Secure Attachment — MRCPsych Paper B MCQ

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EasyPsychotherapySecure AttachmentMRCPsych Paper B

An 18-month-old child is observed during the Strange Situation Procedure. She becomes distressed when her mother leaves. On reunion, she actively seeks contact, is quickly comforted and then resumes exploration while using her mother as a secure base. Which attachment pattern is demonstrated?

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Correct answer: A — Secure (Type B)

This is secure attachment (Type B). The discriminating features are active comfort-seeking on reunion, effective soothing by the caregiver and a prompt return to exploration using the caregiver as a secure base. Separation distress can occur in secure attachment; it is the organised and effective reunion response that is most informative. In avoidant attachment, the child tends to minimise attachment behaviour and avoid or ignore the caregiver on reunion. A resistant/ambivalent child seeks proximity but remains distressed, angry or resistant and is not readily soothed. Disorganised attachment involves contradictory, apprehensive, freezing or otherwise disoriented behaviour without a coherent strategy. The behaviour is sufficiently characteristic that an unspecified classification is unnecessary.

Reference: National Institute for Health and Care Excellence. Children's attachment: attachment in children and young people who are adopted from care, in care or at high risk of going into care. NICE guideline NG26, section 2.3, Types of attachment patterns, 2015. https://www.nice.org.uk/guidance/ng26/evidence/full-guideline-pdf-78486774807