Attachment disorder symptoms in foster children: development and associations with attachment security.

BACKGROUND: Children in foster care constitute a risk population for developing symptoms of attachment disorders. However, little is known about the longitudinal course of attachment disorders and their association with attachment security in foster children. METHOD: This longitudinal study assessed attachment disorder symptoms in a sample of foster children (n = 55) aged 12 to 82 months. Foster parents with a newly placed foster child were assessed at three points during the first year of placement. At all assessment points, the Disturbance of Attachment Interview (DAI; Smyke and Zeanah in Disturbances of attachment interview, Tulane University, New Orleans, 1999) and the Attachment Q-sort (AQS; Waters and Deane in Monogr Soc Res Child Dev 50:41-65, 1985 German version as reported (Schölmerich and Leyendecker in Deutsche Übersetzung des attachment behavior Q-Set, revision 3.2. Unpublished manual, Ruhr University Bochum, Bochum, 1999) were used to investigate the interplay between disorder symptoms and attachment security. RESULTS: The results revealed that the symptoms of attachment disorders decreased. The decrease was more pronounced for the inhibited than for the disinhibited symptoms with marked changes in the first 6 months of placement. There was a noticeable gender difference in the development with boys showing a more pronounced decrease in inhibited attachment disorder symptoms and a stronger increase of attachment security. After 12 months, no significant gender effects were found. Regarding the association between symptoms of attachment disorders and attachment security, a significant negative correlation between the inhibited attachment disorder symptoms and attachment security was found 12 months after placement. CONCLUSIONS: Attachment disorder symptoms decreased in the stable foster care environment. Thus, foster care seems to be an effective placement option regarding children's attachment development.

Inhibited symptoms of Attachment Disorder in children from institutional and foster care samples.

The main objective of the article was to study the prevalence of symptoms of the inhibited attachment disorder depending on type and quality of the caregiving environment. Analyses were based on data of a sample of institutionalized children from Georgia (N = 16), and two samples of foster children from Georgia (N = 27) and Germany (N = 55). Inhibited attachment disorder symptoms were assessed by the Disturbances of Attachment Interview (DAI) and the Rating of Inhibited Attachment Behavior (RInAB). Further assessments included behavior problems in children, quality of caregiving behavior in foster parents/caregivers, and presence of preferred caregiver in the institution. Regarding inhibited attachment behavior, expected differences between institutional (high scores) and foster samples (low scores) found for both measures (RInAB and DAI), and convergent validity between these measures was found in the institutional sample, but not in the foster samples. There were also indications of construct validity (regarding preferred caregiver in institution and caregiver supportive presence). The findings also suggest methodological issues brought about by skewed distributions of positive and negative measures in high-risk and low-risk samples, respectively.

Assessment of attachment disorder symptoms in foster children: comparing diagnostic assessment tools.

BACKGROUND: Standardized methods for assessing attachment disorders are scarce but needed for research and practice. METHODS: In the current study, several assessments for attachment disorder symptoms are used within a German sample of foster children after being exposed to neglect and maltreatment in their biological families. The symptoms were assessed with four established assessment methods based on both parents' report and behavioral observation: The Rating for Infant Stranger Engagement, the Stranger at the Door, the Disturbances of Attachment Interview and the Reactive Attachment Disorder Questionnaire. RESULTS: The foster care sample showed symptoms of both the inhibited and the disinhibited attachment disorder. The degree of symptoms is comparable to previous findings. The results of the different tools investigating the disinhibited type of attachment disorder are correlated to each other, but do not overlap. CONCLUSIONS: Although all approaches are based on the clinical criteria of the DSM-IV, the assessments do not coincide. Each tool provides a different point of view on the symptoms, so a multi methodical approach for assessing attachment disorder symptoms should be implemented. Furthermore, the inhibited and the disinhibited symptoms represent separate categories, as reflected in the DSM-5, requiring separate assessment.