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Proposes a phase model describing the course of first pregnancy, while outlining an extended view of pregnancy as both a biological and psychosocial process. Four ideal phase types are distinguished: a disruption phase of radical change, an adaptation phase of readjustment, a centering phase focused on production, and a final phase of anticipation of birth and preparation for expected child. (Author/RH)

Attachment narratives are increasingly used as a diagnostic tool in the therapeutic work with children in middle childhood. This, however, demands extensive procedures to ensure its adequate analysis and reliability.Thus, a new diagnostic instrument has been developed. It is a short version of the coding procedure used in the German Attachment Story Completion Task (GASCT) andmakes use of the idea of traffic lights. It can be understood quite intuitively and can be applied time-economically in practice. Instead of a qualitative classification into four attachment groups it results in a five-graded clinical assessment of the child's attachment security towards his or her attachment figures. This can be compared to the attachment security score of the GASCT. Psychometric qualities of the "Attachment Story Completion Light" were analyzed in a sample of 50 patients of a child and adolescent psychiatric hospital aged between four and eight years. Reliability was high, validity of the new instrument was also satisfying, regarding it's association with the original GASCT. For applying the new attachment screening tool a supervised training is required.The tool will enable practitioners to better recognize strengths and difficulties in the attachment representations of children and to plan adequate individualized therapy. As a rating identifying developmental risks, the instrument can help to clarify therapeutic procedures as well as service delivery for child and family.

Introduction: Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9., Methods: A total of 135 children aged between 5 and 9 years (M=7.17 years, SD=1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development., Results: The prevalence of AR in children with AD was 28.6% for the 'secure' form of AR, 17.1% for the 'insecure-avoidant' form, 25.7% for the 'insecure-ambivalent' form, and 28.6% for the 'disorganized' form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills., Conclusions: Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models., (Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)

Attachment in middle childhood increasingly attracts the interest of developmental psychologists and clinicians. Recent studies using attachment narratives elicited by story stems reported gender-specific aspects of attachment development, potentially evoked by developmental tasks during this period of the life span. There is evidence that children with risk factors present more insecure and disorganized attachment narratives compared to children without risk. Yet, there is little research concerning the joint effects of gender, risk, and age for attachment classifications. The paper presents a pooled analysis of 22 samples (eight risk samples) including 887 children (411 girls), aged between 4.5 and 8.5 years who were assessed with the same "German Attachment Story Completion Procedure" (GASCP). Girls were 1.8 times more likely to present secure and 0.4 times less likely to present disorganized narratives compared to boys when controlling for risk status and age. Children from risk samples were more likely (odd ratio 5.4) to display disorganized and less likely to show a secure attachment (odd ratio 0.3) compared to those from no-risk samples in multilevel logistic regressions. Remarkably, the effect of risk was not moderated by age and gender, and gender effects were not moderated by age.

During preschool and early school age attachment quality can be assessed by different means: at the behavioral level by the Strange Situation (SS), at the representational level by semiprojective methods using story stems or pictures. Both methods gain access to different levels of a theoretically assumed inner working model of attachment, in which attachment at the behavioral level is supposed to be person specific, attachment at the representational level generalized. This study aimed at analyzing whether attachment behavior to mother and father is associated, and how it is linked to the generalized attachment representation. It was also examined whether in the case of no association between mother and father attachment behavior towards the major attachment figure is linked to the attachment representation. In the Duesseldorf study 67 children aged 5 years were observed in the SS with mother, 31 of them also in the SS with father. At the age of 6.5 years an attachment story completion task was conducted. When person specific attachment to mother and father was congruent (SS secure n=6, or insecure n=8) the attachment representation was consistent as well, when father and mother attachment were discrepant no association with attachment representation could be found. The findings did not confirm a stronger influence of the major attachment figure on the formation of the attachment representation.

In this contribution relationship-oriented assessment methods and preventive measures during infancy and childhood are founded in an ecological and differential understanding of development in context. Using selected developmental milestones it is demonstrated that relationships as a social context play an important role particularly during early infancy. Criteria for describing well functioning and maladaptive relationships can be derived from theoretical presumptions, empirical longitudinal studies and health related clinical judgements. These criteria may serve as guidelines for interventions, especially in cases of children with a clinical diagnosis of child neglect. Possible procedures to assess the quality of relationships are discussed using methods from contributions in this issue of the journal as examples. Diagnostic and preventive procedures are seen as mutually interacting within continuous feedback loops, where assessment procedures serve to both give evidence for the efficacy of interventions and for specifying further preventive methods.

A new method to assess attachment representations in children by applying a story completion procedure in doll play (SCPDP) is presented. Transmission and continuity of attachment were tested in 28 German families by using the Strange Situation procedure (SS) with the mother and her infant, the Adult Attachment Interview (AAI) with the mother when the child is 5 years old, and the attachment representations (SCPDP) of the 6-year-olds. Relying on the twofold distinction (secure/insecure), results revealed a significant continuity of attachment from 1 to 6 years of age, and a correspondence between maternal AAI and child's attachment quality in SS, as well as a correspondence between maternal AAI and the 6-year-olds' attachment representations. Using configural frequency analysis, we found continuity in patterns of security and insecurity when looking across the measures of infant and pre-school attachment and maternal adult attachment. Processes underlying the high match of mothers' and children's attachment representations are discussed.

The Adult Attachment Interview (AAI; George et al. 1996) was conducted with 28 mothers in order to assess their mental representations of attachment 4 years after giving birth to their first child. The interviews were coded and classified according to the method of Main and Goldwyn (1994). Using longitudinal data from the "Heidelberg Study on Transition to Parenthood", a significant correspondence was found between mothers' attachment representations and their childrens' patterns of attachment in the Ainsworth Strange Situation procedure after the first year of life. Additionally, further connections emerged between the mothers' attachment representation, their pre and post natal conceptions of their first child, their early bonding behavior, and their sensitive behavior with their 5-month-old infant in family interactions at home. These findings support the assumption of a transgenerational transmission of attachment quality and moreover indicate the usefulness of the Adult Attachment Interview in German-speaking countries, especially for studies on the transition to parenthood.

A new method is presented in order to assess attachment representations in preschoolers. Using the symbolic medium of doll play and story completions the internal representations of attachment in children beyond infancy can be assessed. Additionally the thesis of transmission of attachment across generations was tested empirically in a sample of 28 German families from middle class socioeconomic background as part of longitudinal study. Transmission of attachment means that parents transmit their different attachment representations to preschool-aged children. Secure and insecure attachment representation in mothers assessed with the Adult Attachment Interview, are associated systematically with their childrens' attachment representations coded from the doll play. In the present study the Adult Attachment Interview was conducted with mothers during the fifth year post delivery. Their first-born children, 17 boys and 11 girls with a mean age of 6;4 years participated in the story completion session. Using a two-fold distinction (secure and insecure) as well as a converted 4-level scale of attachment security, results revealed a correspondence between maternal and child attachment representations. According to psychometric indicaters the story completion procedure demonstrates satisfying reliability and convergent validity with the Separation Anxiety Test. Finally, reasons for the high match of mothers' and childrens' attachment representations are discussed. Maternal sensitive behavior, maternal reflection of their own childhood triggered by the observation of their own child, and various learning processes may operate as mediating factors in this case.

A new domain has been established within attachment research that deals with mental representations of attachment in adults, particularly in parents. This contribution describes the procedure of the Adult Attachment Interview (AAI) developed by George et al. (1996) and the scoring and classification system by Main and Goldwyn (1994). This method allow trained coders a reliable classification of different states of mind with respect to attachment based on a content and discourse analysis of the interview transcripts. By means of observational procedure of the Strange Situation for infants and the AAI for the adults, several studies support the assumption of a transmission of attachment relationships from one generation to the next one. These findings reveal that parents with secure autonomous attachment representations predominantly have infants with secure attachment patterns, parents with insecure-dismissing attachment representations mostly have children with an avoidant attachment and parents with insecure-preoccupied representations often have children with an insecure-ambivalent attachment. Less consistent results have been found for the correspondence between parents unresolved attachment status with respect to traumatic experiences and their infants' disoriented/disorganized attachment patterns. A recent study assessing attachment in six year olds revealed as well the transmission from mothers' attachment representations to those of their children for this older age. Since many studies have confirmed the correspondence of parents' and infants' attachment classifications, research interests are now directed towards the mediating processes of transmission.