Caregiver-Child Behaviours in the Immunization Context: Building Understanding Through a Preschool Attachment Lens

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dc.contributor.advisorRiddell, Rebecca
dc.contributor.authorO'Neill, Monica Claire
dc.date.accessioned2021-03-08T17:28:27Z
dc.date.available2021-03-08T17:28:27Z
dc.date.copyright2020-12
dc.date.issued2021-03-08
dc.date.updated2021-03-08T17:28:27Z
dc.degree.disciplinePsychology (Functional Area: Clinical-Developmental)
dc.degree.levelDoctoral
dc.degree.namePhD - Doctor of Philosophy
dc.description.abstractResearch on how caregivers and young children interact during distressing situations through an attachment theory lens demonstrates that less optimal attachment patterns are linked with socio-emotional and biological challenges later in life. Owing to the high pain-related distress from needles, routine pediatric immunization appointments offer a unique opportunity to understand caregiver-child behaviours in an attachment context. To our knowledge, no study has examined both the longitudinal and concurrent relationship between caregiver-child behaviours in the vaccination context and preschool attachment outcomes. The present dissertation encompasses three cohesive studies that examine longitudinal and concurrent predictors of preschool attachment. Study 1 is a systematic literature review and meta-analysis (ONeill et al., under review) that synthesizes the literature examining the longitudinal and concurrent relationships between a key element of caregiver behaviour during distress (caregiver sensitivity) and preschool attachment. Studies 2 and 3 (ONeill et al, in press) examine healthy caregiver-child dyads during their 2-month infant (N = 84) vaccination appointments and 4-5 year preschool (N = 117) vaccination appointments (The OUCH Cohort). Study 2 examined the longitudinal relationship between caregiver behaviours (i.e., caregiver sensitivity, proximal soothing) and infant pain-related distress during infants vaccinations with preschool attachment. Study 3 examined the concurrent relationship between caregiver sensitivity and preschooler pain-related distress during preschoolers vaccinations and preschool attachment outcomes. In Study 1, both longitudinal and concurrent syntheses identified an overall finding that caregiver sensitivity was greater among caregivers of preschoolers with secure and organized attachments compared to insecure and disorganized attachments, respectively. Study 2 revealed that higher sensitivity across the appointment and greater proximal soothing at 1 minute pre-needle during infants 2-month vaccinations were associated with greater preschooler avoidance and less ambivalence, respectively. Moreover, pain-related distress at 2 minutes post-needle was associated with higher preschooler security. In study 3, higher caregiver sensitivity during preschoolers vaccinations was related to higher preschooler attachment security. Findings from both quantitative studies suggest the acute pain context is an appropriate context to understand preschool attachment. Therefore, the vaccination context is a potential paradigm to implement future screening and intervention in order to promote secure preschool attachments.
dc.identifier.urihttp://hdl.handle.net/10315/38228
dc.languageen
dc.rightsAuthor owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
dc.subjectClinical psychology
dc.subject.keywordsInfant pain
dc.subject.keywordsChild pain
dc.subject.keywordsCaregiver sensitivity
dc.subject.keywordsPreschool attachment
dc.subject.keywordsConcurrent
dc.subject.keywordsLongitudinal
dc.titleCaregiver-Child Behaviours in the Immunization Context: Building Understanding Through a Preschool Attachment Lens
dc.typeElectronic Thesis or Dissertation

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