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Attachment representations in pre-adolescents at familial high risk of schizophrenia or bipolar disorder and population-based controls—Characteristics of attachment from middle childhood to pre-adolescence, and its relation to parental functioning and child mental disorder

Krantz, Mette Falkenberg ; Gregersen, Maja ; Veddum, Lotte ; Hjorthøj, Carsten ; Prøsch, Åsa Kremer ; Ohland, Jessica ; Brandt, Julie Marie ; Rohd, Sinnika Birkehøj ; Knudsen, Christina Bruun and Andreasen, Anna Krogh , et al. (2025) In JCPP advances 5(3).
Abstract

Background: Development of secure attachment is crucial to establish and maintain healthy relationships with others throughout life. For parents with schizophrenia or bipolar disorder, challenged parental functioning may compromise the sensitive caregiving needed to establish secure child attachment. We aimed to examine pre-adolescent attachment, predictors related to caregiving, and middle childhood attachment predictors of pre-adolescent mental disorders. Methods: In a population-based nationwide cohort of 522 children of parents with schizophrenia or bipolar disorder and population-based controls, The Secure Base Script Test was used to assess attachment security at age 11 (N = 409). Parental caregiving and functioning were assessed... (More)

Background: Development of secure attachment is crucial to establish and maintain healthy relationships with others throughout life. For parents with schizophrenia or bipolar disorder, challenged parental functioning may compromise the sensitive caregiving needed to establish secure child attachment. We aimed to examine pre-adolescent attachment, predictors related to caregiving, and middle childhood attachment predictors of pre-adolescent mental disorders. Methods: In a population-based nationwide cohort of 522 children of parents with schizophrenia or bipolar disorder and population-based controls, The Secure Base Script Test was used to assess attachment security at age 11 (N = 409). Parental caregiving and functioning were assessed with the Personal and Social Performance Scale and MC-HOME (age 7) and child mental disorder with K-SADS-PL (age 7 and 11). Story Stem Assessment Profile was used for age 7 attachment. Results: We found no differences between risk and control groups in prevalence of pre-adolescent secure attachment. Parental level of functioning and attachment security at age 7 significantly predicted more rich secure base content at age 11. Level of age 7 disorganization significantly predicted presence of mental disorder at age 11. Conclusions: Overall, attachment of children at familial risk of schizophrenia or bipolar disorder did not differ from that of controls. Instead, parental functioning in middle childhood predicts pre-adolescent attachment, and may therefore serve as a focus for supporting healthy attachment development. Middle childhood disorganization might serve as a predictor of pre-adolescent mental disorder if other studies confirm our findings, and awareness hereof may be relevant for guiding intervention to support mental development.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
attachment, bipolar, high risk studies, risk factors, schizophrenia
in
JCPP advances
volume
5
issue
3
article number
e12274
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:40979739
  • scopus:105016561201
ISSN
2692-9384
DOI
10.1002/jcv2.12274
language
English
LU publication?
yes
id
920d3e3a-6bb6-488a-b491-2b382f01b3ca
date added to LUP
2025-11-28 10:59:16
date last changed
2025-11-29 03:00:02
@article{920d3e3a-6bb6-488a-b491-2b382f01b3ca,
  abstract     = {{<p>Background: Development of secure attachment is crucial to establish and maintain healthy relationships with others throughout life. For parents with schizophrenia or bipolar disorder, challenged parental functioning may compromise the sensitive caregiving needed to establish secure child attachment. We aimed to examine pre-adolescent attachment, predictors related to caregiving, and middle childhood attachment predictors of pre-adolescent mental disorders. Methods: In a population-based nationwide cohort of 522 children of parents with schizophrenia or bipolar disorder and population-based controls, The Secure Base Script Test was used to assess attachment security at age 11 (N = 409). Parental caregiving and functioning were assessed with the Personal and Social Performance Scale and MC-HOME (age 7) and child mental disorder with K-SADS-PL (age 7 and 11). Story Stem Assessment Profile was used for age 7 attachment. Results: We found no differences between risk and control groups in prevalence of pre-adolescent secure attachment. Parental level of functioning and attachment security at age 7 significantly predicted more rich secure base content at age 11. Level of age 7 disorganization significantly predicted presence of mental disorder at age 11. Conclusions: Overall, attachment of children at familial risk of schizophrenia or bipolar disorder did not differ from that of controls. Instead, parental functioning in middle childhood predicts pre-adolescent attachment, and may therefore serve as a focus for supporting healthy attachment development. Middle childhood disorganization might serve as a predictor of pre-adolescent mental disorder if other studies confirm our findings, and awareness hereof may be relevant for guiding intervention to support mental development.</p>}},
  author       = {{Krantz, Mette Falkenberg and Gregersen, Maja and Veddum, Lotte and Hjorthøj, Carsten and Prøsch, Åsa Kremer and Ohland, Jessica and Brandt, Julie Marie and Rohd, Sinnika Birkehøj and Knudsen, Christina Bruun and Andreasen, Anna Krogh and Hemager, Nicoline and Greve, Aja and Mors, Ole and Nordentoft, Merete and Psouni, Elia and Thorup, Anne A.E.}},
  issn         = {{2692-9384}},
  keywords     = {{attachment; bipolar; high risk studies; risk factors; schizophrenia}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{JCPP advances}},
  title        = {{Attachment representations in pre-adolescents at familial high risk of schizophrenia or bipolar disorder and population-based controls—Characteristics of attachment from middle childhood to pre-adolescence, and its relation to parental functioning and child mental disorder}},
  url          = {{http://dx.doi.org/10.1002/jcv2.12274}},
  doi          = {{10.1002/jcv2.12274}},
  volume       = {{5}},
  year         = {{2025}},
}