Maltreatment experiences as predictors of Attachment Disorders in children in child protective services: Preliminary data

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Developmental Psychopathology

Abstract

Introduction.
Attachment Disorders (AD), namely Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED), are psychiatric disorders that children may develop as a result of severe early adversity. Most of the research on risk factors associated with AD has been carried out with previously institutionalized children (e.g. Romanian orphanage) and these studies suggests that ADs are associated with social/emotional neglect and/or repeated caregiver changes (APA, 2013). Those risk factors have been little explored in maltreated children in child protective services (CPS). In this population, RAD behaviors have been associated with parental mental health problems (Zeanah et al., 2004) and with a late placement (Jonkman et al., 2014). DSED behaviors have been associated with parental mental health problems and addiction (Zeanah et al., 2004) and with physical abuse (Jonkman et al., 2014; Minnis et al., 2007). The objective of this study is to examine whether such risk factors are associated with symptoms of AD in children in CPS.

Method
Participants. The sample consists of 86 school-age children in out-of-home care (children in foster care, n = 65; children in residential care, n = 21). Children with ASD were excluded (because ASD symptoms can mimic those of RAD) and children had to have a stable primary caregiver for the last six months.
Measures. Primary caregivers completed the Early trauma-related disorders questionnaire (ETRADQ, 42 items, 4 point-Likert scale, Monette et al., submitted), a DSM-5-based AD questionnaire. Maltreatment history, parental risk factors and placement variables were extracted from Child protective services files. Maltreatment types and risk factors are those listed under the Youth Protection Act (Province of Quebec, CANADA).

Results (table 1).
DSED symptoms were associated with neglect risk factors (parental addiction, r = .27; parental instability, r =.21), with a sexual abuse risk factor (inappropriate climate/promiscuity, r = .33) and with a subtype of psychological maltreatment (exposure to domestic violence, r =.22). RAD symptoms were associated physical abuse (physical abuse, r = .23; unexplained injuries, r = .33), with psychological maltreatment (indifference, r = 23), with educational neglect (inappropriate reactions to child's behavior, r = .21; lack of schooling, r =.24), with health neglect (unmet or refused mental health care, r = 28) and with risk of physical abuse (threats, r = .27). RAD symptoms were also associated with age at first placement (r = .28) and number of displacements after age 6 (r = .22).

Discussion.
The results indicate that DSED is mainly associated with neglect risk factors, but not with the different types of neglect per se. It is possible that certain types of neglect (e.g. emotional neglect) associated with DSED in previously institutionalized children are poorly captured by CPS administrative data. Results show that RAD symptoms are associated with a history of serious physical and psychological maltreatment, and not only with neglect. Such results on the potential etiology of RAD are unprecedented and could radically change the way we understand this disorder in children in CPS.

Authors

• Claudelle Baillargeon, Université du Québec à Montréal (UQAM)
  Presenting Author

• Sebastien Monette, Université du Québec à Montréal (UQAM)
  Non-Presenting Author

• Chantal Cyr, Université du Québec à Montréal (UQAM)
  Non-Presenting Author

• Miguel M. Terradas, Univerisité de Sherbrooke
  Non-Presenting Author

• Sophie Couture, Université de Sherbrooke
  Non-Presenting Author