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Vol. 46, No. 3, 2013
Issue release date: April 2013
Psychopathology 2013;46:192-200
(DOI:10.1159/000341591)

Attachment Styles and Outcome of Psychoanalytic Psychotherapy for Children and Adolescents

Stefini A. · Horn H. · Winkelmann K. · Geiser-Elze A. · Hartmann M. · Kronmüller K.-T.
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Abstract

Background: Until now few studies have proven that an attachment style can be changed in the course of psychotherapy and that the attachment style has an impact on the therapy outcome. In particular, there is a lack of studies about these relationships in long-term psychoanalytic psychotherapy with children and adolescents. Sampling and Methods: Seventy-one children with mental disorders receiving long-term outpatient psychodynamic psychotherapy were assessed 4 times using the Heidelberg Attachment Style Rating for Children and Adolescents. The measurements were conducted at the beginning of treatment, at the 25th treatment session, at the end of treatment and 1 year after the completion of treatment. Results: The results showed a significant change in attachment style during treatment. The proportion of children and adolescents with a secure attachment style increased from 23% to 63%. There was no significant difference in the attachment style between patients with good and poor treatment outcome, but a significant relationship between secure attachment and the number of treatment sessions could be demonstrated. Conclusions: A reorientation towards a secure main attachment style over the course of psychotherapy is possible. However, attachment style seems to be not a moderator but a mediator for the outcome of psychoanalytic psychotherapy in children and adolescents.



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References

  1. Bowlby J: Bindung. München, München Kindler, 1975.
  2. Strauss B, Schwark B: Bindungstheorie und ihre Relevanz für die Psychotherapie; in Strauss B (ed): Bindung und Psychopathologie. Stuttgart, Klett-Cotta, 2008, pp 9-48.
  3. Mosheim R, Zachhuber U, Scharf L, Hofmann A, Kemmler G, Danzl C, Kinze J, Biebl W, Richter R: Bindung und Psychotherapie: Bindungsqualität und interpersonale Probleme von Patienten als mögliche Einflussfaktoren auf das Ergebnis stationärer Psychotherapie. Psychotherapeut 2000;45:223-229.

    External Resources

  4. Strauss B, Kirchmann H, Eckert J, Lobo-Drost A, Marquet A, Papenhausen R, Mosheim R, Biebl W, Liebler A, Seidler KP, Schreiber-Willnow K, Mattke D, Mestel R, Daudert E, Nickel R, Schauenburg H, Höger D: Attachment characteristics and treatment outcome following inpatient psychotherapy: results of a multisite study. Psychother Res 2006;16:579-594.

    External Resources

  5. Sachse J, Strauss B: Bindungscharakteristika und Behandlungserfolg nach stationärer psychodynamischer Gruppenpsychotherapie. Psychother Psychosom Med Psychol 2002;52:134-140.

    External Resources

  6. Meyer B, Pilkonis PA, Proietti JM, Heape CL, Egan M: Attachment styles and personality disorders as predictors of symptom course. J Pers Disord 2001;15:371-389.
  7. Stefini A, Geiser-Elze A, Hartmann M, Horn H, Winkelmann K, Kronmüller KT: Bindungsstil und Therapieerfolg in der psychodynamischen Kurzzeittherapie bei Kindern und Jugendlichen. Psychother Psychosom Med Psychol 2009;59:68-74.
  8. Fonagy P, Steele M, Steele H, Leigh T, Kennedy R, Mattoon G, Target M: The predictive specificity of the adult attachment interview and pathological emotional development; in Goldberg S, Muir R, Kerr J (eds): Attachment Theory: Social, Developmental, and Clinical Perspectives. Hillsdale, Analytic Press, 1995.
  9. Hoffman KT, Marvin RS, Cooper G, Powell B: Changing toddlers' and preschoolers' attachment classifications: the circle of security intervention. J Consult Clin Psychol 2006;74:1017-1026.
  10. Strauss B, Schwark B: Die Bindungstheorie und ihre Relevanz für die Psychotherapie. ‘Ten years later'. Psychotherapeut 2007;52:405-425.

    External Resources

  11. Kronmüller KT, Postelnicu I, Hartmann M, Stefini A, Geiser-Elze A, Gerhold M, Hildegard H, Winkelmann K: Zur Wirksamkeit psychodynamischer Kurzzeitpsychotherapie bei Kindern und Jugendlichen mit Angststörungen. Prax Kinderpsychol Kinderpsychiatr 2005;54:559-577.

    External Resources

  12. Dilling H, Mombour W, Schmidt MH, Schulte-Markwort E: Internationale Klassifikation psychischer Störungen: ICD-10, Kapitel V(F). Forschungskriterien. Bern, Huber, 1994.
  13. Hartmann M, Horn H, Winkelmann K, Geiser-Elze A, Kronmüller KT: Therapieleitfaden der Heidelberg Studie zur Evaluation analytischer Psychotherapie bei Kindern und Jugendlichen. University of Heidelberg, Heidelberg, 2001.
  14. Unnewehr S, Schneider S, Margraf J: Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS). Heidelberg, Springer, 1995.
  15. Horn H, Reck C: Heidelberger Bindungsrating für Kinder von 6 bis 12 Jahren und Jugendliche von 13 bis 18 Jahren. University of Heidelberg, Heidelberg, 1997.
  16. Ainsworth M, Blehar MC, Waters E, Wall S: Patterns of Attachment: A Psychological Study of the Strange Situation. Hillsdale, Erlbaum, 1978.
  17. Main M, Weston DR: The quality of the toddler's relationship to mother and to father: related to conflict behavior and the readiness to establish new relationships. Child Dev 1981;52:932-940.

    External Resources

  18. Grossmann KE, August P, Fremmer-Bombik E, Friedl A, Grossmann K, Scheuerer-Englisch H, Spangler G, Stephan C, Suess G: Die Bindungstheorie: Modell und entwicklungspsychologische Forschung; in Keller H (ed): Handbuch der Kleinkindforschung. Berlin, Springer, 1989, pp 31-55.

    External Resources

  19. Main M, Solomon J: Discovery of an insecure-disorganized/disoriented attachment pattern: procedures, findings and implications for the classification of behavior; in Brazelton TB, Yogman M (eds): Affective Development in Infancy. Norwood, Ablex, 1986, pp 95-124.
  20. Armsden GC, Greenberg MT: The inventory of parent and peer attachment: individual differences and their relationship to psychological well-being in adolescence. J Youth Adolesc 1987;16:427-454.

    External Resources

  21. Zimmermann P: Eine deutsche Fassung des inventory of parent and peer attachment; University of Regensburg, Regensburg, 1992.
  22. Kronmüller KT, Stefini A, Geiser-Elze A, Horn H, Hartmann M, Winkelmann K: The Heidelberg study of psychodynamic psychotherapy for children and adolescents; in Tsiantis J, Trowel J (eds): Assessing Change in Psychoanalytic Psychotherapy of Children and Adolescents: Today's Challenge. London, Karnac, 2010.
  23. Schepank H: Der Beeinträchtigungsschwere-Score (BSS). Ein Instrument zur Bestimmung der Schwere einer Psychogenen Erkrankung. Göttingen, Beltz, 1995.
  24. Fahrig H, Kronmüller KT, Hartmann M, Rudolf G: Therapieerfolg analytischer Psychotherapie bei Kindern und Jugendlichen. Die Heidelberger Studie zur analytischen Kinder- und Jugendlichen-Psychotherapie. Z Psychosom Med Psychoanal 1996;42:375-395.
  25. Grawe K, Donati R, Bernauer F: Psychotherapie im Wandel. Von der Konfession zur Profession. Göttingen, Hogrefe, 1994.
  26. Rudolf G: Ergebnisforschung in der Psychoanalyse. Eine dringende Notwendigkeit. Psychoanal Widerspruch 1993;4:85-91.
  27. Schulte D: Wie soll Therapieerfolg gemessen werden? Z Klin Psychol Psychother 1993;22:374-393.
  28. Grizzle JE, Starmer CF, Koch GG: Analysis of categorical data by linear models. Biometrics 1969;25:489-504.
  29. Koch GG, Landis JR, Freeman JL, Freeman DH, Lehnen RG: A general methodology for the analysis of experiments with repeated measurement of categorical data. Biometrics 1977;33:133-158.
  30. Cohen J: Statistical Power Analysis for the Behavioral Sciences. New York, Academic Press, 1988.
  31. Sas System for Windows V. Cary, SAS Institute, 2002.
  32. Fleiss JL: Statistical Methods for Rates and Proportions. New York, Wiley, 1981.
  33. Dührssen A: Katamnestische Untersuchung bei 150 Kindern und Jugendlichen nach analytischer Psychotherapie. Prax Kinderpsychol Kinderpsychiatr 1964;7:241-255.
  34. Fonagy P, Target M: The efficacy of psychoanalysis for children with disruptive disorders. J Am Acad Child Adolesc Psychiatry 1994;33:45-55.
  35. Köhler L: Anwendung der Bindungstheorie in der psychoanalytischen Praxis. Einschränkende Vorbehalte, Nutzen, Fallbeispiele. Psyche (Stuttg) 1998;52:369-397.
  36. Mallinckrodt B: Attachment, social competencies, social support, and interpersonal process in psychotherapy. Psychother Res 2000;10:239-266.

    External Resources

  37. Grossmann KE, Grossmann K: Attachment quality as an organizer of emotional and behavioral responses in a longitudinal perspective; in Parkes CM, Stevenson-Hinde J, Marris P (eds): Attachment across the Life Cycle. London, Routledge, 1991.


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