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Background: Anxiety is considered a 'frequent' feature in the clinical criteria for Angelman syndrome; however, the nature and severity of anxiety symptoms have not been well characterised in this population. Anxiety behaviours, especially in response to separation from a preferred caregiver, have been described clinically but have not yet been explored empirically., Method: This study used a combination of standardised and clinician-derived survey items to assess the frequency, nature and severity of behaviours associated with anxiety and separation distress in 100 individuals with Angelman syndrome. Family (e.g. income and maternal education) and individual (e.g. age, sex, genetic subtype, sleep difficulties and aggressive behaviours) variables were also gathered to assess possible predictors of higher anxiety levels. Approximately half of the sample was seen in clinic and assessed with standardised measures of development and daily functioning, allowing for an additional exploration of the association between anxiety symptoms and extent of cognitive impairment., Results: Anxiety concerns were reported in 40% of the sample, almost 70% were reported to have a preferred caregiver and over half displayed distress when separated from that caregiver. Individuals with the deletion subtype and individuals who are younger were less likely to have anxiety behaviours. Sleep difficulties and aggressive behaviour consistently significantly predicted total anxiety, the latter suggesting a need for future studies to tease apart differences between anxiety and aggression or anger in this population., Conclusions: Anxiety concerns, especially separation distress, are common in individuals with Angelman syndrome and represent an area of unmet need for this population., (© 2019 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Starting from an outline of the refugee experience as a process of cumulative traumatisation, we review research literature on mental health outcomes in refugees. Next, an integration of findings on relational processes in refugee families documents the role of the family unit as a key interactive context patterning the impact of sequential traumatisation. Relating these trauma- and migration-specific family processes to their central dimension of provision or disruption of emotional availability in a context of chronic adversity, we aim to explore the development of unresolved and insecure parental states of mind regarding attachment during forced migration. Starting the research report, a method discussion on the administration of 11 Adult Attachment Interviews with adult refugees as part of an explorative multiple case study integrates deontological and technical reflections on the use of the Adult Attachment Interview in a context of ongoing traumatisation. The paper then presents findings on adult attachment in refugees and highlights representational processes involved in the potential disruption of caregiver availability during refugee traumatisation.

In this commentary to the child-mother attachment findings of the NICHD Study of Early Child Care and Youth Development (SECCYD) we focus on the contextual conditions under which child care and the child's attachment relationship(s) may function as a risk or protective factor for child development. First, the authors' conclusion concerning child care as a risk factor for attachment security is refined. Second, suggestions are provided for incorporating possible moderators and mediators of the relations between child care, child-mother attachment, and developmental outcomes. Children's attachment relationship to nonmaternal caregivers, their temperament, and their genetic make-up may be relevant factors; and we discuss them in the context of children's differential susceptibility to influences from the caregiving environment. Third, and following from the above, we argue for specificity in predicting developmental outcomes from attachment security and nonmaternal care.

This review paper presents and places in context findings from 23 manuscripts based on the data sets of the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD). The NICHD study tracked the development of more than 1000 children from birth through age 15. The children were born across the USA to families that were diverse in terms of their economic, educational, and ethnic background. The children also varied in terms of the timing, extent, quality, and type of their child care experiences. The findings reported in this review paper pertain to (1) predictors of child-mother attachment; (2) links between child-mother attachment and children's developmental outcomes; and (3) methods for assessing attachment. The review paper also includes suggestions for future attachment research afforded by the data sets of the NICHD SECCYD. Not all the hypotheses tested in the reviewed papers were confirmed, and those that were confirmed were associated with modest effect sizes. Some findings emerged under specific conditions, even though they were expected to be more universal. These findings need to be discussed and aligned with theory. Also, the extent to which the findings generalize beyond the historical period and the country in which the data were collected merits discussion and exploration.

Both avoidant and borderline personality disorder (APD and BPD) are theoretically associated with temperamental vulnerabilities, adverse attachment experiences, and negative (pessimistic or catastrophic) reactions to the threat of perceived rejection; however, more work is needed to differentiate how these processes account for the etiology and maintenance of both disorders. In this study, 156 adults completed questionnaires measuring APD and BPD features, temperament (sensory-processing sensitivity), mood, and attachment experiences. A vignette task was devised to examine pessimistic cognitive-affective reactions in situations signaling potential rejection. Both APD and BPD were associated with temperamental sensitivity, but BPD was uniquely linked with a subscale measuring sensitivity to mental and emotive stimuli, whereas APD was uniquely linked with a subscale measuring the control and avoidance of aversive stimulation. Compared to APD, BPD was more strongly linked with negative moods (anxiety, anger, sadness) and insecure attachment to parents, whereas APD was more strongly linked (than BPD) to pessimistic cognitive-affective responses to rejection-related situations.

An account is given of attachment theory as a way of conceptualizing the propensity of human beings to make strong affectional bonds to particular others and of explaining the many forms of emotional distress and personality disturbance, including anxiety, anger, depression and emotional detachment, to which unwilling separation and loss give rise. Though it incorporates much psychoanalytic thinking, many of its principles derive from ethology, cognitive psychology and control theory. It conforms to the ordinary criteria of a scientific discipline. Certain common patterns of personality development, both healthy and pathological, are described in these terms, and also some of the common patterns of parenting that contribute to them.

This paper describes the essence of object relations theory as developed by Winnicott through his concepts of transtional object, the good enough mother holding a situation for her child and play both solitary and mutual. These concepts are compared and contrasted with the essential features of attachment theory as put forward by Bowlby. It is suggested that Winnicotts object relations concepts and attachment theory each provide a framework to explain similar psychological and interpersonal phenomena. Reasons are put forward for the choice of attachment theory as a basis for family therapy and to suggest hypotheses to investigate the quality and quantity of intrafamilial social interaction and concomitant emotional states. The family in family therapy is described in terms of the interpersonal dynamic suggested by attachment theory. The family is seen as a homoeostatic system of relationships between individuals at different stages of development who share set goals aimed at terminating a specific form of proximity-seeking attachment behaviour and promoting exploratory behaviour.