Journal Mobile Options
Table of Contents
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.
aDepartment of Psychiatry, University Hospital Heidelberg, and bInstitute of Analytic Child and Adolescent Psychotherapy Heidelberg, Heidelberg, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

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.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. 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.
  2. Mallinckrodt B: Attachment, social competencies, social support, and interpersonal process in psychotherapy. Psychother Res 2000;10:239-266.

    External Resources

  3. Köhler L: Anwendung der Bindungstheorie in der psychoanalytischen Praxis. Einschränkende Vorbehalte, Nutzen, Fallbeispiele. Psyche (Stuttg) 1998;52:369-397.
  4. Fonagy P, Target M: The efficacy of psychoanalysis for children with disruptive disorders. J Am Acad Child Adolesc Psychiatry 1994;33:45-55.
  5. Dührssen A: Katamnestische Untersuchung bei 150 Kindern und Jugendlichen nach analytischer Psychotherapie. Prax Kinderpsychol Kinderpsychiatr 1964;7:241-255.
  6. Fleiss JL: Statistical Methods for Rates and Proportions. New York, Wiley, 1981.
  7. Sas System for Windows V. Cary, SAS Institute, 2002.
  8. Cohen J: Statistical Power Analysis for the Behavioral Sciences. New York, Academic Press, 1988.
  9. 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.
  10. Grizzle JE, Starmer CF, Koch GG: Analysis of categorical data by linear models. Biometrics 1969;25:489-504.
  11. Schulte D: Wie soll Therapieerfolg gemessen werden? Z Klin Psychol Psychother 1993;22:374-393.
  12. Rudolf G: Ergebnisforschung in der Psychoanalyse. Eine dringende Notwendigkeit. Psychoanal Widerspruch 1993;4:85-91.
  13. Grawe K, Donati R, Bernauer F: Psychotherapie im Wandel. Von der Konfession zur Profession. Göttingen, Hogrefe, 1994.
  14. 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.
  15. Schepank H: Der Beeinträchtigungsschwere-Score (BSS). Ein Instrument zur Bestimmung der Schwere einer Psychogenen Erkrankung. Göttingen, Beltz, 1995.
  16. 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.
  17. Zimmermann P: Eine deutsche Fassung des inventory of parent and peer attachment; University of Regensburg, Regensburg, 1992.
  18. 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

  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. 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

  21. 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

  22. Ainsworth M, Blehar MC, Waters E, Wall S: Patterns of Attachment: A Psychological Study of the Strange Situation. Hillsdale, Erlbaum, 1978.
  23. 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.
  24. Unnewehr S, Schneider S, Margraf J: Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS). Heidelberg, Springer, 1995.
  25. 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.
  26. Dilling H, Mombour W, Schmidt MH, Schulte-Markwort E: Internationale Klassifikation psychischer Störungen: ICD-10, Kapitel V(F). Forschungskriterien. Bern, Huber, 1994.
  27. 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

  28. Strauss B, Schwark B: Die Bindungstheorie und ihre Relevanz für die Psychotherapie. ‘Ten years later'. Psychotherapeut 2007;52:405-425.

    External Resources

  29. 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.
  30. 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.
  31. 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.
  32. 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.
  33. Sachse J, Strauss B: Bindungscharakteristika und Behandlungserfolg nach stationärer psychodynamischer Gruppenpsychotherapie. Psychother Psychosom Med Psychol 2002;52:134-140.

    External Resources

  34. 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

  35. 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

  36. 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.
  37. Bowlby J: Bindung. München, München Kindler, 1975.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50