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 hostile-aggressive 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, non-DBD 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