Summary

1. Age Maternal Separation Anxiety Adult Relationship Avoidance Adult Relationship Anxiety Child Attachment Maternal Separation Anxiety -.110 Adult Relationship Avoidance .174 .107 -.023 .292 .504* Adult Relationship Anxiety Child Attachment -.441* .042 -.460* -.181 Has SAD? -.074 .090 -.133 -.147 .126 * p<.001 THE ROLE OF PARENT AND CHILD ATTACHMENT IN SEPARATION ANXIETY DISORDER Eileen Rodriguez, Steven L. Berman, Irving Zamora, Jacqueline Alfonso, Wendy K. Silverman Child Anxiety and Phobia Program at Florida International University, Miami, Florida Presented at the Association for Advancement of Behavior Therapy’s Annual Convention, Nov. 2000, New Orleans Summary The assumption that the quality of the offspring-caretaker interaction is a major determinant of the early attachment, and the assumption that early attachment style is predictive of later adult interpersonal functioning (including adult insecurity and anxiety) are both core assumptions in the attachment literature. However, previous studies have not examined these assumptions directly with children and their parents. The first aim of this study was to begin to test some of the core developmental assumptions of the attachment literature by examining whether insecure attachment and/or Separation Anxiety Disorder (SAD) in the parent predicts (1) insecure attachment in the child and (2) SAD in the child. The second aim of this study was to examine whether insecure attachment in the child predicts SAD in the child. Participants were 39 children (20 females, 19 males; age 7 to 17 years, M = 10.74 years, SD.= 2.75) and their parents referred to a child anxiety and phobia treatment program. Neither child nor parent attachment was related to SAD in the child. Maternal separation anxiety also failed to predict SAD in the child. The best predictors of child attachment were child’s age and maternal relationship avoidance. Implications of these results in regard to attachment theory are discussed. Introduction Method Measures Separation Anxiety Disorder in the child was assessed via the Anxiety Disorders Interview Schedule for for DSM IV: Child Version, (ADIS-C: IV & ADIS-P: IV; Silverman & Albano, 1996) which are structured interviews used to derive DSM IV diagnoses. The Maternal Separation Anxiety Scale (MSAS; Hock, McBride, & Gnezda, 1989) was used to assess maternal separation anxiety, and Experiences in Close Relationships (ECL; Brennan, Clark, & Shaver, 1998) was used to measure adult attachment style. The ECR yields two indices of adult attachment (relationship anxiety and relationship avoidance). The strength of children’s attachment to their parents was assessed via the Inventory of Parent and Peer Attachment (IPPA; Armsden & Greenberg, 1987). Procedure Participants referred for treatment of child anxiety and phobias were assessed by trained interviewers using the ADIS-C: IV & ADIS-P: IV. While the child was being interviewed, the parent (usually the mother) was in a separate room completing the paper and pencil surveys, and vice versa. Trained research assistants read the questions on the survey to children 10 and under. Participants Participants were 39 children (20 females, 19 males) and their parents referred to the Child Anxiety and Phobia Program at Florida International University, Miami. Children’s age ranged from 7 to 17 years (M = 10.74 years, SD = 2.75). Participants identified themselves as belonging to one of the following ethnic groups: Hispanic (53.8%), White (25.6%), Black (5.1%), Asian (5.1%), and Other (10.3%). Results and Discussion A series of regression analyses were conducted to examine the predictive links between attachment and separation anxiety variables in parents and their children. The best predictors of child attachment were child’s age and maternal relationship avoidance, yielding a significant regression equation, F(3,35)=6.15, p=.002, R=59%, R2=35%, with beta weights for age equal to -.37 (t=-2.64, p=.012) and relationship avoidance equal to -.40 (t=-2.48, p=.018). The correlations between variables can be seen in Table 1. The negative correlation between age and child attachment suggests that the intensity of children’s attachment to their parents declines with age. Adult attachment was measured in terms of feelings about adult romantic relationships rather than attachment toward the child. The two subscales of adult attachment, relationship anxiety and relationship avoidance, were positively correlated. In addition, and more interestingly, adult relationship avoidance was negatively correlated with child attachment. Thus, parents who avoid close romantic relationships tended to have children who were less attached to them. It might be the case that adults who avoid close romantic relationships also avoid close relationships with their children, thus, their children in turn feel less close (attached) to them. However less direct pathways are also theoretically possible. For instance, parents who avoid close romantic relationships with their peers might instead become more invested in their children. These children might react negatively toward their parents’ intrusive attempts at enmeshment and rebel by pushing away the parent and becoming less attached. Future research is needed to further examine these possibilities. Neither child nor parent attachment was related to SAD in the child nor in the parent. Maternal separation anxiety also failed to predict SAD in the child.The lack of an expected relation between the attachment variables and SAD was surprising and suggests the need for further investigation. Some possible explanations may be found in the limitations of this study. For instance, SAD was measured as an all or none variable (i.e., meets DSM IV criteria vs. does not meet criteria) thus limiting the range of scores. A continuous measure may be more sensitive to a possible relationship. Likewise, using a sample of anxiety disordered children may limit the range of anxiety levels. On the other hand, the measures of child and adult attachment relied on continuous measures that are not exactly the same as Ainsworth’s categorical measurement approach. Future studies need to investigate some of these other approaches to construct measurement before we can fully interpret these results. Attachment theory suggests that infants are capable of forming an enduring emotional bond with their caretakers (Ainsworth, 1973, 1989; Bowlby, 1982, 1988) which provides a lasting sense of security that continues even when the caretaker is not present, and persists throughout the individual’s life into adulthood. On the other hand, a non-responsive caretaker can cause the child to be insecure and develop “interactional styles” (Bretherton, 1985) of either clinging dependency or resentful detachment. These styles become especially salient in the context of separation from attachment figures and in relating to strangers. Bowlby used the term “internal working model” to describe the way in which the relationship with the child’s primary caretaker serves to guide the child’s life long approach to all future relationships including friendships and romantic relationships. Although some literature has been emerging in an attempt to establish the long term stability of attachment style (Armsden & Greenberg, 1987; Mayseless, Danieli, & Sharabany, 1996; Papini & Roggman, 1992; Papini, Roggman, & Anderson, 1991), most of the evidence comes from studies that have used retrospective methods to show that adults’ recollections of their relationship with their own parents are related to current classifications of their adult romantic attachments (Feeney & Noller, 1990; Hazan & Shaver, 1987). The core assumption that parents’ responsiveness to their children’s needs is a crucial factor in determining attachment style suggests the notion of intergenerational transmission in that an insecurely attached parent is likely to foster the development of an insecurely attached child. Some studies have used retrospective methods to show that adults’ recollections of their relationship with their own parents are related to the classification of their infant’s attachment to them (Main, Kaplan, & Cassidy, 1985; van Ijzendoorn, 1995). More research is needed to determine if this relation continues to exist among older children and adolescents with their parents. Better knowledge of the etiology and developmental continuity of attachment security might have important implications for the understanding and treatment of attachment related disorders such as Separation Anxiety Disorder (SAD). Table 1: Correlation Matrix for Age, Attachment, and Separation Anxiety Variables Despite the strong theoretical link, there is a paucity of empirical research to document the relation between attachment style and anxiety disorders in general and Separation Anxiety Disorder in particular. One study exploring this issue found a relation between one of Ainsworth’s insecure attachment styles (i.e., anxious/resistant) and various anxiety disorders, including SAD in adolescents (Warren, Huston, Egeland, & Sroufe, 1997). More specifically, attachment style at 12 months of age predicted anxiety disorders at 17 years of age. Although this finding suggests a link between early attachment and later anxiety disorders, more research is needed to further investigate this linkage. The present study examined child and parent socio-demographic variables (age, gender, ethnicity) and psychosocial variables (child attachment, parent attachment, and parent separation anxiety) that may contribute to and/or maintain Separation Anxiety Disorder. The relation among these variables was investigated both cross-sectionally (i.e., Does child attachment predict child separation anxiety; does adult attachment predict adult separation anxiety?) and intergenerationally (i.e., Does attachment and/or separation anxiety in the parent predict attachment and/or separation anxiety in the child?) as a way to begin to evaluate their developmental linkages. References Ainsworth, M.D.S. (1973). The development of infant-mother attachment. In B.M. Caldwell & H.N. Ricciuti (Eds.), Review of child development research (Vol. 3). Chicago: University of Chicago Press. Ainsworth, M.D.S. (1989). Attachments beyond infancy. American Psychologist, 44, 709-716. Armsden, G.C., & Greenberg, M.T. (1987) The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16, 427-454. Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment. New York: Basic Books. Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. NY: Basic Books. Brennan, K., Clark, C. & Shaver, P. (1998). Self-report measurement of adult attachment: An integrative overview. In J. Simpson & W.S. Rholes (Eds.), Attachment theory and close relationships (pp. 46-76). New York: Guilford Press. Bretherton, I. (1985). Attachment theory. In I. Bretherton & E. Waters (Eds.), Growing points in attachment theory and research. Monograph of the society for research in child development, Vol. 50, (1-2, Serial No. 209), U. of Chicago Press. Feeney, J.A., & Noller, P. (1990). Attachment style as a predictor of adult romantic relationships. Journal of Personality and Social Psychology, 58, 281-291. Hazan, C., & Shaver, P.R. (1987). Romantic love conceptualised as an attachment process. Journal of Personality and Social Psychology, 52, 511-524. Hock, E., McBride, S., & Gnezda, M. (1989). Maternal separation anxiety: Mother-infant separation from the maternal perspective. Child Development, 60, 793-802. Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. In I. Bretherton & E. Waters (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50 (1-2, Serial No. 209), 66-106. Mayseless, O., Danieli, R., & Sharabany, R. (1996) Adults’ attachment patterns: Coping with separations. Journal of Youth and Adolescence, 25, 667-690. Papini, D.R., Roggman, L.A., & Anderson, J. (1991). Early-adolescent perceptions of attachment to mother and father: a test of the emotional distancing and buffering hypotheses. Journal of Early Adolescence, 11, 258-275. Papini, D.R., & Roggman, L.A. (1992) Adolescent perceived attachment to parents in relation to competence, depression, and anxiety: A longitudinal study. Journal of Early Adolescence, 12, 420-440. Silverman, W.K. & Albano, A.M. (1996). The anxiety disorders interview schedule for DSM IV: Child version. San Antonio, TX: The Psychological Corporation. Van Ijzendoorn, M.H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin, 117, 387-403. Warren, S. L., Huston, L., Egeland, B., & Sroufe, L. A. (1997). Child and adolescent anxiety disorders and early attachment. Journal of the American Academy of Child & Adolescent Psychiatry, 36 , 387-403.