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Working Models of Attachment and Reactions to Different Forms of Caregiving. Jeffry A. Simpson University of Minnesota "The past is never dead; it's not even past."  --Gavin Stevens, in William Faulkner's Requiem for a Nun

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Working models of attachment and reactions to different forms of caregiving l.jpg

Working Models of Attachment and Reactions to Different Forms of Caregiving

Jeffry A. Simpson

University of Minnesota

"The past is never dead; it's not even past." 

--Gavin Stevens, in William Faulkner's Requiem for a Nun

Collaborators: Heike Winterheld, Steven Rholes, & Minda Oriña; NIMH grant MH49599

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Overview of the Talk Forms of Caregiving

  • An enigma in the social support literature

  • Attachment theory as a guide to understanding this enigma

  • A study of attachment and responses to different types of caregiving in romantic relationships

  • Conclusions and health implications

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Early Social Support Research Forms of Caregiving

  • Cassel (1976): The presence of others is associated with better health and lower mortality rates in different species.

  • Cobb (1976): Social support conveys to the recipient that s/he is valued and cared for.

  • However, early social support research ignored the impact of relationships and focused mainly on perceptions of available support.

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Recent Social Support Research Forms of Caregiving

  • Greater emphasis on cognitive processes: The qualities of past and present relationships affect the perception and appraisal of support.

  • Greater emphasis on dyadic processes: Expectations of both relationship partners affect how support is perceived and enacted.

  • Both the support provider and the support recipient must be examined when investigating support processes (Rutter, 1987).

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An Enigma Forms of Caregiving

Social support does not always alleviate distress:

Support recipients do not always benefit from or feel better after receiving support, and sometimes they actually feel worse (Taylor, 2007).

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Why Does Support Sometimes Fail? Forms of Caregiving

  • Support givers may be unskilled (Bolger et al., 1996)

  • Receiving support may undermine self-esteem or make care-recipients feel indebted (Bolger et al., 2000)

  • The support received may be the wrong kind delivered at the wrong time or place to the wrong person (Westmaas & Jamner, 2006)

  • Thus, what “works” may depend on which type of support is delivered to which support recipient in which social context (Cohen, 2004)

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Attachment Theory Forms of Caregiving

Bowlby (1969, 1973, 1980):

  • Interactions with caregivers during social development generate internal working models that guide thoughts, emotions, and behavior in later relationships.

  • Working models involve attachment-relevant:

    • Beliefs, attitudes, and expectancies

    • Memories

    • Goals and needs

    • Strategies and plans for achieving goals/needs

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Attachment Theory Forms of Caregiving

  • People develop working models about themselves and others based on their experiences—or perceptions of their experiences—with significant others.

  • 2 Domains:

    - Self: Am I worthy of love/support?

    - Others: Are others willing to provide

    love/support when I need it?

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Attachment and Caregiving Forms of Caregiving

  • Much is known about how attachment working models are associated with the enactment of caregiving behavior (Feeney & Collins, 2001; Kunce & Shaver, 1994)

  • Little is known about how people who have different attachment models respond to different types of caregiving in situations that activate the attachment system.

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Attachment and Caregiving Forms of Caregiving

  • Working models of early experiences with caregivers should dictate the type of care that adults find most comforting, especially when they are distressed (Bowlby, 1973).

  • Early experiences with caregivers in distressing situations convey diagnostic information about an individual’s self-worth and what s/he can expect from future caregivers (George & Solomon, 1999).

  • Thus, perceptions/memories of the type of early care received should govern the type of care that best soothes distressed individuals in adult romantic relationships.

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The Adult Attachment Interview (AAI) Forms of Caregiving

  • The AAI is a semi-structured interview that assesses memories, construals, and recollections of early childhood with parents (ages 5-12).

  • It is scored for discourse properties and violations of norms regarding clear and coherent communication.

  • The degree to which respondents describe their childhoods in a clear, credible, and coherent manner determines placement into 1 of 3 primary categories (secure, dismissive, preoccupied).

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The Adult Attachment Interview (AAI) Forms of Caregiving

  • Greater AAI security predicts: (a) warmer and more sensitive caregiving by mothers toward their children (Crowell & Feldman, 1988; 1991); (b) more collaborative (Roisman et al., 2007) and more secure-base behaviors (Crowell et al., 2002) toward romantic partners; and (c) the provision of more situationally-contingent care/support when romantic partners are upset (Simpson et al., 2002).

  • The AAI should also predict how individuals respond to different types of caregiving from their romantic partners, particularly when individuals are distressed (Bowlby, 1973; George & Solomon, 1999).

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The AAI: Secure Individuals Forms of Caregiving

  • During development, securely attached individuals probably received emotional forms of care and support, especially when they were upset (Ainsworth et al., 1978; Bowlby, 1973).

  • When distressed, secure individuals have learned that they can count on attachment figures for emotional support to reduce and regulate negative affect.

  • Thus, more secure individuals should be more comforted by emotional than instrumental or informational forms of care (Bowlby, 1973).

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The AAI: Dismissive Individuals Forms of Caregiving

  • Insecurely attached (especially dismissive) individuals probably received instrumental/informational forms of care and support during development (Ainsworth et al., 1978; Crittenden & Ainsworth, 1989).

  • They have learned that the best way to mitigate and manage negative affect is to be self-reliant (to self-soothe) or to seek advice about how to solve problems.

  • Receiving emotional care might undermine dismissive individuals’ goal of being independent and autonomous, and it could signal that others are getting “too close.”

  • Thus, more insecure (dismissive) individuals should be more comforted by instrumental/informational than emotional forms of care (Bowlby, 1973).

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The Study Forms of Caregiving

Simpson, Winterheld, Rholes, & Oriña(JPSP, in press): Studying long-term dating couples, we assessed the extent to which: (a) each individual offered emotional, instrumental/informational, and physical forms of caregiving when his/her partner appeared distressed during a conflict resolution task, and (b) how calmed/satisfied the care-recipient appeared following caregiving from his/her partner.

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Hypotheses Forms of Caregiving

1. More secure individuals should be more calmed/satisfied if their partners offer more emotional forms of care (HO1a), particularly if they (care-recipients) are more distressed (HO1b).

2. More insecure (dismissive) individuals should be more calmed/satisfied if their partners offer more instrumental/informational forms of care (HO2a), especially if they (care-recipients) are more distressed (HO2b).

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Sample Forms of Caregiving

  • 93 couples dating for at least 3 months

  • Mean relationship length = 1.48 years (SD = 1.30)

  • Mean ages of men and women = 19.53 and 18.80 years, respectively

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Method: Measuring AAI Security Forms of Caregiving

  • Individuals were classified into AAI subcategories (e.g., DS1, F3, E2)

  • We then calculated a degree of security dimension, where F3=6, F2/F4=5, F1/F5=4, DS3=3, DS1=2, and DS2=1 (Simpson et al., 2002)

  • Note: Given few Es (N=12; 6.45%), we did not include them in the main analyses. When we did, all effects remained the same.

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Method: Questionnaires and Conflict Resolution Task Forms of Caregiving

  • One week after completing the AAI, each couple returned to the lab and each partner completed questionnaires

  • Each couple then engaged in a standard 10 minute videotaped conflict resolution task

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Method: Rating Different Forms of CaregivingForms of Caregiving

  • Different forms of caregiving were rated by observers on 9-point Likert-type scales:

    • Emotional Caregiving: Encouraging the partner to talk about feelings/emotions, being nurturant/soothing, expressing shared emotional intimacy/closeness (α = .92)

    • Instrumental/Informational Caregiving: Offering concrete advice/suggestions, discussing/clarifying a problem or situation in an intellectual/rational manner (α = .84)

    • Physical Caregiving: Leaning toward the partner, providing (or trying to provide) physical contact to console the partner (α = .75)

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Method: Rating Reactions to Caregiving Forms of Caregiving

  • Reactions to caregiving were rated by observers on two 9-point Likert-type scales (r = .89):

    (1) The extent to which the care-recipient appeared calmed by care provision at time points when s/he appeared most distressed during the discussion.

    (2) The extent to which the care-recipient appeared satisfied with the general resolution of the conflict.

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Method: Rating Stress/Anxiety Forms of Caregiving

  • Stress/anxiety was rated by observers on 9-point Likert-type scales (α = .89).

  • Sample items:

    • Stressed

    • Anxious

    • Relaxed (reverse-keyed)

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Descriptive Statistics: Forms of Caregiving

Variable: Women: Men: t(187):

M: SD: M: SD:

AAI Security 4.31 1.84 3.94 2.00 -1.30, ns

Instrumental Care 4.19 1.20 3.91 1.06 -2.23, p< .03

Emotional Care 3.48 .95 3.33 .98 -1.26, ns

Physical Care 4.35 .91 4.53 1.02 1.50, ns

Calming Response 8.54 1.40 9.06 1.23 3.08, p < .01

Stress/Anxiety 25.02 1.73 24.77 1.83 -1.68, ns

Scale Ranges:AAI Security = 1-6; Instrumental/Informational, Emotional, and Physical Care = 1-9; Calming Response = 2-18; Stress/Anxiety =5-45.

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Hypotheses 1a and 1b: AAI Security and Emotional Caregiving Forms of Caregiving

Actor-Partner Interdependence Model (APIM) analyses revealed:

  • More secure individuals reacted better (were rated as more calmed/satisfied) than more insecure individuals if their partners provided more emotional care, b = .03, t(122) = 2.14, p < .04.

  • This pattern was clearer when care-recipients were more distressed (a 3-way interaction), b = .004, t(117) = 2.27, p < .03.

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Hypothesis 1a Forms of Caregiving

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Hypothesis 1b Forms of Caregiving

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Hypotheses 2a and 2b: AAI Security and Instrumental/Informational Caregiving

  • More insecure individuals reacted better (were rated as more calmed/satisfied) if their partners provided more instrumental/ informational care, b = -.07, t(123) = -2.60, p = .01.

  • This pattern was clearer when care-recipients were more distressed, b = -.008, t(117) = -2.29, p < .025.

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Hypothesis 2a Instrumental/Informational Caregiving

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Hypothesis 2b Instrumental/Informational Caregiving

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Discriminant Validity Instrumental/Informational Caregiving

  • All of these effects remained significant when: (1) actor’s self-reported relationship satisfaction, (2) actor’s observer-rated degree of care-seeking, and (3) partner’s AAI security scores were partialed.

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What about Physical Caregiving? Instrumental/Informational Caregiving

  • No effects emerged for physical caregiving.

  • We thought that more dismissive persons might react more negatively to physical forms of caregiving (e.g., touch or attempts at touch by their partners).

  • Why?: The physical setting of the study (having partners sit across a table) may have limited or constrained intimate forms of touch/contact, which dismissive persons find especially aversive.

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What about Romantic Attachment Orientations? Instrumental/Informational Caregiving

  • Romantic attachment orientations also did not predict how individuals reacted to different forms of caregiving.

  • Why?: The AAI taps perceptions/memories of the care individuals received when theywere vulnerable and outcome dependent. Latent (less conscious, more temporally distant) working models may override manifest (more conscious and recent) models when people are upset or are in situations that rekindle attachment-relevant memories (Wilson et al., 2000)

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Connections with Long-Term Health Instrumental/Informational Caregiving

  • Cohen et al. (1985): Greater perceived emotional support buffers college students from depressive symptoms across different types of stressors, whereas instrumental and informational support have more stress-specific buffering effects.

  • Rosengren et al. (1993): Middle-aged men who report more stressful life events in the preceding year have higher mortality risk over the next 7 years. Greater perceived emotional support, however, buffers “high stress” men from premature death.

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Connections with Long-Term Health Instrumental/Informational Caregiving

  • Seeman et al. (1994): In elderly people, having good close relationships predicts better neuroendocrine outcomes (i.e., lower uninary levels of epinephrine and cortisol), especially in men.

    -- For men, the strongest links involve the reported frequency of greater emotional support received from partners; weaker effects exist for the reported frequency of instrumental support.

  • Given attachment differences in preferences for and responses to emotional caregiving, long-term health disparities could exist between secure and insecure adults, particularly men. Dismissive people, however, might benefit more from instrumental support, which may attenuate or complicate attachment-health connections.

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Conclusions Instrumental/Informational Caregiving

  • Secure and insecure persons both benefit from receiving care from their romantic partners in conflict resolution settings.

  • However, the type of care that “works best” for secure and insecure persons is different, at least when one considers initial (first-line)calming responses.

  • These findings might help resolve the puzzle of what constitutes “effective” support.

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Conclusions Instrumental/Informational Caregiving

  • The social support and close relationships literatures need to be better integrated to identify the specific processes through which caregiving in couples is linked to long-term mental and physical health outcomes (Cohen, 2004).

  • Identifying who benefits most—and least—from specific forms of caregiving in which specific contexts could have important implications for how support interventions should be designed in the future.

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THANK YOU Instrumental/Informational Caregiving