Attachment--and loss.

Without exception, sadomasochistic subjects (n =48), unlike controls (n =35), are found to have developed insecure internal models of personal attachment, as a result of childhoods which were all problematic in one way or another. Their capacity for metacognition and their coherence of mind are found to be, on average, less than that of controls.

The Adult Attachment Interview

Fostering security? A meta-analysis of attachment in adopted children.

This volume is the second monograph to be published by the Journal of the American Psychoanalytic Association and deals with the ubiquitous problems of identity. Identity is defined as the ability to experience one's self as something that has continuity, uniqueness, and sameness. The vicissitudes of identity have been assessed by other authors, but they have never integrated this data into orthodox psychoanalytic theory. The author brings this theme within the mainstream of psychoanalysis. Dr. Jacobson is a brilliant clinician and is able to articulate her ideas with simplicity. She graphically harmonizes object relations, psychosexual development, and ego maturation and its role in the development of self. She redefines such basic assumptions as infantile narcissism, masochism, the distinction between ego and self, and self and object representations. She traces the development of identity from the early infantile period to the postadolescent period. To illustrate her concept she discusses her theories

The Self and the Object World.

Attachment Disorganization: Unresolved Loss, Relational Violence, and Lapses in Behavioral and Attentional Strategies

The study reported here by Jeanne Kaniuk, Miriam Steele and Jill Hodges explored the development of attachments between a group of 63 children aged four to eight years at placement, all of whom had a history of separations and neglect or abuse. The 63 children and their adopters (42 families) were followed up for two years after placement. They were compared with a group of 48 children who had been adopted as infants (under 12 months of age) but who were of similar age to the research sample at the time of the study. Measures used included measures of the children's attachments and psychological development and of the adopters' attachment status and experience as parents. Uniquely in the field of adoption, this project has included measures of attachment that look below the surface to explore the inner worlds of both the children and the adopters. The children's schools were also contacted for a report on their progress.

Report on a Longitudinal Research Project, Exploring the Development of Attachments between Older, Hard-To-Place Children and Their Adopters over the First Two Years of Placement:

Children adopted from care are known to be at increased risk for mental health difficulties although relatively little research has been carried out to explore this question. This study assessed the mental health and psychological development of children placed for adoption by one UK Local Authority. We compared the pattern and prevalence of difficulties to existing data including that on Looked-After Children (LAC) children. Totally, 106 families were initially approached and parent interviews and at least partial questionnaire data were gathered on 47 children, 72.3% of whom were known to have been maltreated prior to adoption. Of the 34 children with a complete data set including Development and Well-Being Assessment (DAWBA), 76.4% met full criteria for at least one neurodevelopmental or mental health diagnosis, a markedly higher rate than comparison data on LAC or community samples. Less than half of those identified with a mental health diagnosis had received any prior diagnosis, and only a minority had received appropriate services. Despite the children's difficulties, the great majority of parents reported high enjoyment of bringing up their child.

Children after adoption: Exploring their psychological needs:

In the best interests of the late-placed child: a report from the Attachment Representations and Adoption Outcome study

Intervening with maltreated children and their adoptive families: Identifying attachment-facilitative behaviors.

Adopted and foster children are a heterogeneous group. Though children adopted in infancy are over-represented in clinical populations, they show no consistent pattern of difficulties, and infancy adoption acts as a developmental protective factor against a number of risks. Apart from children adopted in early infancy, adopted and foster children share difficulties common to ‘looked-after’ children. This population is at high risk of mental health disorder, although the level of disorder varies by type of placement, and suffers the consequences of the maltreatment or adversity which necessitated their being ‘looked after’ in foster or other placements rather than their families of origin. Children placed for adoption after a period in care have been shown to be a particularly challenging group relative to the total population of children leaving care. The number of children adopted from care has risen very substantially in response to Government policy targets, and is set to rise further. Particular psychiatric sequelae of maltreatment, associated with foster children and those adopted from care, include posttraumatic symptoms and difficulties in forming attachments and relationships. Treatment interventions are outlined; it is important to note that there are no universally recognized mode of treatment for difficulties in attachment, no adequate evidence of effectiveness for various techniques which are publicized, and no reason to assume that the often associated behavioural difficulties necessarily derive from attachment difficulties or can be treated via this route. Adequate support for adoptive families is critical to the success of adoption but its provision is patchy.

Adoption and fostering

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