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Abstract Self-regulation and executive functioning are known key predictors of future cognitive development and mental health. We examined the effect of early life neonatal stress, maternal perinatal stress, kangaroo care, maternal parenting behavior and secure child attachment on executive function at 2 years corrected age (CA) in children born preterm (i.e. < 34 weeks of gestation and/or

Abstract Background Young adult suicidality is worldwide a prevalent mental health problem and the number one cause of death, with devastating consequences for individuals and their families, and substantial economic costs. However, psychological and pharmacological treatments currently recommended in guidelines for treatment of high-risk youth for fatal suicide have limited effect. In line with the World Health Organization’s (WHO) recommendation to involve the family in treatment of these youth, attachment-based family therapy (ABFT) was developed, a 16-week attachment and emotion-focused treatment, implemented in mental health care settings across various European countries in the past years, and becoming increasingly popular among therapists. However, the (cost-)effectiveness of ABFT has not been studied in emerging adults. In the proposed pragmatic randomized controlled trial (RCT), we aim to evaluate the effectiveness and cost-effectiveness of ABFT compared to treatment as usual (TAU) on suicidality, as delivered in daily practice. Methods This pragmatic multicenter study in the Netherlands and Belgium includes 13 participating sites. Participants are suicidal young adults (≥ 31 SIQ-JR score) between 16 and 30 years old who seek mental health treatment (n = 142) and their caregivers. The primary outcome is suicidality (SIQ-JR), with assessments at baseline, post-intervention (5 months after baseline), 3, 6, and 12 months after intervention. We predict that, compared to TAU, ABFT will lead to a stronger reduction in suicidality and will be more cost-effective, over the course of all time points. We also expect stronger decreases in depressive symptoms, given that suicidality is very common in individuals with depressive disorder, as well as more improvement in family functioning, autonomy, entrapment, and young adult attachment, in the ABFT condition. Discussion This study can contribute to improving the care for suicidal youngsters with high mortality risk. Treatment of suicidal emerging adults is understudied. The results will inform clinical guidelines and policy makers and improve treatment of suicidal emerging adults. Trial registration This trial is registered on ClinicalTrials.gov (NCT05965622, first posted on July 28, 2023).

The transition from primary to secondary school is an impactful life event for early adolescents. This life event is hypothesized to be associated with increased feelings of loneliness, as it is often associated with changes in adolescents’ social network. However, this hypothesis has not been empirically tested so far. The present study aimed to fill this gap in the literature. A sample of 330 early adolescents (MageW1 = 10.73, SD = 0.46) were followed for three years. Between the second and the third wave, the secondary school transition occurred for most of the adolescents in the sample. Multi-level models with random intercepts were used to model the change in loneliness. A cross-level interaction was included to examine whether these changes in loneliness were associated with the secondary school transition. The results showed that loneliness decreased across the three waves for all adolescents. This decreasing developmental trend was not moderated by the secondary school transition. Our findings do not show that the secondary school transition is associated with increases in adolescent loneliness. That is, the decreasing developmental trend of loneliness across the three waves was the same for all adolescents. (189 words)

The aim of the present study was to examine whether loneliness and friendship quality are bidirectionally associated with one another over time. Based on the Evolutionary Theory of Loneliness (Cacioppo & Cacioppo, 2018) and the classical definition of loneliness (Peplau & Perlman, 1982), such a bidirectional association would be expected, but empirical research in this regard is limited. We used data from 615 adolescents (Mage = 10.77 years at Wave 1; 53.5% girls) in a three-wave longitudinal study with one-year intervals between successive measurement waves. Loneliness was measured using the peer-related loneliness subscale of the Loneliness and Aloneness Scale for Children and Adolescents. Friendship quality was measured using the help and closeness subscales of the Friendship Qualities Scale. To test our hypothesis we estimated a cross-lagged panel model. Higher friendship quality was associated with lower levels of concurrent loneliness, which is in line with findings of previous research. However, no significant across-time predictions were found between the two constructs. Hence, using a sample of early adolescents, we could not provide evidence supporting important aspects of the aforementioned loneliness theories.

Abstract Background Children with attachment disorder show prosocial behavior problems. Children with a reactive attachment disorder show inhibited and emotionally withdrawn behavior. Consequently, these children typically display prosocial behavior problems. However, the underlying mechanism between reactive attachment disorder and prosocial behavior problems is still unclear and findings in literature are mixed. Methods The current study investigated the role of children’s attachment representations in this association. Attachment representations reflect knowledge about a cognitive script regarding the attachment figure as a source for support (Secure Base Script). We tested whether secure base script knowledge 1) mediates or 2) moderates the link between reactive attachment disorder and prosocial behavior problems in 83 children (6–11 years; 83.1% boys) recruited from special education schools for children with behavioral problems. Children completed a pictorial Secure Base Script Test. Their reactive attachment disorder symptoms were assessed during an interview with the primary caregivers. Primary caregivers and teachers filled out a prosocial behavior questionnaire about the child. Results Results did not support the mediation hypothesis, but evidence for the moderation hypothesis was found. Secure base script knowledge attenuated the negative association between attachment disorder symptoms and prosocial behavior. Conclusions These findings contribute to the discussion about the link between attachment representations and attachment disorders.

Abstract Background Intranasal administration of the “prosocial” neuropeptide oxytocin is increasingly explored as a potential treatment for targeting the core characteristics of autism spectrum disorder (ASD). However, long-term follow-up studies, evaluating the possibility of long-lasting retention effects, are currently lacking. Methods Using a double-blind, randomized, placebo-controlled, parallel design, this pilot clinical trial explored the possibility of long-lasting behavioral effects of 4 weeks of intranasal oxytocin treatment (24 International Units once daily in the morning) in 40 adult men with ASD. To do so, self-report and informant-based questionnaires assessing core autism symptoms and characterizations of attachment were administered at baseline, immediately after 4 weeks of treatment (approximately 24 h after the last nasal spray administration), and at two follow-up sessions, 4 weeks and 1 year post-treatment. Results No treatment-specific effects were identified in the primary outcome assessing social symptoms (Social Responsiveness Scale, self- and informant-rated). In particular, with respect to self-reported social responsiveness, improvements were evident both in the oxytocin and in the placebo group, yielding no significant between-group difference (p = .37). Also informant-rated improvements in social responsiveness were not significantly larger in the oxytocin, compared to the placebo group (between-group difference: p = .19). Among the secondary outcome measures, treatment-specific improvements were identified in the Repetitive Behavior Scale and State Adult Attachment Measure, indicating reductions in self-reported repetitive behaviors (p = .04) and reduced feelings of avoidance toward others (p = .03) in the oxytocin group compared to the placebo group, up to 1 month and even 1 year post-treatment. Treatment-specific effects were also revealed in screenings of mood states (Profile of Mood States), indicating higher reports of “vigor” (feeling energetic, active, lively) in the oxytocin, compared to the placebo group (p = .03). Conclusions While no treatment-specific improvements were evident in terms of core social symptoms, the current observations of long-term beneficial effects on repetitive behaviors and feelings of avoidance are promising and suggestive of a therapeutic potential of oxytocin treatment for ASD. However, given the exploratory nature of this pilot study, future studies are warranted to evaluate the long-term effects of OT administration further. Trial registration The trial was registered with the European Clinical Trial Registry (Eudract 2014-000586-45) on January 22, 2014 (https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-000586-45/BE).

The breadth of children’s attentional field around their mother determines whether securely or insecurely attached children are at risk to develop depressive symptoms when confronted with distress in adolescence. To test this effect longitudinally, we measured children’s ('Mage' = 10.93; 'N' = 109) baseline attentional breadth around their mother, attachment status (combining attachment coherence, secure base script knowledge, and self-reported trust), and self-reported depressive symptoms. One and two years later, we measured self-reported distress and depressive symptoms. We tested three-way interactions between attentional breadth × attachment × distress on changes in depressive symptoms. This three-way interaction was marginally significantly linked with changes in depressive symptoms from baseline to year 1, and significantly with changes in depressive symptoms from baseline to year 2. Results pointed to the protective role of a narrow attentional field around the mother in middle childhood for securely attached children who are confronted with distress later in life.

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Attention-Deficit/Hyperactivity Disorder (ADHD) in children is associated with several adverse family characteristics, such as higher parenting stress, more conflicted parent–child relationships, lower parental competence, and higher levels of parental psychopathology. Hence, children with ADHD more often grow up under suboptimal circumstances, which may impact the development of their attachment representations. Here, we investigated whether children with ADHD have more insecure and disorganized attachment representations than their typically developing peers, and which factors could explain this association. We included 104 children between 4 and 11 years old, 74 with ADHD (without Conduct Disorder) and 30 typically developing control children. Children completed a state-of-the-art story stem task to assess their attachment representation, and we measured parents’ expressed emotion (as an index of parent–child relationship quality), parents’ perceived sense of competence, parental education levels, and parent-rated ODD symptoms of the child. We found that, after controlling for multiple comparisons, children with ADHD had less secure and more ambivalent and disorganized attachment representations relative to their typically developing peers. These group differences were independent of comorbid ODD and parental education levels. There were no group differences on avoidant attachment representations. Explorative analyses within the ADHD group showed that attachment representations were not related to parent–child relationship quality, perceived parenting competence, parental education levels, and comorbid ODD symptoms. We conclude that children with ADHD disproportionately often have attachment problems. Although this conclusion is important, treatment implications of this co-occurrence are yet unclear as research on ADHD and attachment is still in its infancy.

Abstract Background Lack of trust in parental support is a transdiagnostic risk factor for the development of psychological problems throughout the lifespan. Research suggests that children’s cognitive attachment representations and related information processing biases could be an important target for interventions aiming to build trust in the parent-child relationship. A paradigm that can alter these biases and increase trust is that of Cognitive Bias Modification (CBM), during which a target processing bias is systematically trained. Trust-related CBM training effects could possibly be enhanced by oxytocin, a neuropeptide that has been proposed to play an important role in social information processing and social relationships. The present article describes the study protocol for a double-blind randomized controlled trial (RCT) aimed at testing the individual and combined effects of CBM training and oxytocin administration on trust in maternal support. Methods/design One hundred children (aged 8–12 years) are randomly assigned to one of four intervention conditions. Participants inhale a nasal spray that either contains oxytocin (OT) or a placebo. Additionally, they receive either a CBM training aimed at positively modifying trust-related information processing bias or a neutral placebo training aimed to have no trust-related effects. Main and interaction effects of the interventions are assessed on three levels of trust-related outcome measures: trust-related interpretation bias; self-reported trust; and mother-child interactional behavior. Importantly, side-effects of a single administration of OT in middle childhood are monitored closely to provide further information on the safety of OT administration in this age group. Discussion The present RCT is the first study to combine CBM training with oxytocin to test for individual and combined effects on trust in mother. If effective, CBM training and oxytocin could be easily applicable and nonintrusive additions to interventions that target trust in the context of the parent-child relationship. Trial registration ClinicalTrials.gov, ID: NCT02737254 . Registered on 23 March 2016.

The Flemish Child Welfare System (CWS) is in great need of a shared empirically informed clinical strategy for working with depressed adolescents and their families. Many evidence-based practices (EBP) exist, but little is known as to whether they can be successfully imported in the CWS. Therefore, the current study explores the implementation of a particular EBP, Attachment-Based Family Therapy (ABFT), in home-based services of the Flemish CWS in Belgium. Specifically, the study focused on (1) the acceptability of ABFT by counselors and whether negative attitudes about EBP can be changed ('n' = 73 counselors), and (2) the feasibility of implementing ABFT ('n' = 43 adolescents, 11–17 years old, 72% female) by exploring initial effectiveness. The results suggest that (1) initial negative attitudes of counselors towards ABFT were significantly more positive after attending training and discussions about ABFT, and that (2) ABFT could be used by counselors to successfully reduce adolescent depressive symptoms. Future research should include a control group to draw stronger causal conclusions. Strengths and limitations of the study’s design and implications for further dissemination are discussed.

Infant-parent attachment is highly selective and continues beyond essential care in primates, most prominently in humans, and the quality of this attachment crucially determines cognitive and emotional development of the infant. Altricial rodent species such as mice (Mus musculus) display mutual recognition and communal nursing in wild and laboratory environments, but parental bonding beyond the nursing period has not been reported. We presently demonstrated that socially and nutritionally independent mice still prefer to interact selectively with their mother dam. Furthermore, we observed gender differences in the mother-infant relationship, and showed disruption of this relationship in haploinsufficient Nbea+/- mice, a putative autism model with neuroendocrine dysregulation. To our knowledge, this is the first observation of murine infant-to-mother bonding beyond the nursing period.

AbstractBackground.Social anxiety symptoms (SAS) are among the most common mental health problems during adolescence, and it has been shown that parenting influences the adolescent’s level of social anxiety. In addition, it is now widely assumed that most mental health problems, including social anxiety, originate from a complex interplay between genes and environment. However, to date, gene–environment (G × E) interactions studies in the field of social anxiety remain limited. In this study, we have examined how 274 genes involved in different neurotransmission pathways interact with five aspects of perceived parenting as environmental exposure (i.e., support, proactive control, psychological control, punitive control, and harsh punitive control) to affect SAS during adolescence.Methods.We have applied an analytical technique that allows studying genetic information at the gene level, by aggregating data from multiple single-nucleotide-polymorphisms within the same gene and by taking into account the linkage disequilibrium structure of the gene. All participants were part of the STRATEGIES cohort of 948 Flemish adolescents (mean age = 13.7), a population-based study on the development of problem behaviors in adolescence. Relevant genes were preselected based on prior findings and neurotransmitter-related functional protein networks.Results.The results suggest that genes involved in glutamate (SLC1A1), glutathione neurotransmission (GSTZ1), and oxidative stress (CALCRL), in association with harsh punitive parenting, may contribute to social anxiety in adolescence. Isolated polymorphisms in these genes have been related to anxiety and related disorders in earlier work.Conclusions: Taken together, these findings provide new insights into possible biological pathways and environmental risk factors involved in the etiology of social anxiety symptoms’ development.Conclusions.Taken together, these findings provide new insights into possible biological pathways and environmental risk factors involved in the etiology of social anxiety symptoms’ development.

The attachment-based perspective on teacher-student relationships assumes that teachers internalize experiences with specific students into mental representations of dyadic relationships. Once activated, mental representations are believed to influence teachers’ affective and cognitive social information processing. Two priming experiments with 57 elementary school teachers were conducted to test these assumptions. To activate teachers’ mental representations of dyadic relationships, teachers were primed with photographs of students with whom they have a positive and negative relationship (two experimental conditions) as well as with photographs of students with whom they have a distant relationship and unknown students (two control conditions). Teachers’ responses in two different experiments –an emotion categorization task and a vignette task –were analyzed to measure differences between conditions. Mixed evidence was found for the idea that teachers’ mental representations of dyadic relationships impact their affective and cognitive information processing.

Research suggests that inter-individual differences in the degree of state attachment variability are related to differences in trait attachment and psychological problems between children. In this study, we tested whether such associations are also relevant at a within-person level, and if so, whether intra-individual fluctuations in the degree of variability were predictive of or predicted by intra-individual fluctuations in trait attachment and psychological problems. Children (N = 152; Mage = 10.41 years, SDage = 0.60 at time 1) were tested three times over a period of one year. At each timepoint, children reported on their expectations of maternal support in different distressing situations. Additionally, we administered measures of trait attachment to children and psychological problems to children and their mothers. We used Random-Intercept Cross-Lagged Panel Models to distinguish between-person from within-person associations between these constructs over time. The results revealed that the degree of state attachment variability was mainly relevant to understand differences between children in trait attachment and psychological problems: children who overall showed more state attachment variability were overall less securely attached at a trait-level and reported more psychological problems. Although evidence for within-person associations was less robust, there was some indication that the degree of state attachment variability might be related to the development of trust and psychological problems at a within-person level.

Co-rumination has consistently been shown to be maladaptive in the context of emotional well-being. However, not much is known about factors that predict one’s tendency to co-ruminate. The current study investigated temperament, attachment, and gender as predictors of co-rumination trajectories in a sample of 1549 early and middle adolescents from fifth to ninth grade (53.4% girls; Mage = 12.93). Analyses were performed on four waves of data with one-year intervals using multi-level modeling. First, girls were found to be more likely to co-ruminate. Second, high positive affectivity in boys and girls and high effortful control in boys was related to higher co-rumination. Third, high attachment anxiety and high general trust in the availability and support of a mother were predictive of higher co-rumination levels. High attachment avoidance was negatively related to co-rumination in boys. High positive affectivity in boys and girls and high trust in boys predicted decreases in reported co-rumination levels over time. Results highlight differences between boys and girls in factors that predict the tendency to co-ruminate. The current study adds to the literature by helping to identify factors associated with the development of co-rumination, which is a well-established risk factor of internalizing symptoms. Monitoring youth affected with these vulnerabilities may be recommended for prevention efforts.

Theory and research both point at epigenetic processes affecting both parenting behavior and child functioning. However, little is known about the convergence of mother and child’s epigenetic patterns in families. Therefore, the current study investigated epigenetic covariance in mother–child dyads’ methylation levels regarding four stress-regulation related genes (5HTT, NR3C1, FKBP5, and BDNF). Covariance was tested in a general population sample, consisting of early adolescents (Mage = 11.63, SDage = 2.3) and mothers (N = 160 dyads). Results showed that mother and offspring 5HTT and NR3C1 methylation patterns correlated. Furthermore, when averaged across genes, methylation levels strongly correlated. These findings partially supported that child and parent methylation levels covary. It might be important to consider this covariance to understand maladaptive parent–child relationships.

Trust in parental support and subsequent support seeking behavior, a hallmark of secure attachment, result from experiences with sensitive parents during distress. However, the underlying developmental mechanism remains unclear. We tested the hypothesis that trust is the result of an expectancy-learning process condtional upon contingency (the probability that caregiver support has a positive outcome). We developed a new paradigm in which a novel caregiver provides help to solve a problem. Contingency of the caregiver's support was manipulated and participants' trust in the caregiver and their help seeking behavior was measured in three independent samples. The hypothesis was supported suggesting that trust and support seeking result from an expectancy-learning process. These findings' potential contribution to attachment theory is discussed.

Attachment theory states that children learn to trust in their parent's availability and support if they repeatedly experience that their parents respond sensitively to their needs during distress. Attachment is thus developed and shaped by day-to-day interactions, while at the same time, each interaction is a momentary expression of the attachment relation. How attachment-related behaviors of mother and child follow upon each other during interactions in middle childhood, and how these sequences differ in function of attachment quality, has hardly been studied up to now. To fill this gap, we analyzed the micro-coded interaction of 55 mother-child dyads (27 girls, 28 boys, mean age: 10.3) after a standardized stress-induction. Results reveal that all mother-child dyads show a loop between positive mother and child behaviors. This pattern is complemented with a loop of negative mother and child behaviors in low-trust and more avoidantly attached children: these children tend to handle negative mother behavior less well as they show more negative behavior and less positive behavior in response to negative maternal behavior. More anxiously attached children also show less positive behavior, but react positively on collaborative interactions. The micro-coded interactions thus reveal important insights that inform practitioners and advance attachment theory.

Latent growth curve modeling was used to investigate the longitudinal link between attachment, effortful control (EC), and maladaptive development during middle childhood. In a community sample, children (Time 1: n = 157; M[subscript age] = 10.91) and their mothers were examined three times over a two-year period. Attachment was operationalized at a more strategic (self-reported trust in maternal support) and more automatic level (secure base script knowledge). Mothers reported about children's EC and maladjustment. Secure attachment was associated with higher EC, but EC development was only linked with baseline self-reported trust. Also, EC indirectly linked baseline self-reported trust with change in externalizing and internalizing problems over time. In addition, self-reported trust was indirectly linked with change in externalizing problems over time through EC development. EC, and, less robustly, EC development were linked with attachment and change in emotional and behavioral problems.

The aim of this study was to investigate whether food-related thought suppression results in an attention bias for food cues. Fifty-nine female students took part in the experiment. All completed a modified exogenous cueing task containing pictures of foods and toys with a similar valence (presentation duration: 250 ms and 1050 ms). Half of the participants were instructed to suppress thoughts about food and the other half was given control instructions, prior to completing the exogenous cueing task. No evidence was found for an enhanced cue validity effect for food cues after food-related thought suppression. Hence, the preliminary results do not provide support for the hypothesis that thought suppression is sufficient to yield an attention bias. Since the study was the first to employ an exogenous cueing task to study the attentional processing of food cues, replication is warranted.

Attachment expectations regarding the availability of mother as a source for support are supposed to influence distressed children's support seeking behavior. Because research is needed to better understand the mechanisms related to support seeking behavior, this study tested the hypothesis that the cognitive processing of mother-related information is linked to proximity and support seeking behavior. Uncertainty in maternal support has been shown to be characterized by a biased attentional encoding of mother, reducing the breadth of children's attentional field around her. We investigated whether this attentional bias is related to how long distressed children wait before seeking their mother's proximity. Thirty-three children (9-11 years) participated in this study that consisted of experimental tasks to measure attentional breadth and to observe proximity seeking behavior and of questionnaires to measure confidence in maternal support and experienced distress. Results suggested that distressed children with a more narrow attentional field around their mother wait longer to seek her proximity. Key Message: These findings provide a first support for the hypothesis that the attentional processing of mother is related to children's attachment behavior.

Research in both infants and adults demonstrated that attachment expectations are associated with the attentional processing of attachment-related information. However, this research suffered from methodological issues and has not been validated across ages. Employing a more ecologically valid paradigm to measure attentional processes by virtue of eye tracking, the current study tested the defensive exclusion hypothesis in late childhood. According to this hypothesis, insecurely attached children are assumed to defensively exclude attachment-related information. We hypothesized that securely attached children process attachment- related neutral and emotional information in a more open manner compared to insecurely attached children. Sixty-two children (59.7% girls, 8-12 years) completed two different tasks, while eye movements were recorded: task one presented an array of neutral faces including mother and unfamiliar women and task two presented the same with happy and angry faces. Results indicated that more securely attached children looked longer at mother's face regardless of the emotional expression. Also, they tend to have more maintained attention to mother's neutral face. Furthermore, more attachment avoidance was related to a reduced total viewing time of mother's neutral, happy, and angry face. Attachment anxiety was not consistently related to the processing of mother's face. Findings support the theoretical assumption that securely attached children have an open manner of processing all attachment-related information.