Chapter 9: Attachment Theory and Offending

Backdrop to Bowlby’s Theory

• early 1900s

• Romania banned birth control which led to overcrowding in orphanages (lots of death)

• institutionalized infants — tried to limit contact with infants to prevent disease (bacteria had just been discovered)

  • high mortality rate — sometimes as high as 100%

    • infants need to be loves, touched, snuggled — they can’t survive off just food

Effect of Prevailing Norms — Infants in the hospital

• Parents were not allowed to visit

  • slept less and lost weight

• Bakwin changed the policy because of the bad consequences seen in infants (weight loss, sleep regression)

  • wrote an article discussing the negative impact

  • led to improvement in outcome and dramatic reduction of death in that hospital

    • when parents were allowed to visit

Rene Spitz — Maternal Deprivation

• did studies on infants abrupt long-term separation from caregiver

• anaclitic depression — infants response to grief

  • mourning their relationship with caregiver

  • if separated for more than 5 months, damage is permanent

  • if separated for less than 5 months, infant attachment could return to normal

Effects of Maternal Deprivation

• stunted growth

• motor function

• emotions

• relations

• affective expression

Harry Harlow

• tested cloth vs. wire mom with food (monkeys)

  • baby monkeys preferred cloth mom over food mom

  • activated attachment by scaring monkey and they went to the cloth mom

Attachment Theory

• relationship with caregiver functions as “secure base” when distressed

• formed over time through repeated interaction

• two behavioural systems interact

  • fear system

  • exploratory system

Attachment Theory: Fear System

• maintains proximity to caregiver (not just physical)

Attachment Theory: Exploratory System

• allows exploration and learning

Two Classes of Attachment Behaviour

• signaling behaviour

• approach behaviour

Signaling Behaviour

• cute traits: cute chubby face

  • brings caregiver to child

Approach Behaviour

• brings child to caregiver

• develops later

Internal Working Model

• attachment bonds internalized

• internal working model (schema)

• use IWM to guide interaction with others

Bowlby’s Theory

• evolutionary perspective

• attachment behaviour activated during a threat

  • during threat

    • crying

    • getting closer to caregiver

• increase in attachment behaviours when…

  • experiencing hunger

  • mother leaves

  • experiencing other alarming events (scary robot monkey)

4 Attachment Stages

• pre-attachment phase (0 - 2 months)

• indiscriminate attachment phase (6 weeks - 7 months)

• discriminate attachment phase (7+ months, sometimes earlier)

• multiple attachment phase (12 - 24 months)

Pre-Attachment Phase (0-2 months)

• friendly to everyone

• recognize primary caregiver

• develop sense of trust

Indiscriminate Attachment Phase (6 weeks - 7 months)

• preference for primary and secondary caregiver

Discriminate Attachment Phase (7+ months)

• strong attachment to one caregiver

• separation distress (stranger anxiety)

Multiple Attachment Phase (12 - 24 months)

• develops strong attachment to other caregivers

Measure of Attachment in Infancy — Ainsworth

• strange situation

  • parent behaviour

    • responding

    • warmth

    • guidance

  • infant behaviour

    • response when stressed — mother there

    • response when mother leaves

    • response on reunions

Strange Situation Basis

• Uganda Study

  • observed 26 dyad pairs of moms and babies over a year

  • noticed a pattern of attachment and created the Strange situation study

Strange Situation

• phases

  • mom, baby (intro by observer)

  • mom and baby

  • stranger enters (passive, then tries to interact)

  • mom leaves

  • baby with stranger (stranger tries to comfort)

  • mother returns (mother tries to comfort, then play again)

  • stranger leaves

  • mother leaves

  • baby alone

  • stranger enters (stranger tries to comfort)

  • mom comes back (mother tries to comfort)

• structured observation

• pressing for certain behaviours

• clssified infants as “secure” vs. “insecure”

3 Levels of Scoring Attachment

• discrete behaviour

• interactive behaviour

• classification

Discrete Behaviour

• crying

• smiling

• locomotion (whether they move towards mom, how they look around)

Interactive Behaviour

• proximity and contact seeking

• avoidance

3 Attachment Categories

• secure

• avoidant

• ambivilent

Secure Attachment

• exploration

  • explores room

• separation

  • shows signs of missing parent during separation, often crying by second

• return

  • actively greets parents but usually settles to play

Avoidant Attachment

• children who learn their parents will be mad if they cry/they can’t tryst them so they have to do things in their own

• exploration

  • freely explores room

• separation

  • does not cry (but heart rate is very high)

• return

  • actively avoids/ignores parents

Insecure Anxious/Ambivilent Attachment

• exploration

  • does not explore room

• separation

  • appears very upset

• return

  • greeting parent

  • clingy and difficult to comfort

Mary Main

• student of Ainsworth

• interested in adult attachment — made an interview to measure adult attachment

• added a fourth category of attachment — disorganized/disoriented

Disorganized/Disoriented Attachment

• difficult to classify

• no organized strategy

• abusive caregiver

• caregiver frightening

  • caregiver very mentally ill — severe depression and lots of crying can be scary for kids

• conflict: source of safety is scary

• more likely to develop PTSD, borderline personality, antisocial personality

Secure Infants as Toddlers

• studied at 2 years on a tough task

• secure children compared to insecure children

  • manage stress better

  • enthusiasm

  • persisted more

  • cooperated more — better social skills

Caregiver’s Role

• during the 2 year old task, parents of secure children:

  • more helpful

  • not too intrusive

  • more sensitive to child’s cues

  • pacing to suit child

  • more physically affectionate (warmth)

  • promoted exploration and competence

Minesota Study of Risk and Adaptation Longitudinal Study

• 180 dyads in poverty

• infancy to 34 years

• secure attachment (and stayed securely attached) in school associated with…

  • higher self-esteem and ego resiliency

  • higher creativity and imagination

  • more independence

• more category changes in this study

Secure Attachment Later

• adolescence (secure attachment)

  • more adaptive relational skills

  • better school performance

• disorganized attachment

  • more likely to show psychopathology in adolescence and adulthood

• measure of attachment during infancy better predictor of later relationships

• no association between temperature and infancy classification

Emotional Adjustment at 22

• ask for help

• better communicator when distressed

• better regulating emotion in challenging social situations

• value relationships more

Changes Across Lifetime

• classification is fairly stable

• some change during major events

  • change in support system (ex; parent death)

  • increase in stress (ex; start of war)

• even major life changes do not erase early attachment

Social Cognition Review

• most children are born ready to be “programmed” through social interaction

• several early skills that make children socially attuned

• skills help with learning

  • various everyday skills

  • social and emotional understanding

Core Skills

• dyadic reciprocal interaction

• triadic interaction

• imitation

• symbolic development

Dyadic Reciprocal Interaction

• talk to baby and they make some sort of noise in response

Triadic Interaction

• object is involved

  • receptive — showing something

  • initiating — giving something

Symbolic Development

• pretend play

• language

Synchrony

• emotion/behaviour of caregiver and child is correlated in time

• main function is to provide regulation of emotion

External Regulation

• baby is born with immature brain

• dependent initially on parent for regulation of physiological symptoms — physiological responses are better regulated when baby is near parents

  • temperature

  • breathing

  • circadian rythms

• birth to 2 months

Tronick & Gianino (1986)

• mother is important for emotional regulation

• during face to face interaction

  • match

  • mismatch

  • repair — this is the most critical for development of good attachment

• midrange match is best for attachment

• help infants balance affiliation and exploration of world

Depressed Mothers

• babies with depressed moms experience the same consequences as those in the still face study

  • have to work on emotional regulation

  • find it difficult to explore the world

  • Tronick & Weinberg (2000)

    • depressed moms do not match and repair

    • boys are more vulnerable

  • brains of babies of depressed mothers are different

Baby Blues

• effects about 50% of women

  • weepiness

  • sadness

  • loss of appetite

• linked to changing hormone levels

Postpartum Depression

• effects about 10-15% of women

  • symptoms are more severe than baby blues

  • symptoms last longer than 1 week

  • symptoms interfere with life

  • symptoms impact mother-child relationships

Still-Face Procedure

• Tronick & collegues created still-face paradigm

  • mom’s expression is flat

  • simulates depressed mom’s facial expressions

• typical infants are very upset by it but repair

• Weinberg et al. (2006) found that infants of depressed moms rake longer to repair

Parental Sensitivity, Responsiveness, and Warmth → Infant Attachment → Parental State of Mind → Parental Sensitivity, Responsiveness, and Warmth → …

Parental State of Mind

• theory of mind/mentalization

  • ability to understand other people have their own thoughts/feelings

  • ability to put yourself in someone else’s shoes

Abuse and Emotional Development

• attachment is strongly linked to later emotional regulation

• abuse interferes with normal emotional development

• research indicates a link between early abuse (impacts brain development and social skills) and borderline personality disorder

• adverse childhood experiences effect the child’s sense of security

  • constantly living in a state of fear/anxiety can effect brain development

• children can be…

  • dandelions — thrive no matter the environment

  • orchids — need a really good environment to thrive

Sensitivity Extremes

• kids have unrealistic expectations about how others will treat them

  • too sensitive — treat them too gently

  • not sensitive — abusive or neglectful

3 Types of Adverse Childhood Experiences

• Abuse

  • physical

  • emotional

  • sexual

• Neglect

  • physical

  • emotional

• Household Dysfunction

  • mental illness

  • mother treated violently

  • divorce

  • incarcerated relative

  • substance abuse

Borderline Personality Disorder

• avoids imagined/real abandonment

• emotions run high (quick switch from very angry/anxious to emotionally numb)

  • anger

  • anxiety

• relationships are intense

  • very happy when things are good, very upset when things are bad

  • difficulty with all relationships even with a therapist

• unstable self image

  • like cameleons — mold themselves to whatever environment they are in

• reoccuring suicide behaviour/ideation

BPD and Attachment

• associated with disorganized/disoriented attachment

• link between attachment and theory of mind/mentalization

• deficits in mentalization

  • in a constant state of hypervigilence/anxiety

    • interferes with the ability to be social and think about how others think/feel (hard to shift attention)

• hyper responsive to emotion

• failure to self narrate

PTSD and Attachment

• increased risk of PTSD if attachment is disorganized

• some have linked behaviour of attachment disorfered children to PTSD

Fear and Development of Conscience

• normal fear is important for conscience

• evidence

  • typical development

    • fearful children develop conscience more easily

    • fear serves as inhibition

  • psychopaths

    • evidence of a lower level of fear

    • do not react to others’ pain

What Causes Psychopathy

• nurture

  • some evidence of abuse and antisocial personality disorder

  • avoidant and ambivalent attachment

• nature

  • parenting quality associated with externalizing problems in typical children

    • children with high callous-emotional traits

**mix of both causes psychopathy

2 Types of Antisocial Individuals

• impulsive

  • more reactive than instrumental aggression

    • more anxious/emotionally disregulated

• callous/unemotional

  • both reactive and instrumental aggression

    • get angry but with different cues and stuff

2 Types of Aggression

• reactive

  • more impulsive

  • anger in response to something

• instrumental/proactive

  • deliberate/planned aggression

Capacity to Mentalize

• Adshed & Moore

  • mentalization mediates the association of attachment and problems in relationships

• mentalizing skills strongly associated with self-reflection

• insecure attachment over-represented in individuals with mental disorders

• disorganized attachment is associated with severe mental disorders such as psychosis and personality disorders

Attachment Insecurity and Offenders

• Bowlby worked with juvenille delinquents and noticed many of them didn’t have secure attachment

  • avoidant attachment is very common in violent offenders

  • suggested treatment should include

    • secure base with therapist

    • acts as a regulator

• attachment insecurity is a risk factor for offending

• avoidant attachment is most frequent in violent offenders (50-60% vs. 16% in general population)

• men who are violent with intimate partner — high rate preoccipied/ambivalent

  • linked to borderline personality disorder

• women who kill their own children

  • many had disorganized attachment

Attachment Insecurity as Violence Risk Factor

• attachment insecurity is closely linked to emotion dysregulation

  • deactivation and avoidance of feeling (numb or flat)

  • disorganized, hyperactive emotional response

• conflict with victim activates strong painful feelings

  • avoiders (generally violent males)

    • may react with anger

  • anxious (male domestic abusers)

    • may react by being overwhelmed and externalize feeling

  • disorganized

    • may lead to both anger and being overwhelmed (may oscillate between anger and helplessness)

• when triggered

  • unable to mentalize and read others’ intent accurately

  • react in concert with their own interpretation of the events

Attachment and Forensic Practice

• treatment for offenders with PD

  • programs to support prosocial state of mind

  • encourage mentalizing

• pilot study in England on this program for ASPD is promising

Attachment and Forensic Institutions

• offenders may develop attachment to their prison

• particularly relevant to offenders who have had a chaotic life

• staff needs to be sensitive to this

• relevant when offender is transferred

• may have a period of difficulty adjusting

Offenders Relationship with Staff

• power imbalance in prison system

• relationship problems may arise from insecure attachment issues in either staff or resident

• abuse of resident in the form of belittling, name calling, rudeness, inconsistent care, etc.

• important for training of staff to include attachment based ideas

Attachment Informed Assessment and Intervention

• clinician needs to establish rapport/trust first

• history of caregivers, experiences contributing to attachment needs to be assessed

• help oofender understand the meaning of violence for their situation

• relate their offense to history

• understanding attachment witll help clinician anticipate problems

• building a rapport will depend on the offenders particular type of attachment

Risk Assessment

• attachment is crucial for assessing risk of reoffending

  • interpersonal function

  • affect regulation

• several instruments available that assess both attachment and risk

• assessor must be self-aware

  • what types of emotion do they feel when interacting with offender?

  • how does that relate to their own attachment and needs?