Research on infant carrying/babywearing is limited but suggests that frequent close physical contact increases maternal sensitivity and responsiveness. It is unknown whether infant carrying promotes parental reflective functioning (PRF). In this prospective investigation, adolescent mothers (=75; =19.45; 57.4% non-white) in a multi-wave infant carrying intervention trial were followed from early postpartum to preschool to assess long-term impacts of infant carrying on the development of PRF. Participation in the infant carrying intervention (β=0.33, =0.03) and maternal representation of infant carrying as supporting infant wellbeing (β=0.36, <0.01) predicted higher PRF when children were 3.5 years old. There was a significant indirect effect from maternal representation of infant carrying as a bonding tool to enhanced PRF during the preschool period via maternal attunement at seven months (β=0.26, =0.04). Participating in an infant carrying intervention and child-focused representations of infant carrying may support mentalizing among adolescent mothers via distinct direct and indirect pathways.

A basic tenet of Attachment Theory describes a species-wide tendency to search out an attachment figure in times of distress. Expectations of support, or lack thereof, may provide a template for socioemotional functioning. This study investigated potential concurrent predictors (i.e. time spent with one's mother and parenting style) and socioemotional correlates of children's verbally expressed preferences for their mothers (i.e. maternal preference) during hypothetical attachment- and affiliation-related situations in 185 Southeast Asian children aged 3-6 years (95 boys). Though children in the current study were cared for by several caregivers, results here suggest they nevertheless prefer their mothers. Maternal time spent did not significantly predict preferences. However, authoritative parenting style scores did. Maternal preferences predicted higher child prosocial, but not problematic behavior. Implications for future work discerning the role of mothers in children's lives are discussed.

We explored the relationship between cultural values, recollected early caregiving experiences and young adult attachment preference. Young adults in Egypt ( = 209) and the United States ( = 554) ranked their current attachment preference, rated their collectivist and individualist beliefs, and recalled the relative contributions of their early caregivers. Egyptian students scored higher than US students on collectivism and recalled more involvement from non-parental caregivers. Most participants reported a preference hierarchy (82% Egypt & 84% US). Surprisingly, individualism was negatively associated with maternal attachment ratings and with having a clear principal attachment relationship, whereas higher collectivism predicted higher maternal attachment. Findings suggest that attachment hierarchies are normative across varying cultural and child-rearing contexts.

I describe the development, with Ruth Goldwyn, Charlie Stanley and others, of the Manchester Child Attachment Story Task (MCAST); particularly highlighting the pivotal role that Mary Main played in its evolution, and its approach to attachment Disorganization. MCAST is a doll play vignette-completion technique characterizing attachment representations in young school-aged children (4.5-8.5 years). It uses a specific dyadic focus and adapts both Strange Situation Procedure (SSP) and Adult Attachment Interview (AAI) methods within its coding procedure, thus allowing a full detailed attachment classification including Disorganisation. I detail how Mary's prior work, insight and continuing support, along with Erik Hesse, in applying these coding systems to play narratives, was crucial to the successful development of the instrument. With selected research data, I then review some of the developmental and clinical issues that MCAST has subsequently addressed, reflected in a 2018 meta-analytic review of 25 studies investigating MCAST Disorganisation.

This study examined how strategies parents use to maintain a dismissing state of mind while discussing their childhood relationship with their parents relate to the quality of their relationship with their partners and children. During the third trimester, 125 couples were administered the Adult Attachment Interview (AAI) to assess adults' states of mind with respect to relationships with their parents during childhood. Marital quality was assessed via observations of couple interactions during discussion tasks and coded for emotional attunement. At 24 months, researchers assessed caregiver sensitivity by observing mother-toddler and father-toddler interactions. Fathers' idealization of their own father forecasted lower caregiving sensitivity with their 24-month-old children, and this relationship was mediated by emotional attunement in the marriage. This finding did not hold for mothers. For both mothers and fathers, higher marital emotional attunement related to more sensitive caregiving. These findings are discussed in the context of gender socialization. Interventions to disrupt the transmission of negative family interactions are also discussed.

Our memories reflect professional meetings and our private relationship with Mary Main for over more than 50 years, working, travelling jointly, and celebrating together. Klaus met Mary Main at Mary Ainsworth's lab in 1973 in Baltimore. Mary Main's and our own longitudinal studies both started at the same time in which attachment research became a focus of several research groups. Still unpublished research results were eagerly shared. Mary supported our wider view of attachment by emphasizing the importance of exploratory play, enthusiasm, expression, and quality of communication. She also explored infants' unexpected avoidance of their mothers. Some infant's resisted traditional classification and were described as disorganized/ disoriented by her. Later in Regensburg, Mary trained our research group in assessing memories of attachment experiences of young adults. When Klaus retired in 2003, Mary gave a warm review of a long time of mutual devotion in the service of attachment development.

Disorganized attachment is a risk for mental health problems, with increasing work focused on understanding biological mechanisms. Examining late childhood brain morphology may be informative - this stage coincides with the onset of many mental health problems. Past late childhood research reveals promising candidates, including frontal lobe cortical thickness and hippocampal volume. However, work has been limited to Western samples and has not investigated mediation or moderation by brain morphology. Furthermore, past cortical thickness research included only 33 participants. The current study utilized data from 166 children from the GUSTO Asian cohort, who participated in strange situations at 18 months and MRI brain imaging at 10.5 years, with 124 administered the Child Behaviour Checklist at 10.5 years. Results demonstrated disorganization liked to internalizing problems, but no mediation or moderation by brain morphology. The association to internalizing (but not externalizing) problems is discussed with reference to the comparatively higher prevalence of internalizing problems in Singapore.

This article examines Mary Main's impact on attachment research in Israel and , focusing on her contributions: the disorganized attachment classification (D) and the Adult Attachment Interview (AAI). Israeli research spans Jewish and Arab populations, individuals with special needs, and trauma-affected groups, testing the Normativity, Sensitivity, and Competence hypotheses. While confirming traditional findings, some studies revealed deviations, possibly influenced by Israel's unique sociocultural/historical context. Some studies found an overrepresentation of disorganized and ambivalent attachment classifications, possibly linked to regional conflicts. The absence of a distinction between these two classifications in certain outcomes, especially disrupted maternal communication-a precursor to D-challenges the clear-cut classifications found in Western studies. Finally, a Holocaust Project provides unique insights, identifying the absence of intergenerational transmission of an unresolved state of mind from Holocaust survivors to descendants and revealing distinctive AAI classifications, namely, Absence of Attachment Representations and Failed Mourning, all inviting further study.

Frightening maternal behavior is linked to infant disorganization, which predicts child behavioral problems. We examined continuity in frightening maternal behavior across the first 2 years by developing a new measure of anomalous/frightening (AN/FR) behavior that incorporates changes in parent-child interactions as children acquire symbolic representation. Maternal AN/FR behavior in toddlerhood also was examined in relation to later internalizing and externalizing symptoms. First-time mothers ( = 125) completed the Adult Attachment Interview (AAI) prenatally, and mother-child dyads were observed interacting at 8 months, in Strange Situations at 12-15 months, and playing at 24 months. Teachers rated children's behavior problems at 7 years. Mothers classified as Unresolved on the AAI displayed more Frightening (FR) behavior at 8 months. Mothers' FR behavior predicted both attachment disorganization at 12-15 months and maternal AN/FR behavior at 24 months, which then predicted children's internalizing symptoms at age 7. Infant disorganization was indirectly related to internalizing symptoms, mediated by maternal AN/FR behavior.

Among Mary Main's many vital contributions to the field of attachment is the idea that human infants develop adaptive in the service of maintaining proximity to a secure base in light of a particular caregiving history. In this tribute paper, we describe Main's original theorizing, which delineated three types of conditional strategies: a primary strategy and two secondary strategies of or the naturally occurring output of the attachment behavioral system, using a variety of cognitive, affective, and behavioral means. We review the large body of evidence for minimizing and maximizing strategies in infancy, childhood, adolescence, and adulthood. Across a range of studies - including age groups and methodologies extending well beyond Main's original work with infants - there is remarkable convergence of findings that support Main's ideas. We conclude with several promising directions in implementing Main's groundbreaking ideas to enrich future research and clinical applications.

This study examined if considerably different caregiving experiences in infancy influence socio-emotional development later in childhood. We included children aged 6-9 years who were, immediately after birth, placed in quality state-run institutions (N = 24) or quality state-run foster care with one family (N = 23). All children have lived in stable families since their adoption before 15 months of age. Children in the comparison group have always lived with their biological parents (N = 25). We found that the previously institutionalized group had significantly more behavioral problems, more dissociative symptoms, and lower empathic behavior scores than the comparison group. The previously fostered group also exhibited more behavioral problems and dissociative symptoms than the comparison group but, notably, significantly fewer behavioral problems than the previously institutionalized group. The findings underscore the beneficial role of foster care compared to institutional care and that quality and consistency of early caregiving play a crucial role in later socio-emotional development.

This study investigated the influence of parents' Adult Attachment Interview (AAI) responses prior to the birth of a first child, on self-reported mental health symptoms of the first-born child in mid-adolescence. The sample comprised 51 first-born children aged 16 years, their mothers and fathers from a low-risk community urban sample, White, British and 70% middle class. Mothers' responses to the AAI were the strongest predictor of their adolescent children's self-reported mental health symptoms. Children's infant-mother or infant-father attachment patterns were not predictive of these 16-year outcomes, but mothers' insecure (primarily dismissing) attachment representations predicted children's externalizing, aggressive, and delinquent difficulties (though not internalizing difficulties) at 16 years. If one or both parents were autonomous-secure in their response to the AAI then their adolescent children reported significantly fewer mental health problems. Discussion focuses on thepredictive validity of the Adult Attachment Interview, Mary Main's legacy, and possible meanings (and limitations) of the results.

The VIPP-SD (Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline) program has been shown to promote positive interactions between parents and children with behavior problems. This study evaluated an adapted version for teachers (VIPP-School) through a parallel-group randomized controlled trial involving 58 teacher-child dyads from kindergarten to second grade. Teacher-child dyads were randomly assigned to VIPP-School ( = 28) or an active control group ( = 30). Intention-to-treat analyses showed improvements in teacher sensitivity (  = 0.87) and supportive teacher classroom interactions (  = 0.53) in the VIPP-School condition compared to the control condition. VIPP-School had no significant effect on teachers' observed sensitive discipline (although changes were in the expected direction), nor on reported child externalizing behavior, overall relationship quality, school happiness or teacher self-efficacy. These findings show that the intervention, originally developed for families, could be effectively applied to early elementary education. The limited number of sessions increases the feasibility of VIPP-School.

Negative birth experiences are common. It is yet unclear which women may be most at risk already before pregnancy. Childhood trauma and non-autonoumous/unresolved attachment state of mind may affect how women experience giving birth. This study used longitudinal data to test childhood trauma and attachment state of mind as predictors of birth experience in at-risk sample of primipara women ( = 193). The Adverse Childhood Experiences questionnaire and the Adult Attachment interview were administered during pregnancy, and women reported about their birth experience three months postpartum. Partial Least Square Structural Equation Modelling was applied to answer the research questions. Childhood physical neglect and parental substance abuse were predictive of a more negative birth experience, while attachment state of mind was not associated with how women experienced giving birth. Cross-validation suggests that these findings may be considered externally valid. Further research using validated measures on birth experience are needed.

Before the maturation of higher-order cognitive functions, infants primarily communicate via bodily expressions. Their behavior adjustments are also shaped by caregiver reactions, which differ in timing, intensity, and nature. Although mentalizing, or reflective functioning, is thought to influence caregiver interactions, the literature has largely focused on mentalizing as an explicit, cognitive process. Given the inherently embodied nature of early parent-infant exchanges, this emphasis left a clear gap in capturing the implicit facets of parental mentalizing. Addressing this, the concept of "parental embodied mentalizing" (PEM) was developed, which pertains to a caregiver's implicit capacity to discern and respond to an infant's emotional states, thoughts, and intents through bodily movements, gauged via real-time, shared, kinesthetic interplays. This systematic narrative review explores the PEM construct, scrutinizing its theoretical foundations and empirical basis. We aggregate insights from relevant studies, review the current research landscape's strengths and limitations, and pinpoint areas ripe for further investigation.

Since the development of the Adult Attachment Interview (AAI) in 1985, more than 26,000 AAIs have been administered, coded, and reported, representing 170 (wo-)man-years of work. We used multinomial tests and analyses of correspondence to compare the AAI distributions in various cultural and age groups, in mothers, fathers, high-risk, and clinical samples with the combined samples of North American non-clinical, non-risk mothers (22% dismissing, 53% secure, 8% preoccupied, and 17% unresolved loss or other trauma). Males were more often classified as dismissing and less frequently classified as secure compared to females (except adoptive fathers), and females were more frequently classified as unresolved (but not more often preoccupied) compared to males. A combination of high scores on the unresolved and insecure-preoccupied dimensions was shared by borderline personality disorder, autism spectrum disorders, and gender dysphoria, while combined high scores on the unresolved and insecure-dismissing dimensions characterized anxiety problems, obsessive-compulsive and thought disorders.

Given the dearth of literature on attachment theory in the Arab world, this study explores the cross-cultural validity of attachment theory within an Egyptian sample of 60 mother-child dyads through the Strange Situation Procedure (SSP). The study examines the applicability of attachment theory's universality, normativity, and secure base hypotheses, as well as the prevalence and manifestations of insecurity in an Egyptian sample. The findings supported attachment theory's universality, normativity and secure base hypotheses, while simultaneously pointing towards cultural variations in attachment manifestations. Specifically, this study found that all children were classifiable according to the ABC classification system, and that secure attachment was the most prevalent within the sample. Additionally, trends of exploration and crying highly aligned with Ainsworth's findings in the Baltimore study, supporting the secure base phenomenon within this Egyptian sample. Nevertheless, resistant attachment was more common than avoidant attachment, which differs from the global prevalence. Resistant attachment also primarily took the form of inconsolability rather than anger.

As family forms become increasingly diverse, their underrepresentation in attachment research is glaring. Although attachment theory aims to explain the influence of early relationships, studies have disproportionately focused on mothers. Even when other attachment figures are considered, the research is typically limited to fathers in biparental mother-father families. In this piece, we report on the wide variety of family configurations worldwide, and how children experience care from multiple attachment figures. Drawing from the (CASCADE), we assess the current state of attachment research with regard to diverse family configurations. Out of the available records in CASCADE, only four of 2,320 studies (0.2% of available studies) involved samples of diverse families. We conclude by issuing an explicit call for research that acknowledges and explores diverse family forms and propose strategies to improve reporting and research practices to promote more inclusivity of diverse family forms.

We tested the generalizability of the sensitivity-security link in a sample of 35 preschooler-mother dyads from a low socioeconomic district in Lima, Peru. We first describe maternal sensitivity and attachment security at two timepoints during early childhood. Second, we investigated the stability of attachment security and maternal sensitivity over a time span of one year. Third, we tested the association between sensitivity and security at each timepoint. Finally, we investigated whether changes in maternal sensitivity predict changes in child security. The results indicated that sensitivity and security were lower than scores reported in the literature for middle-class samples. T2 maternal sensitivity scores were significantly higher than T1 sensitivity scores, and no significant differences were found between T1 and T2 security. Sensitivity and security were associated at both timepoints, after controlling for socio-demographic variables. One-tail test indicated that changes in maternal sensitivity were associated with changes in child security.

Acknowledged researchers have highlighted the potential pitfalls of using attachment theory to guide decision-making in child protection (CP) cases. This study explores how attachment theory is applied in expert assessments in Norwegian CP decision-making processes, analyzing 285 independent expert reports. Independent experts were mandated to assess the child's attachment quality to the caregiver in one third of the reports. In almost two thirds of the reports, experts weighted the child's attachment quality to the caregiver in their concluding evaluation. Few expert assessments included the employment of attachment measures. When descriptively comparing older and newer reports, there were more newer reports that mandated the experts to assess the child's attachment quality, but fewer newer reports where the experts weighted the child's attachment quality in the concluding evaluation. Our results illustrate that the criticism of an overconfindent use of attachment theory is also relevant for independet expert assessment in CP cases.

Concerns have been raised regarding misconceptions about attachment theory in child protection settings, but the application of attachment concepts in judicial child protection decisions has not been systematically explored. This study therefore examined the perception and application of attachment concepts in Swedish judicial decision protocols concerning involuntary removals of children (aged 0-2 years) where emotional neglect was a notable concern (n=28). Attachment concepts were frequently misunderstood, and imprecisely articulated. Unsystematic observations of child behavior were used to infer attachment insecurity and, by extrapolation, caregiving deficiencies. Attachment concepts were primarily used to support child removal, and insecure attachment seemed to be viewed as meeting the legally required level of risk to warrant involuntary child out-of-home placement. Our results indicate that misconceptions about attachment theory may be prevalent in judicial decision protocols. We emphasize the need to elaborate on risks in legally relevant ways without incorrect appeals to attachment theory.

Fathers remain neglected in attachment research, despite paternal sensitivity being important for children's development. Past research suggested that fathers' parenting may be influenced by contextual factors, including relationship functioning between parents.

This study examined how children's secure base script knowledge and friendship quality were related to bullying and victimization experiences and their emotional, academic, and behavioral adjustment. Participants were 581 children (49.6% males) aged 9 to 13 years old and one of their main caregivers (74% mothers, 23.6% fathers, 2.4% legal guardians) recruited through cluster sampling in Singapore. Most of the children were ethnic Chinese (58.2%), along with Malays, Indians, and Others (e.g. Eurasians). Children's secure base script knowledge was related to less bullying and victimization, which in turn was related to greater positive emotional state, better academic achievement, less aggression, and fewer social problems. Friendship quality did not add unique variance, highlighting the central protective role of attachment representation in the context of school bullying. The findings provide support for the security-competence link in an Asian context, and point to the importance of enhancing children's familial experiences as part of preventive efforts in combating school bullying.

When children are placed into foster care, they experience separations from their primary attachment figures. Visitations are often arranged to provide ongoing birth parent-child contact. These visitations are complicated, though, because young children typically show a range of confusing behaviors when reunited. Fostering Relationships is a brief intervention designed to enhance visitation for the child, birth parent, and foster parent. We examined the effectiveness of the Fostering Relationships intervention through single subject analyses. We examined whether birth parents followed their child's lead during visitation sessions significantly more than they did not follow their child's lead. Six of seven birth parents who received the Fostering Relationships intervention followed their child's lead significantly more often than not, whereas only one of four of the control parents did so. Results are preliminary, but suggest that Fostering Relationships may be a promising intervention for enhancing visitation.

Forcibly displaced children often face separation from their parents, particularly fathers. These children endure the hardships of war, displacement, and the loss of a key attachment figure. Despite the critical role of attachment in children's well-being during periods of heightened stress, the impact of separation due to war and displacement has received little attention in empirical work. Findings from 1544 Syrian refugee children ( = 10.97, = 2.27) living in informal settlements in Lebanon with their mothers ( = 38.07, = 8.49), including 367 father-separated children, show that father-separated children experienced more war-related events and worse refugee environments. Structural equation modelling showed that beyond the direct relation of war exposure and quality of the refugee environment on well-being, father separation was uniquely related to more depressive symptoms and worse self-development, but not to anxiety, PTSD, or externalising problems in children. Maternal parenting did not explain these outcomes, though it had a protective function for children's well-being.

Mary Main's conceptualization and operationalization of attachment states of mind through the Adult Attachment Interview (AAI) represent seminal contributions to the attachment field. The AAI is a semi-structured clinical interview used to assess attachment states of mind that is widely used in research and clinical settings. Unresolved state of mind regarding loss or trauma has been linked to concurrent internalizing symptoms. The current study explored the associations between unresolved classification and later depression and anxiety, above and beyond trauma history and symptoms. Participants ( = 70) were parents (98.6% female, 67.1% Black/African-American) from a follow-up of a randomized clinical trial of a parenting program for families referred to child welfare services. Parents completed the AAI, Childhood Trauma Questionnaire, and the Psychiatric Diagnostic Screening Questionnaire at timepoint 1 (T1) and the Brief Symptom Inventory approximately 12 years later, at timepoint 2 (T2). Hierarchical regressions revealed that unresolved state of mind significantly predicted depression at T2, and marginally predicted anxiety at T2, above and beyond childhood trauma, post-traumatic stress symptoms, and early internalizing symptoms. These results suggest that unresolved states of mind are clinically significant and provide unique information about later internalizing symptoms in adults with a history of trauma or loss.

As a result of the Department of Homeland Security's zero-tolerance policy (ZTP), over 5,000 children were separated from their parents at the U.S. southern border from 2017-2021, with over 1,000 still lacking confirmed reunifications. Separations also occur daily due to immigration raids, chaotic processing, and changing immigration policies. This article addresses the most fundamental question faced by families enduring such separations; how to mend attachment bonds that have been suddenly severed, especially within a population likely already traumatized. The paper begins by updating readers about separation in the United States and offers a concise summary of the consequences of child-parent separation. The paper then introduces Child-Parent Psychotherapy (CPP) as an intervention for affected families. This paper also uniquely applies CPP to older children and provides three case examples of its use in treating separated families. Finally, the paper offers general suggestions for supporting these families.