Attachment Representations in Internationally Adopted Children

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Attachment representations in
internationally adopted children
a a a b
Maite Román , Jesús Palacios , Carmen Moreno & Ana López
a
Department of Developmental Psychology, University of Seville,
Spain
b
Department of Experimental Psychology, University of Seville,
Spain
Version of record first published: 30 Oct 2012.
To cite this article: Maite Román, Jesús Palacios, Carmen Moreno & Ana López (2012): Attachment
representations in internationally adopted children, Attachment & Human Development, 14:6,
585-600
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Attachment & Human Development
Vol. 14, No. 6, November 2012, 585–600
Attachment representations in internationally adopted children

Maite Romána*, Jesús Palaciosa, Carmen Morenoa and Ana Lópezb
a
Department of Developmental Psychology, University of Seville, Spain; bDepartment of
Experimental Psychology, University of Seville, Spain
(Received 20 March 2011; final version received 20 April 2012)
Downloaded by [Fac Psicologia/Biblioteca] at 00:09 05 November 2012
Using the Story Stem Assessment Profile, attachment representations were

analyzed in a group of 40 internationally adopted children studied after an
average of 40 months since their adoption. These children were compared to 58
children living with their birth families and with no experience of maltreatment,
and to 50 children who were living in Spanish institutions. All of the children were
between four and eight years of age at the time of study. Findings indicated that
the adoptees’ representations were more negative than those of the control group,
but similar to those of the institutionalized children. The associations between
different indicators of attachment representations, as well as the role of adopted
children’s characteristics (pre-adoption experiences, adoption age, time with the
adoptive family) were also analyzed. The results showed a long-term impact of
early adversity, a certain degree of heterogeneity in the attachment representa-
tions’ of both the adopted and the institutionalized children, and the role played
by certain background and individual variables.
Keywords: adoption; attachment narratives; attachment representations;
institutionalization
Introduction
Attachment theory (Bowlby, 1958, 1969) offers one of the main perspectives for
understanding emotional development. Empirical efforts were initially centered on
behavioral aspects, with the introduction of the Strange Situation by Ainsworth,
Blehar, Waters, and Wall (1978) having given a major boost to methodological
development of this theory. Later, with the focus of research turning to older
children and adults, a move to the representational level was required (Main,
Kaplan, & Cassidy, 1985), and the construct of attachment representations (ARs)
was approached in greater depth (Bretherton, Ridgeway, & Cassidy, 1990;
Crittenden, 1990), creating an opportunity for the empirical study of verbal and
non-verbal behaviors that reflected internal working models of self and attachment
figures. The current study adds to knowledge of children’s ARs, which are built
according to experiences of close interaction and the emotions associated with them,
and serve as a guide for perceiving oneself and others, as well as interpreting one’s
emotions and regulating one’s emotional behavior (Bowlby, 1969, 1973, 1980;
Bretherton et al., 1990; Cassidy & Shaver, 2008; Crittenden, 1990; Main et al., 1985;
Thompson, 2008).
*Corresponding author. Email: maiteroman@us.es
ISSN 1461-6734 print/ISSN 1469-2988 online

Ó 2012 Taylor & Francis
http://dx.doi.org/10.1080/14616734.2012.727257
http://www.tandfonline.com
586 M. Román et al.
Whilst most children experience continuity in their attachment relationships

throughout childhood, some children’s early development is marked by radical
discontinuity in care and relationships (Juffer et al., 2011; van IJzendoorn et al.,
2011). Adoption offers a unique example of this discontinuity, as it involves a radical
change of family context. In the case of inter-country adoption, most of the children
involved spent a certain amount of time in institutional settings before their
adoption, with little opportunity to develop secure attachment relationships
(Zeanah, 2000). Through their adoption, children become stable members of
families who are deemed suitable to respond to their physical and psychological
needs. Changes are thus to be expected in their attachment system (Juffer et al.,
2011).
While research into adopted children’s attachment behaviors is abundant (see
meta-analysis by van den Dries, Juffer, van IJzendoorn, & Bakermans-Kranenburg,

2009), studies exploring their ARs are more uncommon (e.g., Steele, Hodges,
Kaniuk, Steele, Hillman, & Asquith, 2008). Although the internal working models of
attachment tend to stabilize once formed, they are active constructions which, not
without some resistance, must be restructured in order to continue being effective
when circumstances change (Bowlby, 1980; Bretherton et al., 1990; Main et al.,
1985). The radical change in emotional relationships implied by adoption should find
a reflection in the adopted children’s ARs. The three main goals of the current study
were to analyze: the long term impact of early adversity on ARs, the degree of
internal coherence between the different indicators of these representations, and the
influence of the children’s background and individual characteristics on them.
Our first goal was to explore the impact of early adversity on adopted children’s
internal working models of attachment assessed through their ARs and the extent to
which more positive experiences in their new families are effective in helping them
overcome past adversity. By comparing children whose adverse circumstances
changed dramatically (through adoption) to another group for whom adversity
remained more stable and positive attachment relationships to new adult figures were
more unlikely (institutional care), our study sought to explore the long term impact of
early adversity on the ARs. A third set of children without early adversity and with no
discontinuity in their family served as a control group for the comparisons.
One of the main contributions in this under-explored area was from a British
longitudinal research whose principal goal was the study of ARs in late adopted
children with previous experience of maltreatment (Hodges & Steele, 2000; Hodges,
Steele, Hillman, Henderson, & Kaniuk, 2003, 2005; Steele et al., 2008). Using the
Story Stem Assessment Profile (SSAP), a group of late adopted children in the UK
were compared to children adopted before 12 months who had not suffered previous
abuse. In comparison, the children in the late adopted group presented more
indicators of avoidance and disorganization, more negative representations of adults
and children, and a greater presence of aggression in their narratives.
In Greece, Vorria et al. (2006) used another story-stem task (the Attachment
Story Completion Task; Bretherton et al., 1990) to study the ARs of adopted
children who had been previously institutionalized. The results revealed that,
compared to a control group of children, the adoptees had lower scores for story
resolution, narrative coherence, and pro-social themes, as well as higher scores for
avoidance. Similarly, other European studies that included adopted and foster care
children found more negative ARs than in the control groups (Bovenschen,
Nowacki, Roland, & Spangler, 2009; Euillet, Spencer, Troupel-Cremel, Fresno, &
Attachment & Human Development 587
Zaouche-Gaudron, 2008; Minnis et al., 2006; Nowacki, Roland, Bovenschen, &

Spangler, 2009). These results are in line with those obtained from the study of a
group of institutionalized children in Japan (Katsurada, 2007), with deteriorated
ARs compared to a control sample.
The ARs are typically studied using a number of verbal and nonverbal indicators
in response to a story-stem procedure (Bettmann & Lundahl, 2007; Bretherton et al.,
1990; Hodges et al., 2005; Oppenheim, 2006; Page, 2001; Steele et al., 2008). In the
case of SSAP, these indicators are the dimensions of security, insecurity, avoidance,
and disorganization. Our second goal concerns the degree of internal coherence
between these indicators. In the British adopted children studied one and two years
following the first post-adoption assessment, the security in their ARs increased and
their avoidance decreased over time, but their indicators of insecurity and
disorganization remained stable in both the early and the late adopted groups
(Hodges & Steele, 2000; Hodges, Steele, Hillman, Henderson, & Kaniuk, 2003, 2005;
Steele et al., 2008). The consolidation of some positive contents versus the stability of
some negative ones reflects the complexity of ARs restructuring and the persistence
of some difficulties (Hodges et al., 2005). As Steele et al. (2008) suggested, it seems
much easier to incorporate positive representations than to ‘‘extinguish’’ negative
ones. This suggests that in a one-time study, as reported herein, the adoptees’ ARs
would consist of a heterogeneous picture, with the inter-correlations between
different AR indicators showing less internal consistency than in cases without
discontinuity in the history of attachment relationships.
Finally, our third goal was to study the impact of the children’s background (e.g.,
history of adversity) and personal characteristics (e.g., age, gender) on the ARs.
Regarding the former, a particular interest was to study the potential impact of
family experience before institutionalization. Several adoption studies have shown
that children with only institutional experience fare less well after their adoption
than those with prior family experience (Miller, Chan, Comfort, & Tirella, 2005; van
den Dries, Juffer, van IJzendoorn, & Bakermans-Kranenburg, 2010), but these
studies analyzed growth, motor development, and cognitive development. The
question is thus whether early family experiences (as opposed to only institutional
rearing) contribute to alleviating the impact of early adversity on children’s
emotional development (in our case, ARs).
In what concerns the role of other children’s characteristics, the age at the time of
adoption seems to have a clear moderating effect on their attachment behaviors with
their adoptive parents (van den Dries et al., 2009), so that the differences between
adopted and non-adopted children tend to disappear if the adoption takes place
before one year of age. The effect of the adoption age on ARs is less clear, showing
statistical significance in some studies (Kaniuk, Steele, & Hodges, 2004), but not in
others (Euillet et al., 2008). Although sibling adoption has been shown to play a
protective role in some developmental areas (McRoy, 1999; Rushton, Dance,
Quinton, & Mayes, 2001), its relevance for ARs has not yet been explored. Gender
has been found to play a role in some studies (more security in girls in Pierrehumbert
et al., 2009), but not in others (gender differences in one-parent but not in two-
parent’s children in Gogler-Tippelt & König, 2007). Finally, children’s cognitive
development appears to have some influence on the ARs, as attested by studies on
both adopted (Vorria et al., 2006) and non-adopted children (Stievenart, Roskam,
Meunier, & van de Moortele, 2011). In the latter study, children’s reasoning
capacities were shown to have an influence on security in ARs.
Consistent with the extant literature: (1) it was expected that the ARs of the
adopted children would be impaired by their early adversity, although they were
expected to be more positive (security) and less negative (avoidance, insecurity,
disorganization) than those of the institutionalized children. When compared to a
control group, the adoptees’ ARs were expected to vary as a function of time
since their adoption so that the more time in the adoptive home, the less different
the adoptees would look to the control group); (2) The ARs of the adopted and
institutionalized children were expected to form a more heterogeneous picture
than those of the group without early adversity, with more internal coherence
between the different indicators of ARs; and (3) the adoptees with more negative
pre-adoption backgrounds (no family experience, longer institutionalization)
were expected to show more impaired ARs than those less exposed to early
adversity.
Method
Participants
The sample consisted of a group of 40 children of Russian origin who had been
internationally adopted by Spanish families, a comparison group of 50 children who
lived in Spanish institutions, and a control group of 58 children without family
adversity who lived with their birth families in the same community. The children
were all between four and eight years of age at assessment.
Russia was chosen as the country of origin for several reasons. It is the main
country of origin for inter-country adoption in Spain (Ministerio de Sanidad,
Polı́tica Social e Igualdad, 2012). While children from other countries (e.g., China)
tend to be adopted between their first and second birthday and usually after only
orphanage experience, children from Russia are usually adopted older, some after
orphanage experience only, but others after a significant time spent with a family
prior to institutionalization. Finally, children adopted from Eastern Europe have
been found to display greater difficulty with the formation of new attachments (van
den Dries et al., 2009).
Adoptive families were recruited through two agencies working with Russian
adoptions in Spain. Almost all of the families contacted by the researchers agreed to
participate and only a few (n ¼ 10) refused, due mainly to some incumbent problems
(the death of a relative, for instance). Children in the Spanish institutions were seen
with the authorization and mediation of the child protection authority of the region.
In the case of the control group, 10 schools (which represented different socio-
economic levels) from various neighborhoods of a major city in southern Spain were
chosen at random, and the collaboration of the families was requested. Of those
approached, 10% chose not to participate.
The Russian children were adopted at a mean age of 36 months (SD ¼ 15.97)
and, at the time of the study, had been with their families for an average of 40
months (SD ¼ 14.25). A total of 72.5% were boys and 27.5% girls, which reflects the
typical gender balance of Eastern European adoptions in Spain (Pascual, 2000).
Almost all of these children (95%) had been institutionalized before their adoption,
with an average of 26 months institutional experience (SD ¼ 13.78). While half these
children had effectively spent their whole life in an orphanage, the other half (52.5%)
had an average of 21 months (SD ¼ 18.91) of family experience before their
institutionalization. Some of the children (22.5%) were adopted with a sibling. Only
children who had been with their adoptive family for at least nine months were included
in the study, to ensure that they had sufficient mastery of their new language.
The Spanish institutionalized children had mostly been separated from their
families after experiencing severe abuse and neglect, and after family preservation
attempts. They lived in relatively small protection centers, usually with fewer than 20
children in each. The institutions were well staffed, with qualified caregivers who
worked in weekly shifts, making it more difficult for the children to form stable
emotional relationships with the changing adults. Many of these children were first
sent to emergency units, where they remained for a few months before a more
permanent decision was made. Those who remained institutionalized were then sent
to more permanent centers, with similar structural arrangements in terms of daily
life, staff, etc. Approximately half (52%) the institutionalized group was girls and
48% boys. All had family experience prior to their institutionalization, with an
average of 64 months of family life (SD ¼ 20.68). The average duration of
institutionalization was 14 months (SD ¼ 17.03). All children in the group had
suffered some form of abuse and/or neglect.
At the time of the study, the average age was 76 months (SD ¼ 14.22) for the
adoptees, 78 months (SD ¼ 17.89) for the institutionalized children, and 75 months
(SD ¼ 14.61) for the control group. Table 1 shows the age at time of the study and
gender distribution in the three groups.
Measures
ARs were assessed using a Spanish translation of the 13 narratives of the Story
Stem Assessment Profile (SSAP) (Hodges, Steele, Hillman, & Henderson, 2003),
where a child is given the beginning of each story which contains a problematic
situation played out with dolls and animal figures representing a family scenario,
and then asked ‘‘to show and tell what happens next’’. This allows an assessment
of the child’s perceptions and expectations of attachments and relationships,
without asking directly about his or her family. It invites both verbal and
nonverbal means of communication. This is important because nonverbal
communication is presumed to provide access to feelings and memories which
cannot be recalled verbally.
The SSAP comprises five story stems (Crying outside, Little pig, Stamping
elephant, Picture from school, and Bikes) originally devised by Hodges for use in
clinical and research settings, with an original, clinically based coding system. Eight
additional stems (Spilled juice, Mum’s headache, Three’s a crowd, Burnt hand, Lost
keys, Bathroom shelf, Burglar in the dark, and Exclusion) from the MacArthur
Story Stem Battery (MSSB; Bretherton, Oppenheim, Buchsbaum, Emde, & the
McArthur Narrative Group, 2003) were included in the protocol, for a total of 13
story stems (Hodges, Steele, Hillman, & Henderson, 2003). The stems are always
administered in the same order. All of the sessions were video and audio recorded
and transcribed in terms of both verbal and non-verbal contents.
According to the coding rules (Hodges, Hillman, & Steele, 2004), each of the 13
stories was rated for the presence of 32 themes. These themes broadly cover the
following areas: adult and child representations, aggressive manifestations,
indicators of avoidance, aspects of positive adaptation, and indicators of
disorganization. Data reduction techniques (Hodges & Hillman, 2009) have shown
that these 32 themes reduce reliably and meaningfully to four global constructs or
590
Table 1. Comparison between groups in control and background variables.
A(1) I C Comparisons Effect sizes(2)

Age at the study M ¼ 76 M ¼ 78 M ¼ 75 F(2, 145) ¼ .34, Z2 ¼ .01
(14.22 SD) (17.89 SD) (14.61 SD) p 4 .05
(3)
Gender 72.5% boysa,b 48% boysa 50% boysb w2 (2) ¼ 6.53, Cramer’s V ¼ .21*
p 5 .05
Developmental status M ¼ –.56a M ¼ –1.23a,b M ¼ –.31b F(2, 145) ¼ 11.46 Z2 ¼ .14**
(1.14 SD) (1.05 SD) (.88 SD) p 5 .001
Language competence M ¼ 26.97a M ¼ 14.31 b M ¼ 46.58a,b F(2, 140) ¼ 23.27 Z2 ¼ .25***
(25.38 SD) (19.54 SD) (27.33 SD) p 5 .001
Time in family before M ¼ 21 M ¼ 64 – U ¼ 81.50, Cohen’s d ¼ 2.15***
institution (18.91 SD) (20.68 SD) p 5 .001
M. Román et al.
Age at institutionalization M¼9 M ¼ 64 – t (85.937) ¼ –14.15, Cohen’s d ¼ 2.98***

(15.34 SD) (20.81 SD) p 5 .001
Time in institutionalization M ¼ 26 M ¼ 14 – t(86) ¼ 3.58, Cohen’s d ¼ 0.78**
(13.78 SD) (17.03 SD) p 5 .01
(1)
A ¼ Adopted children; I ¼ Institutionalized children; C ¼ Control children.
(2)
Effect sizes: * small, ** medium, *** large.
(3)
Groups with the same superscript (a, b) are significantly different.
composites, representing four main dimensions of the ARs: (1) security (child seeks
help, sibling/peers help, realistic mastery, adult provides comfort and help, adult
affectionate, limit setting, secure aggression, acknowledgment of distress of child
and adult, realistic/pleasurable domestic life), (2) insecurity (child endangered,
child injured/dead, adult unaware when children distressed, adult actively
rejects, adult injured/dead, excessive compliance, throwing away), (3) avoidance
(no engagement, disengagement, initial aversion, premature foreclosure, changes
constraints, avoidance within narrative framework, denial of distress, neutraliza-
tion); and (4) disorganization (catastrophic fantasy, bizarre/atypical material, bad/
good shift, child parents/controls, extreme aggression, magic omnipotence). Each
of the 32 themes (in parenthesis above) was rated across the 13 stories using a 3-
point scale (not present, limited or moderate presence, definitely present) and then
the total score for each of the four composites was calculated by adding the
scores obtained in its themes and dividing the total by 13, the number of stories.
For the present study, adequate internal consistency for these composites
was observed. The alpha coefficients across the 13 stories were .85 for the
indicators of security, .84 for the indicators of insecurity, .82 for the indicators of
avoidance, and .89 for the indicators of disorganization (Román, 2010).
The coders were blind to the characteristics of each child and their group
(adopted, institutionalized, or control). All 148 transcripts were coded by the first
author and 20 were also coded by the third author, both with accreditation from the
Anna Freud Centre and the University College of London for the coding of SSAP.
The inter-rater reliability was kappa ¼ .90 for the indicators of security, kappa ¼ .85
for the indicators of insecurity, kappa ¼ .88 for the indicators of avoidance, and
kappa ¼ .86 for the indicators of disorganization.
To determine whether the level of psychological development had any relation-
ship to the mental representations of attachment, the Battelle Development
Inventory (Newborg, Stock, Wnek, Guildubaldi, & Snivicki, 1988) was used to
explore the fundamental developmental abilities (adaptation, motor, personal-social,
communication, and cognition). Using this scale, a standardized total score was
obtained, in accordance with the standards for gender and age. The alpha coefficient
was .74.
Since Spanish was a new language for the adoptees, an analysis of their
linguistic competence was necessary in order to explore any potential interference
with the use of verbal narratives. The Comprensión de Estructuras Gramaticales
(CEG) (Understanding of Grammatical Structures) test, devised by Mendoza,
Carballo, Muñoz, and Fresneda (2005) was used. The examiner presented a sheet
containing four drawings and read out a sentence (for example, The pencil is on
the book that is red), asking the child to point to the drawing that matched the
sentence. One of the four drawings was always the correct answer. A total score
was obtained in accordance with the standards for gender and age. The alpha
coefficient was .82.
Finally, for the adopted and institutional groups, an interview with the parents
and the caregivers was performed, if necessary corroborated by an inspection of the
child’s files, to obtain information about the child’s history. In the interview,
questions were asked about family experience before adoption or institutionaliza-
tion, age on entrance and duration of institutionalization, age at adoption, whether
the child had been adopted with a sibling or it was a single adoption, and time with
adoptive family (details shown in Table 1).
Procedure
The children were seen in their homes (adoption and control group) or in the
institutions where they lived. Two trained psychologists were involved in the data
collection for each child. While one was assessing the child (SSAP, Battelle
inventory, linguistic competence) and video recording the session, the other
interviewed the parents or caretakers to obtain information about the child’s
history (adopted and institutionalized). Each child’s main caregiver was interviewed:
the mother in all cases of the control group and the mother in all but four cases,
where it was the father, in the adoptive families. In the institutions, the caregiver
identified by the staff as having more familiarity with each child was interviewed.
Results
The results are organized in three parts. For our first hypothesis, before comparing
the ARs for the adopted, institutionalized and control children, preliminary analysis
will be conducted to test the homogeneity of the groups in the shared variables (age,
gender, developmental status, linguistic competence) which could interfere with the
comparison; the ARs of the groups will then be compared, controlling the relevant
variables with ANCOVA. For our second hypothesis, the associations between
different indicators of ARs within each group will be explored with bivariate
correlational analysis. Finally, and with respect to the third hypothesis, concerning
the influence of adopted and institutional children’s characteristics and background
on their ARs, mean differences, correlations, and regression analysis will be
reported.
Preliminary and comparative analyses of group differences

The first part of Table 1 reports means and standard deviations for age,
developmental status, and language competence by group of children, as well as
the percentages by gender, showing the group comparison and the effect sizes. The
results showed significant differences between the groups in terms of gender,
developmental status, and language competence. The lack of homogeneity between
the groups in these variables required their inclusion in the analysis of group
differences in ARs. Due to the significant effect of age found in previous studies, as
well as the wide range of ages in our sample, this study included age as a covariate in
order to control for this effect. A two-way (Group 6 Gender) ANCOVA was
performed on indicators of security, insecurity, avoidance, and disorganization
controlling for the relevant covariates (age, developmental status, and linguistic
competence).
The ANCOVA results showed that the main effects of group on security
(F(2,142) ¼ 3.86, p 5 .05, Z2 ¼ .05), insecurity (F(2,142) ¼ 12.54, p 5 .001, Z2 ¼ .16),
avoidance (F(2,142) ¼ 21.58, p 5 .001, Z2 ¼ .24), and disorganization
2
(F(2,142) ¼ 10.53, p 5 .001, Z ¼ .14) were significant, as well as the main effects
of age (older children showed more security, F(1,142) ¼ 11.84, p 5 .01, Z2 ¼ .08, and
less avoidance, F(1,142) ¼ 6.52, p 5 .05, Z2 ¼ .05) and developmental status (more
security with higher Battelle scores, F(1,142) ¼ 8.20, p 5 .01, Z2 ¼ .06). Gender had
significant main effects on security and insecurity indicators (female scores were
significantly higher in security, F(1,142) ¼ 6.68, p 5 .05, Z2 ¼ .05, and lower in
insecurity, F(1,142) ¼ 10.93, p 5 .01, Z2 ¼ .08), while linguistic competence and the
interaction Group x Gender showed a non-significant effect on the indicators of

ARs.
Post-hoc group comparisons were performed with the adjusted means obtained
in the ANCOVA. As shown in Table 2, the results indicated that the adopted and
institutionalized children displayed more indicators of insecurity, avoidance, and
disorganization than the control group, with large effect sizes. The institutionalized
children also showed fewer indicators of security than the control group, with a
medium effect size. The differences between the adopted and control children in this
indicator failed to reach significant p levels, but the effect size of the difference was
medium. The adopted children tended to show more indicators of security and fewer
indicators of insecurity, avoidance, and disorganization than the institutionalized
group, but the differences did not reach significant values, with a negligible effect size
in security and a small effect size in the other indicators.
Associations between the different indicators of ARs

Bivariate correlational analyses were conducted to examine the associations between
the raw scores of the four indicators of ARs within each group. In the adoptive
group, security showed a significant negative correlation with avoidance (r ¼ 7.49),
and insecurity showed a significant positive correlation with disorganization
(r ¼ .80). The correlation between insecurity and avoidance (r ¼ .31) fell short of
statistical significance (p ¼ .053). In the institutionalized group, security was
negatively correlated with avoidance (r ¼ 7.33) at significant values, and there
was also a significant positive correlation between disorganization and both
insecurity (r ¼ .71) and avoidance (r ¼ .40). In the control group, all of the
indicators for ARs were correlated with each other, the indicators of security
negatively with the rest, and the indicators of insecurity, avoidance, and
disorganization positively with each other (Table 3).
The influence of adopted and institutionalized children’s characteristics and background

on ARs
Bivariate correlational analyses were conducted to examine the association between
ARs and the available relevant personal and background data for the adopted and
institutionalized children. The group differences were analyzed through mean
comparisons. Finally, the role of age at adoption and time in the adoptive family was
determined with a regression analysis.
Table 2. Post-hoc comparisons for adjusted means in ANCOVA and effect sizes in observed
means by groups.
Effect sizes (Cohen’s d)

Adopted Institutionalized Control A-I A-C I-C
a a
Security 3.25 3.20 3.94 0.10 0.55** 0.67**
Insecurity 1.26a 1.67b 0.74a,b 0.39* 0.80*** 1.15***
Avoidance 1.20a 1.40b 0.52a,b 0.42* 1.31*** 1.41***
Disorganization 1.24a 1.37b 0.52a,b 0.22* 0.90*** 1.18***
Note: Groups with the same superscript (a, b) show means comparison significantly different to .05 level.
Cohen’s d values:* .20, small; ** .50, medium; *** .80, large.
594
Table 3. Correlations between indicators of attachment representations and with adopted, institutionalized, and control children’s characteristics.
Age at Time in family Time in

the start Time in before Age at adoptive
Groups Indicators Security Insecurity Avoidance Disorganization of institution institution institution adoption family
Security .04 –.49** .19 .42* –.14 .50* .26 .13
A Insecurity .31 .80** –.23 .38* –.14 .05 –.09
Avoidance .25 –.14 –.11 .06 –.27 –.08
Disorganization –.03 .27 .16 .15 .07
Security .10 –.33* .02 .13 .09 .16
I Insecurity .22 .71** .01 .06 –.03
Avoidance .40** –.12 –.12 –.12
Disorganization –.06 .05 –.10
M. Román et al.
Security –.31* –.48** –.28*

C Insecurity .38** .92**
Avoidance .40**
Disorganization
Note: A ¼ Adopted children; I ¼ Institutionalized children; C ¼ Control children.

Key:*p 5 .05; **p 5 .01.
Note: Two-tailed t-tests.
Table 3, showing the correlations within each group, reveals that for adopted
children, while age at adoption did not correlate significantly with ARs, other
variables related to early adversity were significantly related. Those with a significant
family experience prior to their adoption obtained lower scores in avoidance (but not
in the other indicators) than those who had spent all their pre-adoption life in
institutions, t(38) ¼ 72.04, p 5 .05. In the first subgroup, the amount of time spent
with a family before institutionalization was related positively to the indicators of
security (r ¼ .50). In the same regard, an older age at entrance to an institution and a
shorter experience there were related to higher security and lower insecurity scores,
with r ¼ .42 and .38, respectively. In the institutionalized group, none of these
variables yield significant relations with the ARs.
Compared to those whose families adopted a single child, children adopted with a
sibling presented significantly lower scores for the indicators of insecurity,

t(38) ¼ 73.20, p 5 .01, and disorganization, t(33.848) ¼ 75.73, p 5 .001, with non-
significant differences in security, t(38) ¼ 71.62, ns, and avoidance, t(9.827) ¼ 70.638,
ns.
Regarding the adoptive experience, no significant bivariate correlations were
found between the four indicators of ARs and the variables age at adoption and time
in the adoptive family. A hierarchical regression analysis in which age at adoption
was entered first, followed by time in the adoptive family, showed that only when
time in the adoptive family was entered, a significant model was obtained explaining
up to 17.9% of the security in mental representations. As shown in Table 4, the time
in the adoptive family increased by 11.1% the explained variance in the security of
the mental representations. No significant prediction was obtained, however, with
the other indicators of ARs.
Discussion
If the internal working models of attachment are formed on the basis of children’s
experiences with close emotional relationships, the study of those with initial
emotional adversity who were later adopted into new families should speak of their
malleability. Since adoption entails a radical modification in children’s life
circumstances, including their experiences of attachment relationships, changes
could also be expected in the adoptees’ ARs reflecting their internal working models
of attachment. Comparing the adoptees with other children who lacked previous
adversity (control group) and with a third group with early adversity but without the
positive transition to a new family life (institutionalized group) was expected to allow
Table 4. Summary of hierarchical regression analysis for variables predicting residual gain
scores on security in mental representations in adopted children.
B b R2 p
Step 1 .068 4.05
Age at adoption .022 .260 4.05
Step 2 .179 5.05
Age at adoption .041 .487 5.05
Time in adoptive family .038 .403 5.05
Note: DR2 ¼ .111 for Step 2 (p ¼ .031).

a better understanding of the healing experience of adoption. The results of the study
are also of interest regarding the associations between different indicators of ARs
(security, insecurity, avoidance, disorganization) and to analyze the role of children’s
characteristics and background on their ARs.
The results of this study showed that, at an average of three years following their
adoption, the mental representations of attachment of the internationally adopted
children in our sample exhibited major differences when compared to those of the
children in the control group, without the experience of early adversity. The adopted
children’s ARs showed higher scores for insecurity, avoidance, and disorganization,
with large effect sizes. These adopted-control group differences remained significant
after controlling for gender, current age, developmental status, and linguistic
competence. The effect size of the adopted-control difference in security was medium.
These results are partly consistent with our first hypothesis and with previous results
from the longitudinal study by Hodges et al. (2005) and Steele et al. (2008), as well as
from other studies with adopted (Vorria et al., 2006), foster-care (Bovenschen et al.,
2009; Minnis et al., 2006; Nowacki et al., 2009), and adopted and foster-care children
(Euillet et al., 2008). This similarity is noteworthy given the fact that different studies
used different methodological approaches in both story stems and coding.
There are two points of interest regarding the more negative representations of
attachment among the adopted children. Firstly, in line with the data from the meta-
analysis by van den Dries et al. (2009) on attachment behaviors, if the adoption had
taken place in the first year of life (no child in the current sample was adopted before
12 months), the ARs deterioration might have been less and recovery greater, as was
the case for the early adopted children in the Hodges et al. (2005) and Kaniuk et al.
(2004) studies. Secondly, the persistence, years later, of the early adversity
repercussions does not necessarily mean that these representations are condemned
to remain unchanged. Compared to other domains, emotional recovery may take a
longer period of time, which is in line with the hypothesis suggested for the analysis
of recovery following initial adversity (Palacios, Román, & Camacho, 2011): while
most of the improvements in growth and cognitive development appears to take
place within the first three post-adoption years, it is possible that recovery in the
socio-emotional domain requires a more protracted period of time. A follow-up
study now underway is addressing this issue.
In agreement with Katsurada (2007), the results showed significant differences
between the ARs of the institutionalized and the control groups, the former having
fewer indicators of security, with medium effect size, and more indicators of
insecurity, avoidance, and disorganization than the latter, with large effect sizes.
Although our first hypothesis expected significant differences in the comparison
between institutionalized and adopted groups, in favor of the latter, the p values of
this comparison were non-significant, and the effect sizes were negligible or small.
Even so, the trend in the data was clear, with all values for the adoptees falling
between those of the other two groups. An optimistic interpretation of this would be
that whilst the adopted children could be considered as progressing towards recovery
(as attested by the increase in security with more time after adoption) , the difficulties
of the institutionalized children appeared to be more static, suggesting that, although
institutionalization can solve some of these youngsters’ problems (protection from
family abuse or neglect, for example), the institutional context does relatively little to
help solve their emotional difficulties. The ongoing follow-up of this same sample
should help to confirm or discard this optimism.
In fact and partly confirming our first hypothesis, as time spent with the
adoptive family increased, indicators of security rose, which is in line with the
findings by Hodges et al. (2005). This reflects the benefits of adoption and
the capacity of the ARs to be progressively up-dated after a significant change in
close emotional relationships. However, the positive effect of time after adoption
was limited to one indicator of ARs (namely, security), but did not extend to the
other AR indicators (insecurity, avoidance, disorganization), which confirms our
second hypothesis and, in a one-time static picture, seems consistent with
longitudinal data from Hodges, Steele, Hillman, Henderson, and Kaniuk (2003,
2005) and Steele et al. (2008), who showed a discontinuous improvement in
impaired attachment representations, with more positive changes in security and
avoidance, and greater stability in insecurity and disorganization. In fact, the more
highly inter-correlated indicators in our adoption group coincided with those that
improved (security and avoidance) or remained more stable (insecurity and
disorganization) in the British research.
While some, but not all, of the ARs indicators were inter-correlated in the two
groups with early adversity (adopted and institutionalized children), the picture was
more homogeneous for the control group, with all indicators significantly inter-
correlated. This suggests that children reared in an overall more positive, stable
context tend to show more internally homogeneous ARs, while those who have
experienced past adversity show a more heterogeneous, less consistent map of
representations.
The current results showed that greater length of a pre-institutional family
experience had a positive effect on adoptees’ ARs (fewer indicators of avoidance and
more indicators of security). However, for the Spanish institutionalized children, the
length of their previous family experience was unrelated to their ARs indicators. The
explanation for this may lie in the different circumstances leading to institutionaliza-
tion in the Russian Federation and Spain. It could be that in Russia separation from
one’s birth family is more likely due to a lack of resources, alcohol abuse, or family
breakdown, whereas in Spain separation normally follows serious abuse and neglect,
and, very often, prolonged fruitless attempts to keep the child in the family, resulting
in an older age at separation. In these circumstances, the length of time spent with
the family may not be beneficial for the children involved.
With regards to the institutionalization experience, the results for the adoptive
group showed its negative impact on ARs even several years after the adoption: an
earlier and more prolonged institutional experience relates to less security and more
insecurity indicators of ARs, confirming our expectations about the negative effect of
greater early adversity on child attachment. These relationships, however, were not
significant in the Spanish institutionalized group. Two different, and perhaps
complementary, explanations may help to understand these differences. They could
be related to the fact that the two groups were very different with regards to age and
length of institutional experience, since entry into Spanish centers takes place, on
average, at an older age than in Russia, or perhaps to the quality of the
institutionalization experience, with a better child/caregiver ratio and better
caregiver qualifications in the Spanish institutions.
In this research, the children adopted with a sibling had lower scores in the
indicators of insecurity and disorganization than those from single adoptions,
suggesting a certain protective role from sibling adoption. A significant relationship
with a sibling or a stronger sense of continuity could explain this difference (McRoy,
1999; Rushton et al., 2001). In fact, the indicators in which the effect of sibling
adoptions in our study was significant were more resistant to positive change in the
study by Hodges et al. (2005). Nevertheless, the low presence of sibling adoption in
our study (22.5%) demands caution in the interpretation of these results.
Finally, our results showed that some children’s characteristics such as age,
gender, and developmental status, were significantly related to indicators of ARs.
These findings are in line with previous studies about the role of age (more security in
older children, as in Kaniuk et al., 2004), gender (more security in girls, as in
Pierrehumbert et al., 2009), and certain developmental components (intelligence in
Vorria et al., 2006, and reasoning skills, in Stievenart et al., 2011) on the
development of ARs.
Regarding the limitations of this study, although the total number of children in
our study was acceptable, larger groups would have allowed more statistical
analyses. Also, the institutionalized and adopted groups differed in a number of
aspects, from their reason for institutionalization, to their age at separation from
their birth family, as well as the time after separation when assessed for the purposes
of this study. Ideally, these two groups should have been similar in all aspects, but
the differences between them are linked to different child protection practices and
children’s profiles in the two countries involved. It should also be mentioned that,
under the labels ‘‘adopted children’’ or ‘‘institutionalized children’’, there is a great
variety in terms of individual characteristics, previous experience, type and intensity
of abuse, quality of early ties within the birth family, and characteristics related to
the vulnerability and resilience of each child. None of these variables could be taken
into account in this study, as information was scarce.
Notwithstanding these limitations, the results of this study show the long-lasting
impact of early adversity on ARs, as well as a certain degree of heterogeneity in
them. Whereas adoption seems to provide an avenue for improvement, institutions
seem to produce a more negative and static picture. While adoptive parents should
be prepared to accompany their children on their long journey towards recovery,
every effort should be made to avoid the institutionalization of children and promote
their integration into stable, loving, and stimulating families as soon as possible.
Acknowledgement
This research study is part of a broader project named Attachment and social competence in the
transition from abandonment to protection, funded by the Spanish’s Ministry of Science and
Innovation (SEJ2006-12216), and the Swedish Department of Health and Welfare.
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Attachment representations in internationally adopted children

Using the Story Stem Assessment Proﬁle, attachment representations were

*Corresponding author. Email: maiteroman@us.es

ISSN 1461-6734 print/ISSN 1469-2988 online

Whilst most children experience continuity in their attachment relationships

meta-analysis by van den Dries, Juﬀer, van IJzendoorn, & Bakermans-Kranenburg,

Zaouche-Gaudron, 2008; Minnis et al., 2006; Nowacki, Roland, Bovenschen, &

Table 1. Comparison between groups in control and background variables.

A(1) I C Comparisons Eﬀect sizes(2)

Age at institutionalization M¼9 M ¼ 64 – t (85.937) ¼ –14.15, Cohen’s d ¼ 2.98***

Preliminary and comparative analyses of group diﬀerences

interaction Group x Gender showed a non-signiﬁcant eﬀect on the indicators of

in security and a small eﬀect size in the other indicators.

Associations between the diﬀerent indicators of ARs

The inﬂuence of adopted and institutionalized children’s characteristics and background

Eﬀect sizes (Cohen’s d)

Age at Time in family Time in

Security –.31* –.48** –.28*

Note: A ¼ Adopted children; I ¼ Institutionalized children; C ¼ Control children.

sibling presented signiﬁcantly lower scores for the indicators of insecurity,

Note: DR2 ¼ .111 for Step 2 (p ¼ .031).

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