title: Attachment disturbances in young children. I: The continuum of caretaking casualty.
abstract: OBJECTIVE
  To determine whether signs of disordered attachment were greater in young children being reared in more socially depriving caregiving environments.
  
  
  METHODS
  Three groups of children were studied by means of structured interviews with caregivers that were administered over several months in Bucharest, Romania, in 1999: (1) 32 toddlers living in a typical unit (standard care) in a large institution in Bucharest; (2) 29 toddlers living in the same institution on a 'pilot unit" designed to reduce the number of adults caring for each child; and (3) 33 toddlers living at home who had never been institutionalized. The presence of attachment disorders and other behavioral problems was assessed by caregiver/ parent report.
  
  
  RESULTS
  Children on the typical unit (standard care) had significantly more signs of disordered attachment than children in the other two groups. Both the emotionally withdrawn and the indiscriminately social pattern of attachment disorder were apparent in these children, but cluster analysis suggested that mixed patterns are more typical.
  
  
  CONCLUSIONS
  The continuum of caretaking casualty is reflected by increasing signs of disordered attachment in toddlers living in more socially depriving environments.
authors.affiliation: Institute of Infant and Early Childhood Mental Health, Department of Psychiatry and Neurology, Tulane University Health Sciences Center, New Orleans, LA 70112, USA. asmyke@tulane.edu
authors.forename: Anna T
authors.initials: AT
authors.lastname: Smyke
authors.forename: Alina
authors.initials: A
authors.lastname: Dumitrescu
authors.forename: Charles H
authors.initials: CH
authors.lastname: Zeanah
mesh_terms: D017028:Caregivers / Q000523:psychology; D002649:Child Abuse / Q000523:psychology*; D002674:Child, Institutionalized / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010552:Personality Assessment; D011610:Psychosocial Deprivation; D019962:Reactive Attachment Disorder / Q000175:diagnosis* / Q000523:psychology; D012383:Romania; D012931:Social Environment