Understanding attachment
Dr Eileen Scott
Public Health Adviser
Children, Families and Communities
Evidence for Action
Outline
• Introduction to attachment theory – attachment what
is it?
• The nature of attachment – the development of
attachment
• Styles of attachment
• Promoting secure attachment – the effectiveness of
interventions
Attachment – what is it?
• Theory developed by John Bowlby in the 1950s
‘the disposition of the child to seek proximity to and
contact with a specific figure and to do so in certain
situations, notably when he is frightened, tired or ill.’
• Ability to form attachments is biological and present from
birth
Attachment = bond from child to caregiver
Bonding = bond from caregiver to child
Development of attachment
• Develops over time and through experience of the caregiving
relationship
• Caregiver responses influence the quality and style of child’s
attachment
• A sensitive response is the ability to understand and react
appropriately and quickly to child’s attachment behaviour.
Sensitive, responsive care is associated with secure
attachment.
• Abusive or neglectful home environments are associated with
disorganised attachment (Van Ijzendoorn et al , 1999)
• Caregiving is one aspect of parenting, other important aspects
include feeding, teaching and play.
Attachment Styles
Why does attachment style matter?
Secure
•
•
•
•
Self confidence
Self esteem
Ability to cope with life stress
Emotional Control
Disorganised
•
•
•
Relationship problems
Emotional problems
Violence and aggression
But it’s not deterministic – other factors such as life stress are likely to
influence life outcomes.
Children with secure attachment can develop problems and most
children with insecure attachment do not have significant problems
(Sroufe et al, 2006; Prior and Glaser, 2006)
Promoting
secure
attachment
Promoting
secure
attachment
• Effective interventions specifically focus on improving sensitive
responses to child’s attachment behaviour
• Interventions which enhancing parental sensitivity are universally
effective (including high risk populations)
• Most effective interventions are brief and behaviourally focused e.g.
– Encouraging close physical contact i.e. soft carriers and
kangaroo care
– Providing information on sensory and perceptual capabilities of
infants
• Promoting the development of secure attachment and reducing
disorganised attachment has the potential to reduce health
inequalities within the early years and longer term.
(Barlow et al., 2008; Bakermans-Kranenburg et al., 2003, Demott et al., 2006)
References
•
•
•
•
•
•
•
Bakermans-Kranenburg MJ, Van Ijzendoorn MH. Less is more: Meta-analyses
of sensitivity and attachment interventions in early childhood. Psychological
Bulletin. 2003; 129 (2):195–215.
Barlow J, Schrader McMillan A, Kirkpatrick S, Ghate D, Smith M, Barnes J.
Health-led parenting interventions in pregnancy and the early years. Research
Report DCSF–RW070. London: DCSF; 2008.
Bowlby J. Attachment and Loss: Vol. 1 Attachment (2nd edn). London: Hogarth
Press; NY Basic Books; 1982.
Demott K, Bick D, Norman R et al. Clinical Guidelines and Evidence Review for
Post Natal Care: Routine Post Natal Care of Recently Delivered Women and
their Babies. London: National Collaborating Centre for Primary Care and Royal
College of General Practitioners; 2006.
Prior V, Glaser, D. Understanding attachment and attachment disorders. Theory,
evidence and practice. London: Jessica Kingsley Publishers; 2006.
Sroufe, L.A. Attachment and development:a prospective, longitudinal study from
birth to adulthood. Attachment and Human Development. 2006; 7:4, 349–367.
Van Ijzendoorn MH, Schuengel C, Bakermans-Kranenburg MJ. Disorganized
attachment in early childhood: Meta-analysis of precursors, concomitants, and
sequelae. Development and Psychopathology. 1999; 11, 225–249