Attachment Disruption and Disorganisation

Attachment Disruption and Disorganisation

Most of the so far described considerations on the social neuroscience of human attachment within this website section relate to organised secure and insecure (avoidant, anxious) attachment. However, attachment theory also includes an attachment classification coded on the basis of relationship-specific behaviour that appears disoriented, conflicted, or apprehensive with regard to a caregiver when the attachment system is activated. Here, SoNeAt Lab’s research into such disrupted and disorganised attachment is presented and discussed in the context of NAMDA.

1. Defining Attachment Disruption and Disorganisation

As described in NAMDA, attachment disorganisation is a very heterogeneous phenomenon – regarding both its aetiology and manifestation on the behavioural and neurobiological level. Such strong heterogeneity of attachment disorganisation calls for the introduction of a differentiation and specification.

One possible approach for achieving such differentiation and specification is to look for dissociable pathways to attachment disorganisation (reflecting specific adaptations to particular caregiver behaviours). NAMDA proposes to distinguish between a hypo- and hyper-arousal subtype of attachment disorganisation, a distinction primarily derived from the caregiver either being a threat or providing insufficient co-regulation. In other words, in NAMDA, the ontogeny and aetiology of attachment disorganisation is associated with different experiences of maltreatment, either related to abuse or neglect. Such notion is in line with a dimensional model of childhood adversity involving two central dimensions of threat and deprivation proposed by McLaughlin & Sheridan (e.g., 2016).

Adapted from White et al. (2020)

The above said, NAMDA does not define attachment disorganisation by the direct impact of distinct adverse experiences per se. Instead, NAMDA emphasises that the influence of adverse experiences is filtered through the child’s self- and co-regulatory efforts with their caregivers. The important implication of this notion is that singular maltreatment events in an otherwise nurturing and secure attachment relationship (or early adverse events occurring outside the family context) should have a relatively weak long-term influence, and attachment disorganisation only emerge through chronic exposure to maltreatment. Such consideration thus also reflects the cumulative risk approach (e.g., Evans et al., 2013).

According to these deliberations as part of NAMDA, more research is crucially needed to better understand attachment disorganisation and its underlying neural patterns associated with different and repeated maltreatment experiences. In doing so, it appears particularly promising to distinguish between maltreatment experiences of abuse versus neglect, but also additional dimensions, particularly emotional (versus physical) maltreatment. It also remains to be seen whether this dissociation of various maltreatment dimensions differentially translates into direct measures of attachment disorganisation. As recently noted by a large consortium of researchers (see here) and picked up by Department of Public Health and Primary Care at the University of Cambridge (see here), there are several other pathways to attachment disorganisation apart from maltreatment: About one third of children who are abused do not show signs of disorganised attachment, and about two thirds of children exposed to five or more socio-economic risks do show signs of disorganised attachment.

In a collaborative project with the University Clinic Leipzig (Germany), the SoNeAt Lab therefore is involved in examining functional and structural differences in adolescents with various maltreatment exposures (as compared to non-maltreated controls).

2. Effects of Abuse, Neglect, and Emotional Maltreatment on Brain Activity during Social Exclusion in Adolescents

Taking into consideration both the cumulative risk approach and dimensional model of childhood adversity, we set out to investigate neural responses to social acceptance versus rejection in a sample of 98 adolescents ages 12 to 17, 58 of whom were exposed to maltreatment and 40 were matched non-maltreated controls. Importantly, we disentangled exposure to different maltreatment subtypes, more specifically abuse, neglect, and emotional maltreatment.

To study neural responses to social acceptance versus rejection, we adapted a widely used virtual ball-tossing game known as “Cyberball“. During Cyberball, a ball is tossed virtually between the study participant and two other players. Classically, there is an initial phase during which all players receive the ball roughly equally (i.e., social inclusion). What then follows is a phase during which the participant is excluded from participating in the game as the other two players almost exclusively toss the ball between themselves (i.e., social exclusion).

Most studies average brain activity during the entire social inclusion and exclusion blocks and compare them to derive a global neural measure of acceptance versus rejection. Initially predominantly associated with a signature thought to reflect “social pain”, rejection during the Cyberball is nowadays related to processes of emotion regulation and social cognition that more robustly emerge in large meta-analyses (e.g., Mwilambwe-Tshilobo et al., 2021; Vijayakumar et al., 2017). In our Cyberball version, we choose to model each movement of the ball as an individual event. Such approach allowed for a much more nuanced investigation of associated neural computations related to particular types of ball tosses.

We found that emotional maltreatment was associated with several of the activation patterns, over and above other exposures. These results therefore not only call for a combined consideration of the cumulative risk approach and the dimensional model of childhood adversity, but also a further specification associated with emotional maltreatment (that could in the future be even extended to a dissociation between emotional and physical maltreatment). The corresponding paper has been published online on February 02, 2022.

Schulz, C. C., von Klitzing, K., Crowley, M. J., Deserno, L., Schoett, M., Hoffmann, F., Villringer, A., Sheridan, M. A., Vrtička, P.*, White, L. O.* (2022). Emotional Maltreatment and Neglect Impact Neural Activation to Social Exclusion in Early and Mid-Adolescence: An Event-Related FMRI Study. Development and Psychopathology, 34, 573–585. *= these authors share senior authorship. OPEN ACCESS.

3. Associations between Abuse, Neglect, and Emotional Maltreatment and Brain Structure in Adolescents

In the same adolescent participant sample as above, we are also looking at associations between different maltreatment dimensions (abuse, neglect, emotional maltreatment) and brain structure. In a previous study (Puhlmann, Derome, et al.; 2022 – see here), we recently explored the association between self-reported attachment and neurostructural development throughout adolescence by assessing attachment with a self-report questionnaire in a normative participant sample. Here, a specific focus will be on maltreatment and its relation to brain structure in cross-sectional analysis of early and mid adolescence.

Data analysis is underway. More information will be made available here as soon as possible.