Can behaviour during immunisation be used to identify attachment patterns?A feasibility study.
AbstractBackground Infant attachment is a strong predictor of mental health, and current measures involve placing children into a stressful situation in order to observe how the child uses their primary caregiver to assuage their distress.Objectives This study aimed to explore observational correlates of attachment patterns during immunisation.Participants and Setting 18 parent child pairs were included in the study. They were all recruited through a single GP practice.Methods Infant immunisation videos were observed and coded for parenting behaviours as well as pain promoting and pain reducing strategies. These scores were compared between different attachment groups, as measured with the Manchester Child Attachment Story Task.
Results
Parents of securely attached children scored higher on positive MellowParenting Observational System behaviours, but not at a statistically significant level.Parents of securely attached children were also significantly more likely to engage in pain reducing behaviours (p<0.01) than parents of insecurely attached children.
2Conclusions Future research should go on to develop robust, composite measures for attachment informative behaviours in the immunisation situation and test these in a fully powered study.Keywords; attachment, immunisation, infant, observation, primary care.
What is already known about the topic?There is a need to develop a new attachment measure because there is no current tool suitable for use in non-specialist settings (e.g. in primary care or paediatric clinics) particularly, as in primary care consultations, where there are significant time constraints.
What this paper adds?This paper is a proof of the concept that immunisation has the potential to be used as an attachment measure which has great clinical potential. Attachment could be classified without placing a child into an artificial state of distress, as well as providing a measurement which could be used with children of different ages. This gives the potential for earlier diagnosis and treatment of attachment problems.
Classifying attachmentDespite various methods of classifying attachment in childhood, a systematic review (Lim et al. 2010), concluded that there is a need to develop a new attachment measure because there is no current tool suitable for use in non-specialist settings (eg in primary care or paediatric clinics) particularly, as in primary care consultations, where there are significant time constraints (O'Connor and Byrne 2007).
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Immunisation and attachmentAttachment behaviours are activated when a child is under stress. Most attachment assessments place a child into a stressful situation and then evaluate how they use their primary caregiver to gain comfort. Wilson et al (Wilson et al. 2008) examined the ways in which health visitors (public health nurses) routinely assess parent/child relationships and the authors proposed immunisation clinics as a setting where attachment behaviours cou...
