Transcript Etiologies of Oppositional-Defiant Behavior in Preschoolers

Etiologies of Oppositional-Defiant
Behavior in Preschoolers
• Developmental context
– End of emotional object constancy subphase
of separation-individuation phase of
development
– Desire for greater autonomy, increased
differentiation from mother
– Bowlby’s goal-corrected partnership
• Two parties agree to a comfort zone in which child
is granted increased autonomy while mother
remains available for “checking in”-now mediated
through language in addition to behavior
• Mother also needs to feel comfortable with the new
arrangements
• Sometimes increased autonomy activates anxiety
in mother, who sets higher proximity goal than
child desires, or vice versa
• Conflicts arise when mother and child cannot
agree on the goals of achieving both attachment
security and autonomy for child
• Articles provide reasons why this goal corrected
partnership between child and mother cannot be
achieved.
• Familial and social contexts
– Family harmony or disharmony influences
child’s behavior
– Family psychiatric history influences child’s
behavior
– Social context (e.g., poverty, single-parent
household, teenage motherhood) also
influences attachment security and behavior
problems
Infant Attachment Disorganization
as Contributor of Behavior
Problems in Preschoolers
(Lyons-Ruth et al.,1993)
• Previous studies assessed traditional attachment
patterns during infancy and produced inconsistent
results with later behavioral problems
• Solution: assess attachment disorganization
• Attachment disorganization
– Infants appear disorganized/disoriented during caregiver
reunion
– Characterizes 13% of middle-income infants, 28% of
infants from multiproblem families receiving support
services, 54% of infants from low-income, depressed
moms with no services, 82% of infants from maltreating
families
– Traditional attachment classifications can also be
assigned (e.g., D/A, D/B, D/C)
– Infant attachment disorganization contributes to
development of behavior problems in preschool years
• Maternal psychosocial stressors also
contribute to development of behavior
problems in preschool years
– Lyons-Ruth assessed three such stressors in
moms
• Depressive symptoms
• Child maltreatment
• History of psychiatric hospitalization
– Perhaps attachment interacts with stressors to
protect against or potentiate behavioral
problems (interaction effect)
• Infant mental development might also contribute
to development of behavior problems,
considering its relation to anxious or D
attachment
• Research design
– Attachment assessment, mental development
assessment, maternal sensitivity, psychosocial data
collected at 18 months
– Behavioral ratings assessment by teacher collected
between ages 4 and 6 (48-71 months) with 3 factors
extracted
• Hostile
• Anxious
• Hyperactive
• Results
– D attachment predicted hostile-aggressive behavior in
classroom, accounting for 71% of serious hostile
behavior
– Maternal hostile-intrusive behavior predicted hostileaggressive behavior
– Mom’s psychosocial problems (especially depression)
predicted hostile aggressive behavior in classroom
– 59.2% of D kids were assigned secondary
classification of A
– But only 44% of disorganized kids were found to be
deviant (difference between looking forward and
looking backward)
Contemporaneous Assessment
of Attachment and Externalizing
Behavior Problems in Preschool
Years
(Greenberg et al., 1991)
• Does anxious or D attachment contribute to
development of disruptive behavior disorders by
preschool years?
• D attachment assumes more organized form in
preschool years
– Controlling-caregiving
– Controlling-punitive
• Research design
– Parents completed questionnaires prior to lab visit
– Teachers completed questionnaires on externalizing,
internalizing behaviors
– Separation-reunion sequence in lab
– Parents also received AAI while child received PPVT
and VMI
– Diagnostic classification assessed prior to lab visit
• Results
– 80% of clinic group classified as insecure, 28%
of nonclinic group insecure
– 32% vs. 4% controlling (clinic vs. comparison)
– Separation distress among insecure clinic boys
twice the level in secure clinic boys
– All 8 controlling clinic boys diagnosed as ODD or
ODD+ADHD only, but other clinic boys carried
multiple diagnoses in addition
– 12 non-D clinic boys diagnosed with other, nonDBD diagnoses in addition, such as anxiety
disorder and phobias (more complicated cases)
– 5 of 8 mothers of controlling clinic boys reported childhood
trauma or loss of attachment figure in childhood
– 5 secure clinic boys-why ODD?
• “temporary exacerbations of family stresses” (p. 426)
– Subject 1- birth of twin brothers
– Subject 2- parents couldn’t cop with child’s increased autonomy
– Subject 3- marital difficulties, paternal absence, poor adjustment to
daycare
• “biologically vulnerable” (p. 424)
– Subject 4- history of significantly medical problems , including FTT; M
was unresolved on AAI
– Subject 5- working parents, MGM-schizophrenia, suicidal ideation
• “In some cases of secure attachment, both biologic vulnerabilities
as well as psychosocial stressors may combine to present with
more difficult and long-term disorders” (p. 427)
– “bringing a developmental perspective to bear on clinical issues, one
can begin to chart the trajectories of children with similar surface
symptoms but different etiologies and family circumstances” (p. 428)
Maternal Sensitivity Related to
Attachment in High-Risk
Preschool Sample
• Attachment Story-Completion Task used to
assess attachment
• Data collected in homes
• Teenage moms on public assistance
• Mean security score: 3 out of possible 10
• Age also varied with attachment security
– Developmentally slower?
– Moms’ caregiving capacities improved with time
as they entered adulthood