The Relationship Between Caregiver Emotional Availability, Caregiver Soothing Behaviours, and Infant Attachment Style in an Acute Pain Context: A Longitudinal Analysis

Through this study, the relationships between caregiver behaviours seen in immunization appointments (i.e. emotional availability, proximal soothing, distraction, verbal reassurance, and pacifying) across the first year of an infant’s life and subsequent infant attachment were examined. Three research aims were addressed: (1) to describe caregiver behaviour trajectories during routine immunizations across the infant’s first year of life; (2) to relate these caregiver behaviour trajectories to subsequent infant attachment during the second year of life, and (3) to relate caregiver behaviour trajectories within each immunization appointment, at a given infant age, to subsequent infant attachment during the second year of life. A subsample of 130 caregiver-infant dyads was recruited from an ongoing longitudinal study. Dyads were videotaped during infants’ 2-, 4-, 6-, and 12-month immunization appointments and subsequently invited to participate in an assessment of attachment when infants were between 12 and 18 months of age at the local children’s hospital. Overall, caregivers remained fairly consistent in terms of their emotional availability and use of specific soothing behaviours during immunization appointments across the first year of life. Although caregiver emotional availability was not related to infant attachment, certain discrete caregiver soothing behaviours were. Higher frequencies of caregiver proximal soothing at 12 months were related to infants’ organized attachment, whereas steeper decreases in proximal soothing across the first year were associated with disorganized infant attachment. In addition, when caregivers engaged in proximal soothing for longer after their 12-month olds’ immunization(s), these infants were more likely to be secure or organized in their attachment. In addition, an accelerating U-shaped verbal reassurance trajectory was related to subsequent organized infant attachment, whereas caregivers of infants with disorganized attachment were characterized by a verbal reassurance trajectory that started out low, increased over time, and then decelerated (i.e., the increase slowed) by 12 months of age. Also, when caregivers engaged in verbal reassurance for longer after their 2 month olds’ immunization(s), these infants were more likely to be organized in their attachment. Clinical implications and suggestions for future research are discussed.