Disorganized Attachment Representations, Externalizing Behavior Problems, and Socio-Emotional Competences

Sammanfattning: Disorganized attachment is a risk-factor for developmental maladaptation in the form of externalizing behavior problems, and for poor development of competences important for socio-emotional functioning. Concerns have however been raised regarding theoretical overextension, and there is consequently a need for multifactorial studies that examine which outcomes disorganized attachment is reliably important for. There is also a lack of research on the mechanisms that mediate the relation between disorganized attachment and externalizing problems. The present thesis therefore examined whether disorganized attachment is a specific risk-factor for symptoms of Oppositional Defiant Disorder (ODD) or Attention-Deficit/Hyperactivity Disorder (ADHD), or a non-specific risk factor for both types of problems. Several emotional and cognitive competences were investigated as mediators, with the question of whether disorganized attachment becomes associated with externalizing problems primarily through any specific mechanism, or through multiple mechanisms. Three studies were conducted. Children completed the separation anxiety test for attachment representations and laboratory tasks for distinct competences, and parents and teachers rated emotion regulation and ODD- and ADHD-symptoms. Study I was cross-sectional and found that disorganized attachment contributed specifically to conduct problems when accounting for ADHD-symptoms. However, disorganized attachment did not contribute to ADHD-symptoms when accounting for conduct problems. Study II found that children with disorganized attachment representations show deviations in identification of emotional expressions, in the form of a generally diminished ability to discriminate between expressions rather than in response biases. Study III was (short-term) longitudinal and replicated the results from Study I; disorganized attachment was primarily associated with ODD-symptoms, not ADHD-symptoms. Elevated emotional reactivity and poor regulation, particularly for anger and fear, mediated the relation between disorganized attachment and ODD-symptoms. Taken together, the present findings suggest that disorganized attachment may constitute a specific risk factor for externalizing problems pertaining to anger and aggression, such as oppositionality and misconduct, rather than ADHD-problems. Importantly, the findings caution against ideas of a pathway from disorganized attachment to ADHD-symptoms. The deviations in processing and regulation of anger and fear corroborate Bowlby´s proposal that these emotions are closely connected, central to disorganization, and a potential mediating mechanism in relation to externalizing problems.