Can behaviour during immunisation be used to identify attachment patterns? A feasibility study

Background - Infant attachment is a strong predictor of mental health, and current measures involve placing children into a stressful situation in order to observe how the child uses their primary caregiver to assuage their distress.Objectives - This study aimed to explore observational correlates of attachment patterns during immunisation.Participants and setting - 18 parent–child pairs were included in the study. They were all recruited through a single general medical practice.Methods - Infant immunisation videos were observed and coded for parenting behaviours as well as pain promoting and pain reducing strategies. Results were compared between different attachment groups, as measured with the Manchester Child Attachment Story Task.Results - Parents of securely attached children scored higher on positive Mellow Parenting Observational System behaviours, but not at a statistically significant level. Parents of securely attached children were also significantly more likely to engage in pain reducing behaviours (p < 0.01) than parents of insecurely attached children.Conclusions - Robust composite measures for attachment informative behaviours in the immunisation situation should be developed and tested in a fully powered study.