Current Medical Diagnosis & Treatment in Psychiatry

General Developmental Theories-Attachment Theory

Attachment Theory

Bowlby generated a theory of attachment that has had enormous influence in contemporary developmental psychology. According to Bowlby, infants are born with innate tendencies to seek direct contact with an adult (usually the mother). In contrast to Freud’s perspective that early attachment-seeking is a function of a desire for the mother’s breast (and food), Bowlby argued that attachment seeking is directed toward social contact with the mother (the desire for a love relationship) and driven by fear of unknown others. By about 6??8 months of age, separation from the mother arouses distress, analogous to free-floating anxiety. The distress of a short-term separation is replaced quickly by the warmth of the reunion with the mother, but longer separations (such as occur in hospitalization or abandonment) can induce clinging, suspicion, and anxiety upon reunion. Similar effects are seen in older children until individuation occurs, at which point the child is cognitively able to hold a mental representation of the mother while she is gone, enabling the child to explore novelty.

Bowlby hypothesized that individual differences exist in patterns of parent-infant relationship quality and that the infant acquires a mental representation (or working model) of this relationship that is stored in memory and carried forward to act as a guiding filter for all future relationships. This working model of relationships generalizes to other contexts and allows future interactions to conform with the working model, thereby reinforcing the initial representation of how relationships operate. Thus the quality of the initial parent-infant relationship has primary and enduring effects on later adjustment, relationships, and parenting.

Individual differences in attachment patterns have been assessed through a laboratory procedure called the Strange Situation, devised by Ainsworth. The parent and 12-month-old child are brought to an unfamiliar room containing toys, after which a stranger enters. The parent then leaves the room for a short period, followed by a reunion. The child’s behavior, especially toward the parent upon reunion, is indicative of the quality of the overall parent-child attachment. Attachment classifications are summarized in Table 1-3.

About two thirds of children fit the “secure” response pattern (type B), in which they demonstrate distress when the parent leaves and enthusiasm (or confident pleasure) upon her return. An “avoidant” response pattern (type A) involves little distress and little relief or pleasure upon reunion with the parent. A “resistant or ambivalent” response pattern (type C) involves panicky distress upon the parent’s departure and emotional ambivalence upon reunion (perhaps running toward the parent to be picked up but then immediately, angrily struggling to get down). Recently, scholars have identified a fourth class of response,"disorganized" (type D, empirically linked to early physical or sexual maltreatment), in which the child’s behavior involves great distress and little systematic exploration or seeking of adults.

Applications of the Theory

Follow-up studies have shown that these patterns of attachment are somewhat stable over time (although not strongly correlated across relationships with different adults) and predictive of behavioral adjustment in middle childhood. Infants of types A, C, and D are all at risk for later maladjustment, although more specific patterns of outcome for each type have not been detected reliably. Developmental scholars have created methods for assessing relationship quality and working models at older ages and have related these assessments to current behavioral functioning.

Criticisms of the Theory

Critics of attachment theory suggest that the initial relationship does not determine destiny as strongly as Bowlby argued, and that any long-term predictive power is due to consistency in the environment that led to the child’s initial response pattern. Attachment theory has been used to condemn the practice of early out-of-home daycare (because it interferes with the development of a secure attachment with the mother), even though most studies find little long-term effect of such care after other confounding factors (eg, economics, family stability, stress, later caregiving) are controlled. More broadly, the reversibility of the effects of early social deprivation and trauma remain controversial. The current general conclusion is that even though early experiences shape later experiences through the filter of mental representations, the plasticity of the human organism is greater than previously believed.

Latest entries

  What Is Mental Health Services Research?

  Functions of Mental Health Services Research

  Child versus Adult Research

  History of Services Research

  Relevance to Psychiatry

  Current Issues & Findings in Mental Health Services Research

  Implications for Future Research


  Anxiety Disorders

  Eating Disorders

  Autistic Disorder

  Antisocial Personality Disorder

Copyright © 2004-2005 All Rights Reserved.