Abstract
Background
Disorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.
MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.
Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.
ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.
| Original language | English |
|---|---|
| Pages (from-to) | 300-316 |
| Number of pages | 17 |
| Journal | Clinical Psychologist |
| Volume | 22 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Nov 2018 |
| Externally published | Yes |
Cite this
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Perinatal maternal mental health and disorganised attachment : A critical systematic review. / Flowers, Alexandra G. D.; McGillivray, Jane A.; Galbally, Megan; Lewis, Andrew J.
In: Clinical Psychologist, Vol. 22, No. 3, 11.2018, p. 300-316.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Perinatal maternal mental health and disorganised attachment
T2 - A critical systematic review
AU - Flowers, Alexandra G. D.
AU - McGillivray, Jane A.
AU - Galbally, Megan
AU - Lewis, Andrew J.
PY - 2018/11
Y1 - 2018/11
N2 - BackgroundDisorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.
AB - BackgroundDisorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.
KW - antenatal depression
KW - child development
KW - disorganised attachment
KW - perinatal mental health
KW - postnatal depression
KW - INFANT-MOTHER ATTACHMENT
KW - RANDOMIZED CONTROLLED-TRIAL
KW - BORDERLINE PERSONALITY
KW - POSTNATAL DEPRESSION
KW - INTERGENERATIONAL TRANSMISSION
KW - POSTPARTUM DEPRESSION
KW - UNRESOLVED STATES
KW - BEHAVIOR
KW - SYMPTOMS
KW - PSYCHOPATHOLOGY
U2 - 10.1111/cp.12145
DO - 10.1111/cp.12145
M3 - Review article
VL - 22
SP - 300
EP - 316
JO - The Clinical Psychologist
JF - The Clinical Psychologist
SN - 1328-4207
IS - 3
ER -