Understanding Maternal Mentalizing Capacity and Attachment Representations of Children with Reactive Attachment Disorder: Two Case Illustrations

Deprivation and neglect during the early care of a child is known to possibly lead to the development of reactive attachment disorder (RAD). However, subtler influences within the relationship between mother and child have been less explored and defined. This article discusses the relevance of understanding the relationship between the mother's mentalizing capacity and the child's attachment representations. Two mother-child dyads of school-age children with RAD inhibited and disinhibited types are used to describe the children's attachment representations and the mothers' capacity to mentalize. The 2 cases were drawn from a larger study at the Université de Sherbrooke in collaboration with the Child Psychiatry Department of a general hospital in the Montreal metropolitan area. The mothers' capacity to mentalize and the children's attachment representations were analyzed using quantitative and qualitative data. The children's attachment representations were assessed using the Attachment Focused Coding System (Reiner & Splaun, 2008), as applied to the Attachment Story Completion Task (Bretherton, Ridgeway, & Cassidy, 1990). The mothers' capacity to mentalize was measured by the Addendum to Reflective Functioning Scoring Manual (Fonagy, Steele, Steele, & Target, 1998) for use with the Parent Development Interview-Revised (Slade, Aber, Berger, Bresgi, & Kaplan, 2005). The relationship between the mother's mentalizing capacity and the children's attachment representations are discussed using mentalization theory.