The impact of early experience

Here are references relating to different types of therapeutic interventions we can offer and different types of mental health issues, developmental disorders and other presenting problems.
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The impact of early experience

Post by miriam » Sat May 12, 2012 1:25 am

I wrote the following article on the impact of very early experiences and attachment relationships, which I thought I would share:
How early attachment experiences influence outcomes later in life

Dr Miriam Silver, Consultant Clinical Psychologist

The type of attachment relationship formed between a parent and their infant has a powerful influence on the potential health, social and economic opportunities of that child throughout their lifetime. This is particularly remarkable given that the template for a child's attachment relationship style is largely determined before the age of two. Attachment style has an impact on a huge variety of psychosocial outcomes, including academic achievements, marital satisfaction, likelihood of criminal involvement, mental health and quality of relationship with their own children (Sainsbury Centre for Mental Health,, 2009). Correlations are also evidenced between childhood trauma and the incidence of chronic diseases in adulthood, and their impact on functioning and healthcare uptake (Feeney, 2000; Raque-Bogan et al., 2011). For example, attachment style is shown to influence health outcomes in childhood infections and asthma, cancer and diabetes (Mantymaa et al., 2003; Tacon et al., 2001 & 2003; Cicero et al., 2009; Ciechanowski et al., 2004; Bazzazian et al., 2012).

There is complex interplay between a baby's experiences and their neurological development, with optimal development being more likely where a parent is physically and psychologically available, attuned to the infant's needs and able to hold that child in mind. It is sensitive interaction with the caregiver that teaches a child to regulate their physiological arousal level, to recognise their emotions and to ‘mentalise’ or understand the nature of minds (Meins et al, 1998). Early attachment experiences have been shown to influence brain development, with early exposure to trauma and a lack of nurture leading to a state of heightened physiological arousal and diffferences in cortisol production (Bruce et al., 2009; Gunnar & Vazquez., 2001). This increased readiness for fight or flight can show in anxious or aggressive behaviour, and may mean the child is less effective at empathy, emotional regulation and executive functions like planning and anticipating the effect of behaviour. This can lead to problems in the family and/or school (which may be conceptualised as internal to the child, eg ADHD) and lead to referrals to educational support services and CAMHS. Early life stress confers risk for later psychopathology such as anxiety, depression, post-traumatic stress, substance use and psychosis (Mueller et al., 2010). When attachment relationships or the early environment are so dysfunctional that the child is removed into care this picture is exaggerated further still. Care leavers are 50 times more likely to go to prison, 88 times more likely to be involved in drug use than people not looked after and 60 times more likely to be homeless (Barnardos et al, 2000).

Maternal factors are a huge influence on the attachment style of the infant, with depression, stress and social or partner support being particularly influential (Atkinson et al., 2000; Halligan, 2007). Interventions which help mothers to improve their mental health, reduce stress, and increase mentalisation and self-compassion have been shown to improve the attachment and outcomes for their infants (Cree, 2010; Neff & McGehee, 2010). Such early interventions have been shown to be highly cost effective and to make lasting changes for the life outcomes of the next generation (Sainsbury Centre for Mental Health, 2009).

Thus it is of key importance that primary practitioners dealing with mothers and infants in the community feel able to recognise early signs of attachment difficulties and have appropriate specialist resources to refer these families on to.


Atkinson, L., Paglia, A., Coolbear, J., Niccols, A., Parker, K. and Guger. S. (2000). Attachment security: A meta-analysis of maternal mental health correlates. Clinical Psychology Review, Volume 20, Issue 8, Pages 1019–1040.

Barnardo's, Child Poverty Action Group, Children in Wales, the Children Society, NSPCC, SCF (2000). Wales' Children, our Future - A Manifesto.

Bazzazian, S., and Besharat, M. (2012). An explanatory model of adjustment to type I diabetes based on attachment, coping, and self-regulation theories. Psychology, Health & Medicine. Vol.17(1), pp. 47-58.

Bruce, J., Fisher, P. A., Pears, K. C., & Levine, S. (2009). Morning cortisol levels in preschool-aged foster children: Differential effects of maltreatment type. Developmental Psychobiology, 51 (1), 14 – 23.

Cicero, V., Lo Coco, G., Gullo, S., and Lo Verso, G. (2009). The role of attachment dimensions and perceived social support in predicting adjustment to cancer. Psycho-Oncology. 18(10):1045-1052.

Ciechanowski, P., Russo, J., Katon, W., Von Korff, M., Ludman, E., Lin, E., Simon, G. and Bush, T., (2004). Influence of Patient Attachment Style on Self-care and Outcomes in Diabetes. Psychosomatic Medicine. 66(5):720-728.

Cree, M. (2010). Compassion Focused Therapy with Perinatal and Mother-Infant Distress. International Journal of Cognitive Therapy: Vol. 3, Special Section: Compassion Focused Therapy, pp. 159-171.

Feeney, J. A. (2000). Implications of attachment style for patterns of health and illness. Child: Care, Health and Development, 26 (4), 277 - 288.

Gunnar, M. R., & Vazquez, D. M. (2001). Low cortisol and a flattening of expected daytime rhythm: Potential indices of risk in human development. Development and Psychopathology, 13, 515 – 538.

Halligan, S.L., Murray, L., Martin, C., & Cooper, P.J. (2007) Maternal depression and psychiatric outcomes in adolescent offspring: a 13-year longitudinal study. Journal of Affective Disorders, 97, 145-154.

Mäntymaa, M., Puura, K., Luoma, I., Salmelin, R., Davis, H., Tsiantis, J. Ispanovic-Radojkovic, V., Paradisiotou and Tamminen, T. (2003). Infant–mother interaction as a predictor of child's chronic health problems. Child: Care, Health and Development, Volume 29, Issue 3, pages 181–191.

Meins, E., Fernyhough, C., Russell, J., and Clark-Carter, D. (1998) Security of Attachment as a Predictor of Symbolic and Mentalising Abilities: A Longitudinal Study. Social Development, 7, 1, 1-24.

Mueller, S., Maheu, F., Dozier, M., Peloso, E., Mandell, D., Leibenluft, E., Pine, D. and Ernst, M. (2010) Early-life stress is associated with impairment in cognitive control in adolescence: an fMRI study. Neuropsychologia, 48, 3037-3044.

Neff, K, & McGehee (2010). Self-compassion and Psychological Resilience Among Adolescents and Young Adults. Self and Identity, 9 (3), 225-240.

Raque-Bogdan, T. L., Ericson, S. K., Jackson, J., Martin, H. M., & Bryan, N. A. (2011). Attachment and mental and physical health: Self-compassion and mattering as mediators. Journal of Counselling Psychology, 58 (2), 272 – 278.

Tacon, A. (2003) Attachment Experiences in Women With Breast Cancer. Family & Community Health. 26(2):147-156.

Tacon, A., Caldera, Y. and Bell, N. (2001). Attachment Style, Emotional Control, and Breast Cancer. Families, Systems, & Health. 19(3):319-326.

Sainsbury Centre for Mental Health (2009).The chance of a lifetime: Preventing early conduct problems and reducing crime. and
If anyone is interested in learning more about this area, this website has a good overview: I particularly recommend their simple and accessible guide to baby brain development, and their podcasts look very interesting...

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Content checked by Team Member on 20.06.2012
Last modified on 20.06.2012

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