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.

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.

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.

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.

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.

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.

Bed-sharing is a controversial but common parenting practice with claimed benefits for emotional and behavioral development. Using data from the UK Millennium Cohort Study ( = 16,599), this prospective study investigated whether bed-sharing at 9 months is associated with childhood internalizing and externalizing symptom trajectories. Children were grouped by their patterns of co-developing internalizing and externalizing symptoms from 3 to 11 years of age using a parallel process latent class growth analysis. There were no associations between bed-sharing at 9 months of age and internalizing and externalizing symptom trajectories across childhood. This finding suggests that bed-sharing at 9 months has no positive or negative influence on the development of internalizing and externalizing symptoms across childhood. Clinicians should inform parents that bed-sharing during the second half of the first year is unlikely to have an impact on the later emotional and behavioral development of the children.

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.

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.

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.

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.

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.

Despite a growing literature, experiments directly related to attachment are still needed. We explored brain processes involved in two aspects of attachment, distress and comfort. Seventy-eight healthy adult males with different attachment styles (secure, avoidant, and anxious) viewed distress, comfort, complicity-joy and neutral images (picture database BAPS-Adult) in an fMRI block design. ROIs from the modules described in the functional Neuro-Anatomical Model of Attachment (Long et al. 2020) were studied. Secure participants used more co- and self-regulation strategies and exhibited a higher activation of the reward network in distress and comfort viewing, than insecure participants. Avoidant participants showed the lower brain activations. Their approach and reward modules were the least activated in distress and comfort. Anxious participants presented both higher activations of the approach and aversion modules during complicity-joy. In addition, comfort and complicity-joy were processed differently according to attachment styles and should be differentiated among positive stimuli to disentangle attachment processes.

This study examined the contribution of early vs. concurrent maternal guidance of emotion dialogues with their children to the security and coherence of the children's attachment representations as adolescents. Maternal Sensitive Guidance was assessed from mother-child emotion dialogues when participants were preschoolers (approximate age 4 years) and young adolescents (approximate age 12.5 years), along with an assessment of adolescents' attachment representations using the Friends and Family Interview (FFI). Mothers' Sensitive Guidance in preschool predicted adolescents' coherence in the FFI, secure maternal (but not paternal) representations, and a positive representation of sibling relationships. In contrast, mothers' concurrent Sensitive Guidance was related only to adolescents' sibling relationships. These results highlight the significance of mothers' sensitive guidance of emotion dialogues during the early years for their children's later attachment representations, and point to the need for further examination of mothers' role when they guide emotion dialogues with their adolescents.

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.

This study used the Actor-Partner Interdependence Model to examine how parents' adult attachment influences their their own and the partners' co-parenting and parent-child relationships. Participants were from a cross-sectional sample of 1313 Chinese heterosexual married couples (fathers' M = 39.74, SD = 5.61; mothers' M = 37.55, SD = 5.04) whose biological children were pupils (M = 10.25, SD = 2.35). Results revealed that: (a) Couple members' actor effects from adult attachment avoidance to positive and negative co-parenting and parent-child closeness and conflict were found both significant; (b) The actor effects from adult attachment anxiety to negative co-parenting and parent-child conflict were found significant, whereas only partner effect from attachment avoidance to positive co-parenting and from attachment anxiety to parent-child conflict were significant. The results highlight the negative effects of parents' attachment avoidance and anxiety on their partners' parenting function.

Prior research suggests that secure base script knowledge is categorically distributed in middle childhood but becomes dimensionally distributed from late adolescence onward, potentially indicating a developmental shift in the nature of secure base script knowledge. Secure base script knowledge may initially be sparse, giving rise to categorical individual differences, while increased relational experiences later in development might contribute to more elaborated secure base script knowledge and dimensional individual differences. However, the cross-sectional nature of prior research limits inferences about developmental changes. To address this, we conducted a three-year, three-wave longitudinal study with a Western European sample transitioning from middle childhood to adolescence. At Wave 1 ( = 599, = 10.30), secure base script knowledge was categorically distributed. By Wave 2 ( = 435, = 11.30), distribution was ambiguous, and by Wave 3 ( = 370, = 12.09), individual differences were dimensional. These results suggest a developmental shift in secure base script knowledge during the transition into adolescence.

Mary Main's operationalization of infant attachment disorganization contributed to our understanding of attachment and psychopathology. Her exploration of attachment patterns at age 6 with Jude Cassidy laid the foundations for studying attachment post-infancy. They found remarkable correspondence from age 1 to age 6 in the disorganization spectrum and documented the emergence of role-reversal. This study proposes a person-centered approach to explore classes of children with respect to attachment disorganization at four time points between infancy and late preschool. Participants ( = 205) were recruited in the UK and formed a socioeconomically diverse community sample of mother-child dyads. We identified three classes of children: 1) a stable organized group; 2) an unstable group becoming organized; and 3) an unstable group becoming disorganized. Results show that major loss predicts membership of the third class of children. These findings contribute to our understanding of disorganization across multiple periods, and thus to Mary Main's legacy.

Mary Main played a key role for this study, in which we used an idiographic approach to examine discourse about abuse, trauma, and maltreatment (ATM) among eight mothers with a mild intellectual disability (ID), whose children had been assigned a secure (the "B-group") or disorganized (the "D-group") attachment classification. Thematic analysis yielded six ATM discourse themes: openness; coherence; presence of trauma in consciousness; support; agency in response to crisis; and self-concept and caregiving self-efficacy. Mothers in the B-group provided coherent narratives, were open with the interviewer, had memories of seeking and receiving support, and reflected freely and autonomously on their experiences. Contrastingly, the mothers in the D-group expressed a guarded, closed-off stance towards ATM, difficulties seeking support, helplessness in response to crisis, and poor self-concept and -efficacy. Their adverse experiences were nonetheless highly present in consciousness, albeit in unintegrated forms. Our findings suggest that the D-group mothers may be unresolved with respect to loss/abuse.

Brett Kahr has referred to the death of Mary Main as the loss of "the queen of attachment research." However, how well is Main's work actually known? In this portrait and tribute, I argue that Main's transformative contributions have become a taken-for-granted part of the basic environment of attachment research, but that readers have faced obstacles in understanding and responding to their strengths and limitations. Drawing from interviews with Main, in this paper I describe some of her early life experiences and mental and physical health challenges, which she felt had influenced what was possible for her in her research. I then highlight less well-known aspects of her ideas regarding the role of attention within attachment strategies, the nature of disorganised attachment, the implications of alarming caregiving behaviours, and what is ultimately measured by the Adult Attachment Interview. My goal throughout is to help reader see both how much Main's rich and exciting works still have to teach, and identify their many loose threads still to follow.

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.

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.

In this paper we describe our Berkeley colleague Mary Main's intellectual contributions to our program of creating and evaluating couples group interventions for parents of young children. The first section presents the theoretical model and the projects at the heart of our research program. The second section illustrates how the Adult Attachment Interview, a Couple Attachment Interview, or a questionnaire describing attachment styles helped us to understand how internal working models of both parent-child and couple relationships added to our observational measures of couple and parenting behavior to provide unique information. In a third section, we conclude that we did not have the kind of impact on Mary's thinking that Mary had on ours, but we are heartened by seeing increasing attempts of some developmental attachment theorists to include fathers in their studies and others who focus on the effects of the quality of relationship between the parents on their children's development.

A fundamental principle of attachment theory is that threatening situations give rise to individual differences in the extent to which people seek proximity to close others. The current research examines the way in which attachment styles predict individual differences in attachment-relevant behavior during threatening events. We tested alternative theoretical perspectives concerning the association between adult attachment (specifically, attachment avoidance) and attachment behavior in the presence of natural clues to danger by observing couples ( = 204) when they were watching horror vs. control film excerpts. Results suggest that highly avoidant people engaged in less attachment behavior across both threatening and non-threatening situations. These findings have implications for the understanding of attachment-related processes and how working models of the self and others facilitate (or inhibit) the expression of attachment behavior.

Social processing, namely the ability to understand others' cognitive and affective states, is crucial for successful social interaction. It encompasses socio-affective abilities such as empathy and compassion, as well as socio-cognitive abilities such as theory of mind (ToM). This study examined the link between social processing and attachment. Our study goes beyond previous research in that social processing abilities were assessed in a single, state-of-the-art behavioral paradigm using video narratives, the EmpaToM. Attachment was captured with the Adult Attachment Interview ( = 85; 50.60% women,  = 25.87 ± 4.50 years) measuring participants' present-day capacity to think about and communicate attachment-relevant information about the past. Additionally, a self-report attachment questionnaire was employed ( = 158). We found that AAI-based attachment security (vs. insecurity) was associated with higher behavioral ToM abilities. Furthermore, self-reported attachment avoidance was negatively correlated with behavioral compassion abilities. Our findings provide further evidence that interview-based and self-reported attachment measures do not converge, but may rather be understood as capturing different facets of attachment that relate to different components of social processing. We conclude that individuals with secure, non-avoidant attachment show social abilities that allow them to better understand others' thoughts and generate positive, caring emotions in face of others' distress.

Mary Main's written work profoundly changed the direction of attachment research through her publications and through her teachings. The current study describes the scientific impact of her her published and unpublished work. We identified 85 such works. Web of Sciences contained k = 7,571 citations to these works from by 13,398 unique authors. The topics of citing work clustered around clinical psychological research, early dyadic relationships, romantic attachment, traumatic experiences, and the adult attachment interview itself. Based on co-citation patterns, Main shared an intellectual space with authors known for developmental psychopathology and child development, parent-child relationships, adult attachment, psychodynamic theorizing, and reciprocity in interaction and infant mental health. We discuss the impact of the "move to the level of representation" and how new ties with researchers unfamiliar with these ideas will be important to realize unused potential in the ideas and methods given to the field by Mary Main.

This study examined the empirical convergence of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous scripts with conceptually corresponding attachment patterns assessed via the Adult Attachment Interview (AAI), and the significance of ASA dimensions for autonomic physiological reactivity during adult attachment assessments. Young adults' (50% male; age = 19 years; 80% White/European American) ASA deactivation, hyperactivation, and anomalous content were significantly associated with AAI dismissing ( = .26-.38), preoccupied ( = .31-.35), and unresolved ( = .37) states of mind, respectively. ASA hyperactivation and anomalous content were associated with heightened RSA reactivity to the AAI and ASA, aligning with expectations that these attachment patterns capture the tendency to heighten expressions of negative, traumatic experiences. ASA deactivation was associated with smaller increases in electrodermal activity to the ASA-indicative of less sympathetic arousal-converging with the tendency of individuals higher in deactivation to avoid discussing attachment themes in the ASA.

This study examined the stability of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous content and their significance for parenting outcomes in mothers (age = 31 years; 78% White/European American) and 6-month-old infants. Comparable to ASA secure base script knowledge (SBSK), mothers' ASA deactivation, hyperactivation, and anomalous content were significantly, moderately stable over two years ('s = .40 - .43). Mothers' ASA hyperactivation and anomalous content were associated with greater maternal intrusiveness, whereas ASA deactivation was associated with greater detachment and less intrusiveness. Only ASA anomalous content was associated with lower maternal sensitivity. Mothers' ASA deactivation was associated with less dynamic change in respiratory sinus arrhythmia during the Still-Face Procedure-reflective of limited mobilization of physiological resources to support responding to infants. Findings support the validity of ASA deactivation, hyperactivation, and anomalous content scripts, and demonstrate their utility in examining adult attachment stability and predictive significance for parent-child outcomes.

This study examined the significance of a novel coding system for evaluating hyperactivation, deactivation, and anomalous content in the Attachment Script Assessment for romantic relationship functioning. In a sample of 208 couples (69% White, age 28.7 years), we tested whether ASA hyperactivation and deactivation were associated with theoretically relevant correlates, including observed behavior, parasympathetic reactivity, self-reported affective reactivity to conflict, and relationship satisfaction. Exploratory analyses examined associations of secure base script knowledge (SBSK) and anomalous content with these outcomes. ASA hyperactivation and deactivation were associated with behavioral, physiological, and self-reported functioning in theory-consistent ways. Anomalous content was not associated with romantic functioning. SBSK was associated with satisfaction, but this was not robust to covariates. Findings support the predictive validity of the hyperactivation and deactivation dimensions and suggest that these scales complement SBSK, enabling researchers to assess a wider range of behavioral and physiological indicators associated with distinctive forms of attachment insecurity.

Although research on adult attachment has yielded insight into the legacy of attachment for functioning in adulthood, methodological challenges persist in the assessment of adult attachment. The Adult Attachment Interview (AAI) offers a rich assessment of secure, insecure, and unresolved states of mind. However, it is resource intensive to administer and code. Attachment Script Assessment (ASA) offers a resource-effective alternative to the AAI. However, the ASA coding system only yields a single, security-like dimension: secure base script knowledge. Here, we introduce a complementary coding system for the ASA to assess attachment deactivation (i.e. script characterized by limited interpersonal connection and minimization of attachment problems/emotions), hyperactivation (i.e. script in which attachment-relevant problems and negative emotions are heightened), and anomalous content (i.e. script in which attachment problems contain elements of fear and/or disorientation); and we discuss the conceptual convergence of these scripts with corresponding patterns of attachment insecurity and disorganization.