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Behavior problems in sexually abused preschoolers over a 1-year period: The mediating role of attachment representations

Published online by Cambridge University Press:  23 April 2018

Florence Charest ,
Martine Hébert ,
Annie Bernier ,
Rachel Langevin  and
Raphaële Miljkovitch
Florence Charest
Affiliation:
Université du Québec à Montréal
Martine Hébert*
Affiliation:
Université du Québec à Montréal
Annie Bernier
Affiliation:
Université de Montréal
Rachel Langevin
Affiliation:
Concordia University
Raphaële Miljkovitch
Affiliation:
Université Paris 8
*
Address correspondence and reprint requests to: Martine Hébert, Department of Sexology, Université du Québec à Montréal, Montréal, Case Postale 8888, Succursale Centre-Ville, Québec, Canada H3C 3P8; E-mail: hebert.m@uqam.ca.
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Abstract

According to the developmental psychopathology framework, adverse childhood experiences, including child sexual abuse (CSA), may alter the course of normal development in children. Attachment security has been identified as a protective factor against psychopathology and may thus play a critical role in predicting victims’ adaptation. The main objective of the present study was to investigate the mediating effect of attachment representations in the relation between CSA and behavior problems over a 1-year period. The sample consisted of 391 children (251 sexually abused) aged 3.5 to 6 years. The Attachment Story Completion Task and the Child Behavior Checklist were used. Disorganized attachment partially mediated the relation between CSA and children's internalizing and externalizing behavior problems 1 year following the initial assessment. This mediation effect was not found for ambivalent nor secure attachment dimensions. Child gender was found to moderate the association between CSA and disorganization, with larger effects of CSA among boys. These findings underscore the importance of considering attachment representations in treatment programs for preschool victims. Evidence-based practice focusing on trauma could be combined with an attachment-based intervention targeting the parent–child relationship. Moreover, interventions should be gender sensitive, as CSA appears to affect boys and girls differently.

Keywords

attachmentbehavior problemschild sexual abusemediationpreschoolers
Type
Regular Articles
Information
Development and Psychopathology , Volume 31 , Issue 2 , May 2019 , pp. 471 - 481
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

This research was supported by Social Sciences and Humanities Research Council Grant SSHRC # 2424 (to M.H.) and a PhD fellowship from the Fonds de recherche du Québec- Société et Culture (to F.C.). We wish to thank the families who participated in this study as well as the practitioners from the different intervention settings involved in this project.

References

Achenbach, T., & Rescorla, L. (2000). Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont.Google Scholar
Achenbach, T., & Rescorla, L. (2001). Manual for the ASEBA school-ages forms and profiles. Burlington, VT: University of Vermont.Google Scholar
Ainsworth, M., Blehar, S., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.Google Scholar
Alink, L., Cicchetti, D., Kim, J., & Rogosch, F. (2009). Mediating and moderating processes in the relation between maltreatment and psychopathology: Mother-child relationship quality and emotion regulation. Journal of Abnormal Child Psychology, 37, 831–843. doi:10.1007/s10802-009-9314-4.Google Scholar
Beaudoin, G., Hébert, M., & Bernier, A. (2013). Contribution of attachment security to the prediction of internalizing and externalizing behavior problems in preschoolers victims of sexual abuse. European Review of Applied Psychology, 63, 147–157. doi:10.1016/j.erap.2012.12.001.Google Scholar
Bernard, K., & Dozier, M. (2010). Examining infants’ cortisol responses to laboratory tasks among children varying in attachment disorganization: Stress reactivity or return to baseline? Developmental Psychology, 46, 1771–1778. doi:10.1037/a0020660.Google Scholar
Bernier, A., & Miljkovitch, R. (2009). Intergenerational transmission of attachment in father-child dyads: The case of single parenthood. Journal of Genetic Psychology, 170, 31–51.10.3200/GNTP.170.1.31-52Google Scholar
Berthelot, N., Langevin, R., & Hébert, M. (2012). L'association entre le victimisation sexuelle dans l'enfance de la mère et les troubles de comportement chez l'enfant victime d'agression sexuelle [The association between mothers’ sexual victimization and behavior problems in sexually abused children]. Journal International de Victimologie, 10, 8–20.Google Scholar
Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment. New York: Basic Books. (Original work published 1969).Google Scholar
Bowlby, J. (1988). A secure base: Parent–child attachment and healthy human development. New York: Basic Books.Google Scholar
Bretherton, I., & Munholland, K. A. (2008). Internal working models in attachment relationships: Elaborating a central construct in attachment theory. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment: Theory, research, and clinical applications (2nd ed., pp. 102–127). New York: Guilford Press.Google Scholar
Bretherton, I., Ridgeway, D., & Cassidy, J. (1990). Assessing internal working models of the attachment relationship: An attachment story completion task for 3-year-olds. In Greenberg, M. T., Cicchetti, D., & Cummings, E. M. (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 273–308). Chicago: University of Chicago Press.Google Scholar
Brumariu, L. E., & Kerns, K. A. (2010). Parent–child attachment and internalizing symptomatology in childhood and adolescence: A review of empirical findings and future directions. Development and Psychopathology, 22, 177–203. doi:10.1017/S0954579409990344.Google Scholar
Calkins, S. D., & Leerkes, E. M. (2011). Early attachment processes and the development of emotional self-regulation. In Vohs, K. D. & Baumeister, R. F. (Eds.), Handbook of self-regulation: Research, theory, and applications (2nd ed., pp. 356–373). New York: Guilford Press.Google Scholar
Cantón-Cortés, D., Cortés, M. R., & Cantón, J. (2015). Child sexual abuse, attachment style, and depression: The role of the characteristics of abuse. Journal of Interpersonal Violence, 30, 420–436. doi:10.1177/0886260514535101.Google Scholar
Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. G. (1989). Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers. In Cicchetti, D. & Carlson, V. (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 494–528). New York: Cambridge University Press.10.1017/CBO9780511665707.017Google Scholar
Cassidy, J. (1994). Emotion regulation: Influences of attachment relationships. Monograph of the Society for Research in Child Development, 59 (2–3, Serial No. 240), 228–249. doi:10.1111/j.1540-5834.1994.tb01287.x.Google Scholar
Cassidy, J., & Berlin, L. J. (1994). The insecure/ambivalent pattern of attachment: Theory and research. Child Development, 65, 971–991. doi:10.1111/j.1467-8624.1994.tb00796.x.Google Scholar
Chaplin, T. M. (2015). Gender and emotion expression: A developmental contextual perspective. Emotion Review, 7, 14–21. doi:10.1177/1754073914544408.Google Scholar
Charest, F., Hébert, M., & Bernier, A. (2018). Attachment representations in sexually abused preschoolers: A comparative study. Attachment and Human Development. Advance online publication. doi:10.1080/14616734.2018.1430838.Google Scholar
Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 541–565. doi:10.1097/00004583-199505000-00008.Google Scholar
Cicchetti, D., & Valentino, K. (2006). An ecological-transactional perspective on child maltreatment: Failure of the average expectable environment and its influence on child development. In Cicchetti, D. & Cohen, D. J. (Eds.), Developmental psychopathology (pp. 129–201). Hoboken, NJ: Wiley.Google Scholar
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). New York: Guilford Press.Google Scholar
Cyr, C., Euser, E. M., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2010). Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses. Development and Psychopathology, 22, 87–108. doi:10.1017/S0954579409990289.Google Scholar
DeKlyen, M., & Greenberg, M. T. (2016). Attachment and psychopathology in childhood. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment: Theory, research and clinical applications (3rd ed., pp. 639–665). New York: Guilford Press.Google Scholar
Doyle, C., & Cicchetti, D. (2017). From the cradle to the grave: The effect of adverse caregiving environments on attachment and relationships throughout the lifespan. Clinical Psychology Science and Practice, 24, 203–217. doi:10.1111/cpsp.12192.Google Scholar
Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.Google Scholar
Facompré, C. R., Bernard, K., & Waters, T. E. A. (2017). Effectiveness of interventions in preventing disorganized attachment: A meta-analysis. Development and Psychopathology. Advance online publication. doi:10.1017/S0954579417000426.Google Scholar
Fearon, R. P., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Lapsley, A. M., & Roisman, G. I. (2010). The significance of insecure attachment and disorganization in the development of children's externalizing behavior: A meta-analytic study. Child Development, 81, 435–456. doi:10.1111/j.1467-8624.2009.01405.x.Google Scholar
Fergusson, D. M., McLeod, G. F. H., & Horwood, L. J. (2013). Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand. Child Abuse and Neglect, 37, 664–674. doi:10.1016/j.chiabu.2013.03.013.Google Scholar
Finkelhor, D., & Browne, A. (1985). The traumatic impact of child sexual abuse: A conceptualization. American Journal of Orthopsychiatry, 55, 540–553. doi:10.1111/j.1939-0025.1985.tb02703.x.Google Scholar
Fresno, A., Spencer, R., Ramos, N., & Pierrehumbert, B. (2014). The effect of sexual abuse on children's attachment representations in Chile. Journal of Sexual Abuse, 23, 128–145. doi:10.1080/10538712.2014.870949.Google Scholar
George, C., & Solomon, J. (2008). Disorganized attachment and caregiving. New York: Guilford Press.Google Scholar
Groh, A. M., Fearon, R. P., van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., & Roisman, G. I. (2017). Attachment in the early life course: Meta-analytic evidence for its role in socioemotional development. Child Development Perspectives, 11, 70–76. doi:10.1111/cdep.12213.Google Scholar
Groh, A. M., Roisman, G. I., van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., & Fearon, R. P. (2012). The significance of insecure and disorganized attachment for children's internalizing symptoms: A meta-analytic study. Child Development, 83, 591–610. doi:10.1111/j.1467-8624.2011.01711.x.Google Scholar
Hayes, A. F., & Preacher, K. J. (2013). Conditional process modeling: Using structural equation modeling to examine contingent causal processes. In Hancock, G. R. & Mueller, R. O. (Eds.), A second course in structural equation modeling (2nd ed., pp. 219–266). Greenwich, CT: Information Age Publishing.Google Scholar
Hébert, M., & Daignault, I. V. (2015). Challenges in treatment of sexually abused preschoolers: A pilot study of the effects of TF-CBT with preschoolers victims of sexual abuse in Quebec. Sexologies, 24, e21–e27. doi:10.1016/j.sexol.2014.09.003.Google Scholar
Hébert, M., Langevin, R., & Bernier, M. J. (2013). Self-reported symptoms and parents' evaluation of behavior problems in preschoolers disclosing sexual abuse. International Journal of Child, Youth and Family Studies, 4, 467–483. doi:10.18357/ijcyfs44201312700.Google Scholar
Hébert, M., Langevin, R., & Charest, F. (2014). Factors associated with resilience in preschoolers reporting sexual abuse: A typological analysis. International Journal of Child and Adolescent Resilience, 2, 46–58.Google Scholar
Keenan, K., & Shaw, D. (1997). Developmental and social influences on young girls’ early problem behavior. Psychological Bulletin, 121, 95–113. doi:10.1037/0033-2909.121.1.95.Google Scholar
Keenan, K., & Wakschlag, L. S. (2000). More than the terrible twos: The nature and severity of behavior problems in clinic-referred preschool children. Journal of Abnormal Child Psychology, 28, 33–46. doi:10.1023/A:1005118000977.Google Scholar
Langevin, R., Hébert, M., Allard-Dansereau, C., & Bernard-Bonnin, A. C. (2016). Emotion regulation in sexually abused preschoolers: The contribution of parental factors. Journal of Traumatic Stress, 29, 180–184. doi:10.1002/jts.22082.Google Scholar
Langevin, R., Hébert, M., & Cossette, L. (2015). Emotion regulation as a mediator of the relation between sexual abuse and behavior problems in preschoolers. Child Abuse & Neglect, 46, 16–26. doi:10.1016/j.chiabu.2015.02.001.Google Scholar
Little, T. D., Jorgensen, T. D., Lang, K. M., & Moore, W. G. (2013). On the joys of missing data. Journal of Pediatric Psychology, 39, 151–162. doi:10.1093/jpepsy/jst048.Google Scholar
Lyons-Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development, 64, 67–96. doi:10.1111/1540-5834.00034.Google Scholar
Lyons-Ruth, K., Easterbrooks, M. A., & Cibelli, C. D. (1997). Infant attachment strategies, infant mental lag, and maternal depressive symptoms: Predictors of internalizing and externalizing problems at age 7. Developmental Psychology, 33, 681–692. doi:10.1037/0012-1649.33.4.681.Google Scholar
Lyons-Ruth, K., & Jacobvitz, D. (2008). Attachment disorganization: Genetic factors, parenting contexts, and developmental transformation from infancy to adulthood. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment: Theory, research, and clinical applications (2nd ed., pp. 666–697). New York: Guilford Press.Google Scholar
Madigan, S., Brumariu, L. E., Villani, V., Atkinson, L., & Lyons-Ruth, K. (2016). Representational and questionnaire measures of attachment: A meta-analysis of relations to child internalizing and externalizing problems. Psychological Bulletin, 142, 367–399. doi:10.1037/bul0000029.Google Scholar
Madigan, S., Moran, G., Schuengel, C., Pederson, D. R., & Rotten, R. (2007). Unresolved maternal attachment representations, disrupted maternal behavior and disorganized attachment in infancy: Links to toddler behavior problems. Journal of Child Psychology and Psychiatry, 48, 1042–1050. doi:10.1111/j.1469-7610.2007.01805.x.Google Scholar
Main, M. (1995). Recent studies in attachment: Overview, with selected implications for clinical work. In Goldberg, S., Muir, R., & Kerr, J. (Eds.), Attachment theory: Social developmental and clinical perspectives (pp. 407–474). Hillsdale, NJ: Analytic Press.Google Scholar
Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. In Greenberg, M. T., Cicchetti, D., & Cummings, E. M. (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121–160). Chicago: University of Chicago Press.Google Scholar
Miljkovitch, R., Danet, M., & Bernier, A. (2012). International transmission of attachment representations in the context of single parenthood in France. Journal of Family Psychology, 26, 784–792. doi:10.1037/a0029627.Google Scholar
Miljkovitch, R., Moran, G., Roy, C., Jaunin, L., Forcada-Guex, M., Pierrehumbert, B., … Borghini, A. (2013). Maternal interactive behaviour as a predictor of preschoolers' attachment representations among full term and premature samples. Early Human Development, 89, 349–354. doi:10.1016/j.earlhumdev.2012.11.006.Google Scholar
Miljkovitch, R., Pierrehumbert, B., Bretherton, I., & Halfon, O. (2004). Associations between parental and child attachment representations. Attachment and Human Development, 6, 305–325. doi:10.1080/14616730412331281557.Google Scholar
Moss, E., Cyr, C., & Dubois-Comtois, K. (2004). Attachment at early school age and developmental risk: Examining family contexts and behavior problems of controlling-caregiving, controlling-punitive, and behaviorally disorganized children. Developmental Psychology, 40, 519–532.10.1037/0012-1649.40.4.519Google Scholar
Moss, E., Dubois-Comtois, K., Cyr, C., Tarabulsy, G. M., St.-Laurent, D., & Bernier, A. (2011). Efficacy of a home-visiting intervention aimed at improving maternal sensitivity, child attachment, and behavioral outcomes for maltreated children: A randomized control trial. Development and Psychopathology, 23, 195–210. doi:10.1017/S0954579410000738.Google Scholar
Muthén, L. K., & Muthén, B. O. (1998–2007). Mplus user's guide (5th ed.). Los Angeles: Muthén & Muthén.Google Scholar
Parent, N., & Hébert, M. (2006). French adaptation of “History of Victimization,” from V. V. Wolfe, C. Gentile, & P. Boudreau (1987). Unpublished manuscript, Université du Québec à Montréal, Department of Sexology.Google Scholar
Perez-Fuentes, G., Olfson, M., Villegas, L., Morcillo, C., Wang, S., & Blanco, C. (2013). Prevalence and correlates of child sexual abuse: A national study. Comprehensive Psychiatry, 54, 16–27. doi:10.1016/j.comppsych.2012.05.010.Google Scholar
Roche, D., Runtz, M., & Hunter, M. (1999). Adult attachment: A mediator between child sexual abuse and later psychological adjustment. Journal of Interpersonal Violence, 14, 184–207.Google Scholar
Stoltenborgh, M., Bakermans-Kranenburg, M. J., Alink, L., & van IJzendoorn, M. H. (2015). The prevalence of child maltreatment across the globe: Review of a series of meta-analyses. Child Abuse Review, 24, 37–50. doi:10.1002/car.Google Scholar
Tabachnick, B. G., & Fidell, L. S. (2013). Cleaning up your act: Screening data. In Tabachnick, B. G. & Fidell, L. S. (Eds.), Using multivariate statistics. Upper Saddle River, NJ: Pearson.Google Scholar
Tereno, S., Madigan, S., Lyons-Ruth, K., Plamondon, A., Atkinson, L., Guedeney, N., … Guedeney, A. (2017). Assessing a change mechanism in a randomized home-visiting trial: Reducing disrupted maternal communication decreases infant disorganization. Development and Psychopathology, 29, 637–649. doi:10.1017/S0954579417000232.Google Scholar
US Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. (2013). Child maltreatment 2012. Retrieved from http://www.acf.hhs.gov/Google Scholar
Valentino, K. (2017). Relational interventions for maltreated children. Child Development, 88, 359–367. doi:10.1111/cdev.12735.Google Scholar
van IJzendoorn, M. H., Schuengel, C., & Bakermans-Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Developmental Psychopathology, 11, 225–249.Google Scholar
Yancey, T. C., & Hansen, D. J. (2010). Relationship of personal, familial, and abuse-specific factors with outcome following childhood sexual abuse. Aggression and Violent Behavior, 15, 410–421. doi:10.1016/j.avb.2010.07.003.Google Scholar
Zéphyr, L., Cyr, C., Hébert, M., Bernier, A., & Beaudoin, G. (2015). Problèmes de comportement chez l'enfant victime d'agression sexuelle: Le rôle de l'attachement [Behavior problems in sexually abused children: The role of attachment]. Canadian Journal of Behavioural Science, 47, 91–101. doi:10.1037/a0037592.Google Scholar