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Running head: DISORGANIZED ATTACHMENT IN INFANTS OF ADOLESCENT MOTHERS
DISORGANIZED ATTACHMENT RELATIONSHIPS IN INFANTS OF ADOLESCENT MOTHERS AND FACTORS THAT MAY AUGMENT POSITIVE OUTCOMES
Melissa Slomski Long
Abstract
Early parenting experiences and child outcomes of adolescent mothers depend greatly on the mother’s intellect, personal adaptability, and cognitive readiness. A plethora of research indicates that parenting adolescent females experience higher rates of depression and stress, attain fewer years of formal education, lack employment skills, live in higher rates of poverty, and tend to their children’s needs inconsistently and less effectively compared to older mothers; these issues are indicative of poor child outcomes. A high percentage of adolescent girls engage in disorganized attachment relationships with their children. This paper will focus on disorganized attachment in infants of adolescent mothers, and will include factors that may assist adolescents and their infants to achieve more positive outcomes.
Introduction
Knowledge in the field of human development is rapidly changing as more research is cultivated and new theories are generated (Lerner, 2002). Because new knowledge is continually being advanced, it is imperative for psychologists to realize that information considered to be accurate is changeable upon the gathering of new information pertinent to the field (Lerner, 2002). According to Madigan, Moran, and Pederson (2006), there has been little information collected on the attachment of infants with adolescent mothers.
Progressively more and more women in the United States and Europe postpone childbearing until their later years (Hamilton, Ventura, Martin, & Sutton, 2005). Although many women delay giving birth, the United States continues to have the highest percentage of teen births, ages 15 to 19, in comparison to other developed countries (Hamilton, Ventura, Martin, & Sutton, 2005; Centers for Disease Control and Prevention, 2000). Further research is necessary in order to enhance outcomes of children born to adolescent mothers.
Parenting in Adolescence
Many challenges exist for adolescent females and their children due to the age and developmental period of the mothers (Easterbrooks, Chaudhuri, & Gestdottir, 2005). It is essential to consider the intelligence, adjustment, and cognitive ability of young mothers when predicting early parenting practices and future child outcomes (Whitman, Borkowski, Keogh, & Weed, 2001). These three factors are sound predictor variables when considering appropriate infant development and success of the child. According to Bornstein and Putnick (2007), the psychosocial effects of mothers bearing children in adolescence are well established. Younger mothers are less knowledgeable about parenting as well as the developmental milestones of children; they are also less confidant in their parenting abilities and express less desirable childrearing attitudes compared to older mothers (Bornstein and Putnick, 2007). Adolescent mothers have more limited educational and employment skills, lack financial resources, endure high stress, and encounter more family discord compared to mature mothers (Letourneau, Stewart, & Barnfather, 2004).
Adverse psychological, social, and health consequences have been associated with adolescent pregnancy and parenting such as pregnancy-induced hypertension, preterm labor and delivery(Sieger & Renk, 2007). Adolescent mothers have more risk factors, therefore it is more difficult for them to engage in a mature, sensitive, and emotionally available manner with their children (Easterbrooks, Chaudhuri, & Gestdottir, 2005). All of these issues can affect outcomes of the infants of adolescent mothers.
Emotional availability in parenting is linked with the development of self-regulation in infants. According to Cole, Martin, and Dennis (2004), emotional regulation is imperative for infants to acquire; emotional regulation dictates how and why emotions manage or facilitate other psychological processes, including engaging in relationships, focusing attention, and problem solving. The ability for the infant to manage his or her emotions in different situations is a developmental task for early childhood.
Birkeland, Thompson, and Phares (2005) established that the first year postpartum is a challenging period of time for adolescent mothers, as they are actively coping with distinctive personal and social changes. Adolescent girls, regardless of whether or not they are pregnant and/or parenting, most often are sensitive about their body image and physical characteristics and are susceptible to the thin-ideal espoused in Western cultures. To study body images of pregnant and parenting adolescent females, Birkeland, Thompson, and Phares (2005) assessed the attitudes and feelings young mothers in seven teen parent programs in the greater Tampa Bay and St. Paul-Minneapolis areas. The Edinburgh Postnatal Depression Scale (EPDS), Parenting Stress Index-Third Edition, and Eating Disorder Inventory: Body Dissatisfaction and Drive for Thinness Subscales were utilized to examine the relation among depression, role restriction, social isolation, maternal self-efficacy, and weight/shape disturbance in young mothers. These issues were found to predict adolescent mothers’ depressive symptoms. Twenty-nine percent of the adolescents in the sample were found to have clinical levels of depressive symptoms.
According to research completed by Moore and Florsheim, (2001) and Sieger and Renk, (2007), pregnant and parenting adolescents may not experience notably greater rates of behavior problems than adolescents who have not parented. Sieger and Renk (2007) found that pregnant and parenting adolescent mothers largely reported nonclinical levels of behavior problems in the Youth Self-Report, and did not differ in the ratings for the variables in this study (ie. age, ethnicity, income, ethnic identity, internalizing problems, externalizing problems, self-esteem, and social support). The researchers assessed social support by utilizing the Multidimensional Scale of Perceived Social Support (MSPSS). The assessment indicated that social support is an important protective factor of pregnant and parenting adolescent females.
Attachment Theory
The notion that there is a tendency for humans to build strong affectional bonds with other people is the cornerstone of the attachment theory as defined by John Bowlby (Corsini, 2002). Attachment is the primary and stable relationship that forms between an infant and the primary caregiver during the first 12 months of a child’s life (Corsini, 2002). It is customary that infants develop strategies to assist them in dealing with discomfort and stress. The Strange Situation is an experimental practice utilized for the assessment of attachment behavior during the first twenty-four months of a child’s life (Corsini, 2002). This procedure includes a number of instances in which a child is with the mother, then left with a stranger, then left alone, and then reunited with the stranger and mother. The child’s reactions are noted during the different stages and the nature of a child’s attachment to a caregiver is determined (Corsini, 2002).
In this experiment, the infants that respond to the mother’s arrival by showing an aspiration for proximity, contact, or a desire for interaction, and are then able to resume exploration of the environment are labeled as having a secure attachment relationship to their mothers (Bailey, Moran, Pederson, & Bento, 2007). Infants classified as avoidant show little to no desire for proximity or interaction with their mothers upon their return to the room. Hesitant behaviors are often displayed by infants classified with a resistant attachment strategy. Infants who exhibit depressed behaviors in front of their caregiver (e.g. behaviors such as freezing or huddling on the floor) and do not maintain an organized strategy for coping in this situation are classified as having a disorganized/disoriented attachment with the mother (Bailey et al., 2007).
Disorganized Attachment
According to Main and Hesse (1990) disorganized attachment develops in relationships where a caregiver frightens the infant, either by engaging in maltreatment, abuse, fear-provoking, fearful, and/or disoriented behaviors. The caregiver becomes the source of the child’s panic or fright as well as his or her comfort in a disorganized attachment. When the infant is not comforted by the primary caregiver consistently, and is often afraid and confused, this ambiguity contributes to the infant’s inability to feel safe and secure. Infants in disorganized attachments with their primary caregiver have difficulty developing necessary strategies to cope with stressful situations.
In the Strange Situation, disorganized attachment is characterized by inappropriate responses given by the infant such as freezing and rocking when the mother comes back into the room; these behaviors indicate a lack of appropriate coping mechanisms (Main & Solomon, 1990). Main and Hesse (1990) as well as Main and Solomon (1990) found links between mothers engaging in frightening behaviors when parenting and unresolved traumas or losses in the attachment figure. Contradictory behaviors such as extreme attachment behavior followed by a freezing behavior or bewilderment are indicative of an infant with disorganized attachment (Madigan, Moran, & Pederson, 2006). These responses show the infant’s inability to utilize a consistent and organized way to manage stressors (Madigan, Moran, & Pederson, 2006). The infant most often will show visible signs of distress, anger, or interrupted movements, as well as avoid or act in an uneasy manner around the caregiver (e.g. hunch his or her shoulders and/or make fearful facial expressions) (Madigan, Moran, & Pederson, 2006).
Moran, Forbes, Evans, Tarabulsy, and Madigan (2008) confirmed the hypothesis of the extant theory to explain that the differences in attachment are chiefly determined by the primary caregiver’s sensitivity, and disorganization manifests in atypical interactions that frighten the infant. Converse to theoretical models, Moran et al. (2008) found that maternal sensitivity observed at the home predicts attachment security, and atypical maternal behavior in the laboratory adds to maternal sensitivity’s prediction of the attachment relationship. Also, the consideration of maternal sensitivity in the home enhances the prediction of disorganization by atypical maternal behavior. Disorganized attachment is a key risk factor in the development of psychopathology and later coping difficulties (Carlson, 1998; Lyons-Ruth, 1996; van IJzendoorn, Schuengel, & Bakermans-Kranenburg, 1999).
Disorganized Attachment in Infants of Adolescent Mothers
Madigan, Moran, and Pederson (2006) in the study titled “Unresolved States of Mind, Disorganized Attachment Relationships, and Disrupted Interactions of Adolescent Mothers and Their Infants” examined the links among unresolved maternal attachment status, disrupted maternal interaction in natural play situations, and disorganized attachment relationships in 82 adolescent mother-infant pairs. The interactive behavior of adolescent mothers (under age 20) was studied with their infants who were physically healthy, born full-term, and without complications. Expectant mothers with an average age of 18.4 with 11.0 years of education, and an average household income of $10,000 to $19,999 were recruited in the hospital after giving birth. The sample consisted of 81% Caucasian females, five Native American, five Middle Eastern, four Latin American, one Caribbean, and one Asian. Of the females in the sample, 57% were single, 28% were living in common-law relationships, and 15% were not married.
The Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) was utilized to measure actions exposing the mothers’ lack of skills in repairing disrupted interactions with their infants, and the mothers’ disposition to recurrently exhibit these insensitive behaviors (Madigan, Moran, & Pederson, 2006). AMBIANCE is a coding method that includes a more complete spectrum of disrupted maternal behaviors compared to the original measure developed in 1992 by Main and Hesse (Madigan, Moran, & Pederson, 2006). AMBIANCE was initially developed with an at-risk sample in which the participants had an assortment of demographic risks and family difficulties to assess a range of poor maternal interactions (Madigan, Moran, & Pederson, 2006). The AMBIANCE measure was fitting to utilize in this study of adolescent mothers and their infants; both the original sample as well as this one were considered to be of high-risk (Madigan, Moran, & Pederson, 2006). Particular patterns of disrupted interaction in disorganized relationships and unresolved states of mind of the mothers were examined in this study (Madigan, Moran, & Pederson, 2006).
Madigan, Moran, and Pederson (2006) had the mothers assigned to either the control or intervention group. Each mother-infant pair in the intervention group was assessed eight times at their home, at the 6th and 12th month of the infant’s life. These visits were videotaped in an attempt to affirm the mother’s parenting strengths, support her sensitivity to the infant, and raise understanding of how exchanges with the child influence his or her behavior. After these sessions the tapes were reviewed with the mothers and the research assistants.
The AAI (Adult Attachment Interview) is a two-hour semi-structured interview including questions examining the mother’s past experiences with her primary attachment figure, early experiences of emotional and physical problems, physical and/or sexual abuse, as well as the deaths of loved ones. After the gathered information was coded according to AAI standards, the mothers were assigned to one of the following primary attachment categories: autonomous, dismissing, preoccupied, or unresolved. The mothers classified as preoccupied were also categorized as unresolved. Thirty-nine percent of the mothers were categorized as dismissing, 29% as autonomous, and 35% as unresolved. Of the mothers classified as unresolved, 55% were labeled as unresolved/dismissing, 7% as unresolved/autonomous, and 38% as unresolved/preoccupied.
Mothers who responded to questions in the AAI about their childhood in a consistent, relevant, and coherent manner were labeled autonomous (Bailey et al., 2007). Those who idealized their childhood experiences, although they had difficultly providing examples to support their positive experiences and sometimes contradicted their statements, were labeled as dismissing. Mothers who most often expressed confusion, passivity, anger, and distress when talking about their attachment figures were classified as preoccupied. Those who exhibited lapses in monitoring of reasoning, or discourse during discussions of abuse or loss were classified as unresolved (Bailey et al., 2007).
The Strange Situation procedure was also facilitated when the children were 12 months of age. Two three-minute sessions were conducted; the first session did not utilize toys, and the second utilized a standard set of toys. At this time the attachment of the child was determined secure, avoidant, resistant, or disorganized. In this study, 9% of the infants were classified as avoidant, 33% as secure, and 59% as disorganized. Infants classified as resistant were also classified as disorganized. Of the infants characterized as disorganized, 44% were disorganized/avoidant, 35% were disorganized/secure, and 31% were classified as disorganized/resistant. Twenty-six percent of mothers and their infants had autonomous states of mind, and 33% had secure attachments. Thirty-five percent displayed unresolved states of mind, and 59% displayed disorganized attachment relationships.
This study advanced the understanding of the connection between maternal representations of attachment and the development of disorganized attachment in infants with adolescent mothers. Mother-infant dyads were assessed not only in the Strange Situation, but also in analyzed unscripted play situations. The results of this study are significant; for the first time observations were made from applications of the AMBIANCE measure of mother-infant interaction outside of the Strange Situation (Madigan, Moran, & Pederson, 2006).
This study indicates that adolescent mothers participating in disorganized relationships with their infants are more likely to display interactive behavior distinguished by affective communication errors, role/boundary uncertainty, fearful/disoriented behavior and intrusive/negative behavior compared to those mothers in organized relationships (Madigan, Moran, & Pederson, 2006). Madigan, Moran, and Pederson (2006) indicate that mothers in disorganized relationships displaying an unresolved state of mind with regard to their attachment tended to interact in a disrupted manner with their infants in the scripted Strange Situation as well as in brief non-structured play. Mothers who showed higher levels of affective communication errors also showed high levels of confusion regarding roles and boundaries, fearful/disoriented behavior, intrusive/negative behavior, as well as withdrawal in interaction (Madigan, Moran, & Pederson, 2006). Converse to current theory, Madigan, Moran, and Pederson (2006) found that atypical maternal behavior and maternal sensitivity were both independent predictors of attachment disorganization and security.
There were many limitations to Madigan, Moran, and Pederson’s (2006) study; although ethnicities of the participants were listed, the study did not state the town, city, or state in which it was conducted. This information would be helpful to know when generalizing the results to other groups of adolescent girls. Also, self-reports from other family members or individuals involved with the mother and the infant would have provided supplementary information in order to paint a clearer picture of the mother’s interactions with her child in addition to the in-home observations and the Strange Situation study facilitated by researchers. Further research about the origins of disorganization is necessary in order to fully understand this attachment system, and to better support young mothers and infants at developmental risk (Madigan, Moran & Pederson, 2006).
In the study titled “Understanding the transmission of attachment using variable- and relationship-centered approaches” Bailey et al. (2007) considered attachment transition through an assessment of interactions of adolescent mothers and their infants at home. This longitudinal study was conducted by the Child Development Center at the University of Western Ontario, and included 99 adolescent mothers and their 12-month-old infants. The mothers were recruited during their postpartum stay in London, Ontario. The participants were less than 20 years of age and had a normal delivery, with infants born at full-term birth and no medical complications.
The sample consisted of 81% Caucasian females, five Native American, five Middle Eastern, four Latin American, one Caribbean, and one Asian woman. Of the sample, 57% of the women were single and never married, 28% were living and common law, and 15% were married. The mean age of the mothers at the time they gave birth was 18.42 with a range from 15.97 to 19.98 years. There were two annual personal incomes, between $5,000 and $9,999 and between $10,000 and $19,999.
The AAI was administered when infants were six months of age. Two researchers visited the mother-infant dyad in their homes and conducted a two-hour semi-structured home visit when the infants were twelve months of age. The goal of this home visit was to complete assessment materials, to lessen observer effects, and to generate a busy period of activity in which the mother’s attention was divided between tending to her infant and carrying out other assignments for the researchers. The mothers also answered questions about demographics, their infant’s health, and developmental history. Researchers assessed the infants’ cognitive development after this interview was completed and while the mothers finished a number of questionnaires. In 46 of the 98 cases the mother’s AAI corresponded with the attachment relationship found in the Strange Situation conducted at a later time in the study.
Another part of the study entailed the researchers videotaping five minutes of mother-infant interaction in the home. Infants played freely when they were not being assessed; this factor placed higher demands on the mothers whose attention was divided between monitoring and responding to their infants while completing the assessment materials. Researchers observed infant and maternal interactions focusing on infant secure base behavior, attention-seeking behavior, fussiness, resistance toward the mother and to maternal availability, monitoring, and the mother’s responsiveness to these signals.
Following the two-hour home observation, the MBQS (Maternal Behavior Q-Sort) and the AQS (Attachment Q-set) were completed by the researchers. The MBQS is a 90-item instrument utilized for measuring the quality of maternal behaviors during mother-infant interactions in the home. The assessment took place when the infant was eight months old. To administer the MBQS, observers choose which items are most like and unlike the behaviors of the mother. The AQS is utilized to attain attachment security and dependence scores from both mothers and observers, and was administered to the mothers when the infants were six months of age. The mothers were also prompted to explain how their past experiences may have affected their personalities.
Each mother-infant dyad also participated in the Strange Situation procedure on a different day following the home visit. The infants were categorized into four attachment relationships: secure, avoidant, resistant, and disorganized/disoriented. Those classified as disorganized/disoriented were also assigned to a category of either secure, avoidant, or resistant classification. According to Bailey et al. (2007), this secondary classification is thought to reveal an attachment strategy that breaks down in stressful situations. The Strange Situation classifications found in this sample were very different compared to another standard community group.
The study indicated that infants and mothers can be consistently described according to patterns of early on interactive behavior. Of the sample, 34 infants were classified as having a secure attachment, 7 had an avoidant relationship, and 58 of the relationships were categorized as disorganized. Forty-eight mothers were coded as sensitive were 48 mothers, 38 disengaged, 7 nonsynchronous, and 5 insensitive. Mothers who responded appropriately to the child’s cues and did not engage in a rejecting or disconnected manner were coded as sensitive. A disengaged maternal pattern was seen as mothers most often not noticing their infants’ signals and rarely initiating interactions with them, suggesting that the mothers did not have an ongoing social or emotional relationship with the infant, aside from providing their basic needs. Nonsynchronous mothers interacted often with their infants, but the mother’s behavior tended to be in accordance with her own needs or plans rather than acting in response to her infant’s needs. Forty-two infants in the study were coded as harmonious, 37 preferred visitors, and 14 were labeled as sad/withdrawn.
Bailey et al. (2007) increased the knowledge base of the relationship between maternal representations of attachment, mother-infant interactions in the home, and the early attachment relationship in the transmission of attachment across a generation. This study provides insight into the interaction of these factors in the development of disorganized attachment and into the nature of the disorganized attachment relationship. Bailey et al. (2007) indicate that there are links between mothers displaying disconnected interactions, the tendency for infants to approach the researcher and engage in friendly interactions while displaying little desire for interaction with their mother, unsettled maternal representations, and disorganized attachment relationships. In turn, infants with secure/autonomous attachment were likely to demonstrate physical affection and secure base behavior toward their mothers; these infants were less likely to engage with the visitor.
It would have been advantageous in this study to also have a friend, family member, or a childcare provider of the mother complete an assessment to share their observations of the mother with her child. This type of assessment would provide the researchers another source of information. Although the study provides important new information pertinent to the field, the research was conducted in Canada and not in the United States; other cultural factors could have played a role.
Factors to Enhance Positive Outcomes
Although much research indicates that adolescent parenting females undergo major life changes and have to deal with many stressors including the likelihood that they will reside in poor conditions, encounter family volatility, as well as lack adequate financial resources, educational skills, and opportunities, these young parents can be successful. The study referenced by Bailey et al. (2007) suggests that there are considerable differences in the attachment patterns and processes in higher risk samples compared to lower risk community-based samples. It is imperative to reach out to teen parents and to provide appropriate services to assist them, as the United States continues to have the highest number of teen parents. The children of adolescent parents will make up a large part of society in future years.
Easterbrooks, Chaudhuri, and Gesdottir (2005) point out the necessity for professionals to realize that not all young mothers are the same and that it is vital to support the individual needs of each young mother. Easterbrooks, Chaudhuri, and Gesdottir (2005) endorse the idea that young mothers have needs and desires that span both developmental periods, adolescence and adulthood; this information may help in prevention and intervention efforts to encourage healthy adjustment for young mothers and their children. For example, it is important to have an understanding of whether the mother lives alone or with other family members who may be helping with the care of the child, as well as to know how the mother is completing her educational and employment goals and developing as a parent; this knowledge may be key in fitting together the best support systems to promote her personal well-being as well as her parenting (Easterbrooks, Chaudhuri, & Gesdottir, 2005). It is also essential to learn about the mother’s current life situation as well as her history; this information may advance the development of specific interventions tailoring to young mothers and their infants within particular life situations or contexts (Easterbrooks, Chaudhuri, & Gesdottir, 2005). Understanding the needs, strengths, and weaknesses of each young mother may help to facilitate better interventions; Easterbrooks, Dhaudhuri, and Gesdottir (2005) explain that many interventions for parenting adolescents may not have been successful because young mothers were considered one homogeneous group.
Birkeland, Thompson, and Phares (2005) note the necessity for future research to examine body image dissatisfaction and eating disturbance in pregnant and parenting adolescent females. Future research should establish what variables protect these adolescents from experiencing clinical levels of depression (Birkeland, Thompson, & Phares, 2005). One possibility for prevention may be to facilitate body image programs regarding body-related changes and concerns that most often take place in the early months of postpartum. These could take place at community centers by Cooperative Extension agents working for Land Grant Universities, be implemented by local non-profits or governmental agencies, and incorporated into already standing adolescent pregnant/parenting programs. Also, social workers at hospitals could discuss body image concerns with new mothers in the days after delivery and offer some supplemental material and point them toward other resources in the community. Many adolescents have great difficulty dealing with the notion that their bodies are changing when they are pregnant and they cannot fit into the same smaller size clothing. Oftentimes, as mothers, these females are angry if their bodies do not resort back to how their bodies were prior to pregnancy. A program specifically designed to deal with body-image during and after pregnancy would be of great help to address these concerns.
According to Maughan, Cicchetti, Toth, and Rogosch (2007), it is also important when working with pregnant and/or parenting adolescent females and their children to consider how socioemotional problems are disseminated from depressed mothers to their infants. Preventative interventions should work to improve emotional competence in mothers suffering from depression as well as to prevent the development of socioemotional maladjustment in their children (Maughan et al., 2007). One way to decrease the number of disorganized attachment relationships in adolescent mother-infant dyads is to focus interventions aimed at increasing maternal sensitivity. This should be accomplished by exploring the specific nature of the emotional and psychological symptoms associated with the trauma the mothers have experienced (Moran, Pederson, and Krupka, 2005).
It is important to understand the trauma history of the mother in order to create approaches that are successful in eliminating the obstacle as well as enhancing positive mother-infant interactions and the development of an organized attachment relationship. This type of programming is helpful in that it allows and encourages the adolescents to work through their issues; it also assists them in putting into perspective how their behaviors can affect their children.
Sieger and Renk (2007) found that social support is an important protective factor of adolescent pregnant and parenting females. Family therapy or meetings should be suggested to assist in helping the adolescent female build positive relationships with family members. Sieger and Renk (2007) attribute the nonclinical degree of behavior problems reported by the pregnant and parenting adolescents to the high levels of social support reported in the MSPSS. Letourneau, Stewart, and Barnfather (2004) advocate that adolescent parents need support to appropriately be able to cope with maternal mental health problems, engage in quality interactions with their children, and take care of their childrens’ health and developmental needs. Typical supports for adolescents are family members, partners, friends, as well as professionals in some instances. Interventions that foster a healthy parental relationship are imperative (Letourneau, Stewart, & Barnfather, 2004). Research should be conducted to create appropriate interventions to enhance the support networks of adolescents (Letourneau, Stewart, & Barnfather, 2004).
Hitchcock, Ammen, O’Connor, and Backman (2008) suggest that therapists working with teen parents should utilize the Marschak Interaction Method Rating Scale (MMRS) to assess the parent-child relationship. The MMRS is a new observational scoring system for the play-based Marschak Interaction Method that gives specific examples of how the parent-child system is operating in five domains: structuring, challenging, engaging, nurturing, and separation-reunion. Fifteen critical items are also included for the observer to note behaviors indicative of potentially harmful behaviors such as child abuse. This MMRS assesses the caregiver’s response to and encouragement of a healthy relationship with the child, as well as the overall quality of the relationship.
Conclusion
Disorganized attachment in infants of adolescent mothers is an important topic as the United States continues to have the highest number of teen births per year. It is imperative to further research and develop effective intervention strategies which will enhance the outcome of children born to adolescent mothers. These mothers have additional risk factors and stressors compared to older mothers. Numerous research studies indicate that parenting adolescent females experience a high rate of depression, lack educational and employment skills, more often live in poverty, and tend to their children’s needs inconsistently and less effectively compared to older mothers; these stressors increase the potential of disorganized attachment and ultimately poor child outcomes. This paper has included pertinent research studies on adolescent parenting and disorganized attachment as well as given suggestions for intervention and treatment programming to assist pregnant and parenting mothers and their infants in achieving more positive outcomes.
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