CAMHS

Question 1

How many stages of attachment are there?

Answer 1

4 stages

• Association stage
• Stage of indiscriminate attachment
• Stage of specific attachments
• Stage of multiple attachments

Question 2

What age range is the indiscriminate attachment age?

Answer 2

6weeks- 6/7 months

Question 3

What age range is association stage?

Answer 3

0-6 weeks

Question 4

What age range is multiple attachment stage?

Answer 4

~ 8 months

Question 5

What age range is specific attachments stage?

Answer 5

~ 7 months

Question 6

What is the association stage?

Answer 6

Social and non-social stimuli will produce favourable response

Question 7

What is specific attachment stage?

Answer 7

Protest only when separated from primary caregivers. Fear strangers

Question 8

What is indiscriminate attachment stage?

Answer 8

Infants enjoy human company but tend to be indiscriminate

Question 9

Stage of multiple attachments?

Answer 9

Attached to many people

Question 10

Categories of attachment?

Answer 10

2 categories one with 2 sub categories

• Secure attachment
• Anxious/insecure attachment:
  - Avoidant
  - Ambivalent
• Disorganized

Question 11

What is secure attachment and percentage of children who have it?

Answer 11

-Confident baby, rarely cries, readily explores (70%)

Question 12

What is anxious attachment: avoidant and the percentage of babies which have it?

Answer 12

-Avoidant (20%)

Avoids/ignores parent and strangers

Question 13

What is anxious attachment: ambivalent and percentage of babies which have it?

Answer 13

10%

Ambivalent in the presence of parent but wary of strangers

Question 14

Test responses of secure attachment?

Answer 14

• Distressed when mother leaves
• Avoidant of stranger when alone but friendly when mother present
• Positive and happy when mother returns
• Will use mother as a safe base to explore their environment

Question 15

Test responses of ambivalent attachment?

Answer 15

• Infant shows signs of distress when mother leaves
• Infant avoids stranger: shows fear of stranger
• Child approaches mother but resists contact, may even push her away
• Infant cries more and explores less than other 2 types

Question 16

Avoidant attachment responses in test ?

Answer 16

• Infant shows no sign of distress when mother leaves
• Infant is okay with stranger and plays normally when stranger present
• Infant shows little interest when mother returns
• Mother and stranger able to comfort infant equally

Question 17

Characteristics of Type A Insecure avoidant?

Answer 17

• Avoid intimacy, dependence, disclosure
• Hard to engage
• View relationships as unimportant
• Don’t feel huge need for people
• Seen as cold- reported as lacking empathy/remorse
• Indifferent to other’s views: assume others dislike them
• Linked with higher incidence of somatising illness and hard drug use

Question 18

Characteristics of Insecure ambivalent Type C?

Answer 18

• View of self = low value, ineffective, independent
• View of others: insensitive, unpredictable, unreliable
• Disruptive ‘attention seeking’, difficult to manage
• Insecure and coercive
• Can alternate between friendly charm and hostile aggression
• Display antisocial behaviour, impulsivity, poor concentration
• Feel a growing sense of unfairness and injustice- lots of complaining
• Dysregulated emotions

Question 19

Behavioural symptoms of disordered attachment?

Answer 19

	Lack of self-control/impulsiveness 
	Lack of normal fear 
	Self-destructive behaviours 
	Destruction of property 
	Aggression 
	Constantly irresponsible 
	Inappropriately demanding or clingy or has a pseudo maturity 
	Stealing 
	Lying/deceit 
	Hoarding 
	Inappropriate sexual behaviour 
	Cruelty to animals 
	Sleep disturbance 
	Abnormal eating habits (hordes/gorges/refusal to eat/hides food)
	Enuresis and encopresis 
	Hyperactivity 
	Preoccupation with fire or gore 
	Persistent nonsense questions/incessant chatter 
	Poor hygiene 
	Difficulties with change 
	Difficulties with emotional change

Question 20

Cognitive functioning symptoms of disordered attachment?

Answer 20

o	Lack of cause and effect thinking 
o	Learning disorders 
o	Language disorders 
o	Distorted self-image 
o	Grandiose self of sense importance 
o	‘Black and white’ and ‘All or nothing’ thinking styles

Question 21

Emotional symptoms of disordered attachment?

Answer 21

	Core emotions are intense, feelings of anger, fear, pain, and shame 
	Often appear disheartened and depressed with mood swings 
	Struggle to express emotions 
	Lack of affection 
	Intense displays of rage 
	Sadness, depression, helplessness 
	Inappropriate expressions of emotions 
	Mood swings 
	Low self esteem

Question 22

Social symptoms of disorganized attachment?

Answer 22

o Superficially engaging lacks genuine trust, intimacy, and affection
o Lack of eye contact for closeness
o Lack of per relationships
o Indiscriminately affectionate with strangers
o Cannot tolerate limits and external control
o Blames others for mistakes
o Victimises others
o Victimised by others
o Lacks trust in others
o Exploitative, bossy

Question 23

Physical aspects of disordered attachment?

Answer 23

	Poor hygiene 
	Chronic body tension 
	Accident prone 
	High pain tolerance/ over reaction to minor injury 
	Tactilely defensive

Question 24

Signs of RAD?

Answer 24

• Noticeable neglectful behaviour from primary caregiver: not comforting baby/child in distress or not responding to needs like hunger etc
• Inappropriate interaction noticed between baby and primary caregiver
• Lack of smiling or responsiveness in baby or child
• Lack of distress in situations which should be expected to cause distress
• Inconsolable crying
• Indiscriminate excessive friendliness towards healthcare workers
• Emotional and behavioural difficulties

Question 25

Presentation of conductive disorder?

Answer 25

• Aggression to people or animals
• Destruction of property
• Deceitfulness or theft
• Serious violation of rules
• Aggression:
   Threatens/bullies or intimidates others
   Often initiates fights
   Physical weapon use
   Physically cruel
   Stolen
   Forced someone into sexual activity
• Destruction of property