Spensley, Sheila R.; (2001) A comparative study of maternal attachment in three groups of mothers having a child with learning impairment. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

In this thesis, maternal attachment of mothers having a child with autism is compared with that of two control groups of mothers, one having Down syndrome children and the other, Rett syndrome children. Attachment status was rated using the Adult Attachment Interview. It was hypothesised that having a child with autism may serve to disorganise the attachment system in mothers and this in turn may complicate the parent -child relationship which is clinically observed in this group. The hypothesis was explored in the context of a detailed study of the narratives of a small group of mothers with learning impaired children. The thesis reviews the literature using the Adult Attachment Interview in the context of psychological disturbance and parent-child relationships, together with the smaller body of work on the Reflective Function Scale, a measure of mentalisation derived from AAI narratives. The literature on maternal attachment in cases of severe psychological disturbance is reviewed along with relevant developmental and psychoanalytic writings. The role of primitive emotional containment in mental development and learning is investigated and related to the factors involved in maternal attunement and the generation of attention. Attunement and attention, both associated with secure personality development, are manifestly deficient in the autistic child. The study samples were 58 subjects (autism group = 27, Down syndrome group = 16, Rett syndrome group = 15). Methods pertinent to parent-child relationships in autism were identified through close scrutiny of the content and form of mothers' narratives of their own attachment histories. The scoring and classification of the interviews is described. A range of variables was found to distinguish the autism group. These involve references to violence, concerns about space and the incidence of disruptions of turn taking and interruptions of the interview process. Results show consistent differences between the index and control groups, supporting the hypothesis of higher levels of disturbances in the attachment system of mothers with children with autism. The results are discussed in terms of the clinical value of recognising these differences in the course of individual and family treatments of these children. More generally, the approach taken in this thesis, combining quantitative and qualitative research methods in the study of parent-child relationships in families with major psychiatric disturbance in the child, are explored and evaluated.

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