Comparing criteria for attachment disorders: establishing reliability and validity in high-risk samples

Area of Science:

• Child Psychology
• Developmental Psychology
• Clinical Psychology

Background:

• Attachment disorders are a significant concern in high-risk populations.
• Reliable diagnosis is crucial for effective early intervention.
• Understanding the link between attachment behaviors and disorder classification is key.

Purpose of the Study:

• To assess the reliability of diagnosing published attachment disorder subtypes in young children by trained clinicians.
• To explore the relationship between attachment disorder classification and standardized measures of attachment behavior.
• To evaluate diagnostic consistency across different high-risk populations.

Main Methods:

• Recruitment of 69 children (18-48 months) and caregivers from maltreatment treatment, homeless shelters, and Head Start programs.
• Utilized semistructured clinical assessments and laboratory/home-based attachment measures.
• Employed inter-rater reliability analysis (kappa statistics) for disorder subtypes.

Main Results:

• High inter-rater reliability (kappa range 0.62-0.74) was achieved for most attachment disorder subtypes.
• Children from maltreatment samples showed significantly higher rates of attachment disorders (p <.001).
• Secure attachment was inversely related to attachment disorder diagnosis (p =.03), but disorganized attachment was not a predictor.

Conclusions:

• Published attachment disorder subtypes demonstrate reliable clinical diagnosis in young children.
• Attachment disorder diagnosis is associated with specific attachment behaviors.
• Further research to refine diagnostic criteria is recommended before initiating intervention trials.