Infant-mother attachment and behavior problems in healthy and chronically ill preschoolers

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Abstract
Analysis of longitudinal data for 145 children [51 healthy, 40 with cystic fibrosis (CF), and 54 with congenital heart disease (CHD)] was conducted: (a) to ascertain whether behavioral problems evident in older medically compromised children would be reported as early as 2–3 years-of-age; and (b) to test theoretical predictions concerning the role of infant-mother attachment in the etiology of behavior problems. As predicted, children with a medical diagnosis received higher scores from parents on the Child Behavior Checklist (CBCL), primarily on the Internalizing scale. Reports of somatic symptoms did not account for this effect. Contrary to predictions, children with CHD were reported to have more behavior problems than those with CF. Secure attachment was associated with lower CBCL scores for internalizing problems regardless of medical status. The increase in behavior problem reports associated with insecure attachment was shown to reflect an effect of avoidance rather than insecurity per se. The importance of distinguishing effects of different types of insecurity and the need for meta-analytic strategies to do so is emphasized.