title: Adult separation anxiety and unsettled infant behavior: Associations with adverse parenting during childhood and insecure adult attachment.
abstract: OBJECTIVE
  This study examined the prevalence and correlates of Adult Separation Anxiety Disorder (ASAD) and Adult Separation Anxiety (ASA) symptoms in a sample of first-time mothers with an unsettled infant during the first postpartum year.
  
  
  METHODS
  Eighty-three primiparous women admitted to a residential parent-infant program participated in a structured clinical interview for DSM-IV diagnosis and questionnaires assessing ASA symptoms, adult attachment and childhood parenting experiences. Nurses recorded infant behavior using 24-hour charts.
  
  
  RESULTS
  The prevalence of ASAD in this sample was 19.3% and women with ASAD were, on average, more likely to be diagnosed with depression and anxiety disorders, report aversive parenting experiences during childhood and show adult attachment style insecurity. Both ASAD and ASA symptoms were predicted by adult attachment anxiety, and ASAD was associated with unsettled infant behavior. Attachment anxiety and attachment avoidance mediated relations between parental over-control and ASAD diagnosis, and between parental abuse and ASAD diagnosis. Attachment anxiety mediated the relation between parental over-control and ASA symptoms, and attachment avoidance mediated the relations of parental over-control and parental abuse with ASA symptoms.
  
  
  CONCLUSIONS
  This study highlights the prevalence of ASAD among first time mothers experiencing early parenting difficulties and the roles of childhood parenting experiences and adult attachment style in the development of the disorder. This points to the importance of introducing universal screening for ASAD in postnatal settings, and for the development of targeted interventions.
authors.affiliation: Karitane, PO Box 241, Villawood, NSW, 2163, Australia. Electronic address: Jane.Kohlhoff@sswahs.nsw.gov.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Kohlhoff
authors.affiliation: St John of God Raphael Services, 36-38 First Avenue, Blacktown, NSW, 2148, Australia.
authors.forename: Bryanne
authors.initials: B
authors.lastname: Barnett
authors.affiliation: Academic Unit of Child Psychiatry, South West Sydney Local Health District, Mental Health Centre, L1 Liverpool Hospital, Elizabeth Street, Liverpool, NSW, 2170, Australia; School of Psychiatry & Ingham Institute, University of New South Wales.
authors.forename: Valsamma
authors.initials: V
authors.lastname: Eapen
mesh_terms: D000328:Adult; D001010:Anxiety, Separation / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001315:Australia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000523:psychology*; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D009769:Object Attachment; D016487:Parenting / Q000523:psychology*; D015995:Prevalence; D055815:Young Adult