The attachment figure may withdraw from helping during difficult tasks
(Stevenson-Hinde, & Verschueren, 2002) and is often unavailable during
emotional distress.

The third attachment style Ainsworth (1970) identified was insecure
ambivalent (also called insecure resistant).
Children with this type of attachment are clingy to their mother in a new
situation and unwilling to explore. They are extremely distressed when left
alone by their mother (separation anxiety), and are scared of the stranger.
When the mother returns, they are pleased to see her and go to her for
comfort, but then they cannot be comforted and may show signs of anger
towards her.
Here children adopt an ambivalent behavioral style towards the attachment
figure. The child commonly exhibits clingy and dependent behavior but
rejects the attachment figure when interacting.
The child fails to develop any feelings of security from the attachment figure.
Accordingly, they exhibit difficulty moving away from the attachment figure
to explore novel surroundings.
When distressed, they are difficult to soothe and are not comforted by
interaction with the attachment figure. This behavior results from an
inconsistent response to their emotional needs from the primary caregiver.
INSECURE
AMBIVALENT /
RESISTANT

Meta-analysis
Madigan et al. (2023) conducted a comprehensive meta-analysis on 285
studies involving over 20,000 infant-caregiver pairs to estimate the global
distribution of attachment classifications derived from the SSP: secure
(51.6%), avoidant (14.7%), resistant (10.2%), and disorganized (23.5%).
The meta-analysis found no differences in attachment distribution by child
age or sex. There was also no difference between mothers and fathers in
rates of secure, avoidant, resistant, or disorganized attachment. However,
attachment distributions did differ across other moderators.
Higher rates of avoidant and disorganized attachment were found in
families with socioeconomic risks. Children who experienced maltreatment
had extremely high rates of disorganized attachment (64%) compared to
non-maltreated children (22%). Infants placed in foster or adoptive care
showed less avoidant attachment but higher disorganized attachment
versus biologically related dyads.

A notable finding was a temporal trend showing decreased avoidant
attachment over time, perhaps reflecting changes in parenting styles or
measurement. Regional differences were also found – Asia, Africa, and South
America showed deviations from the North American distribution.
The meta-analysis provides a definitive estimate of the prevalence of secure
infant-parent attachment globally (51.6%), supporting the notion that secure
attachment is likely to occur when stressors and risks imposed on the parent-
infant relationship are minimal.
However, more research is needed on cultural differences in attachment and
validity of the SSP across diverse groups. The study also highlights factors
like socioeconomic disadvantage and trauma that disrupt secure attachment
formation.

Reliability
The strange situation classification has been found
to have good reliability. This means that it achieves
consistent results.
For example, a study conducted in Germany found
that 78% of the children were classified in the same
way at ages 1 and 6 years (Wartner et al., 1994).
Methodological
Evaluation

Validity
Although, as Melhuish (1993) suggests, the Strange Situation is
the most widely used method for assessing infant attachment
to a caregiver, Lamb et al. (1985) have criticized it for being
highly artificial and lacking ecological validity.
The child is placed in a strange and artificial environment, and
the procedure of the mother and stranger entering and leaving
the room follows a predetermined script of eight stages (e.g.,
mum and stranger entering and leaving the room at set times)
that would be unlikely to happen in real life.
Methodological
Evaluation

Validity
The artificial environment of the SSP may not activate the
attachment system for all infants, meaning some children could be
misclassified (Ziv & Hotam, 2015). For example, avoidant infants
may not actually feel stressed when separated from caregivers in this
unfamiliar setting. Limited evidence exists linking avoidant behavior
in the SSP to physical markers of stress.
Additionally, SSP classifications show only modest connections to
expected correlates like maternal sensitivity.
A problem of the study is that it lacks population validity. The
original study used American infants from middle-class families.
Methodological
Evaluation

Ethics
The strange situation has also been criticized on ethical grounds.
Because the child is put under stress (separation and stranger
anxiety), the study has broken the ethical guidelines for the protection
of participants.
However, in its defense, the separation episodes were curtailed
prematurely if the child became too stressed.
Also, according to Marrone (1998), although the Strange Situation has
been criticized for being stressful, it simulates everyday experiences,
as mothers leave their babies for brief periods in different settings and
often with unfamiliar people such as babysitters.

2024 https://www.google.com/url 44

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attachment-theory
45
Ackerman, C. A. (2018

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Emotion coaching is about helping children to become
aware of their emotions and to manage their own
feelings particularly during instances of ‘misbehavior.’
It enables practitioners to create an ethos of positive
learning behavior and to have the confidence to
de-escalate situations when behavior is challenging”
(National College for Teaching and Leadership, 2014).
USING
ATTACHMENT THEORY
IN THE CLASSROOM
attachment-theory

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•Teaching students about the world of “in the moment” emotion;
•Showing students strategies for dealing with emotional ups and
downs;
•Empathizing with and accepting negative or unpleasant emotions
as normal, but not accepting negative behavior;
•Using moments of challenging behavior as opportunities for
teaching;
•Building trusting and respectful relationships with the students
(National College for Teaching and Leadership, 2014).
Emotion
Coaching
involves:
https://positivepsychology.com/attachment-theory/#classroom-attachment-theory

TUNE IN
CONNECT
ACCEPT AND LISTEN
REFLECT
END WITH PROBLEM
SOLVING/CHOICES/
SETTING LIMITS
According to attachment theory expert Dr. John Gottman, there are
five steps to emotion coaching, and they can be practiced by parents,
teachers, or any significant adult in a child’s life:
https://positivepsychology.com/attachment-theory/#classroom-attachment-theory

Tune in
Notice or become aware of
your own and the child’s
emotions. Make sure you are
calm enough to practice
emotion coaching, otherwise,
you might want to give both
of you a quick breather
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https://positivepsychology.com/attachment-theory/#classroom-attachment-
theory

Connect
Use this situation as an
opportunity for you to practice
and for the child to learn. State
objectively (This is important!)
what emotions you think the
child is experiencing to help
them connect their emotions to
their behavior
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https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

Reflect
Once everyone is calm, go back
over what the child said or did,
mentioning only what you saw,
heard, or understand of the
situation. Reflect on what
happened and why it happened
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theory

End with Problem Solving/Choices/Setting Limits
Whenever possible, try to end
the situation by guiding or
involving the child in problem-
solving (Somerset Children &
Young People, n.d.).
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theory

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1.A pupil arrives late to class. She refuses to communicate with you and says
“Don’t even start, just leave me alone”;
2. A young person refuses to sit by her usual friends at a youth center and
says that they have been saying unkind comments about her size;
3. A boy regularly fails to complete work independently and will often sit
passively and contribute little. He rarely presents with disruptive behavior but
simply completes very little work. He appears isolated from his peers;
4. A nursery child is crying at drop-off time and is clinging to her parent who
has to go to work;
5. An aggressive, confrontational parent is annoyed because she’s been asked
to come in and talk about her son’s behavior. She approaches you and starts
the conversation by saying, “You’re always having a go at us”;
6. During recess, a group of young boys was fighting and one of them was
hurt (not seriously). You approach them and they all look at you with worried
expressions
* Angry pupil
over not wanting
to attend a
compulsory
revision session

For each scenario, the instructions encourage you to:
Recognize the emotion the child is displaying
Validate that emotion
Label the emotion the child is feeling
Empathize with the child
Set limits, if appropriate, and problem-solve
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theory

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