Development and preliminary validation of the caregiving behavior ...

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Abstract. The Marvin and Britner system for classifying caregiver behavior patterns in the preschool Strange. Situation is presented to complement the Cassidy ...
Attachment & Human Development, March 2005; 7(1): 83 – 102

Development and preliminary validation of the caregiving behavior system: Association with child attachment classification in the preschool Strange Situation

PRESTON A. BRITNER1, ROBERT S. MARVIN2, & ROBERT C. PIANTA2 1

University of Connecticut, USA, and 2University of Virginia, USA

Abstract The Marvin and Britner system for classifying caregiver behavior patterns in the preschool Strange Situation is presented to complement the Cassidy and Marvin (1992) preschool child – parent attachment classification system. Participants were 110 mothers and their preschool children (aged 2 to 4 years) with medical risks (epilepsy or mild cerebral palsy) or no diagnosis (i.e., healthy). As coded by reliable, independent raters, there was a highly significant level of concordance between the 5category caregiver and child classifications in the preschool Strange Situation across the medical risk levels. In comparison to other caregivers, mothers classified as secure in their caregiving behavior pattern were rated as more sensitive; they also showed greater delight and were more supportive of their children’s exploration. Combinations of the ten, 9-point caregiver rating scales were useful in discriminating among the insecure caregiver patterns.

Keywords: Attachment, caregiving, classification, maternal behavior, preschool, rating scales

Introduction Despite a growing body of research on adults’ internal representations of attachment relationships (e.g., Cohn, Cowan, Cowan, & Pearson, 1992; Main, Kaplan, & Cassidy, 1985) and on attachment issues in older children as they contrast with infants (e.g., Crowell & Feldman, 1988, 1991; Marvin, 1977; Thompson, 2000), little systematic research has been completed on the parents’ caregiving behaviors in attachment – caregiving contexts (George & Solomon, 1999; Marvin & Britner, 1999). Maternal sensitivity, the most frequently assessed dimension of caregiving behavior, typically explains less than a quarter of the variance in assessments of attachment security (de Wolff & van IJzendoorn, 1997; Pederson, Gleason, Moran, & Bento, 1998). Thus, there is little understanding of which caregiving behaviors are associated with secure versus insecure attachment, much less specific forms of insecurity, especially beyond the period of infancy (Ainsworth, 1990; Pederson & Moran, 1995). In the present study, we attempt to fill in some of the gaps in this literature by presenting a system for classifying parental caregiving behavior in an attachment – caregiving context (i.e., the preschool Strange Situation). In addition to classifications, the system also utilizes Correspondence: Preston A. Britner, Ph.D., School of Family Studies, Division of Health and Human Development, University of Connecticut, U-2058, Storrs, CT 06269-2058, USA. E-mail: [email protected] ISSN 1461-6734 print/ISSN 1469-2988 online # 2005 Taylor & Francis Group Ltd DOI: 10.1080/14616730500039861

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several continuous ratings of caregiving behavior that may be useful in distinguishing various secure and insecure caregiving patterns (or classifications) parents display in their interactions with their preschool-age children. Attachment – caregiving as a systemic construct Attachment as a behavioral control system maintains a homeostatic balance between proximity-seeking and exploratory behavior, depending upon both internal state and environmental demands (Bowlby, 1969/1982). As a complementary system, Bowlby (1969/ 1982) hypothesized a parental ‘caregiving system’ (George & Solomon, 1999). The integrated attachment and caregiving systems function as a self-regulating dyadic system to keep the child organized and safe from harm while he/she explores and develops. The attachment and caregiving systems are represented both as patterns of behaviors and as internal representations held by each of the partners in the relationship (Bowlby, 1969/1982; Main et al., 1985). The representational system includes the inferences, attitudes, goals, plans, feelings, and defenses that organize and regulate the functioning of the behavioral system (Marvin & Britner, 1999). The reciprocal behavioral and representational contributions of each partner tend to bring stability to the dyadic pattern of attachment – caregiving interaction. The pathway between caregiver internal working models (IWMs) and child attachment behavior has become a hallmark of current attachment theory. Hypothetically, this pathway is mediated by the caregiver’s behavior (Meins, 1999). Whereas the accumulating evidence of an association between AAI and child – parent attachment classifications in the Strange Situation (e.g., Fonagy, Steele, & Steele, 1991) suggests predictable differences in organizational, classifiable patterns of caregiver behavior, this behavioral component has not yet systematically been documented. The classification and rating system presented in this study was designed, in part, to help bridge the empirical gap in studying this pathway. A review of the existing literature does provide an outline of systematic differences in caregiver patterns across the different infant and child attachment patterns (cf., Rosen & Rothbaum, 1993). Across a number of studies, maternal interaction style in the first year of life has been linked to infant attachment at 1 year (e.g., Ainsworth, Blehar, Waters, & Wall, 1978; Cassidy & Berlin, 1994; Cohn et al., 1992; Crowell & Feldman, 1988, 1991; Isabella & Belsky, 1991; Pederson & Moran, 1995). In the most extensive study of caregiver behaviors linked to child attachment in the preschool years, Stevenson-Hinde and Shouldice (1995) compared mothers’ behaviors in a laboratory play task with their 4.5 year-old children, self-reports, and mother – child interactions in the home at age 3.5 years. Mothers’ behaviors varied systematically with children’s attachment classifications, using the Cassidy and Marvin (1992) system. The combination of available studies suggests that mothers of secure babies tend to be more sensitive and tender, synchronize feeding better, and hold their infants more than mothers of insecure infants (Ainsworth et al., 1978). Mothers of preschool-age secure children display more positive mood, delight in and enjoyment of their children, nonintrusive play and teaching, and provide a relaxed home atmosphere, relative to mothers of insecure children (Stevenson-Hinde & Shouldice, 1995). Mothers of avoidant babies tend to rebuff their infants’ approaches for comfort or protection under conditions of mild distress, and interactions are characterized by maternal intrusiveness or overstimulation at the expense of intimacy (Ainsworth et al., 1978; Isabella & Belsky, 1991). Mothers of avoidant preschool-age children report themselves more favorably on temperament and depression measures than all other mothers, minimize the

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discussion of anything personal, and can appear cool, distant, and detached (Cassidy & Marvin, 1992; Stevenson-Hinde & Shouldice, 1995). Mothers of ambivalent infants may be inconsistent, being helpful at some times and unresponsive at others (Ainsworth et al., 1978). Mothers of ambivalent preschoolers rated themselves as the most depressed, the most anxious, and the least satisfied with their marital relationships (Stevenson-Hinde & Shouldice, 1995). These mothers report the most conflict with their children, yet tend to emphasize attachment cues and the child – parent relationship, have difficulties with limit-setting, and tend to ignore the child’s signals for autonomy (Cassidy & Berlin, 1994; Cassidy & Marvin, 1992). Disorganized infants’ and controlling preschool children’s caregivers often are unresolved about loss and/or traumas, and several studies now suggest that these mothers exhibit frightening or frightened behavior in the presence of their children (e.g., Schuengel, Bakermans-Kranenburg, van IJzendoorn, & Blom, 1999). Mothers of controlling preschoolers show odd behaviors and participate in their child’s role reversal of the relationship. They tend to elicit and/or accept either punitive or caregiving behaviors from their child, in each case abdicating control of this type of interaction to the child (Cassidy & Marvin, 1992; Mayseless, 1998). The current study This study adds an organizational component to the study of the parental caregiving system, and provides that component in the context of the Strange Situation, the most commonly used standardized procedure for observing attachment behavior. The primary goals of the study are: to identify distinct caregiver patterns, or classifications, in the preschool Strange Situation; to identify theoretically relevant, continuous dimensions of caregiving behavior in the preschool Strange Situation; to establish the reliability of those classifications and rated dimensions; and to relate these caregiver patterns and ratings to the specific attachment patterns displayed by their children in the same Strange Situation. There is no attempt in this particular study to discover (or imply) causality in any linkages found; as a first step, our attempt is to document a reliable system for identifying, describing, and coding caregiver patterns as they relate to child attachment patterns. The study of distinct caregiver behavior patterns is important both theoretically and practically in terms of its implications for behavioral change, especially in clinical work with high-risk populations, such as families of maltreated or developmentally disabled children. In the present study, we used multiple samples, including children with and without medical diagnoses, in order to present evidence of the utility of the new caregiver behavior system for a wide range of preschool child – parent dyads.

Method Sample Preschool Strange Situations for this study came from two sources, described below as Sample 1 and Sample 2. Sample 1. Preschool Strange Situations (n = 32) from the development sample of the MacArthur Working Group on Preschool Attachment (Cassidy & Marvin, 1992) were included as Sample 1. These tapes were coded at 100% reliability among four coders as part of the development of the preschool Strange Situation classification system. All of these

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children were between the ages of 2.5 and 4 years. No additional demographic information was available for this sample. Sample 2. Mothers of 2- to 4.5-year-old preschool children with cerebral palsy (n = 30), epilepsy (n = 20), or no medical diagnosis (n = 28) from the Child – Parent Attachment Project (CPAP; see Marvin & Pianta, 1992, 1996) were observed with their children in the preschool Strange Situation procedure. Children with cerebral palsy (CP), given their motor impairments since birth, and children with epilepsy, with the uncertainty that seizures can bring to the child – parent relationship, represent two interesting groups with which to examine some of the important constructs of attachment theory, including the generalizability of attachment behavioral patterns if not discrete behaviors (see Barnett et al., 1999; Marvin & Pianta, 1992, 1996; Pianta, Marvin, & Morog, 1999; Waters & Crowell, 1999). Families were recruited from clinics at university medical centers, community hospitals, and early intervention programs in Virginia, West Virginia, North Carolina, Maryland, and Washington DC. All data were collected at the same laboratory site. Parents and children participated in a variety of observational and interview procedures, children were administered standardized developmental assessments, and parents completed several self-report questionnaires. All children met a minimum criterion of an 8 – 10 month level of cognitive development as assessed by the Bayley Scales of Infant Development (or the Peabody Picture Vocabulary Test for older and more advanced children), the Vineland Adaptive Behavior Scales, and clinic staff and parent reports of functional levels. In the sub-sample used for this study, the children with CP had been diagnosed at least 10 months prior to the study, and were functionally locomotor. At minimum, they could each follow their caregiver around their homes without assistance, by crawling, scooting, rolling, or walking. All children in the epilepsy group had been diagnosed with epilepsy at least 8 months prior to data collection, and none of the children had a motor impairment or CP. The degree to which the children’s seizures were controlled varied. Only three were not receiving medication for seizures. In 12 of these cases, seizure control was described by parents as fair to good, indicating some breakthrough seizures or good control, respectively. In the other 8 cases, parents reported poor or no control of seizures, reflecting several seizures per week or daily seizures, respectively. Types of seizures varied in the sample, which included children with ‘absence’, generalized, and partial complex seizures. The severity of the seizures was reported as mild to moderate, suggesting that they were not severely disruptive of the child’s functioning. Demographic variables for Sample 2 are reported by diagnostic group (see Table I). There were no significant differences across the groups. Most of the children (n = 71) were White (European American). There were six African American children (two in each group), and there was one Hispanic American child (in the CP group). Measures Preschool Strange Situation. The Preschool Strange Situation procedure is a slight modification of Ainsworth’s Strange Situation procedure infants (Ainsworth et al., 1978). Mothers and their preschool children undergo a series of episodes, consisting of play together, a separation and reunion in which the child is left with a stranger, and a second separation in which the child is left alone, then joined by the stranger, and finally reunited with the mother. Cassidy and Marvin’s (1992) procedures for running and classifying preschool Strange Situations were followed.

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Table I. Sample 2 demographics by medical risk group Group CP (n = 30)

Epilepsy (n = 20) Mean (Std Dev)

No Diagnosis (n = 28)

39.7 (8.6) 30.1 (6.2) 13.3 (2.1) 17.4 (19.2) 85.8 (62.2) 34.3 (24.3)

39.0 (9.8) 30.3 (7.9) 14.3 (2.9) 12.7 (24.1) 80.3 (64.5) 31.7 (23.2) Percentage 44 45

34.9 (7.3) 30.9 (6.3) 14.4 (2.9) 9.6 (15.9) 76.9 (70.2) 28.5 (25.7)

Characteristics Child age (months) Mother age (years) Mother education (years) Mother weekly work out of the home (hours) Mother length of marriage (months) Family annual gross income ($ 000) Neighborhood (% rural) Child sex (% female)

48 43

40 46

Validity for the infant Strange Situation is well established. For example, Belsky and Fearon (2002), using data from the NICHD Study of Early Child Care, found support for hypothesized relationships between attachment security (as assess in the Strange Situation at age 15 months) and age 3 years developmental outcomes of problem behaviors, social competence, expressive language, receptive language, and school readiness. Validity data from a number of recent studies have shown the newer preschool system (Cassidy & Marvin, 1992) system to be related to concurrent social competence, behavior problems, AAI classification, and a number of risk factors (e.g., Booth, Rose-Krasnor, McKinnon, & Rubin, 1994; Greenberg, Speltz, DeKlyen, & Endriga, 1991; Lyons-Ruth, Repacholi, McLeod, & Silva, 1991; Marvin & Pianta, 1996; Pianta, Marvin, & Morog, 1999; Stevenson-Hinde & Shouldice, 1995). Moss, St-Laurent, and Parent (1999) found that attachment classification was related to behavioral and academic outcomes in elementary school. Although there are fewer data available on the preschool system than the more established infant system (Ainsworth et al., 1978), the preschool system does appear to be a reliable, valid, and useful tool for classification and description of preschoolers’ attachment patterns. See Solomon and George (1999) and Teti (1999) for two recent reviews of the system’s validity. In the present study, all child classifications in the Strange Situation were double-coded by two trained coders (including the second author) who have demonstrated reliability with the MacArthur Attachment Working Group tapes. Disagreements were conferenced. Coders were blind to each other’s codes, and to the codes of caregiver behavior in the Strange Situation. Caregiver behavior system (classification system). The caregiver behavior system (Marvin & Britner, 1996) consists of a 5-category behavior classification system, and a set of ten, 9point behavior-rating scales. The classification system was designed to measure parents’ patterns of behaviors in a separation – reunion procedure, as one step toward understanding parents’ caregiving strategies and their relation to children’s strategies of attachment during the preschool years. The implicit framework employed is that these patterns are actually dyadic patterns of interaction between child and parent (George & Solomon, 1999; Marvin & Britner, 1999), that in the long run a dyadic measurement system will probably be the most useful, but that separate yet complementary systems for parent and child are the most appropriate way to work toward that eventual dyadic system.

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This parental classification system was developed subsequent to careful viewing of hundreds of preschool Strange Situations and other separation – reunion procedures. The authors took detailed notes of child – parent interaction from numerous videotapes of each of the five identified patterns of child attachment in the preschool years (A, B, C, D/ Controlling, and Insecure-Other). With these notes, and with knowledge of the child classifications and the published literature on caregiver behavior patterns associated with different child classifications, specific caregiver behavior patterns and inferred caregiving strategies in the Strange Situation common to each child classification group were identified. The system was then ‘fine-tuned’ by applying it to 25 tapes, evenly distributed across major child classification groups, of preschool Strange Situations. In classifying parents’ caregiving patterns in the Strange Situation, attention is given to their behavior across the entire situation, but especially in the context of leave-taking and reunion. In addition, special attention is given to five dimensions of caregiver behavior: gaze; organization of proximity and contact; quality of discourse; affect regulation; and discipline or structuring of the child’s behavior. The five classifications of the caregiver behavior classification system are described in brief detail in Table II (for the full system, see Marvin & Britner, 1996). Caregiver behavior system (rating scales). Ten rating scales of distinct dimensions of parental patterns were also devised (Marvin & Britner, 1996). The 10 dimensions represent qualities of caregiver behavior in attachment – caregiving contexts that have been theoretically and/or empirically linked to child attachment strategies. The Sensitivity and Parental Delight scales were based upon the scales used in the Ainsworth et al. (1978) Baltimore study; the scales for Negative Affect and Support for Competent Exploration were derived from scales used in the Minnesota Mother – Child longitudinal sample (e.g., Sroufe, 1990); and, the remaining six scales (Affection, Rejection, Neglect, Pressuring to Achieve, Overinvolving with Respect to Attachment, and Role-Reversing) were derived from Main and Goldwyn’s (1998) five AAI rating scales of ‘Inferred Early Experience’, (respectively, Loving, Rejecting, Neglecting, Pressuring to Achieve, and Involving/RoleReversing, which was ‘unpacked’ into two scales). Each scale was revised in order to make it applicable to assessment of caregiver behavior in the preschool Strange Situation, but with care to create a point-to-point analog of—and maintain conceptual continuity with— the original scale. In using the system, the rating scales are completed prior to the decision about a classification for the overall pattern of a mother’s behavior in the preschool Strange Situation. Classification decisions are made based upon the best-fitting pattern and are not explicitly contingent upon any rating scale decisions. The use of both rating scales and categorical classifications was intended to improve the description of caregiving behaviors and to allow for the use of statistics suited to both categorical and continuous data (Fraley & Spieker, 2003). Procedure Each Strange Situation was double-coded for caregiver behavior (classification and rating scales) by the first author and either a clinical psychology graduate student or one of two undergraduate research assistants, none of whom was trained to classify children in Strange Situations. In every case, the coders were blind to each other’s codes and to the child’s attachment classification. The coders completed the 10 rating scales on dimensions of caregiver behavior and then classified the behavior of the mother using the caregiver behavior classification system (Alpha, Beta, Gamma, Delta, or Iota). The student coders

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were also naı¨ve to the authors’ predictions about relations between caregiver rating scale patterns and caregiver behavior classifications. Inter-rater reliability Inter-rater reliability for both the child attachment classification system and the new caregiver behavior classification system was high (see Table III), and did not differ significantly across the medically involved (CP and epilepsy) and healthy (no diagnosis) families. Both 5-category systems could therefore be used for the entire sample in the study. Inter-rater reliability was also high for the 10 rating scales of mothers’ caregiving dimensions in the Strange Situation. Exact agreement on the 9-point scales ranged from 61 – 90%, with a mean of 78%; agreement within 1 point on the 9-point scales ranged from 75 – 94%, with a mean of 89%. Because coders completed both the 5-category caregiver behavior classifications and the ten, 9-point caregiver behavior rating scales, we wanted to examine whether one type of code was biased by the completion of the other code. For 30 cases, an additional reliability coder completed caregiver behavior classifications, but not the ten, 9-point caregiver behavior rating scales. The codes were reliable with those completed by coders who did the caregiver behavior classifications and rating scales (exact agreement on the 5-category classifications, 27/30 [90%]). Conversely, an additional coder completed caregiver behavior rating scales, but not the classifications. The codes were reliable with those completed by coders who did the caregiver behavior classifications and rating scales (exact agreement on the 9-point scales, 231/300 [77%]; within 1 point, 265/300 [88.3%]). Results These results summarize basic descriptive statistics about the caregiver behavior classification groups, the concordance rate between caregiver behavior and child attachment classifications, and the association between caregiver rating scales and classifications (employing univariate ANOVAs and multivariate discriminant function and cluster analyses). Descriptive statistics The sample yielded a wide distribution of the caregiver behavior classifications. Approximately half (48%) of the mothers in the total sample were classified as Beta, or secure. The other mothers were classified in one of the four insecure categories on the basis of their behavior in the Strange Situation. The sample also provided enough examples of each of the five classifications to allow for group contrasts. With respect to distributional differences across diagnostic groups, the Beta (secure) class was more common among the healthy than the CP and—to a greater extent—the epilepsy groups, and the complex Iota (insecure-other) class was more common among the epilepsy group than the CP or healthy groups. These trends did not, however, reach significance in crosstabs analyses. These rates were typical of child attachment security rates found with mildly at-risk populations (e.g., low SES, child disabilities) and are somewhat lower than is typical in low-risk, middle class populations of infants or preschoolers (about 60 – 70% rates of security; e.g., Belsky & Isabella, 1988; van IJzendoorn & Sagi, 1999). Using the 78 dyads from Sample 2, demographic and child developmental-level continuous variables describing the mother – child dyads were tested as possible covariates. In fact, caregiver behavior classification was not related to child age, level of cognitive

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Table II. The five classifications of the Marvin and Britner caregiver behavior classification system ORDERED-SECURE Beta These parents display an easy, relaxed, intimate pattern of behavior in the Strange Situation with their preschool children. They are equally comfortable monitoring their children’s autonomous play, and welcoming the children back to them for comfort as needed. Gaze: open; frequent joint eye contact, even when in close proximity. Proximity and contact: accepts closeness without increased tension, but does not demand it. Discourse: responsive, relaxed, respectful of child; language is facilitative, structured, and can deal with personal issues as easily as toys; feels like a partnership. Affect regulation: calm and relaxed; changes in affect are smooth; matches affect of child. Discipline: brief and efficient; shifts quickly (but not abruptly) to discipline when necessary, then returns to another interaction. General: easy, warm, relaxed, comfortable, structured, and intimate with child. Leave-taking: natural and respectful; willing to negotiate but is clearly in charge. Reunion: greets warmly, directly, and immediately; at least brief intimate eye or physical contact; takes cue from child’s mood; soothes as long as necessary, then engages child in play. ORDERED-INSECURE Alpha These parents are avoidant or dismissing of intimate, attachment – caregiving interactions, and either engage in a minimum of interactions with their children, or restrict interaction to exploration, discipline or other nonattachment/caregiving (i.e., intimate) contexts. Gaze: minimal eye contact, especially mutual gaze; often ‘zoned out’ or focused elsewhere. Proximity and contact: often minimal; proximity may occur in process of ‘teaching’; may lean away from child’s attempts at close contact. Discourse: often minimal, didactic, or exploration-focused; often tense or careful, marked by long pauses, overbright tone, or missed opportunities for response. Affect regulation: either flat or tense; abrupt changes in affect; little emotion. Discipline: intervenes quickly with misbehavior—whispering or careful when firm, or rationalizing. General: maintains neutrality by dealing with physical caregiving and teaching, nothing personal or emotional; focus is on child’s exploration or is largely ignoring; interactions about exploration often take on air of quizzing child. Leave-taking: abrupt, short, task-oriented, with minimal preparation or negotiation. Reunion: minimal contact (eye or physical) or personal involvement; overbright greeting, in some cases; often, there is an immediate toy focus; some ignore child after minimal or no greeting. Gamma These parents are overly encouraging of their children’s attachment behavior, and their children’s intimacy with and dependency upon themselves. At the same time, they tend to resent the burden this degree of intimacy places upon themselves. Gaze: often direct gaze; may also avert gaze, roll eyes with impatience or mild disgust, or look sharply at child. Proximity and contact: close and frequent (often inappropriate), interfering with child’s exploration. Discourse: inflected, fake, infantilizing, and often contradicts child or self; often brings topic of conversation back to self; often engages in conflict which the caregiver is seemingly unable to terminate. Affect regulation: anxious; dramatic; forced smiles and affect; very open body language. Discipline: inability to be (successfully) firm; often uses bribes, rational dialogue, tickling, affection as means of discipline. General: anxious; overemphasis on self and relationship; encourages child’s dependency; de-emphasizes child’s autonomous exploration; often projects an image of helplessness. Leave-taking: often long, drawn-out, rational/logical explanations or bribes; conflicted; often unnecessarily calls attention to departure. Reunion: close contact and proximity (often uncomfortable); allows child to hang on, despite clearly disliking it; emphasis on parent’s needs and/or displeasure with child’s behavior. DISORDERED-INSECURE Delta These parents are somewhat disorganized and abdicating in their attachment-caregiving interactions with their children: they seem not to take the ‘executive’ role with their children. A best-fitting, ‘forced’ Alpha, Gamma, or Beta classification is also made. Gaze, proximity and contact, discourse, affect regulation, leave-taking: variable (continued)

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Table II. (continued) Discipline: incompetent; either passive or frightened about disciplining child, or does so suddenly and frighteningly. General: disorganized or confused by interactions; may show disoriented or bizarre behaviors toward child; does not exercise ‘executive control’ of relationship to child, inappropriately accepting the child’s caregiving or punitive behaviors. Reunion: awaits child’s response to re-entry; clearly not in control; role-reversed. Iota These parents do not display an easy, relaxed and intimate pattern of behavior, but they display either a unique pattern not included among the Alpha, Gamma or Delta groups, or they display a combination of identified patterns in their behavior. In general, these patterns offer the child neither a secure base for exploration, nor a haven of safety when distressed. Specific sub-patterns currently identified include: a combination of Alpha and Gamma; Disengaged (often in a dissociative or trance-like state); Controlling-threatening; and Fearful without being rolereversed/abdicating. A best-fitting, ‘forced’ Alpha, Gamma, or Delta classification is also made.

Table III. Inter-rater reliability on Caregiver Behavior (CB) and Child – Parent Attachment (CPA) classications by group Group Level CB Exact 5-category agreement CB Secure – Insecure agreement 90% CPA Exact 5-category agreement CPA Secure – Insecure agreement 93%

CP

Epilepsy

No Diagnosis

Total

26/30 87%

17/20 85%

52/60 87%

95/110 86%

27/30 90%

18/20 90%

54/60 90%

99/110

25/30 83%

16/20 80%

51/60 85%

92/110 84%

28/30 90%

18/20 93%

56/60 93%

102/110

functioning on the Bayley or Peabody Picture Vocabulary Test, family annual gross income, or mother’s years of formal education. Classification was also unrelated to mother’s weekly hours of work outside the home, and an index of percentage of direct caregiving provided by mother compared to all other caregivers. Agreement between child and caregiver classification systems In order to look at the match between mother and child patterns in the same attachment – caregiving interaction, or the two partners in this ‘partnership’ (Bowlby, 1969/1982; Marvin & Britner, 1999), we conducted a series of crosstabs comparisons, using the different breakdowns typically found in the attachment literature (i.e., Secure – Insecure; A/B/C/D/ Insecure-Other). We emphasize that these classifications were concurrent and not independent, and thus we make no claims about causality. A crosstabs analysis was conducted to compare the association between Beta/non-Beta mothers and their secure (B)/insecure (non-B) children, with coders of child class and

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mother class blind to each others’ codes. Exact agreement was 93/110 (85%). The Chisquare of 30.5 (1 df) was highly significant (p 5 .01), with a kappa (adjusted for chance agreement) of .69. Mothers classified as Beta generally had children who were classified as B, or secure; non-Beta mothers often had children who were classified as insecure. A 5 x 5 crosstabs produced a Chi-square of 157.1 (16 df) that was also highly significant (p 5 .01), with a kappa of .57. Exact agreement was 77/110 (70%). Inspection of the diagonal in Table IV reveals that mothers classified as Alpha had children who were classified as ‘A’, and the like. The only (relatively) large off-diagonal cells were those of Iota mothers (who displayed a mix of insecure patterns) who had children classified as ‘A’, and the Alpha mothers who had children classified as I/O. The I/O child pattern was most common in the CP sample, and the Iota maternal pattern was most common in the epilepsy sample. For the other four categories, the caregiver behavior – child attachment match was similarly high across diagnostic groups, suggesting the system’s utility across the groups, though small sample sizes preclude statistical comparisons. Combining the epilepsy and CP groups to form a medical risk (or neurological impairments) sample, the caregiver behavior – child attachment match is significant (n = 50), crosstabs Chi-square = 38.1 (16 df), p 5 .01, but weaker than the match for the healthy sample (n = 60), crosstabs Chi-square = 150.7 (16 df), p 5 .01. Relationships between rating scales and classifications A series of planned group comparison t-tests were used to evaluate predictions involving different levels of caregiving rating scale scores across the caregiver behavior classification groups. All 16 of the specific predictions about group differences on the rating scales were borne out. The rating scales, which were derived from the research literature on attachment and based in large part on the Main and Goldwyn’s (1998) early experience scales of the AAI, were related in theoretically meaningful ways to the maternal classifications, which were derived from the infant and child classifications of Ainsworth and colleagues (1978), Cassidy and Marvin (1992), and Main and Cassidy (1988). The planned comparisons were followed up by a series of oneway analyses of variance with SNK contrasts among groups, one for each of the 10 scales, in order to explore more fully any caregiver behavior class differences on the rating scales. All 10 ANOVAs were significant at p 5 .01 (see Table V). To summarize the univariate findings, mothers who were classified as Beta, or secure, were rated as the most affectionate and delighted with their children, and were also the most

Table IV. Classification table for Caregiver Behavior (CB) and Child – Parent Attachment (CPA) match at the 5category and secure – insecure levels CB CPA A B C D I/O

Alpha 13 5 0 0 6

Beta 3 44 2 1 3 CB

CPA Secure (B) Insecure

Beta 44 9

Insecure 8 49

Gamma 1 1 6 0 3

Delta 0 2 0 6 1

Iota 4 0 0 1 8

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Table V. Univariate oneway ANOVAs on caregiver rating scales by caregiver behavior classification Differences by classifications Caregiver rating scales Affection Overinvolving with respect to attachment Role-reversed Rejecting Neglecting Pressuring to achieve Negative affect Sensitivity Parental delight Support for competent exploration

F (4, 105)

SNK Contrast

24.3 55.4 156.9 31.4 12.1 7.4 5.7 53.7 23.8 19.2

A, IO, D 5 G, B A 5 B 5 D 5 IO 5 G A, B, G 5 IO 5 D B, G 5 D, IO, A B, G, IO 5 A, D B 5 D, IO, A B, A, G 5 IO IO, D, G, A 5 B IO, A, D, G 5 B D, IO, G, A 5 B

sensitive and supportive of their children’s competent exploration. Alpha mothers were seen as the most rejecting of their children’s attachment behaviors, and they did the most pressuring of their children to achieve; they were also rated as highly neglecting of their children in the Strange Situation, relative to the other groups. Gamma mothers were rated as the most overinvolving with respect to attachment, as they attempted to elicit the attention and involvement of the child; like the Beta mothers, they were rated as highly affectionate, but they did not show genuine delight in their interactions with their children. Delta mothers were the most involved in role-reversed relationships, and, on the average, were also rated as neglecting and pressuring of their children. Finally, Iota mothers (those that did not show a coherent insecure strategy) were the most negative; they were also rated as highly rejecting and pressuring of their children. Discriminant function analyses Discriminant function analysis was employed, following the work of Ainsworth et al. (1978) and Crowell and Feldman (1988), in order to investigate scale patterns for each of the classification groups. In discriminant function analysis (DFA), the optimal linear combinations of the independent, or predictor, variables are formed and serve as the basis for classifying cases into one of the defined groups. DFA is a maximization technique that derives composite variables by maximizing the average degree of separation between groups relative to variance within groups. Many of the rating scales were intercorrelated, sometimes highly (see Table VI). DFA was thus selected in order to avoid some of the problems associated with repeated univariate tests, and also to explain the nature of the existing group differences—not only to see whether the groups differed significantly from one another. In this case, the ratings on the 10 scales were used as the independent variables, and the dependent variables were the caregiver behavior classification groups (Alpha, Beta, Gamma, Delta, and Iota). Using a stepwise multivariate DFA with the Wilks method for selection (p 5 .05 to enter, p 4 .10 to exit), four discriminant functions were created to separate maximally the five caregiver behavior classification groups. The first three discriminant functions explained a significant amount of the variance; whereas each of the 10 scales differed significantly across classifications in the univariate analyses, all of the unique variance was accounted for by five scales in the multivariate DFA. Table VII presents the order of entry and the pooled within-groups correlations between the rating scales and the

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Table VI. Intercorrelation matrix of caregiving rating scales

Affection Rejecting Overinvolve Role-reverse Neglect Pressure Sensitive Negative Delight Support

Aff.

Rej.

Over.

RR

Negl.

Press

Sens.

Neg.

Del.

Sup.

1.00 -.75 .06 -.19 -.56 -.43 .75 -.47 .75 .54

1.00 -.13 .18 .64 .51 -.70 .50 -.63 -.55

1.00 .12 -.15 .00 -.33 .18 -.20 -.29

1.00 .32 .13 -.31 .11 -.21 -.31

1.00 .05 -.56 .19 -.53 -.54

1.00 -.45 .40 -.36 -.39

1.00 -.46 .79 .74

1.00 -.37 -.37

1.00 .67

1.00

2-tailed Pearson correlations significant at p 5 .05 are printed in bold.

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Table VII. Pooled within-groups correlations between caregiver rating scales and the discriminant functions using caregiver behavior classifications Discriminant Functions Scales Role-reversed Overinvolving Sensitive Rejecting Negative Affection Delight Pressuring Neglect Support

Step

1

1 2 3 4 5 – – – – –

.96

2

3

7 .77 .66

.55 .60 7 .80

.38

.53 .41

.36

7 .57 .34

4

.33 .97 7 .27 .28

The table includes only correlations greater than r = .25.

discriminant functions using caregiver behavior classifications. Classification results for the 110 dyads indicated that 98 (or 89.1%) were classified correctly, compared to 20% that would have been classified by chance. The first discriminant function (DF) accounted for 60% of the variance and maximally separated the Delta group from the others, primarily using the role-reversal scale. The second DF accounted for 24% of the variance, and used the overinvolving (negative loading) and sensitivity scales (positive loading) to split the Gamma and Beta groups. The third DF used the rejection scale (negative loading) to split off the Alpha group, and it explained 16% of the variance. The fourth DF used the negativity scale to split off the Iota group, but did not explain a significant amount of the variance (less than 1%) after removal of the 3rd DF. The weighted vectors or discriminant functions, like the factors yielded by a factor analysis, may be interpreted as dimensions underlying group differences. The results of the DFA do not mean that the caregiver behavior classification system is the best possible description of maternal caregiving behavior in the preschool Strange Situation. These results simply demonstrate that the caregiver behavior classifications were consistent with the stated specifications. Cross-validation can be achieved by classifying dyads from an independent sample, in order to see whether the DFs derived from the present sample are generalizable. Cluster analyses Using the analytic strategy of Lamb, Thompson, Gardner, and Charnov (1985), the discriminant function analysis was followed by a series of cluster analyses on the standardized (z-scores) rating scales in order to determine whether the caregiver behavior classification system employed yielded the most parsimonious solution from the caregiver rating scales in this sample. Hierarchical cluster analysis groups individuals into clusters on the basis of the similarity of their profile of scores. Like DFA, cluster analysis classifies cases into categories; whereas with DFA the groups must be known to derive the combination rule, in cluster analysis group membership for all cases is unknown and the number of clusters may be unknown. The intent of the cluster analyses, then, was to determine whether the parents’ rated behaviors fall into clear and distinct cluster groups. Specifically, the cluster solutions were

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examined to determine whether the clusters, formed on the basis of the caregiver rating scales, were consistent with the individual differences in the full A-B-C-D-I/O child (Cassidy & Marvin, 1992) and caregiver behavior systems, the more traditional A-B-C breakdown (Ainsworth et al., 1978), a more temperament-based A1-B1 versus B3-C split (examined by Belsky & Rovine, 1987), or another grouping. Upon visual inspection of the patterns of scales in the dendrograms, the clusters in the 5-, 4-, and 3-cluster solutions bear some resemblance to the attachment – caregiving patterns presented in the caregiver behavior system. Across the solutions, the Beta-like clusters showed (modest) positive z-scores on the scales of affection, sensitivity, and delight, and negative z-scores on role-reversal, rejecting, pressuring, and negativity. The Delta-like clusters showed high role-reversal and rejecting, and low affection, sensitivity, and delight. The Alpha-like clusters were highly rejecting, moderately high in pressuring, and low in affection, sensitivity, and delight. The Iota-like clusters, present in the 4- and 5-cluster solutions, were variable across other scales, but were characterized by their high levels of negative affect. The Gamma-like cluster, which emerged in only the 5-cluster solution, showed high overinvolving and affection, and low rejecting. A crosstabs analysis comparing the match between the 5-cluster solution and the 5category caregiver behavior system classifications for the sample was significant, Chi-square (16 df), 187.5, p 5 .01. That is, there was a high level of association between the theoretical clusters derived from patterns among the rating scales and the theoretically-based caregiver behavior classifications. These results support those of the DFA in showing that the caregiver behavior classification system adequately described group differences on the rating scale dimensions of maternal caregiving in the preschool Strange Situation which emerged in this sample. Discussion The new system for classifying parental caregiver behavior patterns in the preschool Strange Situation was, after only a short training period, highly reliable in samples of normally developing children and those with some medical risk (CP and epilepsy). There was a high degree of association between caregiver behavior and child attachment security in the Strange Situation. This demonstration is descriptive, concurrent, and not independent— and certainly is not meant to imply causality (Kenny, 1996). The high concordance rate between the child attachment classifications and the caregiver behavior classifications may be important in several respects. It may have practical utility for research and clinical work with caregivers because of the focus on observing caregiver behavior in a standardized laboratory setting, as opposed to more intensive home observations or by inference from interview or self-report. Further, by measuring parental caregiving behaviors in a stressful laboratory assessment (i.e., the Strange Situation), one can tap into caregiving system behaviors that might not be observed in less stressful situations. This study represents an attempt to develop an important link in the attachment literature between parents’ internal working models of relationships and their children’s attachments to them—the link being, of course, the parents’ caregiving behavior toward the child in an attachment – caregiving context. Caregiving patterns The caregiver behavior – child attachment match was highly significant in the medical risk and healthy groups, although the relationship was stronger in the healthy sample. The most

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child – mother ‘mis-matches’ occurred when either mother or child displayed a complex mix of strategies (Insecure-Other or Iota) and the other member of the dyad showed a simpler (most commonly Avoidant, or Alpha) strategy. These complex insecure patterns were more common among dyads in the sample of children with medical diagnoses than those in the control sample, and may reflect disorganization associated with the children’s neurological impairments, in addition to disordered speech, learning, and cognition (Barnett et al., 1999; Pianta, Marvin, Britner, & Borowitz, 1996; Pianta et al., 1999; Pipp-Siegel, Siegel, & Dean, 1999; Teti, 1999), or measurement error (see Pipp-Siegel et al., 1999, on differentiating the attachment relationship quality from neurological impairment). Following the theoretical writings of developmental changes in attachment relationships in the preschool years (Bowlby, 1969/1982; Marvin, 1977), the present study begins to identify some potentially important caregiving dimensions beyond infancy. The use of the rating scales begins to give some understanding of what caregiving dimensions are associated with positive attachment – caregiving interactions in the preschool years. The DFA and cluster analyses suggest that, given the dimensions of caregiving on which mothers were rated, the caregiver behavior system is useful for classifying five distinct caregiver behavior patterns in the preschool Strange Situation (though discriminant and convergent validity, generalizability, and replication remains to be demonstrated in future work). Across the different samples, the caregiver behavior patterns were consistent with theoretical expectations in their links to child classifications and to hypothesized combinations of rating scale dimensions of caregiving. The Beta mothers had children who were classified as secure (B), and the mothers’ behavior in the preschool Strange Situation was characterized by parental delight, affection, sensitivity, and support for the children’s competent exploration. The various insecure patterns of caregiver behavior and child attachment classification were similarly consistent with findings in the behavioral and representational attachment literatures (Ainsworth et al., 1978; Cassidy & Marvin, 1992; Greenberg et al., 1991; Main & Cassidy, 1988; Main et al., 1985; Stevenson-Hinde & Shouldice, 1995). For example, the mothers classified as Alpha, conceptualized to have a ‘minimizing’ strategy with respect to attachment or intimate interactions/conversations, interacted the least with their children and remained impersonal (by rejecting, neglecting, or pressuring their children, or focusing on competent exploration at times when a focus on intimacy and soothing would be expected) throughout the preschool Strange Situation. Mothers classified as Gamma demonstrated intrusive overinvolvement with—and infantalization of—their children. Mothers classified as Delta displayed a role-reversed relationship with their preschool children. Mothers classified as Iota showed a mix of strategies, but were often characterized by their high levels of negative affect. Sensitivity versus other dimensions of caregiving Consistent with the literature (e.g., Ainsworth et al., 1978; Pederson & Moran, 1995; Seifer, Schiller, Sameroff, Resnick, & Riordan, 1996), sensitivity routinely distinguished the secure from insecure dyads (using both the caregiver behavior and child attachment systems). Whereas ratings on the sensitivity scale were higher among secure than insecure groups, the scale did not have utility in discriminating among insecure groups. In contrast to many other attachment studies, multiple scales were included for the purpose of distinguishing among insecure groups in the sample. A patterned combination of the other rating scales was necessary for detecting insecure group differences, and these scales also adequately separated secure from insecure groups, independent of sensitivity (cf., Seifer et al., 1996). The construct of sensitivity, common to many studies of attachment but complicated by

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judgments of ‘appropriateness’ (Meins, 1999), was no more useful in distinguishing between secure and insecure dyads in univariate analyses than was the unidimensional scale of level of parental delight. In the multivariate discriminant function analyses, however, sensitivity (rather than parental delight or support for competent exploration) accounted for more of the unique variance in differences between secure and insecure dyads. Sensitivity is an integral component of the attachment – caregiving relationship, but it is not the only important dimension is describing the relationship. Use of rating scales versus classifications Fraley and Spieker (2003) report the results of analyses of data from the NICHD Study of Early Child Care and argue that variation in attachment patterns is largely continuous rather than categorical. They present an interesting discussion comparing types and dimensions of attachment behaviors, and they also call for an expanded range of behaviors to be coded in the Strange Situation. We attempted to rate a number of theoretically relevant parental behaviors in an attachment – caregiving context. The strong associations in this study between complex patterns of multiple rating scales and the classifications of caregiver behavior may offer some support for the use of both categorical and continuous scoring in attachment research. In the present study, coders were not constrained in their classification choices by any rating scale decisions. An algorithm of scale combinations, over a variety of samples, could potentially be created in order to arrive at classification decisions. Rating scales based upon levels of behaviors may be easier to export and learn than more abstract and less rule-governed classifications. Classifications are particularly useful as descriptive tools and a means to understanding the nature of group differences; they are also useful diagnostically, but this can lead to potentially damaging ‘labeling’. The use of patterns of continuous rating scales could avoid some of the labeling problems, open up the available types of statistical analyses, and allow a researcher or practitioner to select a few or all of the scales for a given assessment (depending on the focus). Clearly, there are advantages and disadvantages of both continuous scales and categorical classifications, and the method selection should follow from the purpose of the question at hand. Interventions Bowlby (1988) wrote about his surprise that his theory, originally designed to aid clinical diagnosis and the treatment of children and families with emotional disturbances, had been used primarily by developmental researchers. Clinicians are beginning to recognize the utility of attachment-based interventions for the treatment of some relationship-based difficulties. Some attachment-based interventions have attempted to facilitate effective parenting through ‘deep structural change’ (Nezworski, Tolan, & Belsky, 1988, p. 360). Other intervention studies have focused on more ‘surface’, behavioral change. For example, van den Boom (1995) has designed an intervention for mothers of temperamentally irritable infants, aimed at promoting maternal responsiveness (to positive and negative emotional expressions of the infant) and discouragement of intrusive behavior and detached uninvolvement. In the children’s third year, her results show direct enduring effects on parent responsiveness and child cooperation. Van den Boom (1995, p. 1799) believes that the intervention has been successful ‘‘in inducing the transfer of training in sensitivity to the prominent interactional dimensions (teaching and control) of toddlerhood’’. In fact, Bakermans-Kranenburg, van IJzendoorn, and Juffer (2003) report in a meta-analysis that

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behaviorally oriented, short-term preventive interventions in a variety of risk populations are more effective in changing parent insensitivity and children’s attachment insecurity than are longer, more intensive, and therapeutic approaches. The caregiver behavior system is currently being used clinically by the second author and colleagues in an attachment-based intervention with Head Start/Early Head Start children and their primary caregivers (Marvin, Cooper, Hoffman, & Powell, 2002). It is being used for two purposes: to identify parental caregiving patterns prior to the intervention; and as one basis for designing individualized intervention goals for the parent and parent – child dyad. The caregiver behavior system may represent a step toward designing behaviorally oriented interventions for parental caregiving in the preschool period. Similar work with parents of infants, young children in foster care, and young, high-risk parents represent other possible clinical extensions of the present research, pending further validation of the system. Conclusion Although the hypothesized maternal caregiving behavior patterns fit well to these data, the use of this system in other parent – child interactional contexts and the comparison of caregiver behavior patterns in the Strange Situation and in the home (and other ecologically valid contexts) are necessary for the establishment of external validity. As part of our larger project, we are currently beginning to examine the connections between adults’ working models of close relationships with parents, spouse, and child, maternal caregiving behavior patterns, and child attachment. As research on attachment in the preschool years continues, it is increasingly obvious that Bowlby was correct in emphasizing the systemic nature of attachment – caregiving behavior. To a certain extent, it is the parent who selects the tune, teaches the first steps, and is the partner who ‘leads’ in this dance. Before moving to dyadic assessments and models, however, we must have a clear understanding of parental caregiving behaviors that complement child patterns of attachment. Acknowledgements This work was supported by an NIMH Training Grant (MH18242) and a Dissertation Year Fellowship from the University of Virginia to the first author, and by grants from NICHD (R01 HD 26911) and NIDRR (H133G20118) to the second and third authors. The authors wish to thank Kristin K. Nicholas, Ph.D., and Thomas G. O’Connor, Ph.D., for assistance with data coding, and two anonymous reviewers for their insightful comments. References Ainsworth, M. D. S. (1990). Some considerations regarding theory and assessment relevant to attachments beyond infancy. In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 463 – 488). Chicago: The University of Chicago Press. Ainsworth, M. D. S., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale, NJ: Erlbaum. Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129, 195 – 215. Barnett, D., Hill Hunt, K., Butler, C. M., McCaskill, J. W., Kaplan-Estrin, M., & Pipp-Siegel, S. (1999). Indices of attachment disorganization among toddlers with neurological and non-neurological problems. In J. Solomon & C. George (Eds.), Attachment disorganization (pp. 189 – 212). New York: Guilford.

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