Sandra Gabler

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Precursors and Effects of Self-reported Parental Reflective Functioning: Links to Parental Attachment Representations and Behavioral Sensitivity

Child psychiatry and human development, Feb 7, 2024

Parental reflective functioning is thought to provide a missing link between caregivers' own atta... more Parental reflective functioning is thought to provide a missing link between caregivers' own attachment histories and their ensuing parenting behaviors. The current study sought to extend research on this association involving 115 parents, both mothers and fathers, of 5-to-6-year-old preschoolers using the German version of the Parental Reflective Functioning Questionnaire (PRFQ). Our study was the first to combine Adult Attachment Interview classifications of parental attachment, behavioral observations of parental sensitivity and PRFQ ratings while drawing on a sizable father subsample. We found theoretically consistent significant relations between all measures, while our results particularly highlighted the role of dismissing attachment for decreases in parenting quality on both cognitive and behavioral levels as the dismissing status differentially affected specific components of self-reported parental reflective functioning and observed sensitivity. Interestingly, these patterns were largely comparable in mothers and fathers. Exploratory mediation analyses further suggested that decreased parental reflective functioning may partially mediate the relationship between parents' dismissing attachment and decreased parental sensitivity. Thus, for prevention and intervention programs targeting parental sensitivity and thus children's long term healthy mental development, the interplay between parental reflective functioning and parents' own attachment history emerges as a key mechanism. Finally, our study served as a further validation of the PRFQ given the caveat that the pre-mentalizing subscale may need further revision in the German version.

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Attachment disorder symptoms in foster children: development and associations with attachment security

Child and Adolescent Psychiatry and Mental Health

Background Children in foster care constitute a risk population for developing symptoms of attach... more Background Children in foster care constitute a risk population for developing symptoms of attachment disorders. However, little is known about the longitudinal course of attachment disorders and their association with attachment security in foster children. Method This longitudinal study assessed attachment disorder symptoms in a sample of foster children (n = 55) aged 12 to 82 months. Foster parents with a newly placed foster child were assessed at three points during the first year of placement. At all assessment points, the Disturbance of Attachment Interview (DAI; Smyke and Zeanah in Disturbances of attachment interview, Tulane University, New Orleans, 1999) and the Attachment Q-sort (AQS; Waters and Deane in Monogr Soc Res Child Dev 50:41–65, 1985 German version as reported (Schölmerich and Leyendecker in Deutsche Übersetzung des attachment behavior Q-Set, revision 3.2. Unpublished manual, Ruhr University Bochum, Bochum, 1999) were used to investigate the interplay between dis...

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Editorial zum Themenheft: Risiko und Resilienz im Kindes- und Jugendalter

Psychologie in Erziehung Und Unterricht, Dec 19, 2022

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Precursors and effects of parental reflective functioning: Links to caregivers' attachment representations and behavioral sensitivity

Parental reflective functioning is thought to provide a missing link between caregivers' own atta... more Parental reflective functioning is thought to provide a missing link between caregivers' own attachment histories and their ensuing parenting behaviors. The current study sought to extend research on this association involving 115 parents, both mothers and fathers, of 5-to-6-year-old preschoolers using the German version of the Parental Reflective Functioning Questionnaire (PRFQ). Our study was the first to combine Adult Attachment Interview classifications of parental attachment, behavioral observations of parental sensitivity and PRFQ ratings while drawing on a sizable father subsample. We found theoretically consistent significant relations between all measures, while our results particularly highlighted the role of dismissing attachment for decreases in parenting quality on both cognitive and behavioral levels as the dismissing status differentially affected specific components of self-reported parental reflective functioning and observed sensitivity. Interestingly, these patterns were largely comparable in mothers and fathers. Exploratory mediation analyses further suggested that decreased parental reflective functioning may partially mediate the relationship between parents' dismissing attachment and decreased parental sensitivity. Thus, for prevention and intervention programs targeting parental sensitivity and thus children's long term healthy mental development, the interplay between parental reflective functioning and parents' own attachment history emerges as a key mechanism. Finally, our study served as a further validation of the Parental Reflective Functioning Questionnaire (PRFQ) given the caveat that the prementalizing scale may need further revision in the German version.

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Überblicksartikel: Die Bedeutung von Resilienz für die kindliche Entwicklung aus biopsychosozialer Perspektive

Psychologie in Erziehung und Unterricht

Assessment of attachment disorder symptoms in foster children: comparing diagnostic assessment tools

Child and Adolescent Psychiatry and Mental Health, 2018

Background: Standardized methods for assessing attachment disorders are scarce but needed for res... more Background: Standardized methods for assessing attachment disorders are scarce but needed for research and practice. In the current study, several assessments for attachment disorder symptoms are used within a German sample of foster children after being exposed to neglect and maltreatment in their biological families. The symptoms were assessed with four established assessment methods based on both parents' report and behavioral observation: The Rating for Infant Stranger Engagement, the Stranger at the Door, the Disturbances of Attachment Interview and the Reactive Attachment Disorder Questionnaire. The foster care sample showed symptoms of both the inhibited and the disinhibited attachment disorder. The degree of symptoms is comparable to previous findings. The results of the different tools investigating the disinhibited type of attachment disorder are correlated to each other, but do not overlap. Conclusions: Although all approaches are based on the clinical criteria of the DSM-IV, the assessments do not coincide. Each tool provides a different point of view on the symptoms, so a multi methodical approach for assessing attachment disorder symptoms should be implemented. Furthermore, the inhibited and the disinhibited symptoms represent separate categories, as reflected in the DSM-5, requiring separate assessment.

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Mothers With Postpartum Psychiatric Disorders: Proposal for an Adapted Method to Assess Maternal Sensitivity in Interaction With the Child

Frontiers in Psychiatry, 2019

About 15% of mothers suffer from postpartum psychiatric disorders, such as depression, anxiety, o... more About 15% of mothers suffer from postpartum psychiatric disorders, such as depression, anxiety, or psychosis. Numerous studies have shown maternal caregiving behavior to be negatively affected under these circumstances. The current study sets out to shed light on specific caregiving behaviors of affected mothers in the context of parental mental illness at an early stage. There are several methods to assess maternal caregiving behavior in terms of sensitivity. However, all of them have limitations regarding the peculiarities of mothers with postpartum disorders, that is, changes in affect regulation, and the early onset of the disorder postpartum. With the current study, we provide an adapted method to assess maternal sensitivity based on methods recently approved in attachment research. Two groups of mothers, who were either healthy or had different postpartum disorders, were recorded on video during interactions with their infants. Behaviors were rated regarding responsiveness, promptness, appropriateness, intrusiveness, and positive and negative affect. A first analysis revealed an increased number of deficits on all subscales in mothers with postpartum psychiatric disorders as compared to healthy mothers. Depressive mothers with a single diagnosis had lower scores in responsiveness, promptness, and appropriateness and higher scores on intrusiveness as compared to those in healthy mothers. Here, maternal behavior appears more parent-centered, whereas affect seemed to be relatively unharmed. Moreover, as compared to healthy mothers, mothers with comorbid depression and anxiety symptomatology achieved lower scores on responsiveness, appropriateness, and positive affect and higher scores on intrusiveness and negative affect. It is suggested, that increased deficits are related to the severity of illness in mothers with comorbidities. Results on promptness indicate that these mothers are still capable of maintaining higher vigilance to infant cues. Variance in maternal behavior was relatively high in clinical mothers, showing that some of them are well capable of behaving in

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Predictors of foster parents’ stress and associations to sensitivity in the first year after placement

Child Abuse & Neglect, 2018

In Germany, almost 70 000 children are living in foster families (Statistisches Bundesamt, 2016).... more In Germany, almost 70 000 children are living in foster families (Statistisches Bundesamt, 2016). Many foster children show mental health problems as they were exposed to an accumulation of risk factors. Hence, foster parents are often faced with challenging parenting situations. The current study focuses on the predictors of foster parents' stress and examines longitudinally whether parenting stress is associated with foster parents' sensitivity. The sample consisted of 55 children (aged from 1 to 6 years) and their foster caregivers. Foster parents' sensitivity was observed during home visits. Caregiver reports were used to assess parenting stress (Parenting Stress Index) as well as foster children's externalizing behavior problems (Child Behavior Checklist). For main caregivers' stress at the beginning of placement, regression analyses revealed both, foster children's externalizing problems as well as partners' stress as predictive. For main caregivers' stress one year after, only initial parenting stress and partners' stress were predictive. Foster parents' sensitivity was correlated with their parenting stress one year after placement. Regression analyses revealed no longitudinal effects of initial parenting stress on overall sensitivity. However, supportive presence was predicted by initial supportive presence and by the interaction between parenting stress and children's externalizing problems at placement. The findings highlight the role of the partner in experiencing parenting stress when taking care of a foster child. Furthermore, they emphasize that foster parents who care for children with behavior problems need adequate support that can buffer initial parenting stress and thereby promote sensitive caregiving.

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Attachment, dependency, and attachment-related behaviors in foster children: A closer look at the nature of the foster child–caregiver relationship

Developmental Child Welfare, 2019

There is evidence that within the first year in the foster home, children are capable of forming ... more There is evidence that within the first year in the foster home, children are capable of forming secure attachment comparable to normative samples. However, less is known about the nature of these newly formed relationships and it has been claimed that they may serve different developmental functions as those to primary caregivers formed in the first year of life. The current study aimed to address this void by applying a behavioral system approach. The sample consisted of 46 children (aged 3–6), 16 of which were currently placed in foster care. Attachment security and dependency were assessed during a home visit using the Attachment Q-Sort. Furthermore, activation of several attachment-related behavioral systems was assessed during a stranger approach in a standardized laboratory setting. Compared to the control group, foster children showed equal levels of attachment security but highly increased dependency scores. Also, during the stranger approach, they showed increased attachme...

Inhibited symptoms of Attachment Disorder in children from institutional and foster care samples

Attachment & Human Development, 2018

ABSTRACT The main objective of the article was to study the prevalence of symptoms of the inhibit... more ABSTRACT The main objective of the article was to study the prevalence of symptoms of the inhibited attachment disorder depending on type and quality of the caregiving environment. Analyses were based on data of a sample of institutionalized children from Georgia (N = 16), and two samples of foster children from Georgia (N = 27) and Germany (N = 55). Inhibited attachment disorder symptoms were assessed by the Disturbances of Attachment Interview (DAI) and the Rating of Inhibited Attachment Behavior (RInAB). Further assessments included behavior problems in children, quality of caregiving behavior in foster parents/caregivers, and presence of preferred caregiver in the institution. Regarding inhibited attachment behavior, expected differences between institutional (high scores) and foster samples (low scores) found for both measures (RInAB and DAI), and convergent validity between these measures was found in the institutional sample, but not in the foster samples. There were also indications of construct validity (regarding preferred caregiver in institution and caregiver supportive presence). The findings also suggest methodological issues brought about by skewed distributions of positive and negative measures in high-risk and low-risk samples, respectively.

Videogestuetzte Beratung zur Beziehungsfoerderung bei Jungen Müttern und ihren Säuglingen. Auswirkungen auf die mütterliche Feinfühligkeit. [Video-based intervention for mother-infant-dyads at risk - effects on maternal sensitivity]

Psychologie in Erziehung Und Unterricht, 2012

Foster children's attachment security in the first year after placement: A longitudinal study of predictors

Early Childhood Research Quarterly, 2016

Abstract The current study focuses on foster children's attachment formation and its factors ... more Abstract The current study focuses on foster children's attachment formation and its factors of influence during the first year in foster placement. The sample consists of 55 children (1–6 years) and their primary foster caregiver. Analyses revealed a significant increase in foster children's attachment security. Multiple placement changes and mental illness of biological parents lowered attachment security in the beginning, while the professional background of foster parents fostered early attachment formation. Authoritative parenting was the main predictor for an increase in attachment security during the first year in placement with highly introverted children being specifically susceptible to the influence of parenting. Data point at the need of improved training and selection of foster parents.

Effects of early intervention in children at risk: Short-term and long-term findings from an attachment-based intervention program

Mental Health & Prevention, 2015

ABSTRACT

Infant temperament and parental authoritative parenting style: differential findings on foster children's attachment and mental health

Current data are part of a longitudinal study to assess foster children's attachment and ment... more Current data are part of a longitudinal study to assess foster children's attachment and mental health in the first year after placement. Foster families were contacted three times: as close as possible to the child's arrival, six months after placement and 12 months after placement. The sample consisted of 55 foster children (27 male, 28 female) and their foster caregivers from different parts of Germany. At placement foster children's age ranged from 9 to 79 month (M = 33, SD = 19). Primary foster caregivers (48 female, 7 male) were on average 41 (SD = 6) years old. Foster children's attachment security AQS security scores increased significantly from placement to one year later, F(2,102) = 11.23, p < .001, η p 2 = .18, (see Figure 1). Attachment security scores were significantly lower both, at placement, t(2615) = 6.35, p < .001, d = 0.87, and six months later, t(2614) = 2.28, p = .022, d = 0.31, than among 28 low-risk samples (van IJzendoorn et al., 2004)....

Child Abuse and Neglect: Screening for Risks During the Perinatal Period

Geburtshilfe und Frauenheilkunde, 2012

Purpose: Currently, there is a claim for earlier interventions for families in order to prevent c... more Purpose: Currently, there is a claim for earlier interventions for families in order to prevent child maltreatment. Here, a screening instrument to assess risk indicators for child abuse and neglect already in the context of maternity clinics is introduced. The present study is the first report on the psychometric properties of this instrument, the “short questionnaire for risk indices around birth” (RIAB). Material and Methods: Data were collected in the context of three different studies conducted at Ulm University Hospital. To examine interrater reliability eight case vignettes were rated by n = 90 study participants (50 students and 40 experts working at a maternity clinic). Criterion validity was examined in two studies applying the German version of the child abuse potential inventory CAPI (n = 96 families at risk and n = 160 additional families). Results: Both laymen and experts were able to understand and use the screening instrument correctly, leading to a high agreement wi...

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Foster children's attachment security and behavior problems in the first six months of placement: associations with foster parents' stress and sensitivity

Attachment & human development, 2014

Both traumatic experiences in their birth families and multiple placement histories lead to incre... more Both traumatic experiences in their birth families and multiple placement histories lead to increased mental health problems in foster children. The formation of secure attachments to new caregivers could be a protective factor for foster children. The current study focused on the associations between foster parents' sensitivity, parenting stress and foster children's attachment behavior as well as behavior problems. The sample consists of 48 children (aged from 1 to 6 years) and their foster caregivers. Attachment behavior and sensitivity were observed during home visits. Furthermore, caregiver reports were used to assess parenting stress and children's behavior problems. Compared to normative data, foster children showed lower levels of attachment security and more behavior problems. Foster children's attachment security and behavior problems were predicted significantly or marginally by foster parents' stress and supportive presence.

Videogestützte Beratung zur Beziehungsförderung bei jungen Müttern und ihren Säuglingen - Auswirkungen auf die mütterliche Feinfühligkeit

Psychologie in Erziehung und Unterricht, 2012

Angebote im Bereich der Fruhen Hilfen wurden in Deutschland in den letzten Jahren zunehmend ausge... more Angebote im Bereich der Fruhen Hilfen wurden in Deutschland in den letzten Jahren zunehmend ausgebaut und etabliert. In der vorliegenden Studie wurde mittels eines randomisierten Kontrollgruppendesigns die Wirksamkeit eines bindungstheoretischen Beratungsansat-zes zur fruhen Beziehungsforderung an einer Gruppe hoch belasteter Mutter (N=36) untersucht: eine Teilgruppe erhielt in den ersten drei Lebensmonaten des Sauglings videogestutzte Beratungen und wurde mit einer Kontrollgruppe ohne spezifische Beratungsangebote im Hinblick auf Veranderungen in der mutterlichen Feinfuhligkeit verglichen. Die mutterliche Feinfuhligkeit wurde 1, 3 und 6 Monate nach der Geburt des Sauglings erhoben. Die Ergebnisse zeigen, dass die Interven-tion das mutterliche Verhalten positiv beeinflusste. Die Effekte konnten allerdings nicht langfristig aufrechterhalten werden, so dass langerfristige Beratungsangebote bzw. Auffrischungssitzungen zum Erhalt der Effekte notwendig scheinen. Zudem ergaben sich Hinweise auf eine differenzielle Wirksamkeit, da die Beratung bei nicht-jugendlichen und psychisch belasteten Muttern positiv wirkte, wahrend die Beratung bei jugendlichen Muttern durch flankierende Masnahmen unterstutzt werden sollte.

Pilot study of a program delivered within the regular service system in Germany: Effect of a short-term attachment-based intervention on maternal sensitivity in mothers at risk for child abuse and neglect

Child Abuse & Neglect, 2015

This pilot study examined the effectiveness of a short-term attachment-based intervention, the Ul... more This pilot study examined the effectiveness of a short-term attachment-based intervention, the Ulm Model, in a German population at risk for child abuse and neglect. The intervention used home visits and video feedback to promote maternal sensitivity, and was implemented by trained staff within the health care and youth welfare systems. Mothers in the control group (n=33) received standard services only, while those in the intervention group (n=63) additionally the Ulm Model intervention. The outcomes measured were maternal sensitivity, as assessed by the CARE-Index at pre-intervention, after the last session, and at about 6 and 12 months of age; and infant socio-emotional development, as assessed by the ET6-6 development test at about 6 and 12 months of age. The moderating effects on treatment outcomes of two variables were examined: risk for child abuse (moderate vs. high) and type of maternal attachment representation (secure vs. insecure). Among participants at moderate risk for child abuse, no differences were found between the intervention group and control group in either maternal sensitivity or infant development. Among those considered high risk, mothers in the intervention group showed a significant increase in maternal sensitivity from pre- to post-intervention; however, no group differences were seen at follow-up. There were some indications that infants of mothers in the intervention group showed better emotional development. The variable of maternal attachment representation was not a significant moderator for the intervention effect, but post hoc analysis indicated that the mean sensitivity of secure mothers was significant higher at the 6-month follow-up.

by Gottfried Spangler and Sandra Gabler

Child Abuse & Neglect, 2014

Sandra Gabler

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