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Background: Attachment theory was conceptualized by Bowlby as relevant across the life span, from "cradle to grave". The research literature on attachment in infants and preschool-aged children is extensive, but it is limited in adolescence. In particular, it is unclear whether or not attachment security is distinguishable from other qualities of the parent-adolescent relationship and predicts adjustment independently of alternate measures of it. Methods: Data from three parallel studies of adolescents, representing normal- to high-risk status, were combined, n = 248. Attachment was assessed using the Child Attachment Interview, a recently constructed measure designed for older children and adolescents. Parent-adolescent relationship quality was assessed in detail through questionnaires, interviews and observation of a standard problem-solving interaction. Adolescent adjustment was assessed through parental psychiatric interview, teacher questionnaire and adolescent self-report. Results: Bivariate analyses showed that secure attachment representations were modestly associated with diverse measures of the current parent-adolescent relationship such as monitoring, negative expressed emotion, and directly observed parental warmth and anger. In addition, attachment representations were reliably associated with key indicators of psychological adjustment in adolescence, including parent-rated oppositional-defiant disorder symptoms and teacher-reported emotional and behavioural difficulties. Regression analyses revealed that secure attachment representations explained unique variance in these indicators of adjustment, independent of alternative measures of the parent-adolescent relationship. Conclusion: Adolescents' representational models of attachment are related to but distinct from current parenting quality and provide unique insight into the understanding of behavioural adjustment. The findings support a distinct conceptual role of attachment representations in adolescence. Clinical assessment and treatment models should include attachment patterns in this age group.

Objective: Callous-unemotional (CU) traits in children and adolescents are increasingly recognized as a distinctive dimension of prognostic importance in clinical samples. Nevertheless, comparatively little is known about the longitudinal effects of these personality traits on the mental health of young people from the general population. Using a large representative sample of children and adolescents living in Great Britain, we set out to examine the effects of CU traits on a range of mental health outcomes measured 3 years after the initial assessment. Method: Parents were interviewed to determine the presence of CU traits in a representative sample of 7,636 children and adolescents. The parents also completed the Strengths and Difficulties Questionnaire, a broad measure of childhood psychopathology. Three years later, parents repeated the Strengths and Difficulties Questionnaire. Results: At 3-year follow-up, CU traits were associated with conduct, hyperactivity, emotional, and total symptom scores. After adjusting for the effects of all covariates, including baseline symptom score, CU traits remained robustly associated with the overall levels of conduct problems and emotional problems and with total psychiatric difficulties at 3-year follow-up. Conclusions: Callous-unemotional traits are independently associated with future psychiatric difficulties in children and adolescents. An assessment of CU traits adds small but significant improvements to the prediction of future psychopathology. (Contains 2 tables.)

Background: The concept of "health need" relates patient problems in symptom and psychosocial domains to available appropriate treatments. We studied the effectiveness of inpatient treatment in modifying measured "Health Needs" in children and adolescents admitted to UK inpatient units. Methods: A prospective cohort study of 150 children and adolescents admitted to eight UK inpatient units, using formal pre-admission, pre-discharge and 1-year follow-up measurement of Health Needs. Results: Total patient "Cardinal Problems" reduced highly significantly (p less than 0.001) from 8.5 at admission to 5.7 at discharge (effect size 0.81) and to 4.1 one year after discharge (effect size 1.35). Functional domains free of "Health Needs" increased from 14.9 to 19.4 (effect size 1.08) from the point of admission to the end of follow-up. These changes were clinically meaningful, present in all domains and reduced morbidity to a level typical of outpatient cases. Conclusions: Admission (mean length 116 days, SD 88) leads to clinically important improvement in measured Health Needs over multiple domains for children with serious, complex mental health difficulties. These improvements in multiple symptom and functional domains persist over the next year.

A study involving 12 preschool children with mental retardation, 13 children with autism, and 21 controls failed to show any facilitative effects of the use of representational and nonrepresentational cues on the performance of the children with and without autism on false belief tasks. (Contains references.) (CR)

Background: A growing research base demonstrates that adolescents' construction of secure attachment relationships may underlie successful social and personal relationships and healthy behavioral adjustment. Little is known about the early caregiving origins of adolescent attachment security; this study provides some of the first data on this topic. Method: The relative contribution of early and current caregiving quality to attachment security in adolescence was assessed in two longitudinal studies of a clinic‐referred and an at‐risk community sample using identical measures (n = 209). Quality of early parent–child relationships at age 3–7 years of age and parent–adolescent relationship quality at approximately 12 years were assessed using observational methods; psychosocial risk was derived from extensive interview and questionnaire assessments; adolescent attachment quality was assessed using a standard attachment interview. Results: Analyses indicated moderate stability in observed parent–child interaction quality from early childhood to adolescence. Observational ratings of both early childhood and current caregiving quality were significantly associated with adolescent attachment security; however, early caregiver sensitivity was more strongly associated with adolescent attachment security and predicted later attachment security independently from current caregiving quality. Follow‐up analyses indicated that this longitudinal prediction was significantly weaker in the clinic than in the at‐risk community sample. Conclusions: Parental sensitive responding in childhood has enduring effects on attachment representation in adolescence, independent of current parenting relationship quality. These findings provide important new evidence supporting early parenting interventions for promoting youth well‐being and adjustment. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate a parenting programme designed for foster carers from an independent fostering agency. The programme (Park’s Parenting Approach) adapted existing parenting programmes to be more specific to the needs of looked-after children. Sixty-one carers consented to take part in the evaluation of the training, and 55 (90%) completed the programme. The training was delivered over 9 weeks, once a week for 2 h, and pre- and post-course evaluations were carried out at the first and last sessions of the course. The evaluation included carers’ ratings of their fosterchild’s most challenging problems, parenting style, carer efficacy and a survey of carer satisfaction with training. Results showed a decrease in foster children’s problem behaviours and an increase in carer confidence. Carers expressed a high level of satisfaction with the programme, and 100% felt that they would be able to retain the information and skills they had acquired on the course. The implications of providing training within an independent foster care context are discussed. [ABSTRACT FROM AUTHOR]

Children who were maltreated and enter foster care are at risk for maladjustment and relationship disturbances with foster carers. A popular hypothesis is that prior attachment relationships with abusive birth parents are internalized and carried forward to impair the child's subsequent attachment relationships. However, the empirical base for this model is limited, especially in adolescence. We examined the attachment patterns of 62 adolescents with their birth parents and their foster parents; we compared them to a comparison sample of 50 adolescents in normal-risk families. Attachment was assessed using the Child Attachment Interview; adolescent-parent interaction quality was assessed from direct observation; disruptive behavior symptoms were assessed from multiple informants. Whereas nearly all of the adolescents in foster families exhibited insecure attachments to their birth mothers (90%) and birth fathers (100%), nearly one-half were classified as having a secure attachment with their foster mother (46%) and father (49%); rates of secure attachment toward foster parents did not differ significantly from the rate in comparison families. Within the foster care sample, attachment security to the foster mother was predicted from current observed relationship quality and the duration of current placement. In addition, attachment quality in foster adolescents was associated with fewer disruptive behavior symptoms, and this association was equally strong in foster and comparison families. Our findings demonstrate that there is substantial potential for maltreated children to change and develop subsequent secure attachments in adolescence. [ABSTRACT FROM AUTHOR]

Two experiments were conducted in which a variant of J. McGarrigle and M. Donaldson's (1975) "Naughty Teddy" intervention was applied to children's understanding of false drawings and false beliefs. The results showed that preschool children's understanding of the contents of an out-of-date drawing improved when the drawing was made by a capricious agent ("Naughty Snakey" glove puppet) rather than by the experimenter. The children's performance on a false belief task also improved when the events that set up the false belief were the result of the actions of the glove puppet. The results are discussed in terms of the role of children's sensitivity to the pragmatics of interactions in their development of a theory of mind. [ABSTRACT FROM AUTHOR]