Sequential Latent Structure Analysis of Segregated System Material in the Doll Play of Maltreated Children.

A range of assessment methodologies pertaining to attachment in children have been developed and validated during the past decades. The present study examined the validity of a sequential, profile-centered approach to the assessment of attachment disorganization using a doll play methodology developed by George and Solomon (1990). The sample was composed of sixty-two children between the age of 5 and 12 who had been removed from their family of origin due to abuse or neglect. Latent Markov Models performed on markers of defensive dysregulation (Frightening, Chaos, Constriction) yielded three distinct states, characterized respectively by themes of fear or chaos, presence of at least partial constriction, and absence of segregated system markers across doll play stories. The states generally showed a high degree of stability across scenarios. The Frightening-Chaotic state was positively associated with sexual abuse, placement in a specialized setting and caregiver-reported externalizing problems whereas the Constricted state was associated with placement in a specialized setting and self-reported hyperactivity and attention problems. These results provide support for the validity and clinical utility of this approach to assessing attachment disorganization on the doll play.