Attachment 2024

Attachment Theory
2024 Raymundo Hombrebueno Pawid, Jr, RPsy, RPm, LPT Benguet State University
According to Bowlby and Ainsworth, attachments
with the primary caregiver develop during the first 18
months or so of the child’s life, starting with
instinctual behaviors like crying and clinging
(Kennedy & Kennedy, 2004). Click icon to add picture
These behaviors are quickly directed at one or a few
caregivers in particular, and by 7 or 8 months old,
children usually start protesting against the
caregiver(s) leaving and grieve for their absence.
https://positivepsychology.com/attachment-theory/#classroom-attachment-
2024
theory
Once children reach the toddler stage, they
begin forming an internal working model of
their attachment relationships.
This internal working model provides the Click icon to add picture
framework for the child’s beliefs about their
own self-worth and how much they can
depend on others to meet their needs.
2024
theory
Click icon to add picture
2024 presentation title

2024 https://www.simplypsychology.org/internal-working-models-of-attachment.html
https://www.google.com/url
2024
Introduction
• Attachment disorders are the psychological result of significant
social neglect, that is, the absence of adequate social and
emotional caregiving during childhood, disrupting the normative
bond between children and their caregivers.
• According to DSM-5:
1. Reactive Attachment Disorder (RAD) and
2. Disinhibited Social Engagement Disorder (DSED)
https://emedicine.medscape.com/article/915447-overview?form=fpf Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD

Symptoms of RAD may include the
following:
DIAGNOSIS:
•A child who rarely or minimally seeks comfort when •consistent pattern of inhibited,
distressed emotionally withdrawn behavior
toward adult caregivers
•A child who rarely or minimally responds to comfort when •persistent social and emotional
disturbance
distressed Click icon to add picture
•pattern of extremes of insufficient
care
•Minimal social and emotional responses to others •The disturbance is evident before age
5 years
•Episodes of unexplained irritability, sadness or tearfulness •The child has a developmental age of
at least 9 months
•criteria for autism spectrum disorder
•Limited expressions of positive affect or joy are not met
• Evidence of inadequate basic emotional and social caretaking
2024 https://emedicine.medscape.com/article/915447-overview?form=fpf Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD
Symptoms of DSED may include the
following:
DIAGNOSIS:
•pattern of behavior in which a child
•Lack of reticence in approaching and interacting with
actively approaches and interacts with
unfamiliar adults unfamiliar adults in an impulsive,
•Overly familiar verbal or physical behaviors such as incautious, and overfamiliar way
•behaviors described in the first
hugging strangers, or sitting on the laps of unfamiliar adults criterion are not limited to impulsivity
•Willingness to approach a complete stranger for comfort or Click icon to add picture
but also include socially disinhibited
food, to be picked up, or to receive a toy behavior
•pattern of extremes of insufficient
•Diminished or absent checking back with adult caretaker
care
when in unfamiliar situations •care described in the third criterion is
•Evidence of inadequate social and emotional caretaking, presumed to be responsible for the
disturbed behavior described in the
sometimes with a history of repeated changes in the primary first criterion
caretaker •child has a developmental age of at
least 9 months
Complications of attachment disorders may include the
following:
•Defiant behavior
•Refusal to cooperate
•Pervasive anger and resentment
•Cognitive delays Click icon to add picture
•Language delays
•Stereotypies
•Conduct disorder
•Difficulties in social settings
•Academic difficulties
Management
Principles of treatment for RAD and DSED include the following:
•Most of the treatment is provided by modifying the behavior of the

primary caregivers (eg, parents or substitute parents) in their everyday
interactions with the child
•Referral to a mental health professional who is aware of the emotional Click icon to add picture
needs of children, the phenomenology of attachment disruptions, and the
need to repair and recreate the sense of security in the child may be
critical
•Pharmacologic treatment may be helpful for comorbid disorders such as

depression, but not for the attachment disorders themselves
•There is no specific indication for inpatient treatment; however, the

occasional child may need to be hospitalized for a time so that issues such
as mistrust or lack of emotional involvement with others can be addressed
Management
Therapeutic ingredients that appear to promote attachment
when provided by caregivers include the following:
•Security (sense of psychological safety)

•Stability (permanence of the attachment figure)
•Sensitivity (emotional availability)
Over the course of treatment, occasional regressive

behaviors should be expected and tolerated.
Internal Working Models Of
Key Takeaways
Attachment •Attachment theory posits that individuals develop
By internal working models of attachment based on their
early experiences with caregivers and operate outside of
Saul Mcleod, PhD awareness (Bowlby, 1969/1982).
Updated on Click icon to add picture
•According to Bowlby (1969), the primary caregiver acts as
November 29, 2023 a prototype for future relationships via the internal
working model.
•These models consist of mental representations of the

self, others, and relationships that guide thoughts,
feelings, and behaviors in attachment-relevant situations
throughout life (Bretherton & Munholland, 1999).
https://www.simplypsychology.org/internal-working-models-of-
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attachment.html
Key Takeaways
Internal Working Models Of
Attachment •Internal working models of attachment
By significantly impact social cognition,
Saul Mcleod, PhD emotion regulation, relationship
Updated on Click icon to
dynamics, and psychological add picture
well-being
November 29, 2023 (Mikulincer & Shaver, 2016).
•Recognizing the power of working

models provides insight into individual
differences in relational functioning and
points toward avenues for therapeutic
change.
Background On Attachment Theory
John Bowlby originally conceived of

attachment theory to explain the intense distress
experienced by infants when separatedClick
fromicon
their
to add picture
caregivers.
He proposed that humans have an innate attachment

behavioral system that motivates them to seek
proximity, contact, and comfort from significant
others (attachment figures) under conditions of threat
or distress (Bowlby, 1969/1982).
Origins
This system evolved to promote survival by keeping
vulnerable infants close to nurturing caregivers who provide
protection, support, and care.
Individual differences in attachment security emerge based

on the sensitivity and responsiveness of the caregiver.
John Bowlby (1969/1982) theorized that these early
attachment experiences form the foundation for mental
representations called internal working models. These models
consist of cognitive-affective schemas about the self as
worthy/unworthy of care and others as reliable/unreliable
sources of support.
The social and emotional responses of the primary caregiver (usually
a parent) provide the infant with information about the world and
other people and how they view themselves as individuals.
For example, the extent to which an individual perceives

himself/herself as being worthy of love and care, and information
regarding the availability and reliability of others (Bowlby, 1969).
Bowlby referred to this knowledge as an internal working model

(IWM), which begins as a mental and emotional representation of the
infant’s first attachment relationship and forms the basis of an
individual’s attachment style.
20XX presentation title

2024 https://www.verywellmind.com/what-is-attachment-theory-2795337
Psychologist Mary Ainsworth devised an
assessment technique called the Strange
Situation Classification (SSC) to investigate
how attachments might vary between children
The Strange Situation was devised by

Ainsworth and Wittig (1969) and was based
on Ainsworth’s previous Uganda (1967) and
later Baltimore studies (Ainsworth et al., 1971,
1978)
2024 https://www.simplypsychology.org/mary-ainsworth.html
The room was set up with a clear 9 x 9-foot floor space divided
into 16 squares for recording location and movement.
One end housed a chair laden with toys, while the other had
chairs for the mother and a stranger. The baby was placed
centrally, free to move around. The mother and stranger were
pre-instructed on their roles.
The child is observed playing for 20 minutes while caregivers

and strangers enter and leave the room, recreating the flow of
the familiar and unfamiliar presence in most children’s lives.
Ainsworth & Bell observed from the other side of a one-way

mirror, so the children did not know they were being observed.
The strange situation
Scoring
Observers noted the child’s willingness to explore, separation
anxiety, stranger anxiety, and reunion behavior.
Two observers narrated continuous accounts into a two-channel

tape recorder that also captured a timer’s click every 15 seconds.
This is the standard procedure now, although, for the initial 14

participants, only one observer narrated as the other took notes
due to the lack of a two-channel recorder.
For the latter 33 participants, Bell was the sole observer. The
observations were later transcribed, consolidated, and coded.
These four classes of behavior
were scored for interaction with
the mother in episodes 2, 3, 5, and
8, and for interaction with the
stranger in episodes 3, 4, and 7.
1.Proximity and contact seeking:
Behaviors involve active efforts such as purposeful

approaching, climbing, gesturing (like reaching or leaning),
partial approaches, and directed cries.The criteria include
the child’s initiative, persistence, and effectiveness in
gaining (or regaining) contact or proximity. The score
reflects the intensity and nature of the child’s efforts across
different episodes.
1.Contact maintaining:
Behaviors relevant after the baby has made physical

contact, either self-initiated or otherwise.They
encompass clinging, embracing, resisting release
through intensified clinging or turning back and
reaching if contact is lost, and vocal protestations.
1.Avoidance of proximity and contact:
Interaction-avoiding behaviors apply in situations that typically

incite approach or interaction, such as an adult entering or trying to
attract the baby’s attention.The behaviors indicative of avoidance
include increasing distance, turning away, averting gaze, hiding the
face, or ignoring the person, especially when the person is attempting
to engage the child’s attention.
Unlike the resistance variable, which is often associated with anger,

avoidance may have a neutral tone or reflect apprehension.
It may be seen as a defensive behavior that conceals feelings, possibly

including resentment. The coding for this variable distinguishes
between the child’s interactions with the mother and a stranger.
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1.Resistance to contact and comfort:
Assesses the child’s resistant behavior towards someone who

attempts to interact or come into proximity.
Contact- and interaction-resisting behaviors include angry,

conflicting attempts to repel the adult, wriggling to get down
if picked up, or rejecting toys used by the adult to interact.
Other indications could be angry screams, thrashing about,
pouting, irritable fussing, or showing petulance.
These resistant behaviors may alternate with efforts to

maintain contact with the person being rejected.
1. Search behavior:
During episodes 4, 6, and 7, search behaviors were recorded. These

included following the mother to the door, attempting to open it,
banging on it, keeping the focus on the door or glancing towards it,
approaching the mother’s empty chair, or observing it.
These behaviors indicated the infant’s active search or orientation

towards the last seen location of the absent mother (usually the
door) or a place associated with her in the unfamiliar setting (her
chair).
Behavioral categories allow the researcher to focus on the behaviors to observe
clearly. For example, smiling, crying, or the baby moving towards or away from
the mother.
This allows the observers to tally observations into pre-arranged groupings. It
also makes the observations replicable, so the results have greater reliability.
Other behaviors observed included:
•Exploratory behaviors
e.g., moving around the room, playing with toys, looking around the room.
•Search behaviors
e.g., following mother to the door, banging on the door, orienting to the door,
looking at the door, going to mother’s empty chair, looking at mother’s empty
chair.
•Affect Displays negative

e.g., crying, smiling.
Observation reliability was assessed by independent
codings of the narrated reports by the two authors in four
dual-observed cases.
Correlation coefficients of 0.99 for each locomotor,

manipulatory, and visual exploration, and 0.98 for
crying, were achieved.
RESULTS [ATTACHMENT STYLES]
RESULTS [ATTACHMENT STYLES]
Ainsworth (1970) identified three main attachment styles,
1. Secure (Type B)
2. Insecure avoidant (Type A), and
3. Insecure ambivalent/resistant (Type C).
A fourth attachment style, known as (4) Disorganized, was

later identified (Main, & Solomon, 1990).
According to Bowlby (1980), an individual who has
experienced a secure attachment “is likely to possess a
SECURE representational model of attachment figures(s) as being
ATTACHMENT available, responsive, and helpful” (Bowlby, 1980, p. 242).
Securely attached children comprised most of the sample in Ainsworth’s (1971, 1978) studies.
Infants with this type of attachment explore their environment (explorative behavior) and are
moderately distressed when their mother leaves the room (separation anxiety).
They also show moderate stranger anxiety and some distress when they are approached by a stranger.
They seek contact with their mother when she returns.
Such children feel confident that the attachment figure will be available to meet their needs. They use
the attachment figure as a safe base to explore the environment and seek the attachment figure in
times of distress (Main, & Cassidy, 1988).
Securely attached infants are easily soothed by the attachment figure when upset. Infants develop a
secure attachment when the caregiver is sensitive to their signals, and responds appropriately to their
needs
https://www.simplypsychology.org/mary-
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ainsworth.html
Infants with an insecure-avoidant attachment are
unconcerned by their mother’s absence when she
Insecure leaves the room (no separation anxiety).
Avoidant
They show little interest when reunited with the mother (i.e., she returns to the
room). Infants are strongly avoidant of the mother and stranger, showing no
motivation to interact with either adult. They do not seek contact with the
attachment figure when distressed. The stranger is treated similarly to the mother
(does not seek contact).
They are very independent of the attachment figure, both physically and
emotionally (Behrens, Hesse, & Main, 2007). Insecure avoidant children do not
orientate to their attachment figure while investigating the environment.
Such children will likely have insensitive caregivers who ignore their emotional
needs (Ainsworth, 1979).
The attachment figure may withdraw from helping during difficult tasks
(Stevenson-Hinde, & Verschueren, 2002) and is often unavailable during
emotional distress.
The third attachment style Ainsworth (1970) identified was insecure ambivalent
INSECURE (also called insecure resistant).
AMBIVALENT
Children with this type of attachment are clingy to their mother in a new situation
/ RESISTANT and unwilling to explore. They are extremely distressed when left alone by their
mother (separation anxiety), and are scared of the stranger.
When the mother returns, they are pleased to see her and go to her for comfort,
but then they cannot be comforted and may show signs of anger towards her.
Here children adopt an ambivalent behavioral style towards the attachment figure.
The child commonly exhibits clingy and dependent behavior but rejects the
attachment figure when interacting.
The child fails to develop any feelings of security from the attachment figure.
Accordingly, they exhibit difficulty moving away from the attachment figure to
explore novel surroundings.
When distressed, they are difficult to soothe and are not comforted by interaction
with the attachment figure. This behavior results from an inconsistent response to
their emotional needs from the primary caregiver.
Meta-analysis
Madigan et al. (2023) conducted a comprehensive meta-analysis on 285 studies
involving over 20,000 infant-caregiver pairs to estimate the global distribution of
attachment classifications derived from the SSP: secure (51.6%), avoidant
(14.7%), resistant (10.2%), and disorganized (23.5%).
The meta-analysis found no differences in attachment distribution by child age or

sex. There was also no difference between mothers and fathers in rates of secure,
avoidant, resistant, or disorganized attachment. However, attachment
distributions did differ across other moderators.
Higher rates of avoidant and disorganized attachment were found in families

with socioeconomic risks. Children who experienced maltreatment had extremely
high rates of disorganized attachment (64%) compared to non-maltreated
children (22%). Infants placed in foster or adoptive care showed less avoidant
attachment but higher disorganized attachment versus biologically related dyads.
A notable finding was a temporal trend showing decreased avoidant
attachment over time, perhaps reflecting changes in parenting styles or
measurement. Regional differences were also found – Asia, Africa, and South
America showed deviations from the North American distribution.
The meta-analysis provides a definitive estimate of the prevalence of secure

infant-parent attachment globally (51.6%), supporting the notion that secure
attachment is likely to occur when stressors and risks imposed on the parent-
infant relationship are minimal.
However, more research is needed on cultural differences in attachment and

validity of the SSP across diverse groups. The study also highlights factors
like socioeconomic disadvantage and trauma that disrupt secure attachment
formation.
Methodological
Evaluation
Reliability
The strange situation classification has been found to

have good reliability. This means that it achieves
consistent results.
For example, a study conducted in Germany found

that 78% of the children were classified in the same
way at ages 1 and 6 years (Wartner et al., 1994).
Methodological
Evaluation Validity
Although, as Melhuish (1993) suggests, the Strange Situation is

the most widely used method for assessing infant attachment to a
caregiver, Lamb et al. (1985) have criticized it for being highly
artificial and lacking ecological validity.
The child is placed in a strange and artificial environment, and the

procedure of the mother and stranger entering and leaving the
room follows a predetermined script of eight stages (e.g., mum
and stranger entering and leaving the room at set times) that
would be unlikely to happen in real life.
Methodological
Evaluation Validity
The artificial environment of the SSP may not activate the attachment
system for all infants, meaning some children could be misclassified (Ziv &
Hotam, 2015). For example, avoidant infants may not actually feel stressed
when separated from caregivers in this unfamiliar setting. Limited evidence
exists linking avoidant behavior in the SSP to physical markers of stress.
Additionally, SSP classifications show only modest connections to expected

correlates like maternal sensitivity.
A problem of the study is that it lacks population validity. The original

study used American infants from middle-class families.
Ethics
The strange situation has also been criticized on ethical grounds. Because
the child is put under stress (separation and stranger anxiety), the study
has broken the ethical guidelines for the protection of participants.
However, in its defense, the separation episodes were curtailed

prematurely if the child became too stressed.
Also, according to Marrone (1998), although the Strange Situation has

been criticized for being stressful, it simulates everyday experiences, as
mothers leave their babies for brief periods in different settings and often
with unfamiliar people such as babysitters.
2024 https://www.google.com/url
https://positivepsychology.com/attachment-theory/#classroom-attachment- Ackerman, C. A. (2018
2024
theory
USING
ATTACHMENT
THEORY
IN THE CLASSROOM
Emotion coaching is about helping children to become
aware of their emotions and to manage their own feelings
particularly during instances of ‘misbehavior.’
It enables practitioners to create an ethos of positive

learning behavior and to have the confidence to
de-escalate situations when behavior is challenging”
(National College for Teaching and Leadership, 2014).
2024
theory
Emotion
Coaching •Teaching students about the world of “in the moment” emotion;
involves:
•Showing students strategies for dealing with emotional ups and downs;
•Empathizing with and accepting negative or unpleasant emotions as

normal, but not accepting negative behavior;
•Using moments of challenging behavior as opportunities for teaching;
•Building trusting and respectful relationships with the students

(National College for Teaching and Leadership, 2014).
2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory
According to attachment theory expert Dr. John Gottman, there are five steps
to emotion coaching, and they can be practiced by parents, teachers, or any
significant adult in a child’s life:
CONNECT
TUNE IN
ACCEPT AND LISTEN
END WITH PROBLEM

REFLECT SOLVING/CHOICES/
SETTING LIMITS
https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

Tune in
Notice or become aware of your
own and the child’s emotions.
Make sure you are calm enough
to practice emotion coaching,
otherwise, you might want to
give both of you a quick
breather
2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

Connect
Use this situation as an opportunity
for you to practice and for the child
to learn. State objectively (This is
important!)
what emotions you think the child is
experiencing to help them connect
their emotions to their behavior

Reflect
Once everyone is calm, go back
over what the child said or did,
mentioning only what you saw,
heard, or understand of the situation.
Reflect on what happened and why
it happened

End with Problem Solving/Choices/Setting Limits
Whenever possible, try to end the

situation by guiding or involving the
child in problem-solving (Somerset
Children & Young People, n.d.).

1.A pupil arrives late to class. She refuses to communicate with you and says “Don’t
even start, just leave me alone”;
2. A young person refuses to sit by her usual friends at a youth center and says that
they have been saying unkind comments about her size;
3. A boy regularly fails to complete work independently and will often sit passively
and contribute little. He rarely presents with disruptive behavior but simply
completes very little work. He appears isolated from his peers;
* Angry pupil over
4. A nursery child is crying at drop-off time and is clinging to her parent who has to not wanting to
go to work; attend a
compulsory revision
5. An aggressive, confrontational parent is annoyed because she’s been asked to come session
in and talk about her son’s behavior. She approaches you and starts the conversation
by saying, “You’re always having a go at us”;
6. During recess, a group of young boys was fighting and one of them was hurt (not
seriously). You approach them and they all look at you with worried expressions

For each scenario, the instructions encourage you to:
Recognize the emotion the child is displaying
Validate that emotion
Label the emotion the child is feeling
Empathize with the child
Set limits, if appropriate, and problem-solve

thank you

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Attachment Theory

2024 presentation title

https://emedicine.medscape.com/article/915447-overview?form=fpf Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD

• Evidence of inadequate basic emotional and social caretaking

•Most of the treatment is provided by modifying the behavior of the

•Pharmacologic treatment may be helpful for comorbid disorders such as

•There is no specific indication for inpatient treatment; however, the

•Security (sense of psychological safety)

•Sensitivity (emotional availability)

Over the course of treatment, occasional regressive

•These models consist of mental representations of the

•Recognizing the power of working

John Bowlby originally conceived of

He proposed that humans have an innate attachment

Individual differences in attachment security emerge based

For example, the extent to which an individual perceives

Bowlby referred to this knowledge as an internal working model

20XX presentation title

The Strange Situation was devised by

The child is observed playing for 20 minutes while caregivers

Ainsworth & Bell observed from the other side of a one-way

Two observers narrated continuous accounts into a two-channel

This is the standard procedure now, although, for the initial 14

Behaviors involve active efforts such as purposeful

Behaviors relevant after the baby has made physical

Interaction-avoiding behaviors apply in situations that typically

Unlike the resistance variable, which is often associated with anger,

It may be seen as a defensive behavior that conceals feelings, possibly

20XX presentation title

Assesses the child’s resistant behavior towards someone who

Contact- and interaction-resisting behaviors include angry,

These resistant behaviors may alternate with efforts to

During episodes 4, 6, and 7, search behaviors were recorded. These

These behaviors indicated the infant’s active search or orientation

•Affect Displays negative

Correlation coefficients of 0.99 for each locomotor,

A fourth attachment style, known as (4) Disorganized, was

The meta-analysis found no differences in attachment distribution by child age or

Higher rates of avoidant and disorganized attachment were found in families

The meta-analysis provides a definitive estimate of the prevalence of secure

However, more research is needed on cultural differences in attachment and

The strange situation classification has been found to

For example, a study conducted in Germany found

Although, as Melhuish (1993) suggests, the Strange Situation is

The child is placed in a strange and artificial environment, and the

Additionally, SSP classifications show only modest connections to expected

A problem of the study is that it lacks population validity. The original

However, in its defense, the separation episodes were curtailed

Also, according to Marrone (1998), although the Strange Situation has

It enables practitioners to create an ethos of positive

•Empathizing with and accepting negative or unpleasant emotions as

•Using moments of challenging behavior as opportunities for teaching;

•Building trusting and respectful relationships with the students

ACCEPT AND LISTEN

END WITH PROBLEM

https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

Whenever possible, try to end the

2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

2024 https://positivepsychology.com/attachment-theory/#classroom-attachment-theory Ackerman, C. A. (2018

Recognize the emotion the child is displaying

Validate that emotion