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Chapter 31: Child Psychiatry
raised with terry-cloth surrogates showed intense clinging
behavior and appeared to be comforted, whereas those raised
with wire-mesh surrogates gained no comfort and appeared
to be disorganized. The results of Harlow’s experiments were
widely interpreted as indicating that infant attachment is not
simply the result of feeding.
Both types of surrogate-reared monkeys were subse-
quently unable to adjust to life in a monkey colony and had
extraordinary difficulty learning to mate. When impregnated,
the female monkeys failed to mother their young. These
behavioral peculiarities were attributed to the isolates’ lack of
mothering in infancy.
John Bowlby.
John Bowlby studied the attachment of
infants to mothers and concluded that early separation of
infants from their mothers had severe negative effects on chil-
dren’s emotional and intellectual development. He described
attachment behavior, which develops during the first year of
life, as the maintenance of physical contact between the mother
and child when the child is hungry, frightened, or in distress.
Mary Ainsworth.
Mary Ainsworth expanded on Bowlby’s
observations and found that the interaction between mother and
baby during the attachment period influences the baby’s cur-
rent and future behavior significantly. Many observers believe
that patterns of infant attachment affect future adult emotional
relationships. Patterns of attachment vary among babies; for
example, some babies signal or cry less than others. Sensitive
responsiveness to infant signals, such as cuddling the baby when
it cries, causes infants to cry less in later months. Close bodily
contact with the mother when the baby signals for her is also
associated with the growth of self-reliance, rather than cling-
ing dependence, as the baby grows older. Unresponsive mothers
produce anxious babies.
Ainsworth also confirmed that attachment serves to reduce
anxiety. What she called the secured base effect enables a child
to move away from the attachment figure and explore the envi-
ronment. Inanimate objects, such as a teddy bear or a blanket
(called the transitional object by Donald Winnicott), also serve
as a secure base, one that often accompanies children as they
investigate the world. A growing body of literature derived from
direct observation of mother–infant interactions and longitudi-
nal studies has expanded on, and refined, Ainsworth’s original
descriptions. Maternal sensitivity and responsiveness are the
main determinants of secure attachment. But when the attach-
ment is insecure, the type of insecurity (avoidant, anxious, or
ambivalent) is determined by infant temperament. Overall, male
infants are less likely to have secure attachments and are more
vulnerable to changes in maternal sensitivity than are female
infants.
The attachment of the firstborn child is decreased by the
birth of a second, but it is decreased much more when the first-
born is 2 to 5 years of age when the younger sibling is born than
when the firstborn is younger than 24 months. Not surprisingly,
the extent of the decrease also depends on the mother’s own
sense of security, confidence, and mental health.
Social Deprivation Syndromes and Maternal Neglect.
Investigators, especially René Spitz, have long documented
the severe developmental retardation that accompanies mater-
nal rejection and neglect. Infants in institutions characterized
by low staff-to-infant ratios and frequent turnover of person-
nel tend to display marked developmental retardation, even
with adequate physical care and freedom from infection. The
same infants, placed in adequate foster or adoptive care, exhibit
marked acceleration in development.
Fathers and Attachment.
Babies become attached to
fathers as well as to mothers, but the attachment is different.
Generally, mothers hold babies for caregiving, and fathers hold
babies for purposes of play. Given a choice of either parent after
separation, infants usually go to the mother, but if the mother is
unavailable they turn to the father for comfort. Babies raised in
extended families or with multiple caregivers are able to estab-
lish many attachments.
Stranger Anxiety.
A developmentally expected fear of
strangers is first noted in infants at about 26 weeks of age, and
more fully developed by 32 weeks (8 months). At the approach
of a stranger, infants cry and cling to their mothers. Babies
exposed to only one caregiver are more likely to have stranger
anxiety than babies exposed to a variety of caregivers. Stranger
anxiety is believed to result from a baby’s growing ability to
distinguish caregivers from all other persons.
Separation anxiety, which occurs between 10 and 18 months
of age, is related to stranger anxiety but is not identical to it.
Table 31.1-7
Types of Attachment
Secure Attachment
Children show fewer adjustment
problems; however, these children
have typically received more consistent
and developmentally appropriate
parenting for most of their life. The
parents of securely attached children
are likely better able to maintain these
aspects of parenting through a divorce.
Given that the family factors that lead
to divorce also impact the children,
there could be fewer securely attached
children in divorcing families
Insecure/Avoidant
Attachment
Children become anxious, clinging,
and angry with the parent. These
children typically come from families
with adults who were also insecurely
attached to their families and, thus,
were unable to provide the kind of
consistency, emotional responsiveness,
and care that securely attached parents
could offer. Such parents have a more
difficult time with divorce, and are
more likely to become rejecting.
Insecure/Ambivalent
Attachment
Children generally are raised with
disorganized, neglecting, and
inattentive parenting. The parents are
even less able to provide stability
and psychological strength for them
after a divorce and, as a result, the
children are even more likely to
become clinging but inconsolable in
their distress, as well as to act out,
suffer mood swings, and become
oversensitive to stress.
