Attachment representations in pre-adolescents at familial high risk of schizophrenia or bipolar disorder and population-based controls—Characteristics of attachment from middle childhood to pre-adolescence, and its relation to parental functioning and child mental disorder

IF 3.1
JCPP advances Pub Date : 2024-09-12 DOI:10.1002/jcv2.12274
Mette Falkenberg Krantz, Maja Gregersen, Lotte Veddum, Carsten Hjorthøj, Åsa Kremer Prøsch, Jessica Ohland, Julie Marie Brandt, Sinnika Birkehøj Rohd, Christina Bruun Knudsen, Anna Krogh Andreasen, Nicoline Hemager, Aja Greve, Ole Mors, Merete Nordentoft, Elia Psouni, Anne A. E. Thorup
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Abstract

Background

Development of secure attachment is crucial to establish and maintain healthy relationships with others throughout life. For parents with schizophrenia or bipolar disorder, challenged parental functioning may compromise the sensitive caregiving needed to establish secure child attachment. We aimed to examine pre-adolescent attachment, predictors related to caregiving, and middle childhood attachment predictors of pre-adolescent mental disorders.

Methods

In a population-based nationwide cohort of 522 children of parents with schizophrenia or bipolar disorder and population-based controls, The Secure Base Script Test was used to assess attachment security at age 11 (N = 409). Parental caregiving and functioning were assessed with the Personal and Social Performance Scale and MC-HOME (age 7) and child mental disorder with K-SADS-PL (age 7 and 11). Story Stem Assessment Profile was used for age 7 attachment.

Results

We found no differences between risk and control groups in prevalence of pre-adolescent secure attachment. Parental level of functioning and attachment security at age 7 significantly predicted more rich secure base content at age 11. Level of age 7 disorganization significantly predicted presence of mental disorder at age 11.

Conclusions

Overall, attachment of children at familial risk of schizophrenia or bipolar disorder did not differ from that of controls. Instead, parental functioning in middle childhood predicts pre-adolescent attachment, and may therefore serve as a focus for supporting healthy attachment development. Middle childhood disorganization might serve as a predictor of pre-adolescent mental disorder if other studies confirm our findings, and awareness hereof may be relevant for guiding intervention to support mental development.

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家族性精神分裂症或双相情感障碍高危人群的依恋表征及基于人群的对照——童年中期至青春期前依恋特征及其与父母功能和儿童精神障碍的关系
安全依恋的发展对于一生中与他人建立和维持健康的关系至关重要。对于患有精神分裂症或双相情感障碍的父母来说,受到挑战的父母功能可能会损害建立安全儿童依恋所需的敏感照顾。我们的目的是检查青春期前的依恋,与照顾相关的预测因子,以及青春期前精神障碍的中期童年依恋预测因子。方法在以人群为基础的全国队列中,522名父母患有精神分裂症或双相情感障碍的儿童和以人群为基础的对照组,使用安全基础脚本测试来评估11岁时的依恋安全性(N = 409)。采用个人与社会表现量表和MC-HOME量表(7岁)和儿童精神障碍k - ssad - pl量表(7岁和11岁)对父母的照顾和功能进行评估。故事干评估档案用于7岁依恋。结果青少年前安全依恋的发生率在风险组和对照组之间无显著差异。7岁时父母的功能和依恋安全水平显著预测了11岁时更丰富的安全基础内容。7岁时的紊乱水平显著预测11岁时精神障碍的存在。结论:总体而言,具有精神分裂症或双相情感障碍家族风险的儿童的依恋与对照组没有差异。相反,童年中期的父母功能预测了青春期前的依恋,因此可能作为支持健康依恋发展的焦点。如果其他研究证实了我们的发现,那么中期童年紊乱可能作为青春期前精神障碍的预测因子,并且对这一点的认识可能与指导干预支持心理发展有关。
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