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Disorganised Attachment Cause — MRCPsych Paper B MCQ

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HardPsychotherapyDisorganised Attachment CauseMRCPsych Paper B

During the Strange Situation, a 14-month-old infant approaches their caregiver on reunion but then abruptly freezes, averts their gaze and displays contradictory approach–avoidance behaviour. According to Main and Hesse’s “fright without solution” account, which caregiving pattern most specifically explains this disorganised attachment behaviour?

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Correct answer: B — Frightening, frightened or dissociative behaviour from the infant’s attachment figure

Explanation lettering: D = shown as C · E = shown as D · C = shown as E

The correct answer is B. In Main and Hesse’s fright-without-solution formulation, the caregiver is simultaneously the infant’s attachment figure and a source of alarm. Frightening, visibly frightened or dissociative behaviour therefore creates an irresolvable approach–avoidance conflict, producing contradictory, interrupted or disoriented attachment behaviours. This is an attachment classification, not an attachment disorder diagnosis. Consistently sensitive care supports secure attachment (A). Inconsistent availability is classically associated with resistant/ambivalent attachment, although it may also be a broader risk factor for disorganisation (C). Persistent rejection favours avoidant attachment (D). Intrusive overprotection may restrict exploration but does not specifically produce the fright-without-solution mechanism (E).

Reference: Hesse E, Main M. Frightened, threatening, and dissociative parental behavior in low-risk samples: description, discussion, and interpretations. Development and Psychopathology. 2006;18(2):309–343. https://pubmed.ncbi.nlm.nih.gov/16600057/