Attachment and

psychopathology
Hetal Patel
Learning objectives
By the end of this session you should have some
understanding of:

1. The importance of parental contact in

development

2. Bowlby’s theory of attachment

3. How we might measure attachment

4. Whether attachment can affect development of

psychological problems in later life
Attachment theories
(Harwood et al., 2008)

Freud – I love you because you feed me

◉Biological drives (e.g. hunger and thirst)
◉Basic drives are satisfied – pleasure
◉Attached to those who provide this pleasure

Behaviourist – I love you because you reward me

◉Associate parents with relief of hunger (reward)
◉Learned response

Both the above – hunger is a primary drive, attachment

arises secondary from feeding experiences
 The importance of contact
Classic research by Harlow (1958)
Reared monkeys without their mothers but
with or without a cloth ‘mother substitute’

Monkeys preferred the cloth mother even

when the wire alternative provided food

Monkeys reared only on wire mother

demonstrated behavioural problems
The importance of contact
Recent research by Takeuchi et al., (2010)

◎Investigated impact of interpersonal touch in

childhood on adult adjustment and relationships.

◎Lower levels of interpersonal touching as a child

were associated with:

-Increased likelihood of adult depression

- Poorer image of adults’ current romantic
partner

◎ Relied on self-report
The attachment figure
The idea of a key figure in childhood to whom
we form attachments is prevalent in
developmental psychology

Lorenz (1961)
Seminal work on animal behaviour based on
observations
– Baby geese ‘imprint’ onto their mother
who they follow
– In the absence of mother, the geese
imprinted on Lorenz
The attachment figure
Bowlby (1961) proposed the following ideas:

◎Monotropism – there is an emotional bond

with only one key attachment figure that should be
the mother

◎There is a link between this attachment and

later life – people with psychiatric problems may
have had poor bonding in childhood
Bowlby’s view of attachment
Internal working model - the primary caregiver
is the prototype for future relationships

Critical Period (0-3 years)

•Critical time frame for the bond to develop
or it cannot develop at all
•Optimal period though bond can still
develop outside of this time frame
 Phases of attachment

Phase 3: The
Phase 1: Phase 2: the Phase 4: the Phase 5:
infant prefers
The infant infant begins infant begins School-age
proxmity to
signals to signals to one to accomodate and after.
primary
people or more the ‘primary Attachment
caregiver, and
without discriminated caregivers becomes
is wary of
discriminating. people needs’. ‘abtract’
strangers
 Evaluation of Bowlby

Bowlby’s ‘maternal deprivation hypothesis’ has since been criticised

◉Idea that any (even temporary) separation causes lasting damage
◉Idea of critical/sensitive period
◉Fathers are supplemental to mothers
◉Problems can arise when children lack a strong attachment to
any care-giver.
 Evaluation of Bowlby
However there are some positive aspects
◉Influenced more placement of children with foster families rather than in
institutions.
￮Roy et al., (2000) looked at the outcomes of 19 children over 6 years. Those
who were institutionalised scored significantly worse on attention,
hyperactivity and emotional disturbance, in comparison to those who had
been in long term foster care.

◉Changed the way visiting of sick children in hospital is considered

◉Has evolved over the years to consider other attachment figures than the
mother including fathers and grandparents
Assessing attachment
quality
Ainsworth & Bell (1978) placed 100 infants in a situation of
mild stress (so that they seek comfort) & novelty (so that they
explore).

Both comfort-seeking & exploration behaviours were

indicators of the quality of attachment.

They observed infant & mothers during specific

predetermined activities (“the strange situation”)
The Strange Situation experiment
Styles of attachment proposed by Ainsworth & Bell (1978)
using the ‘strange situation’ experiment

Strange Situation
Children observed during the following events:

1. Play with attachment figure in an unfamiliar environment

2. Stranger enters the room
3. Attachment figure leave child with stranger
4. Attachment figure re-enters.
5. Child left alone
6. Stranger only re-enters.
7. Attachment figure re-enters.
 Assessing attachment quality
Observers recorded behaviours, especially:
◉unease when left by the caregiver
◉infant's willingness to explore
◉infant's response to the presence of a stranger
◉the way the caregiver was greeted on return
 Types of attachment
Type Label Characteristics

A Avoidant Lack of distress at mother’s absence; avoidant

behaviour upon reunion

B Secure Active seeking and maintaining of behaviour.

Any distress upon separation is due to mother’s
absence and contact is sought upon reunion

C Ambivalent/ Some seeking of proximity and contact

resistant combined with contact-resisting behaviour

D Disorganised Inconsistent and bizarre responses; no

discernible pattern (Main and Solomon, 1986).
Ainsworth’s caregiving
hypothesis
oSecure attachment - the caregiver is sensitive to the child’s
needs
oResistant children – the caregiver is interested in them but
may misunderstand them
oAvoidant children: the caregiver is not sensitive, is
indifferent, rejects them, is self-centred, rigid OR suffocates
them with too much interaction even when they do not want
any interaction
oInfants who were unable to establish an organised pattern
of attachment because they are frightened by caregivers or
have experienced caregivers showing frightened or fearful
behaviour (Main and Hesse, 1990).
 Criticism for Ainsworth &
Bell’s conclusions
◎Cannot generalise the results (the sample was not
representative of the general population)

◎Doesn’t take into account the past experiences of the

children (e.g. children who spend time away from the
mother in child care may not be as bothered by her
departure)

◎Another type of attachment, ‘disorganised’ may exist

(Main and Solomon, 1986). Children show inconsistent
behaviour, confusion & indecision.
 Between 1920 and 1940 U.S Children’s
Bureau urged mothers not to pick up their
babies between feedings

This behaviour will teach infants that

crying will get him/her what he/she wants
and make a spoiled, fussy baby who makes
continual demands of the mother
Responding to infant cries
◎Ainsworth et al. (1972) found that mothers who
responded promptly to cries throughout the first year of
life cried less often at age 12 months than those mothers
who did not do respond
◎Enjoy being held but content with less physical
contact and move off into independent exploratory play
◎Responsiveness makes infants learn more
sophisticated social signals to communicate needs and
wants
Impact on future relationships:
The continuity hypothesis

Lots of research linking insecure attachment with

psychological problems.

Bowlby (1946)
Sample of 44 juvenile offenders:

Those who had ‘affectionless psychopathy’ were

more likely to have experienced maternal
separation in the first 6 months of life
The continuity hypothesis (short term)

Kochanska (2001)
Exposed children to fear, anger or joy induced experiences
in a lab.

Children were measured on several occasions from 9-33

months and changes over time assessed

Over time ….
◎Type A became more fearful
◎Type B showed less fear/distress
◎Type C became less joyful
◎Type D became more angry
The continuity hypothesis (long term)

Sroufe, Egeland, Carlson & Collins (2005)

Conducted a large scale longitudinal study with 200
mothers/children.
◎Assessed attachment at 12 and 18 months
◎Various measures of adjustment 30 years later

They found that those with an insecure attachment were:

◎less self-reliant
◎worse at emotional regulation
◎related more poorly to others
Adolescent attachment
In older individuals, attachment assessed by the Adult Attachment
Interview (AAI; George, Kapalan & Main, 1985)

AAI
Semi structured interview which examines memories of childhood. Analysis
of how memories are expressed.
Four main patterns emerged:
1. Autonomous: Objective and open recall (even if memories are not
pleasant)
2. Dismissive: Dismissal of early relationships as unimportant.
3. Enmeshed/preoccupied: High level of dependency on parents which is
still present
4. Unresolved: early trauma or parental death but this has not been come
to terms with.
Adolescent attachment and psychopathology

Rosenstein & Horowitz (1996)

Examined attachment styles of adolescents and mothers.

Sample was 60 adolescents residing in private psychiatric

hospital.

Recorded …
◎Attachment style of adolescent and (in 27 cases)
mother using the AAI
◎Diagnosis
◎Other symptoms
 Adolescent attachment and
psychopathology
Conduct disorder:
• Distress is denied
Autonomous
• Emotions are contained,
but expressed towards
others

Dismissive
Substance abuse
• Expression of emotions
through substance use
• Denial of distress
Preoccupied
Affective disorder
• Expression of extreme
levels of distress
• Distress directed towards
the self Unresolved
Attachment and eating disorders
Eating disorders refer to eating behaviour
considered pathological including:
◎Anorexia nervosa – food restriction and
maintenance of a low body weight
◎Bulimia nervosa - pattern of bingeing and
compensatory behaviours like laxative use or
purging
◎Binge-eating disorder - binge-eating without
compensatory behaviours
Attachment and eating disorders
Ward et al (2000)
Reviewed studies investigating attachment patterns of
◎Clinical populations with eating disorders
◎Student populations [typically] screened for disordered
eating

Found that when using the AAI:

◎Those with restrictive anorexia tended to be dismissive
◎Those with bulimic symptoms tended to be
preoccupied
Does attachment predict psychopathology?

◎Attachment may often be confounded

with other factors:
◉Poor maternal health
◉Parental substance abuse
◉Poverty and lack of resources

◎Attachment styles tend to be passed down from

generation to generation (e.g. Rosenstein & Horowitz,
1996)
◉but this is confounded with genetic similarity

◎Attachment is just one piece of the puzzle

Is phone addiction linked to
attachment style?
Konok et al., 2016
◎Do people who are anxiously attached in their human
relationships show anxious attachment towards their phones?

Results:
◎People with anxious attachment style – reported being more
stressed than others if they couldn’t reach someone on their phone or
couldn’t answer a call.
◎Used their phones more for accessing social networking sites.
◎BUT they did not report greater stress when they were
separated from their phones. Nearly all participants, regardless of
their attachment style, said they felt bad when they were apart from
their phones
◎Anxiously attached people need more contact through the phone
 To summarise
The importance of contact and parental comfort has been
emphasised since the middle of the 20th century

Bowlby proposed that attachment was generally to one

attachment figure and had lasting effects on development and
mental health

Ainsworth devised a method of measuring and classifying

attachment which has been used extensively in developmental
psychology – the Strange Situation (SS)

The AAI and SS are used to determine long term effects of

insecure attachment
Example of exam questions
1. Discuss Bowlby’s theory of attachment
with reference to psychological theory
and research.

2. How important is early attachment for

healthy psychological adjustment later in
life? Discuss with reference to
psychological theory and research.
Any questions?
References
◎Kochanska, G. (2001) ‘Emotional development in
children with difference attachment histories: the first three
years.’ Child Development, 72(2) pp.474-490.
◎Konok, V., Gigler, D., Bereczky, B. and Miklosi, A. (2016)
‘Humans' attachment to their mobile phones and its
relationship with interpersonal attachment style’ Computers in
Human Behaviour, 61 pp.537-547.
◎Takeuchi, M., Miyaoka, H., Tomoda, A., Suzuki, M., Liu,
Q. and Kitamura, T. (2010) ‘The Effect of Interpersonal Touch
During Childhood on Adult Attachment and Depression: A
Neglected Area of Family and Developmental Psychology?’
Journal of Child and Family Studies, 19(1) pp.109-117.