Tuesday, April 8, 2014

What are attachment and bonding in infancy and childhood?


Introduction


Bonding refers to the development of an emotional tie of the mother to the infant. This biologically based process is believed to occur in mothers shortly after the birth of an infant, when the
mother’s intense emotional response is triggered by contact with her newborn. The existence of such a bond is then evidenced in the mother’s behavior. Attachment, on the other hand, refers to a relationship between the caregiver and infant that develops over the infant’s first year of life; the quality of the attachment is apparent in the behavior of the infant.










Evidence for the biologically based bonding process remains limited. According to Karl Heinz Brisch, neurobiological research suggests that mirror neurons play a role in a mother's sensitivity, that is, her empathic capability and responsiveness to the infant's needs, and that maternal sensitivity is heritable. Oxytocin, a hormone released during pregnancy and after birth, is thought to be not only responsible for regulating labor and lactation but also for promoting the maternal bonding process. The concept of attachment, in contrast to bonding, has more empirical support. Thus, the remainder of this discussion will focus on the development of the attachment relationship.


The work of British psychiatrist John Bowlby played an important role in the acceptance and understanding of the notion of mother-infant attachment. Bowlby argued that the behaviors of infants are not random and that some of the behaviors exhibited most commonly by infants actually serve a single goal. Specifically, he argued that the behaviors of crying, babbling, smiling, clinging, nonnutritional sucking, and following all play an important role in bringing infants into close contact with the caregiver. He believed that, for infants, seeking and maintaining proximity to their caregivers are essential for survival because infants depend on the caregiver for food, shelter, and protection. Thus, infants’ behavior is organized and goal-directed. Infants neither understand this goal nor learn this behavior but rather are born with a biological predisposition to engage in certain behaviors that aid in maintaining proximity to the caregiver. With further development, infants become more aware of the goal, and therefore their behaviors become more intentional.


The emotional state of infants is also believed to play an important role in attempts to seek and maintain proximity to the caregiver. That is, infants’ behavior depends on their sense of emotional security. For example, as long as children are in the immediate presence of the attachment figure, or within easy reach, they feel secure and may then attend to important developmental tasks such as exploration of the environment, using the mother as a secure base from which to explore. On the threat of loss of the attachment figure, however, infants may lose that sense of security and may exhibit attachment behaviors designed to increase the proximity of the attachment figure. Thus, infants’ attempts to seek or maintain proximity to the caregiver are determined by how secure they feel with the caregiver in a specific environment.


The attachment relationship and infants’ sense of security develop over the period of infancy. Bowlby has described four phases in the development of attachment to the caregiver. In phase 1, newborns show limited discrimination among people and therefore exhibit no preferential or differential behaviors, thus behaving in a friendly manner toward all people. In phase 2, eight- to twelve-week-old infants show the ability to discriminate the caregiver from others but exhibit no preferential behavior toward the caregiver. In phase 3, which generally appears at approximately seven or eight months of age, infants clearly discriminate the caregiver from other people and begin to show preferential treatment toward the caregiver. For example, infants begin to follow their departing mother, greet her on her return, and use her as a base from which to explore an unfamiliar environment. Furthermore, during phase 3, infants begin to treat strangers with caution and may withdraw from them. In phase 4, children maintain a goal-directed partnership with the caregiver, a more complex relationship in which children are acquiring some insight into the caregiver’s own feelings and motives, and thus interact with the caregiver as a partner. This final phase is apparent in most children by preschool.




Patterns of Infant-Mother Attachment

During the second half of the first year of life (after about eight months of age), infants begin to show very clear attempts at exploration when their mothers are present. In fact, research reported by Mary Ainsworth in the mid-1970s suggests that once infants are able to crawl, they do not always remain close to their mother. Instead, they begin to move away from their mother, more carefully exploring objects and people. From time to time children return to her, as if to check her whereabouts or to check in with her. If their mother moves away, however, or if the infants are frightened by some event, they will either approach their mother or will signal to bring her closer. For example, infants often fuss, cry, and cling to their caregiver at the first sign of their caregiver’s possible departure, a response known as "separation protest." At about the same time, infants begin to express stranger anxiety or stranger wariness by fussing and crying when an unfamiliar person enters the room or approaches.


Ainsworth designed a special laboratory technique, known as the "strange situation," that allows direct observation of the interactions between the behaviors associated with exploration, attachment, separation protest, and stranger anxiety. This situation places an infant in an unfamiliar setting with a stranger, both in the presence and in the absence of the child’s mother. The procedure consists of a series of three-minute episodes (the process lasts a total of about twenty minutes) in which the child is exposed to an unfamiliar playroom containing a set of age-appropriate toys. During the initial episodes, the mother remains in the playroom with the infant. Mother and infant are then joined in the playroom by a female stranger, who first talks to the mother, then approaches the child. Next, the mother leaves the room, and the infant and stranger are left alone together. The mother then returns and the stranger leaves, so that the infant is reunited with the mother. Following this episode, the infant is left alone in the room, then joined by the stranger; finally, the mother again returns and the stranger leaves.


This strange situation, therefore, exposes a child to three potentially upsetting experiences: separation from the caregiver, contact with a stranger, and unfamiliar surroundings. The episodes are arranged in such a way that they present a series of stressful experiences to the infant and thus present an opportunity to observe not only the infant’s immediate response to a stranger and to separation from the mother, but also the child’s ability to derive comfort from the mother and to use her as a secure base for exploration.


Ainsworth has reported that, while there are many similarities in infant responses to this strange situation, there are also important individual differences. In her initial study of twelve-month-old infants and their mothers, Ainsworth reported three distinct patterns of responding to the events of the strange situation, and the validity of these behavior patterns has been demonstrated by much additional research.


A majority of the infants exhibited active exploration of the new environment and the available toys when their mothers were present. Some of these infants showed distress during the first separation from their mother, and by the second separation, the majority of these infants expressed distress. On reunion with their mother, they actively sought contact with her and were easily comforted by her, showing considerable signs of positive emotion but very few, if any, signs of negative emotion. Furthermore, these infants frequently returned to play and exploration after a period of contact with their mother. In general, then, these infants used their mothers as a secure base from which to explore the novel environment, exhibited appropriate attachment behaviors following her departure, and were easily comforted by the mother on her return. Ainsworth suggested that this pattern of behavior reflects a secure attachment relationship.


A second group of infants showed a very different pattern of behavior. This minority group showed no evidence of distress during separation. They did sometimes show distress when left alone in the playroom but were easily comforted by the returning stranger. Furthermore, this group actually avoided or ignored their mothers when they returned. In essence, the mothers were treated very much as were the strangers. These infants showed virtually no signs of separation protest or stranger anxiety and exhibited very few attachment behaviors. Ainsworth suggested that this pattern of behavior reflects an insecure-avoidant attachment relationship.


Finally, a third group of children were extremely distressed on separation, but, despite their obvious separation and stranger anxiety, resisted comfort from their mothers. Their behavior suggested an angry ambivalence—they objected to being left alone, but they refused to be consoled when reunited with their mothers. This group of infants often exhibited distress on first entering the unfamiliar room with their mothers, and they rarely left the mother’s side to explore the toys or the environment, either before or after separation, suggesting a lack of a sense of security. Ainsworth suggested that this behavior pattern reflects an insecure, resistant, or ambivalent attachment relationship.


It is important to note that Ainsworth’s research was done in the United States in the 1970s. Follow-up work has demonstrated that various sociocultural factors can influence the patterns of attachment behavior seen in the strange situation. For instance, studies done in Germany in the 1980s revealed that as many as 60 percent of babies in that culture were classified as insecure-avoidant because of their lack of distress at separation from their mothers in the strange situation test. In contrast, studies of attachment carried out in Japan in the 1980s and 1990s indicate that up to 40 percent of Japanese infants are classified as insecure-ambivalent in the strange situation due to their tendency to cling to their mothers throughout the procedure. These differing cross-cultural patterns imply that the wider sociocultural context influences how mothers and infants interact: German mothers expect their infants to be relatively self-sufficient and confident, even during short separations such as those characteristic of the strange situation procedure. Japanese mothers, on the other hand, expect their infants to be upset when they are out of close proximity and in daily practice are unlikely to leave their infants alone even for short periods. These cross-cultural variations in patterns of attachment highlight the importance of considering mother-infant attachment in context.


Several follow-up studies were conducted by E. Hesse, M. Main, C. C. George, J. Solomon, K. Lyons-Ruth, and others in the 1990s using the strange situation. Their findings showed that a number of children could not be categorized as secure, insecure-avoidant, or insecure-ambivalent. Those children instead exhibited contradictory or partial responses to the experimental conditions and, often, repetitive behaviors or movements. This attachment type has been termed "insecure-disorganized" or "insecure-disoriented," and further research by M. L. Rutter and T. G. O'Connor in the late 1990s and early 2000s indicates a correlation between disorganized attachment and attention-deficit hyperactivity disorder (ADHD) in school-aged children.


The development of these distinct patterns of attachment is believed to be the result of the history of interaction between the caregiver and infant. Specifically, attachment theory suggests that responsive and consistent ("sensitive") caregiving results in a secure mother-infant attachment, unresponsive caregiving results in an avoidant attachment, and inconsistent caregiving results in a resistant/ambivalent attachment. The avoidant mother has been described as cold and disliking physical contact with the infant, who responds by acting aloof and avoiding social interaction. The resistant mother, however, has been described as unpredictable, sometimes responding but sometimes not, and the infant often responds with anger and ambivalence. Risk factors for disorganized attachment appear to include unresolved parental trauma, preterm birth, early abuse or neglect, infant health conditions, and genetic variation in dopamine regulation


As the infant matures, the specific behaviors that indicate the existence of the attachment relationship may change. The research evidence strongly suggests, however, that such individual differences in the quality of the mother-infant attachment relationship are predictive of later behavior. For example, infants who exhibit secure attachment patterns at one year of age have been found to be more cooperative with adults, to show greater enthusiasm for learning, to be more independent, and to be more popular with their peers during the preschool years. Thus, the quality of the mother-infant attachment relationship may have long-range effects. This does not mean that the child’s future is determined solely by the quality of the attachment relationship. The evidence indicates that certain negative consequences of an insecure attachment relationship may be overcome by changes in the nature of the child’s important relationships.




Attachment in Nonhuman Primates

The existence of a mother-infant attachment relationship has been recognized for many years. For most of those years, however, psychologists explained the development of this attachment by way of traditional learning theory. That is, behaviorists argued that the infant-mother attachment develops because mothers are associated with the powerful, reinforcing event of being fed. In this way, the mother becomes a conditioned reinforcer. This reinforcement theory of attachment, however, came into question as a result of the work of Harry and Margaret Harlow in the early 1960s.


The
Harlows’ work was not with human infants but with infant rhesus monkeys. They removed newborn monkeys from their mothers at birth and raised them in the laboratory with two types of artificial or surrogate mothers. One surrogate mother was made of terrycloth and could provide “contact comfort.” The other surrogate mother was made of wire. A feeding bottle was attached to one of the substitute mothers for each of the monkeys. Half of the monkeys were fed by the wire mother; the other half were fed by the cloth mother. This allowed the Harlows to compare the importance of feeding with the importance of contact comfort for the monkeys.


To elicit attachment behaviors, the Harlows introduced some frightening stimulus, such as a strange toy, into the cages of the young monkeys. They expected that if feeding were the key to attachment, then the frightened monkeys should run to the surrogate mother that fed them. This was not the case, however: all the young monkeys ran to their cloth mothers and clung to them, even if they were not fed by them. Only the cloth mothers were able to provide security for the frightened monkeys. The Harlows concluded that a simple reinforcement explanation of attachment was inaccurate and that the contact comfort, not the food, provided by a mother plays a critical role in the development of attachment.


This research provided the impetus for the development of Bowlby’s ethological account of attachment. Since that time, research by Ainsworth and Alan Sroufe, as well as many others, has provided important information for the continuing development of understanding of the complex relationship between caregivers and infants.




Bibliography


Ainsworth, Mary D. Salter, et al. Patterns of Attachment: A Psychological Study of the Strange Situation. 1978. New York: Psychology, 2014. Print.



Bowlby, John. Attachment and Loss. 2nd ed. New York: Basic, 1999. Print.



Brisch, Karl Heinz. "Attachment Theory and Its Basic Concepts." Treating Attachment Disorders: From Theory to Therapy. New York: Guilford, 2012. 7–71. Print.



Cassidy, Jude, and Phillip R. Shaver, eds. Handbook of Attachment: Theory, Research, and Clinical Applications. 2nd ed. New York: Guilford, 2008. Print.



Crittenden, Patricia McKinsey, and Angelika Hartl Claussen, eds. The Organization of Attachment Relationships: Maturation, Culture, and Context. 2000. New York: Cambridge UP, 2003. Print.



Hirsch, Larissa. "Bonding with Your Baby." KidsHealth.org. Nemours Foundation, Jan. 2012. Web.19 Feb. 2014.



Posada, Germán, and Garene Kaloustian. "Attachment in Infancy." Wiley-Blackwell Handbook of Infant Development. Malden: Wiley-Blackwell, 2010. 483–509. Print.



Oppenheim, David, and Douglas F. Goldsmith, eds. Attachment Theory in Clinical Work with Children: Bridging the Gap between Research and Practice. New York: Guilford, 2007. Print.



Rubin, Kenneth H., Wonjung Oh, Melissa Menzer, and Katie Ellison. "Dyadic Relationships from a Cross-Cultural Perspective: Parent–Child Relationships and Friendships." Socioemotional Development in Cultural Context. Ed. Xinyin Chen and Kenneth H. Rubin. New York: Guilford, 2011. 208–38. Print.

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