Ambivalent attachment — MRCPsych Paper A MCQ

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ModeratePsychologyAmbivalent attachmentMRCPsych Paper A

During the Strange Situation, a 14-month-old infant becomes intensely distressed when separated from their caregiver. On reunion, the infant approaches and clings to the caregiver but also angrily pushes them away and remains difficult to soothe. This pattern is consistent across reunion episodes, without freezing, fearful approach or disorientation. Which attachment classification best describes this behaviour?

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Correct answer: E — Ambivalent attachment

Ambivalent attachment, also termed insecure-resistant attachment, is characterised by intense separation distress, high-amplitude proximity-seeking and difficulty being soothed after reunion. The infant may seek contact while simultaneously resisting it, as described here. Securely attached infants seek comfort but settle relatively quickly and resume exploration. Avoidantly attached infants minimise overt attachment signalling and tend not to seek substantial comfort on reunion. Disorganised attachment involves a breakdown of a coherent strategy, with behaviours such as freezing, apprehensive approach, confusion or disorientation; these are specifically absent. Reactive attachment disorder is a clinical disorder associated with markedly insufficient care and predominantly withdrawn behaviour, including failure to seek or respond to comfort, rather than this organised insecure attachment pattern.

Reference: British Psychological Society, Incorporating Attachment Theory into Practice: Clinical Practice Guideline, section 2.1 'Overview of attachment theory', 2017. https://www.rcpsych.ac.uk/docs/default-source/members/faculties/intellectual-disability/bps-attachment-guidelines.pdf?sfvrsn=a83ef76b_2