Antonella: ‘A Stranger in the Family’—A Case Study of Eating Disorders Across Cultures

The story of Antonella illustrates the way in which cultural and other values impact on the presentation and treatment of eating disorders. Displaced from her European home culture to live in Canada, Antonella presents with an eating disorder and a fluctuating tableau of anxiety and mood symptoms linked to her lack of a sense of identity. These arose against a background of her adoption as a foundling child in Italy and her attachment problems with her adoptive family generating chronically unfixed and unstable identities, resulting in her cross-cultural marriage as both flight and refuge followed by intense conflicts. Her predicament is resolved only when after an extended period in cultural family therapy she establishes a deep cross-species identification by becoming a breeder of husky dogs. The wider implications of Antonella’s story for understanding the relationship between cultural values and mental health are briefly considered.

Attachment in family foster care: Literature review of associated characteristics

Foster children often had negative experiences in the past, which can contribute to attachment problems. In their meta-analysis, van den Dries et al. found that foster children were more often disorganized attached when compared to the general population. It is to be expected that the quality of attachment between the foster children and their foster parents is related to various factors. However, research into which factors are associated with the development of secure attachment is scarce. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, a total of 13 articles were included in this review. This review provides an overview of the associated characteristics with the quality of attachment between foster carers and foster children. In the articles included in this review, the foster carers’ characteristics were often described as more important than characteristics of the foster child and placement when it comes to developing a secure attachment. The most consensus, although not unanimous, existed on the finding that a positive, sensitive parenting style of foster parents was positively related to a secure attachment between the foster children and their foster carers.

Attachment Theory from Ethology to the Strange Situation

In psychology, the term “attachment” has been made popular by British psychiatrist and psychoanalyst John Bowlby’s theory about the adaptive value of the mother–infant bond. Bowlby was not the first to use the term “attachment” or to study the significance of close emotional relationships for infants and young children. Anna Freud and other psychoanalysts had used the term to refer to the mother–child relationship. Bowlby’s views, however, departed from psychoanalysis because he appealed to the science of ethology, the biological study of behavior, for support. According to Bowlby, the mother–infant attachment has a biological basis. The operationalization of the ethological theory of attachment through the work of American- Canadian child psychologist Mary Ainsworth played a key role in the rise of the ethological theory of attachment to paradigmatic status toward the end of the 20th century. Ainsworth carried out observational studies of the attachment between mothers and infants. She also designed an experiment, the strange situation procedure (SSP), to measure and categorize attachment relationships between infants and mothers. Ainsworth and her students argued that their experimental work in the SSP supported Bowlby’s views about the instinctual nature of the child’s attachment to the mother and the importance of a secure attachment in infancy for a person’s adequate emotional development. Attachment theory has become one of psychology’s most influential theories about early child development and its impact on an individual’s subsequent emotional life and adult relationships. Supporters claim its universal validity and its prescriptive character. For them, attachment theory establishes the norm of what is considered healthy emotional and psychological childhood development, and it sets the standards for good parenting. In the Western world, attachment theory has an impact in various realms, including childcare, adoption policies, education, and therapy. Many schools of early childhood education identify children at risk for poor learning in the classroom as a result of attachment problems at home. Pediatricians often rely on attachment theory to encourage specific practices in parent–child interactions. Therapeutic approaches for children, families, and couples are sometimes based on attachment theory, as are decisions about adoption, parental rights, and child custody. Furthermore, some intervention programs in family and educational practices implemented by international NGOs rely on attachment theory. The ethological theory of attachment, however, has also been contested since its inception. Several psychologists critiqued the empirical studies about maternal deprivation on which it was erected. Other scholars challenged the notion that biological science supports its claims. Finally, numerous cross-cultural psychologists and anthropologists challenged the universality of several of its central tenets. They call for recognizing the cultural assumptions embedded in attachment theory, in the instruments and constructs used to measure it, and in the expectations it promotes about good parenting.

Attachment and Children with Disabilities: Knowledge and Views of Early Intervention Professionals

The parent–child bond known as attachment plays a pivotal role in the development and wellbeing of all young children. While research indicates that there are challenges for children with a disability in developing a secure attachment, little is known about early childhood intervention (ECI) professionals’ knowledge of attachment, how they view its importance in their work, and how they translate this knowledge into practice. To address this gap in research, a questionnaire was developed and administered to ECI professionals at an Australian ECI organisation. Qualitative analysis of results (N= 49) revealed an overall understanding of the role of attachment in child development and indicated that ECI professionals perceive attachment as being very important in their role of enhancing children's learning and wellbeing. Importantly, it emerged that less than half the participants learnt about attachment in their undergraduate training, with most learning about it ‘on the job’ and just over half the respondents felt comfortable in addressing attachment concerns with families. Some families are thus left at risk of being inadequately supported to manage attachment problems. Participants identified a desire for further training. This exploratory study has implications for orientation, training, practice, and further research.