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      The Child Attachment Interview: A Narrative Review

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          Abstract

          Attachment theory promoted an impressive body of research on the psychic developmental processes, resulting in studies on both typical and atypical development. Much of the diffusion of the attachment theory in the clinical field was related to the design of reliable instruments to evaluate the organization of attachment in infancy as well as in adulthood. Until recently, the lack of a suitable instrument to assess attachment in middle childhood as well as in adolescence hindered the expansion of research in these developmental phases during which the parent-child relationship takes on a different, albeit still crucial, role. The Child Attachment Interview (CAI), a measure that was recently designed to assess attachment at a representational level in middle childhood and adolescence, filled the measurement gap. The aim of the current review was to summarize previous empirical investigations concerning CAI in order to (a) provide an overview of the state of current research, (b) identify unanswered questions, and (c) propose future research directions. A narrative review was conducted to map the current research findings by searching for the term “Child Attachment Interview” in the Medline, Scopus, Web of Science, and PsychINFO databases, followed by a search in Mendeley. Limits were set to exclude dissertations, chapters in books, and qualitative or theoretical papers, while empirical studies were included if they used the CAI and were published in English language, peer-reviewed journals by July, 2016. The review, which ultimately included 39 studies meeting the criteria, showed that the CAI is a reliable instrument to assess attachment organization in clinical and non-clinical samples, thus providing a worthwhile contribution to the investigation of the influence of the parent-child relationship beyond infancy and early childhood. Nevertheless, the review pointed out a number of relevant open issues, the most critical of which concerned the CAI coding and classification system. In particular, some relevant questions arose about (a) how opportune it would be to maintain a distinct classification for mother and father, (b) coding challenges regarding both the father and the Preoccupied and Disorganized classification, and finally (c) the advantage of a dimensional vs. a categorical approach.

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          Balancing the strengths of systematic and narrative reviews.

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            Representational and questionnaire measures of attachment: A meta-analysis of relations to child internalizing and externalizing problems.

            Although the quality of the attachment relationship is often cited as an important determinant of development, the extent of impact of this environmental influence in shaping behavioral outcomes has been a matter of considerable debate. This may, in part, be because of the variability in methodologies used for assessing attachment across infancy, childhood, and adolescence, including behavioral, representational, and questionnaire measures of attachment. Previous meta-analyses of the relations between attachment and internalizing and externalizing problems have focused on the behavioral measures of attachment used primarily in infancy. The current meta-analysis is a comprehensive examination of the literature on attachment and behavioral problems in children aged 3-18 years, focusing on the representational and questionnaire measures most commonly used in this age range. When secure attachment was compared with insecure attachment, modest associations with internalizing behavior (165 studies; 48,224 families; d = .58; 95% confidence interval [CI] [.52-.64]) were found. Multivariate moderator analyses were used to disentangle the unique influence of each significant univariate moderator more precisely, and results revealed that effect sizes decreased as the child aged, and were larger in studies in which the participants were ethnically White, where the child was the problem informant, and when the internalizing measure was depressive symptoms. Attachment and externalizing behavior were also associated (116 studies; 24,689 families; d = .49; 95% CI [42-.56]), and effect sizes were larger in ethnically White samples, and in those where the child was the problem informant. Avoidant, ambivalent, and disorganized attachment classifications were associated with internalizing behavior, but only disorganized attachment was associated with externalizing behavior.
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              A new method of evaluating attachment representations in young school-age children: the Manchester Child Attachment Story Task.

              We describe a new instrument, using a doll-play vignette completion method, which applies concepts and methodologies from infant and adult attachment research to enable identification and detailed classification of internal representations of attachment relationships in young school-age children. Validation of the Manchester Child Attachment Story Task (MCAST) in a normal population (N = 53) shows good interrater reliability and content validity. Patterns of attachment representation identified show stability over time. Comparisons are made with existing methodologies, and potential applications of the instrument and directions for future research are discussed.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                14 March 2017
                2017
                : 8
                : 384
                Affiliations
                Dipartimento Salute Mentale e Dipendenze, ASL 3 Genovese Genova, Italy
                Author notes

                Edited by: Gianluca Castelnuovo, Università Cattolica del Sacro Cuore, Italy

                Reviewed by: Raffaella Calati, University of Montpellier, France; Simona Di Folco, University of Cagliari, Italy

                *Correspondence: Antonella Privizzini antonellaprivizzini@ 123456gmail.com

                This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2017.00384
                5348517
                28352244
                67b09c32-4cc9-4d24-a3e3-ac96c9a0f4a1
                Copyright © 2017 Privizzini.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 01 September 2016
                : 28 February 2017
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 66, Pages: 12, Words: 10334
                Categories
                Psychology
                Review

                Clinical Psychology & Psychiatry
                child attachment interview,middle childhood,adolescence,mentalization,child development

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