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Impact of Attachment and Parenting Styles on Children’s Mental Health

DR. KGAPURU S. MASHISHI

30TH AUGUST 2022

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What is Attachment?

  • Intimate emotional relationship which forms over time with primary caregivers/special person
  • Children need parents/primary caregivers for survival
  • Attachment develops through quality of consistent, reliable and sensitive care giving
  • It is expressed in non-verbal communication- Mother’s gaze, tone, touch, smile etc

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What is Attachment?

  • Bond between child and caregiver shapes child’s emotional-wellbeing and ability to form healthy relationships
  • Happens when the caregiver responds sensitively/attentively

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Pregnancy and Attachment

  • Attachment starts during pregnancy
  • Mother’s enthusiasm to interact with the fetus(unborn baby)
  • Relationship between mother and her unborn child is NB!-creates attachment after birth
  • Attachment during this period predicts attachment post-delivery

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Pregnancy and Attachment

  • Talk/Sing to your baby
  • Gently rub your belly
  • Play music to your baby
  • Self care- Avoid stress

- Go for a walk

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Birth and Attachment

  • At birth an infant/baby’s brain is not fully developed
  • 90% of growth of the human brain occur in the 1st 5yrs of life ( NB! Time)
  • From few weeks after birth, infant-parent relationship & the mother’s genes has direct impact on the:
  • Nature/Growth and Structure of the baby’s still developing brain
  • Brain development/Mental Health- Shaped by the quality of their relationships with caregivers

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Birth and Attachment

  • Its in this 1st few years of life that connections between brain cells happen
  • This connections are shaped by:
  • Repeated experiences (Good/Bad)
  • Greatly impacted by the quality of the early relationship with caregivers
  • This developing brain is very sensitive and vulnerable to stress

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��SECURE ATTACHMENT-John Bowlby�

  • Sense of safety/security
  • Learn that parents are always available in time of stress and crisis
  • This allows the child to feel safe to learn and explore the world
  • Form safe bond and trust others
  • Feel concern and show awareness of others
  • Understand/Manage their feelings/behaviour

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SECURE ATTACHMENT

In Children it leads to:

  • Children who are comfortable exploring their environment (learn new things)
  • NB! In healthy development

In Adults:

  • Self confidence
  • An ability to ask and accept help

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SECURE ATTACHMENT

  • Friendly/Warm people
  • Ability to receive and give love back
  • Healthy/long-term relationships
  • High-self esteem

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HOW TO CREATE SECURE ATTACHMENT WITH YOUR CHILD?

  • Hold and cuddle your baby- Reassures your baby/sense of safety
  • Make eye contact- Feeding, bathing, changing diapers
  • Watch and listen to your baby
  • Comfort your baby every time she cries.
  • Speak in a warm, soothing tone of voice.
  • Maintain realistic expectations of your baby.
  • Be fully present.
  • Practice being self-aware. Notice when you are tired, anxious, angry, or frustrated, and take care of yourself. You are better able to meet your baby’s needs when you are aware of your own needs.

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��������������������INSECURE ATTACHMENT

  • Baby learns that people cannot be trusted
  • Sensitive to perceived threat
  • Affect their development
  • Channel much of their energy in coping with stress
  • Blue print/template for relating with others

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ATTACHMENT STYLES

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Attachment Styles

  • Secure
  • Insecure
  • Avoidant
  • Ambivalent
  • Disorganized

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Avoidant Attachment

  • In children whose parents are inconsistent
  • Children feels that they cannot count on their caregiver for comfort and care
  • No preference for caregiver over a stranger

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Avoidant Attachment

  • Difficulty in trusting
  • Believe that no one loves them/don’t deserve to be loved
  • In Adults: Problems with intimacy/Can’t form healthy relationships

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Anxious/Ambivalent Attachment

  • In children whose parents were consistently not present/dismissive
  • Believe that you cannot rely on anyone
  • Clingy to their caregiver-Not easily comforted
  • As Adults:
  • Fear of closeness/intimacy
  • Fear of rejection

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Anxious/Ambivalent Attachment

  • Inability to meet others emotional needs
  • As parents- Have difficulties in connecting with their children

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Fearful/Disorganized Attachment

  • Inconsistent connection with caregivers
  • Often fearful of the caregivers
  • Caregiver’s behavior is unpredictable (caring/abusive)
  • Struggle with relationships throughout life
  • Children don’t learn what healthy relationship is
  • Difficulty to provide healthy relationship as adults
  • Often in abusive homes

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Attachment-Risk Factors

  • Infant Factors
  • Parent Factors
  • Environmental Factors

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Infant-Risk Factors

  • Premature birth
  • Lengthy stay in hospital
  • Severe medical illnesses
  • Extensive surgical procedures

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Parent-Risk Factors

  • Parent’s attachment to their own parents
  • Parent’s physical and mental health
  • Unwanted baby
  • Substance abuse
  • Neglect/Abuse

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Parenting/Environmental�-Risk Factors

  • Inconsistent parenting
  • Domestic violence and trauma
  • Ongoing exposure to trauma
  • Lengthy separation from caregivers
  • Multiple changes in caregivers

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FETAL(UNBORN BABY) MENTAL HEALTH

  • AFFECTED BY:
  • Genetic factors
  • Prolonged stress
  • Maternal mental illness

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4 MAJOR PARENTING STYLES

  • 1. AUTHORITARIAN PARENT
  • Controlling
  • Punitive
  • Children struggle socially
  • More likely to become Authoritarian parents themselves
  • Associated with INSECURE attachment

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4 MAJOR PARENTING STYLES

  • 2. NEGLECTFUL PARENTS
  • Limited parent role
  • Don’t bother to set house rules
  • Children- May resist rules outside of home
  • Associated with INSECURE attachment

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4 MAJOR PARENTING STYLES

  • 3. PERMISSSIVE PARENTS
  • don’t set many rules for children
  • Prioritize being child’s friend than a parent
  • Children- More entitled
  • Associated with INSECURE attachment

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4 MAJOR PARENTING STYLES

  • 4. AUTHORITATIVE PARENT
  • Parents are more flexible
  • Set clear boundaries
  • Encourage children’s independence within limits
  • More supportive
  • This is associated with SECURE attachment

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INSECURE ATTACHMENT AND MENTAL HEALTH CONDITIONS

  • Insecure attachment increases the risk of mental health conditions:
  • Anxiety
  • Depression
  • Behavioral Problems
  • Eating Disorders
  • Substance Use Disorders

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DEPRESSION IN CHILDREN AND ADOLESCENTS

  • Common in children
  • Can be mild or severe
  • Depression can lead to suicide

  • STATISTICS
  • 1 in 10 teenage deaths in SOUTH AFRICA every year are the result of SUICIDE!
  • Up to 20% of high school learners have tried to take their own lives

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DEPRESSION IN CHILDREN AND ADOLESCENTS

  • Prevention of teen suicide starts with better understanding symptoms of depression (SASOP)
  • Most suicidal people are depressed
  • Depression is globally the third highest disease burden amongst adolescents (WHO)
  • According to WHO suicide is the 2nd leading cause of death in 15-29yrs old

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DEPRESSION IN CHILDREN AND ADOLESCENTS

  • CAUSES OF DEPRESSION
  • Prolonged stress
  • Family history of depression
  • Childhood trauma-Abuse/Violence/Absent Parents/Attachment Issues/Divorce/Loss of loved one

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DEPRESSION IN CHILDREN AND ADOLESCENTS

  • CAUSES OF DEPRESSION
  • SYMPTOMS OF DEPRESSION
  • PRE-PUBERTY/PRIOR TO ADOLESCENTS
  • Irritability/tantrums
  • Behavioral problems
  • Physical complaints
  • Changes from their usual self( Not playing with others, self-isolation, school refusal)
  • NB! Different from how depression present in adults

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DEPRESSION IN CHILDREN AND ADOLESCENTS

  • ADOLESCENTS
  • Persistent sadness
  • Loss of interest in previously enjoyed leisure activities
  • No longer wanting to “hang out” with friends

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DEPRESSION IN CHILDREN AND ADOLESCENTS

  • Avoiding school
  • A drop/decline in their academic performance
  • Behavioral problems-Bullying, running away from home
  • Abusing alcohol and other substances
  • Multiple physical complaints
  • Sleeping too much especially during the day

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ANXIETY IN CHILDREN

  • Anxious children are at risk of developing other mental disorders into adolescents and adulthood
  • Different Types of Anxiety Disorder-Present differently
  • GENERALISED ANXIETY DISORDER
  • Excessive worry
  • Sleeplessness
  • Irritability
  • Physical Symptoms(Muscle tension, tremors etc)
  • Small Children-Nail biting, thumb sucking, bed wetting,nightmares

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ANXIETY IN CHILDREN

  • SEPARATION ANXIETY DISORDER
  • Nightmares about separation
  • Refusal to be separated from caregivers(refusing to go to school/visiting friends)
  • Excessive worry about what will happen to them or caregiver while separated
  • Physical Symptoms(Stomach cramps, headache, vomiting)

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BEHAVIOURAL PROBLEMS IN CHILDREN

  • Constantly involved in fights
  • Refusing to take an instruction from an authority figure
  • Refusing to go to school/Bunking classes
  • Bullying others
  • Cruelty to animals
  • Habitual lying
  • Stealing
  • Self-harming behavior (Cutting their wrist)

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How to improve mother-child relationship

  • Get help for your own childhood trauma
  • Get treatment and therapy if you have any mental illness(e.g. Depression and Anxiety)
  • Avoid stress if possible especially during pregnancy
  • Self care
  • Ask for help if needed
  • Get help for substance abuse
  • Treatment for any physical conditions

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How to improve mother-child relationship

  • Remove children from toxic environment
  • Go for therapy/family therapy
  • Show interest in what you child loves
  • Spend time with your children
  • Know what your children are up to
  • Give every child undivided attention

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EMERGENCY HELPLINES

Department of Social Development Substance Abuse Line 24hr helpline�0800 12 13 14�SMS 32312

Adcock Ingram Depression and Anxiety Helpline�0800 70 80 90

SADAG Mental Health Line�011 234 4837

Suicide Crisis Line�0800 567 567

Cipla 24hr Mental Health Helpline�0800 456 789

Dr Reddy's Help Line�0800 21 22 23

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THANK YOU