The Role of Attachment and Narrative In Parental Coping with a Child's Diagnosis of Autism

Background: Having a child diagnosed with autism can be a traumatic experience and has been likened to bereavement.  Employing coping strategies such as engaging social support (Hastings & Johnson, 2001) and becoming resolved to diagnosis have been linked to lower levels of parenting stress and more secure child-parent attachment in parents dealing with a child diagnosed with a life-long disability (Knight, 2001; Marvin & Pianta, 1996). Sharing narratives of stressful experiences is seen as an important step towards resolving them (Bowlby, 1980) and narrative discourse features have been implicated as one potential mechanism underlying the coping process (Capps & Bonanno, 2000). This study applies a specific coding scheme to two interviews given to parents of children diagnosed with ASD: the Adult Attachment Interview (AAI: George, Kaplan, & Main, 1985)—which codes feelings of security towards caregivers based on narrative coherence—and the Reaction to Diagnosis Interview (RDI: Pianta & Marvin, 1992)—which uses narrative to rate how parents resolve to diagnosis. When used in bereavement narratives, this coding scheme showed links between grammatical constructions and resolution to a loved one’s death as well as an individual’s likelihood to garner support from others (Capps & Bonanno, 2000).

Objectives:   Adopting paradigms from attachment and bereavement theory, we employed narrative analysis to examine the relationships among discourse, adult attachment status, and patterns of resolution to a child’s diagnosis of ASD.  We speculated that (1) parents with secure attachment histories would show more successful patterns of grief resolution than parents with insecure or unresolved attachment styles and (2) narrative discourse styles would be associated with attachment history and resolution patterns.

Methods:   Fourteen parents of children with ASD were administered the RDI and AAI. Interviews were coded for attachment and resolution status as well as narrative discourse devices previously shown to relate to resolution styles, including constructions of diminished agency (e.g. passive voice) and valence (e.g. positive or negative thoughts). Naïve individuals were then asked to read de-identified transcripts of the interviews and rate how likely they were to support the individual being interviewed. Relationships among narrative devices and attachment and resolution status were examined in relation to how likely others were to offer support.

Results:   Preliminary results indicate an association between the increased use of constructions of diminished agency and being unresolved to diagnosis. Unresolved parents used passive voice 17% more often and expressed more negative thoughts and emotions (51% of total thoughts versus 35%) than those who were resolved. Those same unresolved narratives showed a trend towards raters indicating they would be more likely to avoid prolonged contact with the subject (12% higher ratings of avoidance). 

Conclusions: Findings suggest a relationship among attachment status, the use of certain narrative discourse devices, and parents’ resolution to their child’s diagnosis. Such relationships require further investigation, however, these findings may have important implications for how professionals identify individuals who may be struggling with resolution and identify biases in their own reactions to parental discourse with the goal of increased sensitivity during the diagnostic process.