ATTACHMENT, DEFENSE MECHANISMS AND EMOTION USAGE IN

CHILDREN IN INSTITUTIONS DURING MIDDLE CHILDHOOD

WITHIN A SOUTH AFRICAN CONTEXT

Megan McKenzie Robinson

A research report submitted to the Discipline of Psychology. Faculty of Humanities,

University of the Witwatersrand, in partial fulfilment of the requirements for the degree
of Master of Education (Educational Psychology)

Johannesburg, South Africa October 2012

1
 Abstract

Although the importance of Attachment in the normal development of a child has repeatedly
been shown (Bowlby, 1961; 1979) there is a limited amount of research into its relationships
with the usage of defense mechanisms and emotions. This research, therefore, investigated
the relationships between attachment type, defense mechanisms and emotions during middle
childhood (8-12 years) in 64 children from 4 children’s homes and 1 hospital in the Gauteng
area. The children completed the Deferential Emotions Scale IV (DES-IV), the Attachment
Story Completion Test (ASCT) and the Attachment Security Scale (ASS). The legal
guardians of the children completed the Comprehensive Assessment of Defense Scale
(CADS). Significant correlations were found to exist between the usage defense mechanisms
and emotions. The results obtained from the analyses therefore suggest a complex interplay
of relationships between attachment, defense mechanisms and emotion during middle
childhood for the children in these institutions. For example, the research found that certain
defense mechanisms and emotions were found to be correlated in a complex and interrelated
system of interactions. Similarly, although no significant associations were found between
attachment, defense mechanisms and emotions were found, the frequency distributions
provided detailed information suggesting that attachment does influence the defenses used
and emotion during middle childhood. These finding suggest that further research needs to be
conducted in this area to further this knowledge base and to inform the caregivers and staff at
institutions such as those included in the study.

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 Table of Contents

Chapter One: ............................................................................................................................ 5

1.1 Introduction ................................................................................................................... 5
Chapter Two: Literature Review ........................................................................................... 8
2.1 Introduction .................................................................................................................................. 8
2.2 Attachment ................................................................................................................................... 8
2.3 Attachment During Middle Childhood ........................................................................................ 11
2.4 Attachment in Context ................................................................................................................ 13
2.5 Defense Mechanisms .................................................................................................................. 14
2.6 Emotions ..................................................................................................................................... 17
2.7 Attachment, Emotion and Defense Mechanisms ....................................................................... 19
Chapter Three: Methodology ............................................................................................... 22
3.1 General Research Design ............................................................................................................ 22
3.2 Research Questions .................................................................................................................... 22
3.3 Sample......................................................................................................................................... 23
3.4 Procedures ................................................................................................................................... 23
3.5 Instruments.................................................................................................................................. 24
i) Demographic Questionnaire ................................................................................................. 24
ii) Attachment Story Completion Test ....................................................................................... 25
iii) The Comprehensive Assessment of Defence Styles ............................................................... 26
iv) Deferential Emotions Scale –IV ............................................................................................. 26
v) Attachment Security Scale .................................................................................................... 27
3.6 Methods of Analysis ................................................................................................................... 27
3.7 Ethical Considerations ................................................................................................................ 29
Chapter Four: Results ........................................................................................................... 29
4.1 Descriptive Statistics ................................................................................................................... 30
i) Mean Distribution of Emotions ............................................................................................. 30
ii) Mean Distributions of Defense Mechanisms......................................................................... 31
4.2 Correlations Between Defense Mechanisms .............................................................................. 32
4.3 Correlations Between Emotions ................................................................................................. 37
4.4 Correlations Between Defense Mechanisms and Emotions ....................................................... 41
4.5 Associations Between Attachment and Frequency of Emotions ................................................ 43
4.6 Association Between Attachment and Frequency of Defense Mechanisms .............................. 45
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 4.7 Associations Between Type of Emotion and the Maturity of Defense Mechanisms.................. 47
Chapter Five: Discussion ....................................................................................................... 49
5.1 Discussion of Results ................................................................................................................... 49
i) The Characteristics of the Sample ........................................................................................ 49
ii) Correlations Between Defense Mechanisms ......................................................................... 51
iii) Correlations Between Emotions........................................................................................ 52
iv) Correlations Between Emotions and Defense Mechanisms .............................................. 53
v) Associations Between Attachment and Frequency of Emotions............................................ 54
vi) Associations Between Attachment and Frequency of Defense Mechanisms ..................... 56
vii) Associations Between Type of Emotions and the Maturity of Defense Mechanisms ........ 57
5.2 Implications of the Research....................................................................................................... 57
5.3 Limitations of the Research ........................................................................................................ 58
5.4 Directions for Future Research ................................................................................................... 59
5.5 Conclusion .................................................................................................................................. 60
6. Reference List ................................................................................................................. 61
7. Appendices ...................................................................................................................... 67
7.1 Child Demographics Questionnaire ............................................................................................ 67
7.2 Parent Information Letter for the Legal Guardians at the Hospital............................................. 68
7.3 Child Information Letter for of the Hospital ............................................................................... 70
7.4 Information Letter for the Legal Guardians of the Children’s Homes ........................................ 71
7.5 Information Letter for the children of the children’s homes ....................................................... 72
7.6 Consent form for the legal guardians at the hospital................................................................... 73
7.7 Assent form for the children at the hospital ................................................................................ 74
7.8 Assent form for the children at the children’s homes ................................................................. 75
7.9 Permission Letter from Rahima Moosa Mother and Child Hospital .......................................... 76
7.10 Permission Letter from Johannesburg Children’s Home .......................................................... 77
7.11 Permission Letter from Abraham Kriel Children’s Home ........................................................ 78
7.12 Permission Letter from TLC children’s home .......................................................................... 79
7.13 Permission Letter from Jacaranda Children’s home ................................................................. 80
7.14 Medical Ethics Clearance Certificate ........................................................................................ 82
7.15 Distribution Analyses: Tests for Normality .............................................................................. 83

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Chapter One:

1.1 Introduction

The following research aimed to investigate and explore the relationships between attachment
type, defense mechanisms and emotions during middle childhood (eight-twelve years) for a
disadvantaged and clinical population in a South African context. Although there is a plethora
of research into attachment, defense mechanisms and emotion respectively, there is limited
research into the relationships between attachment type, defense styles and emotion
specifically, particularly during middle childhood (Dwyer, 2005; Weinfield, 2005; Laible,
2005; Kerns, Abraham, Schlegelmilch & Morgan, 2007). There is also limited research
exploring middle childhood which seeks to investigate and explain certain characteristic
changes in a child’s development and emotional experiences, which is vital knowledge
regarding typical human development (Kerns et al., 2007). Therefore, this research
specifically sought to further the knowledge basis regarding the development of children as
impacted by institutions. This furtherance of knowledge is of vital importance for the
fostering of increased understanding on the inner workings of children from disadvantaged
and clinical settings, in an attempt to improve the treatment of, community interaction with
and development of children from these often overlooked communities globally and
specifically in South Africa. Moreover, as Zilberstein (2008) states, there has been limited
research into the development of attachment past six years of age, especially within children
currently placed in children’s homes.

There has undoubtedly been a significant amount of research into attachment, particularly
during early childhood and infancy (for example Cassidy, 1986; Cassidy & Berlin, 1994;
Izard, Haynes, Chisholm & Baak, 1991). However, there has been limited research into the
development and characteristics of attachment during middle childhood. Emotion regulation
and experience during childhood, like early attachment, has also received substantial
attention within the field of research (Bretherton, Fritz, Zahn-Waxler, and Rideway, 1986;
Cassidy, 1994). However, limited research has been conducted that specifically examines
emotion during middle childhood and its relationships with both attachment type and defense
mechanisms. There has, nevertheless, been mounting interest with respect to researching the
fundamental interactions that occur between attachment and emotion (De Rosnay & Harris,
2002; Kerns, Abraham, Schlegelmilch & Morgan, 2007) but these do not acknowledge or
investigate the effect of defense mechanisms. With respect to research conducted into defense
mechanisms during childhood there has been a substantial amount of research investigating
5
the development from mature to immature defences in children for the duration of middle
childhood and beyond (Cramer & Brilliant, 2001; Cramer, 1997). In contrast to this, there has
been sparse research which explores how defense styles interact with attachment types and
the specific experiences of emotions. Therefore, this research aimed at investigating middle
childhood and at providing detailed information on the relationship between attachment type,
defense styles and emotion range and intensity to attempt to fill in the above discussed gaps
in the literature and theory.

The importance of knowledge surrounding attachment to primary caregivers, the use of

defense mechanisms and the experience of emotions for normal psychological development
and maturation during childhood, is indisputable. Bretherton et al. (1986) highlight the need
for more in-depth research attention to be paid to the development of all forms of emotion
during childhood. This is as a result of the importance of emotions in the development of
normal psychological and social development across the lifespan, which has been repeatedly
highlighted by various theorists and researchers (Bretherton et al., 1986; DeOliveira et al.,
2004; Cassidy, 1994). Therefore, furthering our knowledge and understanding of the
experience of emotions across development is of utmost importance in the conceptualisation
of the way in which children perceive the people around them and their interpersonal
relationships (Raikes and Thompson, 2008). The majority of research into attachment has
investigated the children and infant’s representations of their attachment relationship and
attachment figure whereas little research has been conducted which investigates the secure
base behaviour and the characteristics of all the attachment types (Kerns et al., 2007).

Cassidy (1994) highlights the need for continued research into the often complex relationship
between attachment and emotions as it is an integral part of a child’s continued development.
Emotion is perceived to be an essential element of attachment and the attachment relationship
(Kerns et al., 2007) and therefore further research needs to be conducted to fully understand
the developmental changes to the relationship during the period of middle childhood. Middle
childhood is a period of a person’s development in which the internal working models
associated with the formation and maintenance of attachment to caregivers are under
transition and often subject to modification or alteration with respect to a child’s interaction
with their environment (Kerns, Abraham, Schlegelmilch & Morgan, 2005; Dubois-Comtois
& Moss, 2008). Thus the importance of understanding how normal psychosocial elements of
development, such as attachment type and defense styles interact to impact on children’s use
of emotions during middle childhood, is particularly vital to furthering our knowledge,
especially concerning children in institutions and from clinical settings.

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There is substantial evidence that defense mechanisms develop as a vital part of a
development continuum and are continuously shifting throughout childhood, particularly
during middle childhood (Cramer and Brilliant, 2001: Cramer, 1997). This change may be
due to a number of reasons including, among others, increasing cognitive abilities and
awareness (Cramer, 1997). However, although a link between the use of defense mechanisms
and the ability to regulate emotions has been acknowledged (Sandstrom & Cramer, 2003),
little is known of the impact of attachment in the developmental shifting of defenses and the
consequential impact on emotion. The majority of the research into attachment, emotions and
defenses has been conducted in Western countries and little research has been conducted in
the developing world, such as South Africa (Tomlinson, Cooper & Murray, 2005). It is
inarguable, given the evidence, that an important component of assisting those with
attachment problems lies in the ability to assess and measure attachment behaviours and its
impacts throughout the lifespan, including during middle childhood (Fairchild, 2006).

The following research, therefore, collected data through conducting interviews with 64
caregiver-child pairings at a variety of children’s homes and clinics in and around the greater
Johannesburg region. During the interview with the child’s parents/caregiver the
Comprehensive Assessment of Defense Styles (CADS) was administered. During the
interviews with the children the Attachment Story Completion Test (ASCT), The Attachment
Security Scale (ASS) and the Deferential Emotions Scale-IV (DES-IV) were administered.
The data was then quantitatively assessed to determine and explore the different relationships
between attachment type, defense style and emotional range and intensity.

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Chapter Two: Literature Review

2.1 Introduction

Attachment, defenses and emotion in children have been a subject of intensive debate and
research for many years. This is as a direct result of attachment and its correlates repeatedly
being shown to play a crucial role in human development across the lifespan (Bowlby, 1961;
1979; Bretherton, 1985; Kerns, Abraham, Schlegelmilch & Morgan, 2007). Therefore the
following literature review will look at attachment theory and the presentation of attachment
relationships, emotions and defense mechanisms and how each of these is characterised
during middle childhood. The impact of culture and the context, on the development and
presentation of attachment will also be discussed, principally with respect to those in relation
to children from institutions or foster care. The review will also consider the literature on
attachment, defense mechanisms and emotions and the interactions between these variables.

2.2 Attachment

The theory of attachment, according to its founder John Bowlby (1961; 1979), was grounded
on the child’s innate biological need for closeness both emotionally and in terms of proximity
to the caregiver in order to survive. Attachment theory is largely believed to be unique within
the spectrum of psychoanalytic theories as it closes the difference between general
psychology and the more traditional psychodynamic theory (Fonagy & Target, 2003).
Bowlby further believed that in order for mental health to be achieved and maintained across
the lifespan it is imperative that the infant and child should experience a consistent, warm,
pleasurable and close relationship with the primary caregiver (Bowlby, 1961; 1979). The
object of attachment is often experienced by the child as being a source of protection from
possibly dangerous or unwanted experiences and also to provide for their basic needs. When
these needs are met sufficiently, security is believed to be reached (Ainsworth, Waters &
Wall, 1978). Bowlby (1979) also placed relative importance on attachment to caregivers as
an imperative contributor to later development and personality formation (Kaplan & Sadock,
2007). Attachment is, therefore, experienced by children as being a natural psychological and
emotional connection with their caregivers who should present a place of safety and security
(Bretherton, 1985).

Attachment-related behaviours are at their most evident in circumstances where the infant or
child is scared of something, exhausted or physically unwell and these behaviours become

8
palpable when the child consequently seeks reassurance or affection from the caregiver, as is
discussed in further detail below (Bretherton, 1985). Children, therefore, develop ‘internal
working models’ of their caregivers based on the expected behaviours of the caregiver in
circumstances when the child seeks reassurance-related behaviours (Bowlby, 1961; 1979;
Cassidy, 1994). However, these internal working models are in constant revision, especially
during middle childhood, where children’s development is particularly swift (Bretherton,
1985). Therefore, a secure attachment is considered to be of utmost benefit to children’s
ability to explore their worlds as well as in their general range of cognition potential and their
capacity for social interaction (Fonagy & Target, 2003). However, when the child’s fear
system is stimulated by sources of danger the child will automatically seek out the attachment
figure for comfort, reassurance and a source of safety (Fonagy & Target, 2003). A secure
attachment to at least one primary caregiver is thus imperative for the child’s later ability to
be self-sufficient (Sroufe, Fox & Pancake, 1983).

Although infants are able to express attachment related behaviours from birth, it is from the
sixth month of the child’s life that these behaviours are “integrated into a coherent system,
organised around a particular figure or figures” (Bretherton, 1985. P.6). Therefore, a child is
believed to seek out an attachment figure in times of stress or discomfort, whereas when they
are in good spirits they will seek out a playmate. Nevertheless, an attachment figure can fulfil
the two roles (Bretherton, 1985). However, as mentioned above, attachment behaviours are at
their most evident when the child is frightened, tired or sick and their reactions to an
attachment figure at such times are used in the diagnosis of attachment security or insecurity
(Bretherton, 1985). Therefore, attachment behaviours “such as crying, clinging and searching
that the infant displays at times of stress evoke responses in the attachment figure leading to
greater proximity and contact to the attachment figure” (Stansfeld et al., 2008. P. 517). How
these behaviours are completed and expressed is closely related to the type of attachment the
child has with the primary caregiver. The four main attachment types include secure,
avoidant, ambivalent and disorganised (Fairchild, 2006). The insecure attachment
classifications are further divided into: the avoidant, ambivalent and disorganised attachments
which will be discussed in more detail below (Ainsworth, Waters & Wall, 1978).

Attachment security or insecurity is directly and positively linked to the accessibility of the
caregiver to the child, as well as the caregiver’s responsiveness to the child’s needs (Solomon
& George, 1999). The securely attached child will develop an internal working model which
primes the child to expect that his or her emotional needs will be met and responded to
9
appropriately by the caregiver (Cassidy, 1994). This secure attachment to a primary caregiver
is symptomatic of a balance being reached between the ability to explore actively in the
completion of goals and the knowledge of the safety of the caregiver (Boris & Zeanah, 1999).
Children with secure attachments have, therefore, been able to develop basic trust in their
caregivers. In a study conducted by Matas, Arend and Sroufe (1978) it was found that
securely attached children were more enthusiastic, confident, cooperative and persistent than
the insecurely attached children. A secure attachment has also been correlated with the ability
of children to express themselves in terms of their positive and negative personal
characteristics, thus having a healthy sense of self (Cassidy, 1988). Securely attached infants
were also found by van Ijzendoorn and Vliet Visser (2001) to have a higher intelligence (IQ)
during kindergarten as a result of more highly developed problem-solving skills and as a
result of thir ability to confidently explore their environment. Therefore, a secure attachment
suggests that the child feels comfortable with expressing and experiencing feelings of
intimacy and dependency as well as a lack of anxiety surrounding loss or separation
(Stansfeld et al., 2008).

In contrast to the above discussed securely attached child, the insecurely attached child will
develop an internal working model that predisposes the child to expect that the caregiver will
only selectively and unsatisfactorily attend to its emotional needs (Cassidy, 1994). These
insecure attachments are usually formed as a result of a disturbance in the early attachment
formation process in the early years (Stansfeld et al., 2008). The insecure attachments are
further divided into ambivalent, avoidant and disorganised attachments which will
accordingly be discussed. Firstly, the Ambivalent attachment type is characterised by a
“great desire to be close, anxiety about rejection and an awareness of wanting more intimacy
than most people” (Stansfeld et al.., 2008, p. 517). Children with ambivalent attachments, as
found by Cassidy (1988) tended to describe themselves with overt negative descriptions
which highlighted the children’s perceptions of their own lack of self-worth. Ambivalent
attachments have also been related to increased disruptive behaviours in the classroom such
as acting out, being withdrawn and often in having attention problems which are not easily
controllable (Erickson, Sroufe & Egeland, 1985).

Secondly, the Avoidant type of attachment is associated with a lack of trust in relationships
coupled with a tangible discomfort with intimacy and dependency (Stansfeld et al., 2008).
Avoidant attachments are also associated with an insistence on perfection in most areas of
life, which may be viewed as a defensive avoidance technique (Cassidy, 1988). Disorganised
attachments have been increasingly associated with the development of later

10
psychopathology (Boris & Zeanah, 1999). It is important, however, for one to take into
account that changing life circumstances have been known to alter the basic qualities of the
relationship (Bretherton, 1985).

Lastly, Disorganised attachments have also been correlated with a higher frequency of
externalising and internalising behavioural problems (Bureau, Easlerbrooks & Lyons-Ruth,
2009). Disorganised attachments, as discussed further below, represent with a fundamental
inability to regulate their emotions effectively and they therefore experience an increased
negative effect and are unable to regulate this effect when with their attachment figure, thus
impacting on the relationship (DeOliveira et al., 2004). In the disorganised attachment, the
child often fluctuates rapidly between the two extremes of having control and then suddenly
losing control over the caregiver’s behaviours (Koos & Gergely, 2001).

2.3 Attachment During Middle Childhood

Attachment behaviours are largely believed, with much debate, not to remain constant after
the infancy period (Dwyer, 2005). Middle childhood refers to the period between eight and
twelve years of age (Dwyer, 2005). According to Dwyer (2005), during middle childhood the
“children are better able to understand that caregivers have their own goals, motivations, and
feelings and can consider these factors when formulating plans to achieve their own
attachment-related goals” (P.156). However, although the basic relationships with the
attachment figures remain unchanged, the behaviours regulated by the attachment
relationship may change (Bretherton, 1985). Hence, during middle childhood the child’s
internal working models begin to represent the on-going family interactions and the resulting
understanding more than the historical relationship with their primary caregivers (Dubois-
Comtois & Moss, 2008). This may be as a result of the child’s continuing ability to more
fully understand group dynamics and social interactions and the roles they play (Dubois-
Comtois and Moss, 2008). The child’s capacity for social cognition also improves during this
period, which also impacts on its understandings and interactions (Dwyer, 2005). Middle
childhood is therefore, as described by Kerns and Seibert (2011), a time of constant
expansion of the child’s social world, relationships, cognitions and social cognitions.

Children during middle childhood are also in the process of developing a more concrete sense
of who they are and therefore are increasingly more willing and capable of managing their
own behaviours and feelings (Dwyer, 2005). Attachment behaviours also begin to change
during middle childhood, and they begin to interact and be impacted on more by external
environmental elements and internal features associated with maturational factors
11
(Zilberstein, 2006). The children are becoming more able to accurately assess the behaviours
of the attachment figure and their motives, and therefore are able to form improved coping
abilities and learn to make better assessments as to what is dangerous (Bretherton, 1985).
Although middle childhood is a period of transitions, growth and changes, there is evidence
that the attachment relationship to the primary caregiver is still central to the life of the child
(Kerns & Siebert, 2011). Although a theoretical distance is created between the parent and
child as the child progresses into middle childhood and their lives become more complex, the
parent is still able to function as a secure base for the child (Weinfield, 2005). This distance
also occurs as a result of the children’s increasing ability to form a solid sense of who they
are as individuals and thus are more able to regulate their own behaviours without reliance on
the attachment figure (Dwyer, 2005).

Therefore, the role of the parent or caregiver as a ‘secure base’ as in the traditional sense of
attachment still remains as a child progresses through middle childhood, but is altered as the
parents need to be able to provide both proximal and distal support for their child (Weinfield,
2005). This requires the parent to be able to allow the child to develop independence and
ability to face different challenges whilst still providing a consistent and supportive base for
their child (Weinfield, 2005). During middle childhood, the child is also now increasingly
able to form new relationships with adults other than the attachment figure and is therefore
more able to make comparisons and extrapolations regarding his or her own relationships
(Dwyer, 2005). Therefore, the representations of relationships the child had previously are
increasingly likely to become more sophisticated and generalised (Dwyer, 2005).

It also has been found that security in attachments with both mothers and fathers for children
in middle childhood is correlated positively to their competence scholastically and with their
relationships with their peers (Diener, Isabella, Behunin & Wong, 2008). Children with
secure attachment were also found by Diener et al. (2008) to have a higher level of overall
competence, as rated by their teachers in the classroom. This most likely occurs as a result of
the fact that as the child’s “affective-cognitive understanding grows, internal models of self,
social partners, and the physical world increase in sophistication” (Bretherton, 1985, p. 12).
Thus, middle childhood is a significant time in which the child is more active in its
exploration of the immediate and extended family relationships as well as a period of the
development of new friendships (Franco & Levitt, 1998).

Therefore, as seen in the discussion above, theories of early attachment formation have
ascertained attachment to be imperative to the future and indeed current behaviour of children
as they progress through life and the developmental demands which are placed upon them
12
(Kaplan & Sadock, 2007). There is increasing evidence from research that the pattern of
attachment relationships that develop during infancy and childhood forms a blue print for
relationships that develop in adulthood (Stansfeld, Head, Bartley & Fonagy, 2008). For
example, those who experienced secure attachments during infancy and childhood are more
likely to be able to develop and maintain stable and open relationships during adulthood as
well, having the ability to build healthy and supportive social networks (Stansfeld et al.,
2008). In contrast to this, insecurely attached children are more likely to have decreased
abilities for stable relationships and may be more subject to relationships or marriages
breaking down (Stansfeld, et al., 2008). The impact of the child’s rearing environment and
context and how it can impact on the formation of attachments will subsequently be discussed
below.

2.4 Attachment in Context

Attachment relationships between child and caregiver do not occur in a vacuum but are rather
immersed within the social context in which they are formed and maintained (Stansfeld et al.,
2008; Dwyer, 2005). Aspects such as the personality of the parent, genetic predispositions
and the mental health of the parents are all influential on the formation of attachments
(Stansfeld et al.., 2008). There is increasing evidence for the argument that environment
plays an important role in the formation and maintenance of attachment types, particularly in
infants but also in older children (Bokhorst et al., 2003). It was also found by Bokhorst et al.
(2003) that a shared environment was a greater predictor of attachment formation than a
genetic component, thus highlighting the importance of context in the development of
attachments. For example Barbarin, Richter and deWet (2001) found that, in South African
children, “ambient community violence was most consistently related to children’s
psychosocial outcomes” (p. 16). Barbarin (1999) also found that poverty is a highly
influential risk factor for South African children with regards to their development. A recent
study by Minde, Minde and Vogel (2006) has also highlighted the impact of culture and
cultural traditions on the representations of attachment patterns as being more influential than
the actual parent-child relations.

For example, the context in which a child grows up may determine the security of an
attachment such as the level of life stress and anxiety (Sroufe, 1985). This has been found in
situations of substantial poverty and lack of consistency such as in South Africa, where the
caregivers and children are facing numerous pressures (Tomlinson, Cooper & Murray, 2005).
This relates in a small number of cases of the caregiver’s preoccupation with external

13
problems or difficulties and often limits their availability to attend to their child’s needs
(Tomlinson, Cooper & Murray, 2005). This material deficit is a substantial psychological
stressor on the caregivers and most likely puts an unhealthy strain on the development of an
attachment relationship (Stansfeld, 2008). Linked to the material strains placed on the family
in the formation of attachments is the parent’s attachment history and the higher the parent or
caregiver’s quality of attachment, the higher the likelihood of their child’s adaptability
(Cowan. Cowan & Mehta, 2009). It is therefore imperative when working with attachment
and related values to always remain aware of the cultural implications and differences of the
sample and population (Minde, Minde & Vogel, 2006).

Contexts such as children’s homes and hospitals also impact on the formation and
maintenance of attachments. Attachment disturbances have increasingly been studied and
acknowledged as a result of the increasing atypical environments that children are being
reared in (Zeanah & Smyke, 2008). A diagnosis of a Reactive Attachment Disorder (APA,
2002) is being increasingly provided for children that are living in institutions such as
children’s homes (Zeanah & Smyke, 2008). It is increasingly found that disturbances of
attachments are increased with experiences of maltreatment and institutional care (Zeanah &
Smyke, 2008). However, Smyke et al. (2010) found that children who were placed in foster
care before twenty four months of age were more likely to develop secure relationships as
foster care proved to be an important intervention which reduces the adverse effects of being
institutionalised or maltreated. Similarly, children who were placed into foster care after
being placed in an institution were able, in most cases, to recover with respect to their
attachment (Smyke et al.., 2010). This highlights Bowlby’s (1979) view that attachment
security is subject to change as a result of life experience. These may include negative
experiences such as trauma or later positive experiences such as having a reliable, consistent
and dependable caregiver (Bowlby, 1961; 1979). Thus it is important for one to look at the
variables of defense mechanisms during this period of a child’s life as they too, like
attachment, are constantly developing as the child progresses through middle childhood.

2.5 Defense Mechanisms

The predominantly psychoanalytic concept of defense mechanisms has proven to be critical

to the understanding of normal psychosocial human development, normal functioning and
maladjustment (Porcerelli, Thomas, Hibbard & Cogan, 1998). Defense mechanisms were
originally considered to be a form of psychopathology, but this view was later reformulated
as understanding grew that defenses were a part of a human’s normal unconscious

14
functioning (Freud, 1954). Freud (1954) states in his series of letters to Wilhelm Fliess that:
“the inclination towards defence is detrimental, however, if it is directed against ideas which
are able, in the form of energy, to release fresh unpleasure” (p. 147). Thus, during the course
of a human’s normal functioning certain unwanted or unpleasurable emotions become
connected to certain drives and further to aspects of the child’s superego functioning
(Brenner, 1981). This, therefore, results in the use of defense mechanisms by the ego in an
attempt to minimise these unwanted or harmful emotions and to try to eliminate them;
therefore, they are seen as being specialised mechanisms employed by the human for self-
protection and maintenance (Brenner, 1981). Thus defenses are used as an attempt to protect
the ego from both the external and internal world of the person (Freud, 1950).

Children will employ ego defense mechanisms either to avoid or to help manage a stressful or
difficult circumstance or to aid in the maintenance of their self-esteem. This occurs at an
unconscious level (McWilliams, 1994; Cassidy & Brilliant, 2001). Consequently, defensive
mechanisms will be used in an attempt by the ego to protect oneself from danger, from
feelings of unwanted or pathological anxiety and also in moments of unpleasure (Freud,
1950). Anxiety and depression have been the two main affects associated with the pleasure
principle prompting the use of defense mechanisms (Brenner, 1975). According to Freud
(1989) defense mechanisms are largely employed to relieve the child of the sense of anxiety,
and if these mechanisms of defense fail the child, symptom formation will occur. This ability
to employ defense mechanisms at times of anger, anxiety or depression was seen by Freud
(1989) to be a sign of strong and largely appropriate ego functioning in the child. Defense
mechanisms are therefore employed to protect the developing ego from states of unpleasure,
thus defense mechanism such as denial, regression and symptom formation are employed in
an attempt to foster a balance between the ego and superego (Freud 1989).

Anna Freud (1989) describes defense mechanisms as being largely unconscious to the child
and therefore employed automatically, however, she viewed their results as being apparent
only to a trained observer. She viewed these mechanisms of defense as protecting the
individual from the emotional results of the continual conflict between the ego and the id, in
which the ego attempts to limit the inappropriate id impulses from entering into
consciousness to obtain gratification (Freud, 1995). According to Freud (1995) “affects must
submit to all the various methods to which the ego resorts in its attempts to master them, i.e.
they must undergo a metamorphosis (p. 32). These attempts at mastery, namely the defense
mechanisms, employed by the ego are limited in number and according to the age and ego
strength of the individual, different defense mechanisms will be employed at different times

15
according to what is required from them (Freud, 1995). A certain defense mechanism will
also be employed by the child as a result of their cognitive developmental level which
impacts on the level of complexity of the child’s mental processes and the ability to
understand his innate psychological responses (Cramer, 1983).

Research into defense use by children has uncovered a possible developmental sequence in
the use of certain defense mechanisms. In this model the primary defence mechanisms in use
during middle childhood were predominately denial, projection and identification (Cramer
and Brilliant, 2001; Cramer 1997; Porcerelli, Thomas, Hibbard and Cogan, 1998; Cramer,
2007). There also appears to be a gender difference in use of defense mechanisms with girls
tending to use more internalising defenses such as repression and boys using more
externalising defenses such as denial (Tallandini & Caudek, 2010). A child may be aware of
the occurrence of defense mechanisms within his or her behaviour but is not aware of the
underlying reasons for their existence, the drive behind their formation and the emotions
underlying them (Tallandini & Caudek, 2010). These defense mechanisms will therefore
remain effective until such time as the child becomes conscious of the defense and will thus
need a new defense to achieve the same aims (Cramer and Brilliant, 2001).

This developmental progression of defense mechanisms may be broken up into immature

defense mechanisms (e.g. denial and projection) and mature defences (e.g. sublimation and
suppression) (Cramer, 1997). The child’s progression from immature to mature defences has
been associated with the child’s cognitive and emotional development and maturation
(Cramer, 1997). Cramer (1997) has found that the average child’s change from denial to
projection occurs between eight and nine years, after which identification is steadily used
more frequently than projection. However, the defenses of projection and identification have
been found to be used more frequently than denial during childhood into adolescence and that
their usage increases with age (Cramer, 2007). This is as denial, ignoring or misrepresenting
thoughts or experiences, is seen to be a largely immature defense which predominates during
early childhood (Cramer, 2008). Whereas projection, the attributing of unwanted or negative
parts of oneself or thought onto another, and identification, the changing of the self to
resemble someone looked up to, are seen to be more mature defenses which require more
advanced cognitive abilities (Cramer, 2007; 2008).

Therefore, the developmental theory of defenses implies that at every critical developmental
stage of a child’s life there will not only be several defense mechanisms being used but that
the strength of these defense mechanisms will change and mature with the child’s increasing
age (Cramer & Brilliant, 2001). Tallandini and Caudek (2010) found a negative relationship
16
between age and the number of defence mechanisms used; for example, as the child’s age
increased, the number of defense mechanisms employed decreased. Cramer and Brilliant
(2001) hypothesise this is a result of the child’s developing understanding of the defense
mechanisms it employs, thus once the child gains intrinsic understanding of its dominant
defense mechanism it will be replaced by one that is not consciously understood. Porcerelli
et al. (1998) expand on this and state that as children move through normal mental and
psychological development, they will begin to adapt more cognitively complex and mature
defense mechanisms. Therefore defense mechanisms “relate to central aspects of the
emotional lives of children and manifest themselves differently depending on age, gender,
temperament, and verbal skills” (Tallandini & Caudek, 2010. p. 542). Linked to the use of
defense mechanisms and attachment type are the emotions that underlay both factors and this
will now be discussed in more detail below.

2.6 Emotions

Emotions are critical in the internal supervising and guiding systems and emotion systems are
thus used to evaluate situations and to stimulate human actions and reactions (Bretherton et
al., 1986). Izard (1983) offers the widely accepted opinion that emotions play a vital role in
the motivational structure of people as well as in interaction with their society and broader
culture. Izard et al. (2011) supports this view of emotions through commenting that:
“different emotion feelings have different motivational functions and are likely to lead to
different effects” (p. 45). The emotions experienced are linked to a certain level of
consciousness which is closely related to a cognitive process (Izard, 1983). This cognitive
process in turn is then linked to the cultural influences which play an important role in what
emotions are acceptable and at what level (Izard, 1983). Therefore, the deferential emotions
theory acknowledges the occurrence of a jointly causal interaction between a person’s
emotions and his or her cognitions as well as the impact of the culture of a person (Blumberg
& Izard, 1986).

Izard’s deferential emotions theory views emotions as being a crucial element of human
adaptation and that they play a vital role in the formation of both personality and
interpersonal relationships (Izard et al., 1991). Linked to this is the central role played by
emotions in the development of an infant’s and child’s attachment relationship (Izard et al.,
1991). Deferential emotions theory also proposes that the pattern of emotions experienced are
related to an integrated collection of emotions in which there is one dominant emotion which
is experienced by the person as being more intense and more frequent than others (Blumberg

17
& Izard, 1986). The emotions in the often unique collection are therefore all interrelated and
thus if one emotion is activated then the other emotions in the similar set will also be
activated as a result (Blumberg & Izard, 1986). Similarly according to Bretherton et al.
(1986) emotions and all emotional signals “permit individuals to interpret, predict, and
influence the behaviour and motivations of companions (unless there is a deliberate attempt
to mislead or deceive)” (p. 530).

The deferential emotions theory links the above mentioned interaction between emotions and
their cognitions to the development of certain emotion influenced personality traits of an
individual (Izard, Libero, Putnam and Haynes, 1993). Izard (1983) expands the description of
the differential emotions theory in stating that “the experiential component of emotion is a
quality of consciousness or feeling and at this level the emotional state is invariant across
cultures” (p. 310). However, as children develop and become more mature cognitively and
emotionally, the culture in which they are immersed will influence to some degree the
expression of certain emotions determined by the child’s age, social status, gender, family
structure and a number of other such variables (Izard, 1983). Therefore the age of a child and
the stage of development will influence the child’s use of emotions as a form of expression
which is triggered by a certain event or situation (Izard, 1983).

The regulation of emotion by children will impact on how the emotion is utilized in their
everyday function, but does not change the core aspects of that emotion (Izard, Stark,
Trentacosta, & Schultz, 2008). In order for the child to achieve adaptive functioning,
according to Izard et al. (2011), he or she must be able to use constructive emotion
utilization, which is largely as a result of a good knowledge of emotions and their differing
aspects. Izard et al. (2008) propose two forms of emotions: firstly basic emotions (interest,
joy and anger), which are present during infancy and early childhood; and more complicated
emotion schemas that emerge later in the child’s development, requiring more complex
regulation and utilization techniques. Thus, once a child has acquired an adequate knowledge
of emotions and has the support from their social environment, he will be able to regulate
emotions more effectively to express himself (Izard et al., 2008). Children are continually
assessing internal and external cues of emotion and as time progresses through middle
childhood, the child begins to use it more accurately to guide its responses to others’
behaviour (Izard et al., 2008). Thus, “as infants’ and young children’s cognitive capacities
develop, they form emotion schemas associating significant others, trust, and felt care” (Izard
et al., 2008, p. 158). Therefore the preceding discussion of emotion, defenses and attachment
has alluded to a set of underlying characteristics between attachment, defense mechanisms

18
and emotions. Consequently the possible interplays between the three variables will be
brought together and discussed below.

2.7 Attachment, Emotion and Defense Mechanisms

As a result of the above discussion it is thus important for one to now look at the relationships
and important interplay between attachment, emotion and defense styles. Attachment has
long had a relationship with emotion and has been the subject of research in previous years
(Kerns et al., 2007; Cassidy, 1994; Izard et al., 1991). For example, securely attached people
and children tend to use their emotions more effectively to help minimise their stress and to
promote the formation of more positive emotions (Kafetsois, 2004). A secure attachment also
allows for easier and more appropriate regulation of emotions (Kerns et al., 2007). This as a
consequence of the child’s ability to seek out help from the attachment figure when
experiencing distressing emotions and receive assistance with respect to how to regulate
emotions effectively and are thus able to use an open and flexible emotional knowledge
(Hageskull & Bohlin, 2004).

However, those with insecure attachments tend to use emotion regulation schemas which
promote the use of negative emotions and thus experience situations in a more disjointed
manner (Kafetsois, 2004). This relationship between attachment and emotion is possibly best
seen in the tendency for an avoidant attached child’s to severely limit his or her emotional
expressions, particularly around the caregiver (Cassidy, 1994). This is believed to be linked
to the child’s desire to minimise the relationship particularly through the limiting of negative
emotions (Cassidy, 1994). Ambivalent attachments are, however, characterised by extreme
negative emotions such as inconsolable distress when separated from caregivers and anger
directed towards the caregiver (Cassidy, 1994).

Disorganised attachments have been associated with a fundamental pathology in the

regulation of and understanding of human emotion (DeOliveira, Bailey, Moran & Pederson
2004). This is linked to a result of the emotional regulation abilities of the child being seen as
part of its strategies employed to maintain certain relationships and behaviours with the
attachment figure (DeOliveira et al., 2004). Morris, Silk, Steinberg, Myers and Robinson
(2007) have supported this hypothesis by highlighting the importance of the role played by
the family, especially the parents or caregivers, in a child’s learning how to regulate his or her
emotions. This supports Kerns et al.’s (2007) findings that children with secure attachments
displayed more positive emotions and those children with insecure attachments displayed
more negative emotions, even after accounting for the temperament of the child. Therefore,
19
emotions and the regulation of emotions may be seen as a strategy used in an attempt to
maintain the relationship they have developed with their primary caregiver (DeOliveira et al.,
2004).

Attachment is commonly seen as a means of the reduction of anxiety through the perception
of the caregiver as a secure base from which they are able to seek comfort and reassurance
(Kaplan & Sadock, 2007). Thus, this correlates with the role played by the defense
mechanisms and the relationship between attachment and defenses becomes increasingly
apparent. Ainsworth and Ainsworth (1958) highlight how a person may use defense
mechanisms in an attempt to alleviate feelings of insecurity which are being subjectively
experienced. As children develop and transition into middle childhood they learn to self
soothe more effectively to reduce their insecurity and learn to rely on themselves more than
on the attachment figure (Ainsworth & Ainsworth, 1958). Thus, in a secure attachment the
mother provides the initial soothing and calming presence and may act in a similar form to an
ego defense mechanism in the reduction of unpleasurable emotions such as anxiety or distress
(Kaplan & Sadock, 2007). As Brenner (1981) states: “when unpleasure is aroused or
threatens to be aroused, one does whatever one can do to avoid or reduce it. When one
desires gratification and pleasure one does whatever one can to achieve it” (p. 564).

Wolmer, Laor and Cicchetti (2001) determined, in their study, that a child’s ability to form
secure attachments and the capacity for emotional development is related to the mother’s
ability to form relationships with her child. The child’s ability to effectively and openly
express emotion depends largely on the attachment relationship with the parent and how the
child believes the parent will respond (Cassidy, 1994). Thus, negative emotions are less likely
to be expressed by a securely attached child and when the child does express negative
emotions the child will use more open, direct and appropriate means of expressing the
emotion (Cassidy, 1994). Therefore, the communication from an attachment relationship with
a caregiver provides the child with an understanding of emotions and how to organise their
emotional responses effectively and appropriately (Cassidy, 1994). De Rosnay and Harris
(2002) also highlight the importance of their finding of a relationship between attachment
type and the understanding of emotions. There is also a link between the use of emotions and
their regulation as a way of preserving their relationships with their attachment figure
(DeOliveira et al., 2004). As mentioned above, this link is largely due to the child’s
dependence on the attachment figure for help during highly negatively charged emotional
experiences and the ways of coping learned from this interaction which will determine the
child’s later regulation of emotion (Hagekull & Bohlin, 2004).

20
Kerns et al. (2007) discovered a relationship between secure attachments, more positive
emotions, more effective emotion regulation; and insecure attachment types such as
disorganised and ambivalent, negative emotions and emotional regulation. Similarly, children
with secure attachments have been found to be less likely to avoid talking about or
acknowledging their negative emotions (Waters, Virmani, Thompson, Meyer, Raikes and
Jochem, 2010). This was most likely due the caregiver’s acceptance of the child’s emotion
and outlook of life in general (Waters et al., 2010). Thus, with this knowledge one is able to
connect this to the use of certain kinds of defense mechanisms. For example, when negative
emotions are experienced one will seek to decrease the negative emotions possibly through
defense mechanisms or attachment seeking behaviour (Diener, Mangelsdorf, McHale &
Frosch, 2002).

Therefore, when defense mechanisms are used effectively, they assist in the management of
stress, of disappointment or sadness and any negative emotions that threaten our sense of
well-being (Cramer, 2008). Therefore, as mentioned above, progression through immature to
mature defences is closely linked to the child’s emotional development (Cramer, 1997).
Dubois-Comtois and Moss (2008) found that children in insecure attachment relationships
with their primary caregivers which were not emotionally open were more likely to use
immature defensive behaviours such as denial. Children with disorganised attachments show
a dysfunction in their ability to effectively use defenses (Koos & Gergerly, 2001). It is, as a
result, possible for one to hypothesise that attachment behaviours in themselves, and their
relationship to emotions, are representations of a complex integration of defense mechanisms
as seen in their role played in attempting to regulate caregiver responses and interactions.

Therefore the above literature review has discussed attachment and the theoretical
underpinnings of the developments of attachment relationships. It has also discussed
attachment during middle childhood, and how the representation of attachment changes as the
child progresses through childhood into early adolescence. As attachment cannot be separated
from the context in which it is both formed and maintained, the impact of environment and
context, as relevant to this research, was also looked at in the above literature review.
Defense mechanisms and defenses during middle childhood and their presentations were also
discussed. The Deferential Emotions Theory and its discussions on emotion and the
characteristics of emotion during childhood were also discussed above. Finally, the above
literature review attempted to bring the previously mentioned variables together and discuss
how attachment, defense styles and emotions are interlinked, as well as the relationships
between them as seen in theory and research. The above literature review has also shown and

21
discussed the possible relationships between the three variables and the reasons for the
relationships.

Chapter Three: Methodology

3.1 General Research Design

Due to the nature of the data collected, this study was quantitatively conducted using
statistical analysis to determine the associations between the nominal variables as well as the
correlational relationships between the interval scales of emotion and defense mechanism
usage. Therefore, this study is a correlational design as it is examining the relationships
between all the variables to better understand how they interact (Devlin, 2006). The research
therefore used statistical techniques to investigate the relationships between attachment type,
defense styles and emotional range and intensity as experienced during middle childhood.

3.2 Research Questions

The research questions for this study were as follows:

1. What is the correlation between the defense mechanisms used by the participants in this
study?

2. What is the correlation between the emotions used by the participants in this study?

3. What is the correlation between the defense mechanisms and the emotions used by the
participants in this study?

4. What are the associations between attachment and the frequency of emotions used by the
participants in this study?

5. What are the associations between attachment type and the frequency of defense
mechanisms?

6. What are the associations between the type of emotion and the maturity of defense
mechanisms?

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3.3 Sample

The sample used in this study was 64 caregiver/legal guardian and child pairings. Non-
probability purposive sampling was used to obtain the sample. The children represent a
diverse collection of socio-economic and cultural backgrounds as the children and parent
groupings came from a variety of different children’s organisations and a government
hospital. These organisations include the government hospital (n=33), Children’s Home A
(n=10), Children’s Home B (n=4), Children’s Home C (n=7) and Children’s Home D (n=10).
The sample was evenly distributed between boys (n=31) and girls (n=33).

3.4 Procedures

Permission to conduct the study by the University of the Witwatersrand and at the respective
organisations and institutions was first obtained. Once the permission had been granted in the
case of the Hospital (Appendix Fourteen) the parents or primary caregivers of the children
attending an initial intake consultation or assessment were approached by either personnel
working at the hospital or the researcher. The parent or legal guardian was then invited to
participate in the study where it was explained in detail what the research entails and a brief
description of what the research is investigating – that is “how children feel inside and
interact with the world”. The parent was then taken into a private consultation room and
received a comprehensive letter (Appendix Six) providing information on the study and what
was required of him or her and the child. The letter contained vital information pertaining to
the nature of the research and all ethical considerations that had been put into place to ensure
confidentiality, the right to withdraw at any stage and information regarding the actual study.

The parent was subsequently asked to sign a consent form (Appendix Ten) which provided
permission to interview both the parent and the child. A short demographic questionnaire
(Appendix Five) was filled in by both the researcher and the parent to gain information
regarding the child’s age, date of birth and gender. The researcher then asked the parent to fill
in a short demographic questionnaire before the CADS (Appendix Two) was administered.
The researcher assisted the parent in the completion of the CADS and was available to
explain the questions if required by the parent. The interview process with the parent did not
take longer than 20 minutes and occurred whilst the child was being interviewed by the
therapist so as to limit the amount of time used for the research. The child was then
interviewed in the same room whilst the parent was consulting with the therapist. The child

23
also received a letter (Appendix Nine), tailored specifically for children, which explained the
research and what was to be expected through their participation and was then asked to sign
an assent form (Appendix Eleven). The researcher then administered the ASCT (Appendix
One), DES-IV (Appendix Three) and the ASS (Appendix Four) to the child. The interview
with the child took approximately 30 minutes depending on the child’s responses to the
respective instruments.

Once permission had been gained from the respective children’s homes (Appendices
Fourteen to Seventeen) to conduct research, the researcher then gained consent (Appendix
Twelve) from each of the home’s caregivers prior to commencing interviews. The caregivers
and the children were invited to participate in the study and were able to refuse their
participation with no consequences. The researcher interviewed the primary caregivers, ward
mothers or house mothers of the children participating in the research. During the interview
the information sheet (Appendix Eight) was provided and read to the caregiver and the CADS
was administered for each respective child participating in the study. The caregivers were
also asked to provide demographic information for each participating child under their care.
The researcher then interviewed the child. The child also received an information sheet
(Appendix Twelve) which was read out, assent (Appendix Thirteen) was gained and the
ASCT, DES-IV and ASS were administered to the child, as in the hospital setting.
Triangulation was achieved by collecting information from a variety of sources such as
parents, children, and caregivers as well as through the use of different instruments.

Once the data has been collected and the final research report finalised all institutions or
organisations will receive a copy of the report and a detailed description of the final overall
results gathered in the study. The researcher’s contact details will be provided on the research
report and the information letters, should there be any further queries regarding the research.

3.5 Instruments

The research used a number of instruments specifically chosen to gain necessary information,
measure attachment type, and the experience of emotions and the use of defense mechanisms
during middle childhood in the sample used in this study.

i) Demographic Questionnaire

A short demographic questionnaire was completed during each interview process by the
caregiver or legal guardian of the child. The questionnaire required the parent/caregiver to

24
provide specific information regarding the child’s age, date of birth and gender. The
demographic questionnaire was completed with the assistance of the researcher.

ii) Attachment Story Completion Test

The Attachment Story Completion Test (ASCT) was specifically chosen for this study as it
makes use of doll play narratives which technique was created for middle childhood and uses
the child’s developing ability to use language to directly access the child’s internal working
models of the primary caregivers, thus classifying into an attachment type (Bretherton,
Ridgeway and Cassidy, 1990). The Attachment Story Completion Test (ASCT) uses play
therapy related acting out of attachment related issues through the use of narratives
specifically chosen to insight attachment behaviours (Fairchild, 2006). The validity of the use
of doll play narratives has been confirmed by correlations between the stories told by the
children and the interactions with their primary caregivers (Dubois-Comtois & Moss, 2008).
The ASCT was the main instrument used by the researcher to diagnose the attachment types
of the children participating in the study. The attachment type was classified according to a
specific set of requirements and characteristics which are specific to each of the respective
attachment types. Granot and Mayseless (2001) have successfully adapted Bretherton,
Ridgeway and Cassidy’s (1990) Attachment Story Completion Task for the assessment of
attachment during middle childhood. This adaptation of the original ASCT was necessary as
this age group has been largely under-researched due to lack of an adequate and reliable
measurement of attachment in older children. The diagnosis and classification of the children
into an attachment type was assisted by the research supervisor, a practicing clinical
psychologist, who has expertise in the field of attachment types during childhood.

During the administration of the ASCT in the interview the researcher used a standardized
set of dolls and various props to present the beginnings of various stories with attachment
related themes to the child. The children were then asked to tell the researcher “what will
happen next” and complete the story as they wished. The gender of the child was matched to
that of the child in the story being told and completed, thus for female children a girl was the
main character in the story and for male children a boy was used. Culturally neutral names
were also used in the stories. The seven story narratives used in the ASCT are 1) the child
spills juice during dinner, 2) the child hurts a knee and bleeds after falling off a rock, 3)
something frightening is seen after going to bed, 4) the mother leaves the child with a sitter
for a few days and 5) the mother and child are reunited after the three day separation, and two
additional stories as introduced by Kerns (2007) 6) the child requires assistance with the
completion of a homework task and 7) the child has a fight with a friend. The children were
25
then classified as belonging to one of four attachment types: Secure, Avoidant, Ambivalent
and Disorganized according to a strict set of criteria provided by Kerns (2007). This scale has
not been standardised in South Africa at the time of completion.

iii) The Comprehensive Assessment of Defence Styles

The Comprehensive Assessment of Defense Style (the CADS) is: “a measure to assess
adaptive and maladaptive defensive behaviour in children and adolescents based on observer
reports” (Wolmer, Laor and Cicchetti, 2001, p. 369). The CADS required the parent of the
child to answer 26 likert type scale questions regarding their child’s behavioural tendencies.
According to Laor, Wolmer and Cicchetti (2001) the CADS is useful in the assessment of the
child’s use of defensive behaviour and focuses specifically on difficult situations the child
may encounter. The CADS has been proven to have both strong validity and reliability (See
Laor, Wolmer and Cicchetti, 2001). This instrument tests for both mature and immature
defences which tend to change as the child matures psychologically (Cramer, 1997). Wolmer
et al. (2001) conclude that: “the assessment of defences with the CADS is efficient in terms
of time and requires no special professional training for coding responses” (p. 375). The
defense mechanisms were then categorised as being mature or immature according to the
responses provided in the likert type scale as based on the defense mechanism literature
(Freud, 1995; 1989).

iv) Deferential Emotions Scale –IV

The Differential Emotions Scale (the DES-IV) was used in the study to assess the range and
intensity of the emotions experienced by each respective child. The DES-IV required the
children to rate how often they felt a certain emotion in the last week, ranging from “never”
to “very often” (Blumberg & Izard, 1986). The researcher did assist the children in their
completion of the DES-IV as some of the children did not have the necessary literary skills to
read and complete the questionnaire unassisted. A child-friendly visual card was also used to
aid the child in choosing their most accurate response. The DES-IV scales were used by the
researcher to assess an individual’s experiences of the fundamental emotions, and the
intensity of these (Izard and Blumberg, 1986). The DES assessed for the presence and
intensity of the twelve fundamental emotions as identified by Izard et al.’s (1993) deferential
emotion scale which are: joy, surprise, interest, fear, sadness, anger, contempt, disgust,
shame, embarrassment (or shyness), self-directed hostility and guilt. The experience of
emotions was provided according to to the likert type scale with a score ranging between 0

26
(Never) and 4 (Very often) as to how often a certain emotion was experienced during the last
week, so as to make it more accessible to the child participant.

v) Attachment Security Scale

The Attachment Security Scale (ASS) (Kerns et al., 1996) was only used in the study to aid
in the classification of the children as either being securely or insecurely attached. The ASS
was also used to validate the attachment classifications as found through the ASCT when the
attachment classification was not clear according to the criteria provided by Granot and
Mayseless (2001) and Kerns et al. (2007). Thus the ASS acted as a classification check for
the classifications into attachment types using the ASCT. The ASS is a 15 point questionnaire
which requires the self-report of the perception of the child’s attachment security. The ASS
asks simple questions such as: “some kids find it easy to trust their mom/dad BUT other kids
are not sure if they can trust their mom/dad”. The ASS therefore assesses the degree to which
the child perceives the attachment figure as being responsive to their needs and available to
the child, the ability and tendency for a child to rely on the attachment figures in times of
stress or need and the child’s perception of the ease in which it is able to communicate its
feelings and interests in the communication with the figure (Kerns & Aspelmeier, 2001).

3.6 Methods of Analysis

Once all the interviews were completed and the data was collected the data was quantitatively
assessed with respect to the relationships between attachment type, defense style and
emotional range and intensity during middle childhood using statistics. The Attachment Story
Completion Test (ASCT) responses for each child were assessed and classified as either
securely or insecurely (avoidant, ambivalent or disorganised) attached providing nominal
data. This classification was completed using the detailed guidelines provided by Granot and
Mayseless (2001) and Kerns et al. (2007) and the criteria highlighted for each of the four
attachment types. According to these guidelines, a secure relationship was characterised by
the parent-child relationship being portrayed as being warm and as providing the child with a
sense of security (Granot & Mayseless, 2001; Kerns et al., 2007). However, in an insecure
attachment a visible distance between the child and the attachment figure was narrated in the
story stem and the parent was not shown to provide a sense of stability or security (Granot &
Mayseless, 2001; Kerns et al., 2007).

As a number of the story stems pose the problem of a possible conflict interaction or an
expression of negative emotions: a secure attachment was seen to provide a ‘happy ending’
27
where the problem was resolved and there was an ability to return to normality, however an
insecure attachment there was either an embellishment of the conflict or a denial/avoidance
of the negative emotions (Granot & Mayseless, 2001; Kerns et al., 2007). The openness of
the expression of emotions and the reactions of the protagonists a well as the coherence of the
story provided were assessed according to the criteria and a final decision was made as to
whether the child had a secure, avoidant, ambivalent or disorganised attachment (Granot &
Mayseless, 2001; Kerns et al., 2007). To provide inter-rater reliability the researcher
consulted colleagues to ensure the correct attachment type was given to the child. The ASS
responses were also taken into consideration when scoring the ASCT if doubt arose as to the
correct attachment type.

The DES-IV provided information regarding the emotions experienced by the child in the
past week on the self-report scale which required the child to choose an option of increasing
intensity (zero being never and five very often) on a likert type scale, a score was obtained for
each emotion experienced. Nominal categories for the frequency of the experience of
emotions was acquired between separating low (below 2.5) and high (2.5 and above) scores
for each emotion score.

The CADs provided numerical information pertaining to the child’s use of immature or
mature defense styles. The primary caregiver or legal guardian of the child was required to
complete 26 questions on a scale ranging between zero (never) to four (frequently) based on
their child’s reactions and behaviours. Nominal categories were obtained for the frequency of
the use of defense mechanism by dividing the scores into high frequency (above 2) and low
frequency (2 and below). A test of normality and parametric assumptions was carried out to
determine the correct statistical analysis for the data collected. Therefore, due to the nominal
(categorical) data that will be provided for the attachment type and the interval data provided
by the defense and emotion (positive and negative) variables a set of Pearson’s correlational
analyses were conducted to investigate the relationships between emotions and defense
mechanisms. The associations between attachment and emotional frequency, between
attachment and defense mechanism frequency and between the frequencies of the type of
emotion (positive and negative) and the maturity (mature and immature) of defense
mechanisms were assessed using a series of chi squared tests of association.

28
3.7 Ethical Considerations

This research dealt with a vulnerable population and therefore it was imperative that certain
ethical considerations were in place in order to protect the children and caregivers
participating in the study. The research was granted ethical clearance by the University of the
Witwatersrand. At all times the research process was overseen by a clinical psychologist and
the researcher worked closely with the staff at all institutions. The child and caregiver were
interviewed in safe, secure and private rooms and were not subject to any external stressors
while they were participating in the research. If, at any stage during the interview process, the
child or caregiver seemed distressed about the content of the interview or by the interview
itself the interview was immediately stopped and appropriate steps taken. However, this only
occurred once during the interview process. All participants received a detailed information
sheet (one for the caregiver and one for the child) which informed that participant about
exactly what the participation entailed, on the researcher contact details and on information
pertaining to the nature of the research.

Most of the facilities or organisations involved in the research do offer inexpensive or free
counselling services to the children and caregivers, and if those were not offered the
participants were informed of organisations were they could seek counselling. All questions
in the instruments being used during the interviews had been thoroughly checked to limit the
possibility of evoking highly emotional or distressful responses. The researcher was,
however, acutely aware throughout the interview process of any questions or tasks which
may be problematic and continuously monitored reactions closely. If at any stage the child
appeared to be distressed, the interview was prepared to immediately terminate the interview
and to make an appropriate referral. This, however, did not occur during the interview
process. The researcher required the informed consent of the caregiver and the informed
assent of the child to be provided prior to any interviews being conducted. Participants were
also informed of the security of their information and responses. The participants were also
informed of any possible risks and benefits in participating in the study before taking part in
the interview process. Each organisation used in the study will be provided with a copy of the
final research report.

Chapter Four: Results

The following results represent the statistical analyses conducted in order to investigate the
relationships between attachment type, emotions and defense mechanisms during middle
29
childhood. The first set of analyses conducted were the one way frequencies, the summary
statistics and the descriptive statistics for the data collected for the 64 children assessed. The
distribution of the data was then analysed to determine normality and were found to be within
the normal range, allowing for the use of parametric statistics to be used. A set of Pearson’s
correlations were conducted to explore the relationships between the use of emotions and
defense mechanisms during middle childhood. The first set of Pearson’s correlations
conducted was to investigate the relationships between the different defense mechanisms
employed by the participants. The next set of Pearson’s correlations was conducted to
research the relationships between the different emotions. The third, and final, set of
Pearson’s correlations was conducted to investigate the relationships between the usage of
defense mechanisms and emotions during middle childhood.

The final sets of statistical analyses run on the data received for the sample were a set of chi
squared tests of association. The first set was run to explore the relationships between the
attachment types and the frequency of emotions used. The second sets of associations that
were investigated through chi squared tests of associations were the relationships between the
type of attachments and the frequency of the use of defense mechanisms. The last chi squared
tests of association that were conducted investigated the associations between the type of
emotion (positive or negative) and the maturity of defense mechanisms (mature or immature),
as used during middle childhood.

4.1 Descriptive Statistics

Firstly the one way frequencies, summary statistics and descriptive statistical analyses were
run of the data to determine its characteristics. Thus table 1 below summarises the results
obtained for the DES-IV (Emotions) and table 2 summarises the results obtained for the
CADS (Defenses). Eleven secure attachments were found within the sample, with 54 having
insecure attachments. The insecure attachments were broken down into 27 avoidant, 15
ambivalent and 11 disorganised type of attachments. The sample’s age range was between
eight to twelve years with an even distribution of: 14 eight year olds, 10 nine year olds, 10 ten
year olds, 15 eleven years and 15 twelve year olds. The genders of the participants were
equally distributed between boys (n=33) and girls (n=31).

i) Mean Distribution of Emotions

Table 1 (below) provides information regarding the usage of emotions through their means
and standard deviations. As seen in Table 1 (below), the three positive emotions that received
30
the highest mean scores were: enjoyment (µ=2.6718; SD=1.322), interest (µ=2.16; SD=1.26)
and surprise (µ=2.09; SD=1.26). The highest mean scores for the negative emotions were for
disgust (µ=1.97; SD=1.31), Fear (µ=1.97; SD=1.42) and Guilt (µ=1.91; SD=1.32) with the
lowest scoring emotion was shame (µ=1.64; SD=1.41).

Table 1: Mean Distribution for Emotions (DES-IV) Scores

Variable Mean Standard Minimum Maximum N

Deviation
Interest 2.1562 1.2626 0 4 64

Enjoyment 2.6718 1.3220 0 4 64

Surprise 2.0937 1.2563 0 4 64

Sadness 1.7812 1.3147 0 4 64

Anger 1.8750 1.4198 0 4 64

Disgust 1.9687 1.3089 0 4 64

Contempt 1.6562 1.2751 0 4 64

Fear 1.9687 1.4250 0 4 64

Guilt 1.9062 1.3179 0 4 64

Shame 1.6406 1.4070 0 4 64

Shyness 1.7343 1.1580 0 4 64

Hostility 1.6718 1.5019 0 4 64

Total 23.125 7.0452 7 42 64

Emotions
Total Positive 6.9218 2.4057 1 12 64

Total 16.2968 6.7557 0 34 64

Negative

ii) Mean Distributions of Defense Mechanisms

Table 2 (below) provides the mean distributions for the defense mechanisms scores obtained
for the participants in the current study. The highest mean scores were for altruism (µ=1.94;
SD=1.49), devaluation (µ=1.96; SD=.9407), idealisation (µ=1.98; SD=.99) with
identification (µ=2.2; SD=.77) having the highest mean score. The lowest mean scores were
for the defense mechanisms were humour (µ=1.44; SD=.79) and denial (µ=1.44; SD=.89).

31
 Table 2: Mean Distribution for Defense (CADS) Scores

Variable Mean Standard Minimum Maximum N

Deviation
Altruism* 1.9375 1.4919 0 3 64

Denial 1.4375 0.8886 0 3 64

Devaluation 1.9609 0.9407 0 3 64

Humor* 1.4375 0.7933 0 3 64

Idealization 1.9843 0.9900 0 3 64

Identification* 2.2031 0.7661 0 3 64

Omnipotence 1.8671 0.8391 0 3 64

Passive aggressive 1.7734 0.9753 0 3 64

Projection 1.7187 1.0259 0 3 64

Somatization 1.1953 0.8462 0 3 64

Splitting 1.8671 1.0586 0 3 64

Suppression 1.1718 1.0586 0 3 64

Withdrawal 1.8047 0.9743 0 3 64

Total Immature 16.9765 4.7796 5.5 27.5 64

Total Mature 5.5 1.8082 1 9 64

Total Defense 22.5625 5.0249 12 34.5 64

4.2 Correlations Between Defense Mechanisms

The next analysis that was conducted was a parametric Pearson’s correlation to investigate
the relationships between the defense mechanisms used by the participants as well as to gain
information regarding the strength of the relationships of the statistically significant
relationships. The results provided by the Pearson’s correlation between the defense
mechanisms are shown in Table 3. Of all the significant relationships found between the
different defense mechanisms, all were positive. This means that, for every significant
relationship found by the analysis, as the usage of one of the defenses increased the

32
significantly related defense also increased. This relationship also applied when the usage
decreased in one of the defenses, it also decreased in the significantly correlated defense
mechanism.

The table of correlations (See Table 3 below) shows that there were fourteen significant
correlations between the defense mechanisms themselves with an additional nine significant
correlations between the defense mechanisms and the total scores for immature defense
mechanisms. There were also five significant correlations between the defense mechanisms
and the total score for mature defense mechanisms. Of these correlations, only four classified
as having weak correlational strengths. In total fifteen of these correlations were within the
moderate relationship range, five within the strong relationship strength range and only two
relationships fell within the very strong strength range of correlational relationships. These
relationships will now be discussed in further detail below. The weak correlations were
concerning: altruism and humour (r=.20; p=.018); passive aggressiveness and omnipotence
(r=.27; p=.032); idealisation and the total for mature defenses (r=.25; p=.042) and finally
between identification and the total for mature defenses (r=.042; p=<0.0001).

The correlational relationships of moderate strength were found between: devaluation and
omnipotence (r=.29; p=.0016); projection and devaluation (r=.34; p=.0046); devaluation and
splitting (r=.43; p=.0004); humour and suppression (r=.36; p=.0032); humour and denial
(r=.31; p=.0124); as well as between omnipotence and splitting (r=.34; p=.0065). The
stronger moderate relationships (above 0.4) were between: devaluation and splitting (r=.43;
p=.0004); passive aggressiveness and somatisation (r=.47; p=<.0001); passive aggressiveness
and splitting (r=.44; p=.0003); and lastly between somatisation and splitting (r=.48;
p=<.0001). Furthermore there were also moderate correlations between: denial and the total
for immature defenses (r=.34; p=.0053); idealisation and the total for immature defenses
(r=.34; p=.0065); omnipotence and the total for immature defenses (r=.36; p=.0035);
Suppression and the total for mature defenses (r.33; p=.0087); and finally the strongest being
that of withdrawal and the total for immature defenses (r=.43; p=.0004). Very strong
correlational relationships were found between splitting and the total for immature defenses
(r=.71; p=<.0001), between altruism and the total for mature defenses (r=.74; <.0001) as well
as between the use of humour and the total for the use of mature defense mechanisms (r=.74;
p=<.0001).

The following diagram (Figure 1 on page 37) provides a visual representation of the
interactions found between the significant correlations from the first set of Pearson’s
correlations, between the different defense mechanisms as reported by the CADs. As
33
illustrated in the diagram, splitting appears to have the most correlations between all of the
defense mechanisms and that humour and its correlates are separate from the main set of
interactions. Thus, humour, altruism, splitting and denial are correlated separately from the
other defense mechanisms, thereby forming a separate interaction and pattern of the defenses
that may occur in isolation. This will be discussed in further detail during the discussion
below.

34
 PASSIVE TOTAL TOTAL DEFENCE
ALTURUISM* DENIAL DEVALUATION HUMOR* IDEALIZATION IDENTIFICATION* OMNIPOTENCE AGGRESSION PROJECTION SOMATISATION SPLITTING SUPPRESSION WITHDRAWAL IMMATURE MATURE TOTAL
ALTURUISM* -0.0237 -0.1160 0.2931 0.2083 0.1716 0.0231 -0.1548 -0.2266 -0.2083 -0.1378 0.1887 -0.0693 -0.1040 0.7433 0.1804
1 0.8523 0.361 0.0187 0.0985 0.1751 0.8558 0.2217 0.0717 0.0984 0.2774 0.1352 0.5862 0.4132 <.0001 0.1537
DENIAL -0.0237 1 -0.0139 0.3110 0.2188 0.0414 0.0982 0.0858 0.0670 0.1033 0.0741 0.1544 0.2245 0.3447 0.1633 0.3895
0.8523 0.9128 0.0124 0.0823 0.7449 0.4401 0.5002 0.5987 0.4166 0.5604 0.2231 0.0744 0.0053 0.1973 0.0015
DEVALUATION -0.1160 -0.0139 1 -0.2103 -0.0858 0.1253 0.3868 0.2092 0.3496 0.2240 0.4295 -0.1950 0.3287 0.5261 -0.1466 0.4386
0.361 0.9128 0.0953 0.4998 0.3236 0.0016 0.097 0.0046 0.0751 0.0004 0.1225 0.008 <.0001 0.2477 0.0003
HUMOR* 0.2931 0.3110 -0.2103 1 0.1451 0.0680 0.1359 0.0393 -0.1089 -0.0268 -0.0763 0.3625 -0.1609 0.0089 0.7381 0.2839
0.0187 0.0124 0.0953 0.2524 0.593 0.284 0.7578 0.3917 0.8331 0.5486 0.0032 0.2039 0.9443 <.0001 0.023
IDEALIZATION 0.2083 0.2188 -0.0858 0.1451 1 0.1963 -0.0139 0.0551 0.0099 0.1503 0.2293 0.0376 0.0862 0.3369 0.2549 0.4022
0.0985 0.0823 0.4998 0.2524 0.1199 0.9129 0.6652 0.9378 0.2357 0.0684 0.768 0.4982 0.0065 0.0421 0.001
IDENTIFICATION* 0.1716 0.0414 0.1253 0.0680 0.1963 1 0.0901 0.05415 0.0660 0.2205 0.0833 0.2057 0.059 0.0863 0.4785 0.2538
0.1751 0.7449 0.3236 0.593 0.1199 0.4788 0.6708 0.604 0.0799 0.5129 0.1029 0.6433 0.4978 <.0001 0.0429
OMNIPOTENCE 0.0231 0.0982 0.3868 0.1359 -0.0139 0.09012 1 0.2684 0.1924 0.0520 0.3367 0.0033 0.1359 0.3598 0.1494 0.4010
0.8558 0.4401 0.0016 0.284 0.9129 0.4788 0.032 0.1277 0.683 0.0065 0.9789 0.2842 0.0035 0.2385 0.001
PASSIVE -0.1548 0.0858 0.2092 0.0393 0.0551 0.0541 0.2684 1 0.6129 0.4724 0.4353 -0.0220 0.0699 0.5507 -0.0205 0.5183
AGGRESSION
0.2217 0.5002 0.097 0.7578 0.6652 0.6708 0.032 <.0001 <.0001 0.0003 0.8625 0.5828 <.0001 0.8719 <.0001
PROJECTION -0.2266 0.0670 0.3496 -0.1089 0.0099 0.0660 0.1924 0.6129 1 0.4919 0.5116 -0.1369 0.0957 0.5629 -0.1462 0.4837
0.0717 0.5987 0.0046 0.3917 0.9378 0.604 0.1277 <.0001 <.0001 <.0001 0.2807 0.4515 <.0001 0.2489 <.0001
SOMATISATION -0.2083 0.1033 0.2240 -0.0268 0.1503 0.2205 0.0520 0.4724 0.4919 1 0.4828 0.1110 0.0903 0.6362 -0.0641 0.5710
0.0984 0.4166 0.0751 0.8331 0.2357 0.0799 0.683 <.0001 <.0001 <.0001 0.3822 0.4776 <.0001 0.6144 <.0001
SPLITTING -0.1378 0.0741 0.4295 -0.0763 0.2293 0.0833 0.3367 0.4353 0.5116 0.4828 1 0.1233 0.2327 0.7055 -0.0881 0.6458
0.2774 0.5604 0.0004 0.5486 0.0684 0.5129 0.0065 0.0003 <.0001 <.0001 0.3316 0.0642 <.0001 0.4885 <.0001
SUPPRESSION 0.1887 0.1544 -0.1950 0.3625 0.0376 0.2057 0.0033 -0.0220 -0.1369 0.1110 0.1233 1 0.0869 0.2141 0.3254 0.3067
0.1352 0.2231 0.1225 0.0032 0.768 0.1029 0.9789 0.8625 0.2807 0.3822 0.3316 0.4946 0.0893 0.0087 0.0137
WITHDRAWAL -0.0693 0.2245 0.3287 -0.1609 0.0862 0.059 0.1359 0.0699 0.0957 0.0903 0.2327 0.0869 1 0.4276 -0.0923 0.3688
0.5862 0.0744 0.008 0.2039 0.4982 0.6433 0.2842 0.5828 0.4515 0.4776 0.0642 0.4946 0.0004 0.468 0.0027
TOTAL -0.1040 0.3447 0.5261 0.0089 0.3369 0.0863 0.3598 0.5507 0.5629 0.6362 0.7055 0.2141 0.4276 1 -0.0394 0.9251
IMMATURE
0.4132 0.0053 <.0001 0.9443 0.0065 0.4978 0.0035 <.0001 <.0001 <.0001 <.0001 0.0893 0.0004 0.7567 <.0001
TOTAL MATURE 0.7433 0.1633 -0.1466 0.7381 0.2549 0.4785 0.1494 -0.0205 -0.1462 -0.0641 -0.0881 0.3254 -0.0923 -0.0394 1 0.3340
Table 3: Correlation Results of Defense Mechanisms (all at 95% significance)

<.0001 0.1973 0.2477 <.0001 0.0421 <.0001 0.2385 0.8719 0.2489 0.6144 0.4885 0.0087 0.468 0.7567 0.007
DEFENSE TOTAL 0.1804 0.3895 0.4386 0.2839 0.4022 0.2538 0.4010 0.5183 0.4837 0.5710 0.6458 0.3067 0.3688 0.9251 0.3340 1
0.1537 0.0015 0.0003 0.023 0.001 0.0429 0.001 <.0001 <.0001 <.0001 <.0001 0.0137 0.0027 <.0001 0.007

35
Figure 1: Defense Mechanism Pearson Correlations Interaction Diagram

36
4.3 Correlations Between Emotions

A second Pearson’s correlation analysis (see Table 4) was conducted to investigate the
relationships between the usages of the different emotions by the participants. Overall the
results showed that there were thirty four significant relationships between all the emotional
variables assessed. Of the relationships found to be significant, thirteen were exclusively
between the different emotions tested. Nine of the relationships were between and emotion
and the total score for emotions. Scores for positive and negative emotions were also
correlated and eight of the significant relationships were between emotions to the negative
emotions total with a total of three to the total for positive emotions. Of the total significant
correlations found between the different emotions, eight were of weak strength and twelve
were considered to have moderate strength. Ten of the significant correlations had a strong
correlation and four had very strong correlational strengths. These different significant
correlations will be discussed below.

Firstly, weak positive correlational relationships were found between surprise and the total
emotional score (r=.26; p=.039); sadness and contempt (r=.29; p=.0196); sadness and guilt
(r=.29; p=.02); Anger and the total for emotion (r=.53; p=<.0001); disgust and contempt
(r=.29; p=.0209); contempt and shame (r=.25; p=.0477); contempt and hostility (r=.28;
p=.025); and finally between guilt and shame (r=.32; p=.009). Secondly moderate positive
correlational relationships were found between the following emotions: surprise and
contempt (r=.35; p=.0049); sadness and fear (r=.47; p=.0001); sadness and shame (r=.40;
p=.001); anger and contempt (r=.35; p=0049); disgust and shame (r=.46; p=.0001); disgust
and shyness (r=.31; p=.0131); contempt and the total score for emotions (r=.44; p=.0003);
contempt and the total score for negative emotions (r=.38; p=.0017); fear and the total for
negative emotions (r=.47; p=<.0001); shyness and the total score for emotions (r=.48;
p=<.0001); and lastly between shyness and the total score for negative emotions (r=.48;
p=<.0001). The only negative moderate correlation was between sadness and enjoyment (r=-
.34; p=.0064).

37
Thirdly strong positive correlational relationships were found between the following
emotions: interest and the total score for positive emotions (r=.61; p=<.0001); enjoyment and
the total score for positive emotions (r=.60; p=<.0001); surprise and the total score for
positive emotions (r=.67; p=<.0001); sadness and the total score for emotions (r=.53;
p=<.0001); anger and the total score for negative emotions (r=.59; p=<.0001); disgust and the
total score for emotions (r=.62; p=<.0001); disgust and the total score for negative emotions
(r=.58; p=<.0001); guilt and the total score for emotions (r=.53; p=<.0001); guilt and the total
score for negative emotions (r=.57; p=<.0001); shame and the total for emotions (r=.63;
p=<.0001); hostility and the total for emotions (r=.50; p=<.0001); and finally between
hostility and the total for negative emotions (r=.55; p=<.0001). It is interesting to note that
the large majority of the significant strong positive correlations between emotions were
between the emotions and the total score for emotions, the total score for negative emotions
and the total score for positive emotions. The only very strong relationship between emotions
was the correlation between shame and the total score for negative emotions (r=.71;
p=<.0001).

Figure 2 (on page 41) provides a visual representation of the interactions found to exist
between the emotions, as reported by the children during the administration of the DES-IV.
Figure 2 provides a diagram of the significant correlations as found by the second set of
Pearson’s correlations that were found to exist in the usage of emotions by the participants in
the study. It is interesting to note the influential role played by contempt with the
experiencing of the other emotions tested.

38
 INTEREST* ENJOYMENT* SURPRISE* SADNESS ANGER DISGUST CONTEMPT FEAR GUILT SHAME SHYNESS HOSTILITY EMOTIONS TOTAL TOTAL
TOTAL POSITIVE NEGATIVE

INTEREST* 1 -0.0068 0.1707 0.0400 -0.0686 0 -0.1435 0.0115 -0.1436 -0.0304 0.1916 -0.1064 0.1280 0.6102 -0.0706
0.9573 0.1774 0.7535 0.59 0.2662 0.2577 0.9276 0.2574 0.8113 0.1292 0.4024 0.3134 <.0001 0.579
ENJOYMENT* -0.0068 1 0.1048 -0.2793 -0.0813 0.1682 -0.0114 -0.0308 -0.0817 -0.1753 -0.0059 -0.0231 0.1033 0.6006 -0.1275

0.9573 0.4097 0.0254 0.5226 0.1838 0.9283 0.8091 0.521 0.1658 0.9625 0.8562 0.4165 <.0001 0.3152
SURPRISE* 0.1707 0.1048 1 -0.1026 0.0422 0.0983 0.3474 -0.1401 0.0149 0.0103 -0.0698 -0.0255 0.2586 0.6694 0.0153
0.1774 0.4097 0.4194 0.7402 0.4395 0.0049 0.2692 0.9065 0.9351 0.5831 0.8415 0.039 <.0001 0.9041
SADNESS 0.0400 -0.2793 -0.1026 1 0.2911 0.3371 -0.0644 0.4706 0.2902 0.4029 0.1697 0.1640 0.5255 -0.1861 0.6131
0.7535 0.0254 0.4194 0.0196 0.0064 0.6127 <.0001 0.02 0.001 0.18 0.1953 <.0001 0.1409 <.0001
ANGER -0.0686 -0.0813 0.0422 0.2911 1 0.2284 0.1424 0.1627 0.4686 0.3267 0.2304 0.2707 0.5855 -0.0586 0.5864

0.59 0.5226 0.7402 0.0196 0.0694 0.2614 0.1987 <.0001 0.0084 0.0669 0.0305 <.0001 0.6452 <.0001
DISGUST -0.1410 0.1682 0.0983 0.3371 0.2284 1 0.2882 0.1611 0.1546 0.4591 0.3085 0.2288 0.6235 0.0697 0.5754
0.2662 0.1838 0.4395 0.0064 0.0694 0.0209 0.2033 0.2223 0.0001 0.0131 0.0689 <.0001 0.5837 <.0001
CONTEMPT -0.1435 -0.0114 0.3474 -0.0644 0.1424 0.2882 1 -0.0846 0.2166 0.2485 0.1414 0.2799 0.4412 0.0997 0.3842
0.2577 0.9283 0.0049 0.6127 0.2614 0.0209 0.5062 0.0855 0.0477 0.265 0.025 0.0003 0.4328 0.0017
FEAR 0.0115 -0.0308 -0.1401 0.4706 0.1627 0.1611 -0.0846 1 0.2266 0.1843 0.1487 0.0470 0.4225 -0.0840 0.4675
0.9276 0.8091 0.2692 <.0001 0.1987 0.2033 0.5062 0.0718 0.1449 0.2406 0.712 0.0005 0.509 <.0001
GUILT -0.1436 -0.0817 0.0149 0.2902 0.4686 0.1546 0.2166 0.2266 1 0.3239 0.1290 0.2007 0.5397 -0.1124 0.5718
0.2574 0.521 0.9065 0.02 <.0001 0.2223 0.0855 0.0718 0.009 0.3096 0.1118 <.0001 0.3762 <.0001
SHAME -0.0304 -0.1753 0.0103 0.4029 0.3267 0.4591 0.2485 0.1843 0.3239 1 0.2035 0.3038 0.6306 -0.1069 0.7127
Table 3: Correlation Table for Emotions

0.8113 0.1658 0.9351 0.001 0.0084 0.0001 0.0477 0.1449 0.009 0.1068 0.0147 <.0001 0.4005 <.0001
SHYNESS 0.1916 -0.0059 -0.0698 0.1697 0.2304 0.3085 0.1414 0.1487 0.1290 0.2035 1 0.2046 0.4846 0.0608 0.4789
0.1292 0.9625 0.5831 0.18 0.0669 0.0131 0.265 0.2406 0.3096 0.1068 0.1048 <.0001 0.6332 <.0001
HOSTILITY -0.1064 -0.0231 -0.0255 0.1640 0.2707 0.2288 0.2799 0.0470 0.2007 0.3038 0.2046 1 0.5049 -0.0818 0.5557
0.4024 0.8562 0.8415 0.1953 0.0305 0.0689 0.025 0.712 0.1118 0.0147 0.1048 <.0001 0.52 <.0001
EMOTIONS 0.1280 0.1033 0.2586 0.5255 0.5855 0.6235 0.4412 0.4225 0.5397 0.6306 0.4846 0.5049 1 0.2590 0.9163
TOTAL
0.3134 0.4165 0.039 <.0001 <.0001 <.0001 0.0003 0.0005 <.0001 <.0001 <.0001 <.0001 0.0387 <.0001
TOTAL 0.6102 0.6006 0.6694 -0.1861 -0.0586 0.0697 0.0997 -0.0840 -0.1124 -0.1069 0.0608 -0.0818 0.2590 1 -0.0991
POSITIVE
<.0001 <.0001 <.0001 0.1409 0.6452 0.5837 0.4328 0.509 0.3762 0.4005 0.6332 0.52 0.0387 0.4357
TOTAL -0.0706 -0.1275 0.0153 0.6131 0.5864 0.5754 0.3842 0.4675 0.5718 0.7127 0.4789 0.5557 0.9163 -0.0991 1
NEGATIVE
0.579 0.3152 0.9041 <.0001 <.0001 <.0001 0.0017 <.0001 <.0001 <.0001 <.0001 <.0001. <.0001 0.4357

39
Figure 2: Emotions Pearson Correlations Interaction Diagram

40
4.4 Correlations Between Defense Mechanisms and Emotions

A Pearson’s correlation was also conducted to explore the relationships between the defense
mechanisms and emotions of the participants (see Table 5, below). In total there were thirteen
significant correlations between the defense mechanisms and the emotions. Of those
correlations nine were of moderate strength. There were no strong or very strong significant
correlations between defense mechanisms and emotions. Negative correlations also greatly
outnumbered positive relationships between the two variables.

The two moderate positive significant correlations were found between the following: fear
and idealisation (r=.26; p=.0371); and sadness and somatisation (r=.29; p=.0172). The
moderate negative correlations were found between the following defenses and emotions:
contempt and idealisation (r=-.26; p=.04); hostility and splitting (r=.011; p=-.32); the total
score for emotions and suppression (r=-.29; p=.0253); the total score for negative emotions
and suppression (r=-.27; p=.033); the total score for immature defense mechanisms and
hostility (r=-.25; p=.04); and lastly between the total score for immature defense mechanisms
and contempt (r=-.25; p=.0451). Figure Three below provides the visual diagrammatic
representation of the results obtained by the third set of Pearson’s correlations to be found
between the emotions and defense mechanisms.

41
 ALTURISM DENIAL DEVALUATI HUMOR IDEALIZATI IDENIFICA OMNIPOTE PASSIVE PROJECTION SOMOTISA SPLITTIN SUPPRESSI WITHDRAW TOTAL TOTAL TOTAL
ON ON TION NCE AGGRESSION TION G ON AL IMMTURE MATURE DEFENSES
INTEREST* 0.0229 0.0751 0.1012 -0.0555 0.1748 0.0894 0.0712 0.1216 0.2553 0.2088 0.0494 -0.0501 -0.0586 0.2412 0.0312 0.2461
0.8569 0.555 0.4259 0.6628 0.167 0.4823 0.5756 0.3383 0.0417 0.0976 0.6981 0.6942 0.6452 0.0548 0.8061 0.05
ENJOYMENT 0.1444 -0.1762 0.0481 0.0750 -0.1618 -0.1178 0.1752 0.1088 0.0873 -0.1509 -0.0041 -0.0781 -0.3832 -0.0652 0.0896 -0.0219
0.2549 0.1635 0.7057 0.5557 0.2014 0.3538 0.1661 0.392 0.4926 0.2338 0.9743 0.5393 0.0018 0.6082 0.4812 0.8633
SURPRISE 0.1546 0.1124 -0.0599 -0.0207 -0.1386 0.1021 0.0577 0.0349 0.0866 0.0779 -0.0179 0.1547 -0.1339 -0.0128 0.1048 0.0418
0.2225 0.3762 0.6378 0.8708 0.2747 0.4221 0.6502 0.7843 0.4961 0.5405 0.888 0.222 0.2914 0.9198 0.4098 0.7429
SADNESS 0.0492 0.2069 -0.0007 0.1966 0.1856 0.1847 -0.1652 -0.0872 -0.0363 0.2969 -0.1263 -0.0295 0.0342 0.0345 0.1435 0.0861
0.6992 0.1009 0.9955 0.1195 0.142 0.1439 0.192 0.4931 0.7755 0.0172 0.3197 0.8166 0.7881 0.7865 0.2579 0.4983
ANGER 0.1069 0.0416 0.1717 -0.0056 -0.0018 0.0483 -0.0364 0.0417 -0.0257 0.0279 0.0388 -0.1386 0.0623 0.1059 0.0371 0.1056
0.4003 0.7442 0.1748 0.9647 0.9886 0.7047 0.775 0.7434 0.8397 0.8266 0.7608 0.2747 0.6243 0.4045 0.771 0.4059
DISGUST -0.029 -0.0854 0.1516 -0.0321 -0.1271 0.0203 -0.1066 -0.1626 -0.1313 0.0459 -0.0826 -0.1965 -0.0484 -0.0737 -0.0469 -0.0757
0.8201 0.5022 0.2316 0.8009 0.3169 0.8734 0.4015 0.1992 0.301 0.7182 0.5163 0.1196 0.704 0.5628 0.7126 0.5521
CONTEMPT -0.1663 -0.1505 0.0335 -0.1744 -0.2574 -0.0820 -0.1844 -0.1090 -0.1236 -0.1784 -0.1974 -0.1730 -0.0485 -0.2513 -0.2030 -0.3149
0.1889 0.2351 0.7922 0.168 0.04 0.5192 0.1446 0.3909 0.3304 0.1584 0.1179 0.1714 0.7035 0.0451 0.1075 0.0113
FEAR -0.0015 0.0577 0.1814 -0.1364 0.2612 0.2111 0.0502 -0.0124 0.0563 0.1888 0.1412 -0.1857 -0.0844 0.1805 -0.0338 0.1643
0.9902 0.6505 0.1514 0.2824 0.0371 0.094 0.6937 0.9223 0.6581 0.1351 0.2655 0.1417 0.5068 0.1535 0.7904 0.1945
GUILT -0.1880 0.0976 0.0495 -0.1931 -0.1429 0.0964 -0.0422 -0.1883 0.0470 -0.0390 -0.0398 -0.1361 0.0782 -0.1200 -0.2097 -0.1980
0.1368 0.4428 0.6973 0.1263 0.2598 0.4484 0.7402 0.1361 0.7119 0.7592 0.7548 0.2834 0.539 0.3447 0.0961 0.1167
SHAME -0.0499 -0.1371 -0.0056 -0.1588 -0.1378 -0.0917 -0.2047 -0.0952 -0.1326 -0.0495 -0.0407 -0.1816 0.0058 -0.1771 -0.1965 -0.2313
0.6949 0.2798 0.9646 0.2101 0.2775 0.4707 0.1046 0.4541 0.2961 0.6973 0.7494 0.1509 0.9632 0.1615 0.1196 0.0658
SHYNESS -0.0626 -0.0009 -0.0114 -0.0077 0.0041 -0.0742 -0.1934 -0.0377 0.0241 0.1846 0.0039 -0.2081 -0.0467 0.0275 -0.0720 0.0151
0.6228 0.9943 0.9283 0.9513 0.9738 0.5597 0.1257 0.7672 0.8497 0.1441 0.9755 0.0988 0.714 0.829 0.5718 0.9053
HOSTILITY -0.0215 0.0414 -0.0575 -0.0353 -0.1010 -0.0596 -0.1944 -0.0341 -0.1127 -0.1534 -0.3158 -0.2285 -0.1095 -0.2542 -0.0467 -0.2517
0.8657 0.7452 0.6515 0.7815 0.4268 0.6398 0.1236 0.7889 0.375 0.226 0.011 0.0693 0.3887 0.0426 0.7137 0.0448
TOTAL EMOTIONS -0.0063 0.0155 0.1159 -0.1058 -0.0819 0.0627 -0.1473 -0.0796 -0.0075 0.0789 -0.1156 -0.2795 -0.1374 -0.0736 -0.0772 -0.0874
0.9604 0.9028 0.3618 0.4053 0.5196 0.6222 0.2454 0.5317 0.9531 0.5353 0.3628 0.0253 0.2788 0.5628 0.544 0.4921
Table 4: Correlation table for Emotions and Defenses

TOTAL POSITIVE 0.1721 0.0013 0.0482 0.0012 -0.0695 0.0355 0.1638 0.1418 0.2272 0.0673 0.0143 0.0115 -0.3113 0.0840 0.1204 0.1389
EMOTIONS
0.1737 0.9918 0.7048 0.9922 0.5849 0.7806 0.1957 0.2634 0.0709 0.5968 0.9106 0.9276 0.0123 0.5091 0.3433 0.2736
TOTAL NEGATIVE -0.0457 0.0142 0.0925 -0.0838 -0.0266 0.0269 -0.1899 -0.1243 -0.0943 0.0739 -0.1096 -0.2669 -0.0392 -0.0880 -0.1091 -0.1179
EMOTIONS
0.7195 0.9113 0.4671 0.5103 0.8342 0.8323 0.1327 0.3277 0.4585 0.5614 0.3886 0.033 0.758 0.4892 0.3906 0.3534

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 Figure 3: Diagram of Emotions and Defense Mechanisms Pearson's Correlation Results

4.5 Associations Between Attachment and Frequency of Emotions

43
The emotions were subsequently categorised into nominal variables by separating the scores
along the median into a low frequency usage of the emotion and a high frequency usage of
the emotion category. A series of chi squared tests of analyses were conducted to investigate
whether there were any significant associations between attachment type and the emotions
experienced during middle childhood for the sample.

Variable N df 2 P-Value Phi Coefficient

Interest 64 3 2.7036 0.4396 0.2055
Enjoyment 64 3 4.7144 0.1939 0.2714
Surprise 64 3 6.7579 0.08 0.3250
Sadness 64 3 1.1636 0.7617 0.1348
Anger 64 3 1.040 0.7916 0.1275
Disgust 64 3 2.1368 0.5445 0.1827
Contempt 64 3 2.7080 0.4389 0.2.57
Fear 64 3 1.7683 0.6219 0.1662
Guilt 64 3 3.1138 0.3744 0.2206
Shame 64 3 0.8813 0.8299 0.1173
Shyness 64 3 2.2152 0.8299 0.1173
Hostility Inward 64 3 3.6606 0.3005 0.2392
Total Emotion 64 3 0.8944 0.8268 0.1182
Total Positive 64 3 2.0848 0.5550 0.1805
Total Negative 64 3 4.7847 0.1883 0.2734
Table 5: Chi Squared table for ASCT-frequency of Emotion

As seen in Table 6 above, no significant associations were found between the attachment type
and the frequency of emotions. This is most likely attributed to the relatively low sample size
and the large discrepancies between the different groupings for attachment type (secure,
avoidant, ambivalent and disorganised). However, despite there not being any statistically
significant associations, a number of observations may be made with respect to the analyses
and the breakdown of the percentages and numbers. A few examples of the most noteworthy
findings will now be discussed. For example, across all of the chi squared tests of association
conducted, there was a higher usage of negative emotions across the attachment types. The
secure attachment group experienced a higher percentage (81%) of a high intensity of
enjoyment, whereas the disorganised attachment category displayed the lowest use of a high
44
frequency of enjoyment (36%). The secure attachment group also presented with the highest
percentage for the overall high level of the total score for positive emotions with sixty four
percent with the disorganised showing the highest percentage at the higher levels (64%).
There was also a tendency towards a lower frequency usage of surprise across the four
attachment types (67%), with the secure (81%) and disorganised (90%) attachments showing
the lowest percentages.

Interestingly, the disorganised attachment experienced the lowest tendency to use a limited
amount of the emotion, sadness (81%). Across all the emotions tested, the avoidant
attachment type repeatedly experienced low occurrences of the emotions, especially the
negative emotions, whereas for enjoyment they reported experiencing it more often than not.
The secure attachment type reported low intensities of anger (77%), contempt (81%), fear
(63%), guilt (55%), shame (64%), shyness (82%), and hostility (55%). As expected the
avoidant attachment group of children reported low levels of emotions across the board, with
the exception of a relatively high level of enjoyment experienced (59%). The ambivalently
attached children also presented with a reasonably equal distribution between high and low
levels of surprise but reported very low levels of negative emotions, particularly sadness
(73%), guilt (73%) and shame (80%). Finally, the disorganised attachment also presented
with very low intensities of all emotions except for feeling a high level of guilt (70%).

4.6 Association Between Attachment and Frequency of Defense

Mechanisms

A series of chi squared tests of associations were also conducted to investigate whether there
were any significant associations between the attachment type (secure, avoidant, ambivalent
ad disorganised) and the frequency of the use of defense mechanisms. No significant results
were obtained which suggests that there are no significant associations between attachment
type and the frequency of use of defense mechanisms during middle childhood as seen in
Table 7 (on page 47)

45
 Variable N df 2 P-Value Phi Coefficient
Altruism 64 3 2.8213 0.4200 0.2100
Denial 64 3 0.6543 0.8839 0.1011
Devaluation 64 3 1.1130 0.7739 0.1319
Humor 64 3 1.6582 0.6463 0.1610
Idealization 64 3 4.9056 0.1788 0.2769
Identification 64 3 5.4949 0.1389 0.2930
Omnipotence 64 3 0.3331 0.9537 0.0721
Passive aggressive 64 3 4.7206 0.1934 0.2716
Projection 64 3 3.4435 0.3282 0.2320
Somatization 64 3 3.5505 0.3143 0.2355
Splitting 64 3 4.3816 0.2231 0.2617
Suppression 64 3 1.5095 0.6801 0.1536
Withdrawal 64 3 2.7166 0.4374 0.2060
Total Immature 64 3 4.7251 0.1931 0.2717
Total Mature 64 3 1.6396 0.6504 0.1601
Total Defense 64 3 1.2199 0.7482 0.1381
Table 6: Chi Squared ASCT-Defenses

Thus, as with the above discussed results obtained with the associations between emotion and
defense style, although there were no significant associations, the results obtained do provide
valuable information regarding the distribution and interactions of defenses and attachment.
Throughout all of the attachment styles there was a high frequency use of defense
mechanisms with three quarters of the usage of defense mechanisms being within the high
range. Although the secure (36%) and disorganised (36%) attachment groups displayed the
limited usage of defense mechanisms, the avoidant group (78%) used the most defenses.
There was not an overall discrepancy between the usage of mature and immature defenses.

The securely attached group had a reasonably equal distribution between the discrepancies
between usages of the immature defenses, but did show a relatively large tendency towards a
high level usage of mature defenses (82%). This high usage of mature defenses was seen in
their tendency towards high levels of altruism (82%), humour (64%) and with all the securely
attached children experiencing high levels of identification (100%). The secure attachment
group also had a very low usage of somatisation (91%), suppression (73%), denial (64%) and
of suppression (73%). The avoidant category used high levels of: denial (74%), devaluations

46
(63%), identification (67%), passive aggression (63%), projection (67%) and high levels of
splitting (74%). They also experienced low frequencies of passive somatisation (63%) and
suppression (67%). The ambivalently attached children were reported to use low levels of
denial (67%) and somatisation (63%), and high levels of: devaluation (60%), idealisation
(73%), identification (67%), passive aggression (63%), projection (67%), splitting (67%) and
withdrawal (73%). Lastly the disorganised attachment group were reported to experience low
levels of denial (64%), passive aggression (73%), projection (64%), somatisation (73%) and
suppression (73%). However, those in the disorganised classification category also
experienced relatively high levels of altruism (73%), idealisation (64%) and very high levels
of identification (83%).

4.7 Associations Between Type of Emotion and the Maturity of Defense

Mechanisms

Three chi squared test of association were conducted to investigate whether there were
significant associations between the intensity or frequency of emotions and the frequency of
defense mechanisms as experienced in the sample. No significant associations were found to
exist between the emotions and defenses of the sample (see Table 8 and 9 below). As
discussed above, this is most likely as a result of the comparatively small sample size.
However, the phi coefficients provided do show that there are very weak negative
correlations between the positive emotions (phi=-.11), the negative emotions (phi=-.13) and
the immature defenses. Thus, as the usage of emotions increases, the use of defense
mechanisms decreases and vice versa.

Variable N DF 2 P-value Phi coefficient

Total Emotion 64 1 0.3166 0.5737 0.0703
Total Positive Emotions 64 1 0.7824 0.3764 -0.1106
Total Negative Emotions 64 1 1.0585 0.3036 -0.1286
Table 7: Chi Squared results for Emotion and Immature Defenses

An analysis of the frequencies provided by the chi squared tests of association highlight that
low levels of total emotion experienced are linked to low levels of immature defense
mechanisms (63%). However, this was also the case for a high level of immature defense use
(56%), suggesting that a low usage of emotions is overall correlated with low usage of
immature defense mechanisms. A high usage of positive emotions was linked to a low use of
immature defenses (63%) as well as with high levels of mature defense usage (69%). Low
47
usage of positive emotions was linked to a low use of immature defenses (37%). High levels
of mature defenses were linked to experiences of both low (74%) and high intensities of
negative emotions (67%).

Variable N DF 2 P-value Phi Coefficient

Total Negative Emotions 64 1 0.4194 0.5172 -0.0810

Total Positive Emotions 64 1 0.4170 0.5184 -0.0807

Table 8: Chi Squared results for motions and Mature Defenses

Low experiences of negative emotions were connected to low levels of the use of mature
defenses (26%). However, high (69%) and low (76%) usage of positive emotions was also
linked with high usage of mature defense mechanisms. When broken down into the different
mature defenses, positive emotion was connected to high usage of altruism (61%), low use of
humour (58%) and high usage of identification (56%).

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Chapter Five: Discussion

5.1 Discussion of Results

This study was one of the first of its kind to be conducted in relation to a sample of children
in institutions within South Africa and to specifically explore the relationships between
attachment type, emotion and defense mechanisms during middle childhood. Limited
research has been conducted on exploring these variables during middle childhood in a
population from a variety of children’s homes and from a clinical setting. The results
obtained from this study do suggest a number of significant correlations between the use of
defense mechanisms and emotions. However, no significant associations were found between
attachment type and the frequency of the use of defense mechanisms or emotion. Similarly,
no significant associations were found to exist between the frequency or intensity of emotions
and defense mechanisms. This lack of significant associations, where they would previously
be expected is likely to be as a result of the relatively small sample size for the statistical
measures used. However, the frequency distributions did provide valuable insight into the
interactions between the different categorical variables. The results obtained from the study
are discussed below.

The following discussion will look at the characteristics of the participants of the study and
their attachment classifications. The following will also discuss the associations between
attachment types and the frequency of emotions experienced by the participants. The
associations between the attachment types and the frequency of the defense mechanisms
employed by the participants will also be discussed. Similarly, the following discussion will
conclude with a deliberation about the associations between the usage of emotions and the
maturity of defense mechanisms used by the participants of the study.

i) The Characteristics of the Sample

An analysis of the results gained by the descriptive statistics of the sample provides
interesting information regarding the distribution of attachment as found in children in
children’s homes and from a clinical setting. Only eleven (17%) of the sixty four children
involved in the study were classified by the Attachment scale as being securely attached with
a substantial fifty four of the children being insecurely attached (83%). Zeanah and Smyke
(2008) provide a possible explanation for this occurrence by stating that disturbances in
attachment relationships most typically arise from abnormal rearing conditions and

49
environments (see also Tomlinson, Cooper & Murray, 2005). Stansfeld et al. (2008) support
this view and have hypothesised that material deprivation may negatively impact on the
psychological stress of both the parent and the child, thus resulting in difficulties in
developing healthy relationships between the parents and the child. As a large number of the
children tested in the children’s homes and the hospital do come from financially insecure
backgrounds, it is likely that this may be a factor influencing the low levels of secure
attachments. Stansfeld et al. (2008) go further to describe how:

“emotional warmth may be less easy to maintain with children and harshness with children
more frequent in parents exposed to socially adverse conditions because living in adversity
provokes worry, disappointment, frustration, and anxiety that interferes in relations with
children as well, of course, as social adversity making it more difficult to provide adequate
housing, food, clothing and other resources for children” (P. 517).

Therefore, given that many of the children have such disadvantaged backgrounds, it is not
unforeseen that the majority of the children participating in the study presented with insecure
story stems and thus attachment styles.

The breakdown of the attachment styles as found in this study was: 17 % secure, 42%
avoidant, 24% ambivalent and 17 % disorganised. This is in contradiction to Tomlinson,
Cooper and Murray’s (2005) findings of 61.9% secure, 4.1% avoidant, 8.2% ambivalent and
25,8% disorganised infants from a peri-urban settlements within South Africa. Therefore, one
may query as to what occurred between 18 months and 8 years of age to drastically alter the
results of the attachments, despite the different samples used. One possible explanation may
be, as discovered by Weinfield, Sroufe and Egeland (2000), that the security of early
attachments is not stable and it is subject to change due to a vulnerability to difficult and/or
chaotic life experiences. Many of the children placed in institutions, or brought to the hospital
with difficulties, have experienced such adverse conditions and although their physical needs
may have been met adequately, many did not receive adequate emotional support (van den
Dries, Juffer, van Ijzendoorn & Bakermans-Kranenburg, 2009). Many of these children have
experienced some form of separation from their original primary caregiver or a loss of their
parents or legal guardians with whom they may have previously had secure attachments
which were altered due to the trauma of separation. As Bowlby (1961, 1979) theorised, this
will have a greatly negative impact on the child’s ability to form secure and healthy
attachments in the future with their other possible caregivers. Bureau, Easlerbrooks and
Lyons-Ruth (2009) also found in their study into attachment disorganisation, that children
with higher disorganised attachments were more likely to come from clinical settings,
especially when one of the referrals was related to a parent-child relational problems.

50
Therefore, high levels of insecure attachments are to be expected in a sample such as that
used for the purposes of this investigation.

ii) Correlations Between Defense Mechanisms

An analysis of the results found for the correlations between the use of defense mechanisms
in the current sample show that splitting appears to have the most correlations between all of
the defense mechanisms and that humour and its correlates are separate from the main set of
interactions. This is most likely as a result of the very nature of altruism being a mature
defense mechanism, and that its interactions with altruism, suppression and denial
respectively often occur in isolation from the other defenses. Cramer (2007) found that the
defense mechanisms of projection and identification were used more frequently than denial in
children and that the usage of these two defenses increases with age, particularly as the child
progressed through into adolescence (also see Porcerelli et al, 1998). However, identification
and projection are not presented as having significant correlations with the other defenses
suggesting that they most likely occur in isolation.

The mean distribution of the scores received for defense mechanisms does support this claim
as they suggest that the defenses of identification and projection were experienced to a
greater extent than denial. Cramer (1997; 2007) found in their study into the developmental
change of defense mechanisms that immature defenses are more commonly associated with
earlier life with mature defenses in later life. Therefore, as middle childhood is a period of
complex development (Dubois-Comtois & Moss, 2008; Granot & Mayseless, 2001), it was
expected that there would be a combination of both mature and immature defense
mechanisms. The results indicate that two of the mature defense mechanisms, altruism and
idealization received the highest mean scores whereas humour was one of the lowest.

As discussed above, Cramer (2007; 1997) and Porcerelli et al. (1998) view the usage of the
defense mechanisms of identification and projection to be more frequent than that of denial
during middle to late childhood. In the current study projection was strongly correlated to the
total score for immature defenses, suggesting that it was commonly used within the sample.
Projection was also strongly correlated to the usage of passive aggressiveness and moderately
with devaluation. These results therefore suggest that when projection is being employed, so
are, to a large extent, the defenses of passive aggressiveness and devaluation. Interestingly,
passive aggression was also strongly correlated to the immature defense mechanism total
score, and moderately with somatisation as well as splitting. There were no significant
correlations between the defenses with identification, and more importantly not with the total

51
score for defense use, suggesting that it was not commonly employed by the participants.
However, as identification is classified as a mature defense and taking into account that a
large proportion of the sample was still below eleven, this is not wholly unexpected. Denial,
on the other hand, the defense as proposed by Cramer (2007; 1997) to be used less often than
projection and identification, was correlated to the use of the mature defense, humour as well
as with the total for immature defenses signifying a high usage.

As the child develops through middle childhood, the specific defense mechanisms employed
steadily develop into more advanced and complex forms of that defense (Cramer, 1997).
Thus, although a number of immature defense mechanisms were employed by the
participants in this study, the correlations between the different defenses suggest that their
usage may be more advanced than previously expected. Immature defenses have also been
associated with clinical samples, such as some of the children used in this study (Laor,
Wolmer & Cicchetti, 2001), and it is therefore expected that more immature defenses would
be used given the sample age and characteristics (Porcerelli et al., 1998). These developments
and complex interplay between the defenses as found in this study and others (Cramer, 2007;
1997) highlights how the increasing cognitive abilities of the children develops into a set
system of defense mechanisms being employed. This increasing cognitive ability of the
children also impacts on their awareness of their usage of defense mechanisms which results
in different defenses being employed (Cramer and Brilliant, 2001; Porcerelli et al, 1998).
Thus, the defense mechanisms used by the participants have a number of significant
correlations with each other, suggesting a complex interplay between the defenses, possibly
as a result of their increasing awareness of the defenses they are using.

iii) Correlations Between Emotions

The deferential emotions theory highlights the casual relationships as between emotions, and
between emotions and cognition, therefore a specific and unique pattern of emotions is
developed (Blumberg & Izard, 1986). Accordingly, although there is generally a key emotion
that is experienced most often, it is linked to a set of emotions that are activated when the key
emotion is experienced (Blumberg & Izard, 1986; Izard, 1993; Izard, 1983). The theory also
holds that all emotions have basic motivational underpinnings and that the experiences of
emotions are continuous and stable in nature (Izard et al, 1993; Izard, 1983). For example,
the emotion fear will be influenced or motivated by a certain motivational state (Izard, 1993),
which for the purposes of this research may be with respect to attachment behaviours and the
utilisation of defense mechanisms. Therefore, the finding that certain emotions were

52
significantly correlated with other emotions is expected, and gives insight into the
relationships between their activations and underlying motivations.

Significant positive correlations of at least moderate strength were found between the
experiences of the following emotions: Surprise and contempt; sadness and enjoyment;
sadness and fear; sadness and shame; anger and contempt; disgust and shame; and lastly
between disgust and shyness. These correlations are interesting, especially as Izard (1983)
described emotion regulation as being “the power of one emotion to control another emotion”
(P. 307). For an example, related to the results obtained by the research, the emotion of
shame will be discussed. Shame is perceived as being a painful emotion because it is felt as
an attack on the worth of the self and therefore, it is seen as common for defense mechanisms
to be employed to protect the self from experiencing pain (Turner, 2009). Shame is especially
influential to behaviour during childhood, (Turner, 2009) and it is therefore not surprising
that is was very strongly correlated to the total for negative emotions, and moderately with
disgust and sadness. Nonetheless, shame did receive the lowest mean score, suggesting that it
was the emotion experienced the least often. This is not entirely unforeseen, especially when
considering that is believed that when shame is denied, possibly through defense
mechanisms, that more violent emotions may take its place, such as hostility and disgust
which are in turn correlated to a number of other emotions (Turner, 2009).

Significant correlations were also found between the total for positive emotions and interest,
enjoyment and surprise, as expected as they were the only positive emotions tested for by the
Deferential Emotions Scale-IV. Correspondingly the negative emotions of disgust, guilt,
shame and hostility were found to be strongly and significantly correlated to both the total
score for all emotions as well as the total negative emotions score. Sadness and shyness were
also correlated strongly to the total with shyness and anger with the total negative score
obtained for all the emotions. Therefore, one may deduct that these were the most common
emotions experienced emotions by the sample collected with shame having the highest
correlation with the total emotions as well as the highest correlation to the total negative
emotions, which is likely as a result of the above discussed sense of shame as being
particularly painful and a sense of something internally not being good enough (Turner,
2009).

iv) Correlations Between Emotions and Defense Mechanisms

More correlations were expected to be found between emotions and defense mechanisms as
defense mechanisms, in essence, are used when protecting the individual from unpleasure or
53
emotions that are not welcomed or are potentially harmful to the individual (Brenner, 1981).
However, the very nature of defense mechanisms may account for the reasonably low levels
of negative emotions reported by the children as well as the relatively small amount of
significant or strong correlations between the defense mechanisms and emotions. Moderate
positive correlations were found between fear and idealisation as well as sadness and
somatisation. Thus, as the emotion of fear increases, so does the use defense of idealisation
and the same with sadness and somatisation. It may indicate that the main defense employed
when a child is fearful of someone, that idealisation is employed to limit the negative aspects
of the fear by making the feared object a looked up to object. Similarly as feelings of sadness
increase, so does the likely hood that the child will experience feelings of being sick or pain,
possibly in an attempt to illicit support, attention or sympathy from a caregiver. This supports
the findings of Hagekull and Bohlin (2004) in that somatisation is mainly predicted by early
negative emotionality, which is linked to insecure attachments. Thus, these interactions are
seen to link attachment behaviours to defense use and emotionality.

However negative significant correlations were found to exist between contempt and
idealisation. Therefore, as the emotion increases the use of the defense mechanism decreases,
and vice versa. Consequently as the child uses more idealisation they feel less contempt.
These interactions between the defense mechanisms and emotions show how they may be
used as strategies to maintain or illicit attachment behaviours, as is discussed in more detail
below. Negative correlations were also found between immature defenses and hostility,
negative emotions and suppression and immature defense mechanisms and contempt.
Defense mechanisms are viewed as attempting to “deny, avoid, or cognitively restructure
aspects of a stressful situation to manage negative emotions” (Sandstrom & Cramer, 2003).
The results obtained regarding the interactions between positive emotions, negative emotions,
immature defenses and mature defenses will be discussed in more detail below.

v) Associations Between Attachment and Frequency of Emotions

The results conducted suggest that there are no significant associations between attachment
type and the frequency of emotions used during middle childhood. Depressive emotions have
previously been associated to the insecure attachments (Stansfeld et al., 2008; Kerns et al,
2007), therefore, it was expected that this would be found within the current study. Similarly
Kerns et al. (2007) also found that children with secure attachments to at least one primary
caregiver expressed and experienced a higher level of positive emotions. This was seen in the
results with the securely attached children repeatedly experiencing high and in some cases the
highest levels or frequencies of the positive emotions. It is also likely, however, that the
54
securely attached children were more able to openly admit to the frequency of their
experiences of negative emotions as they are able to employ more effective means of
regulating such emotions (Cassidy, 1994; Raikes & Thompson, 2008). Securely attached
children have been associated to a decreased likelihood of avoiding discussing or talking
about negative emotions as well as having a greater understanding of those emotions by
Waters et al. (2010). This was seen in study through the securely attached children’s ability
to report experiencing some levels of negative emotions such as hostility, sadness and anger,
although they were of lower levels as compared to the insecure attachments.

Insecure attachments are largely associated with the experiencing of depressive type
symptoms and emotions such as sadness (Stansfeld et al., 2008). However, avoidant
attachments by nature have been associated with a minimisation of emotional experiences,
both positive and negative (Cassidy, 1994). The minimisation of negative emotions by this
group is hypothesised as being a strategy employed by the child to minimise the relationship
with the attachment figure (Cassidy, 1994). The above results from this study found similar
patterns in the avoidant attached classified children’s use of emotions in that they were
consistently reporting to experience low rates of all emotions. Curiously, however, they also
reported having experienced high levels of enjoyment relative to their experiences of other
emotions, possibly as a result of the need to regulate how they appear to both the assessor and
in general to their attachment figures. This is linked to their usage of the defense mechanisms
of denial, devaluation and projection as is discussed in further detail below.

Cassidy (1994) correlated ambivalent attachments with more intensive experiences of both
positive and more frequently negative emotions. The heightening of negative emotions is
seen to be a strategy employed by ambivalent attachments to illicit attention from a
seemingly uninterested or unavailable caregiver (Cassidy, 1994; Cassidy & Berlin, 1994).
The ambivalently attached group in this study, however, reports generally experienced
emotions that were evenly distributed between high levels and low levels, and in the case of
sadness, guilt and shame very low levels. Although, they did report reasonably high levels of
enjoyment, however, this may be as a result of their lack of self-awareness with respect to
their emotionality and a desire to display a positive view of themselves during the research
process. These ambivalently attached children also presented with a high usage of
idealisation and withdrawal which will be impacting on their ability to accurately express
their experiences of emotions.

The disorganised attachments were linked to very low levels of all emotions except for
reporting to feel guilt very often. Disorganised attachments are most commonly associated
55
with an essential inability and dysfunction to effectively regulate their emotions (DeOliveira
et al., 2004). They generally experience intense negative emotions but do not have the
capability to regulate them effectively (DeOliveira et al., 2004). Thus, one would expect that
they would have reported higher levels of all negative emotions as found by Kerns et al.
(2007). However, like the ambivalently attached children, they have not developed effective
emotional understanding modelled to them by their caregiver, thus may have had difficulty
vocalising or understanding the emotions. However, the high level of guilt or of ‘feeling sorry
for something they have done’ is indicative of the dysregulation of their emotions. Therefore,
the findings of the above investigation into attachment and emotion do support the expected
findings that “emotion regulation and quality of attachment are closely linked” (Cassidy,
1994).

vi) Associations Between Attachment and Frequency of Defense Mechanisms

As seen in the discussion linked to attachment and emotion, the ambivalently attached
children were seen to rely on a number of strategies to maintain and control their
emotionality and thus their attachment figure’s attention (Cassidy, 1994; Cassidy & Berlin,
1994). It is therefore not unanticipated that this group displayed high levels of and a wide
range of both immature and mature defense mechanisms, which included high levels of
devaluation, idealisation, identification, passive aggressiveness, projection, somatisation and
suppression. The secure and disorganised attachments showed the lowest use of defense
mechanisms with the avoidant group using the highest. This is expected for the secure and
avoidant groups, given the above discussion, however, it is interesting to note that the
disorganised attachment group also showed an equally low use of defense mechanisms as the
securely attached. The securely attached children also used a higher frequency of mature
defences, such as altruism and humour with all of the securely attached children using high
levels of identification, as expected. They also experienced low levels of somatisation, denial
and suppression. The most frequently used defense mechanism of the securely attached group
was the mature defense, identification.

As briefly deliberated upon above, with respect to the discussion regarding the associations
between attachment type and the frequency of emotions, defense mechanisms have been
shown to play an important role in the regulation of emotion. The avoidant attachment
children exhibited high level usage of predominantly immature defenses such as denial,
devaluation and projection. However, they also were reported to experience low levels of
somatisation, passive aggression and suppression. The most frequently experienced defense
mechanisms for the avoidant group were denial and splitting. Interestingly, splitting was
56
closely linked to the emotion of hostility, see above discussions. The ambivalently attached
participants, like the avoidant group, also made use of a large number of defense mechanisms
with a collection of both mature and immature defenses. The most frequently used defense
mechanisms for the ambivalent attachments were idealisation and withdrawal. The defense
mechanism of idealisation was correlated to the emotions of fear and contempt. The
disorganised attachments were linked with exceptionally high levels of identification and
altruism, but also low levels of the other immature defenses.

vii) Associations Between Type of Emotions and the Maturity of Defense Mechanisms

Therefore, as discussed in detail above, emotions have a complex set of correlations and
interactions between them, as do defense mechanisms; it is thus necessary to discuss how the
positive or negative emotions were linked to the use of immature or mature defense
mechanisms. Indeed, the very act of emotion regulation is seen to function in similar ways as
defense mechanisms (Koole, 2009). This as emotion regulation also seems to place more
emphasis on the decreasing of the negative emotions rather than on the increasing of positive
emotions (Koole, 2009). However, no significant associations were found to exist between
positive and negative emotions; and maturity of defense mechanisms employed during
middle childhood. As with the other association analyses conducted, this is most likely to be
a direct result of the comparatively small sample size. Research into the relationship between
defenses and psychological adjustment has found that children who rely more on the use of
immature defenses, particularly denial, report feeling higher levels of negative emotions such
as anxiety and depression (Sandstrom & Cramer, 2003). However, children who use the more
mature defense of identification reported higher levels of competence and self-assurance
(Sandstrom & Cramer, 2003).

5.2 Implications of the Research

Understanding children’s homes, clinical settings and other such atypical rearing
environments impact on children’s development, especially during middle childhood, is vital
to understanding the ways in which they are able or unable to recover from difficulties or
unhealthy developmental characteristics (Smyke et al., 2010). For example, the current study
found that children from children’s homes and from a clinical setting within a South African
context were more likely to have insecure attachments than secure attachments. As an
increasing number of South African children are being placed in children’s homes and being
referred to clinical settings for therapy and assessment due to a variety of reasons such as

57
becoming orphaned due to HIV/Aids, increasing violence levels among others, it is
imperative to the future functioning of the country to understand the impact the institutions
are having on the children.

Therefore, the above discussion suggests that various steps to try to help the children
overcome these difficulties needs to be taken to limit the negative effects these rearing
environments may have on their later development and functioning. A number of significant
correlations were found to exist between and within the defense mechanisms and emotions as
experienced by this group of children during middle childhood. This provided information
regarding the patterns that develop and how these may be interacting together with the child’s
attachment security to impact on the child’s daily and future functioning. Although no
significant associations were found between the frequency of the usage of emotions and
defense mechanisms (most likely due to a relatively small sample size), a large amount of
valuable information was obtained from the frequency distributions. Overall, the above
research does suggest that attachment type, defense mechanisms and emotions are interlinked
in a complex set of relationships that have been explore but do necessitate further detailed
research and investigation in the future.

5.3 Limitations of the Research

The relatively small sample size likely had the biggest effect on the lack of significant
associations between the variables. This as the data was divided into four different attachment
types which limited the possible number in each subsequent association. The current research
study likewise did not include a measure of the cognitive functioning of the participants,
which may be a contributor to the portrayal of attachment stories, the ability to express
emotions and the usage of defence mechanism maturity. Similarly, this research did not
account for temperament or personality of the children, which may be an extraneous variable
both with respect to the security of their attachment and their emotionality (Hagekull &
Bohlin, 2004; Izard et al., 1993; Sroufe, 1985). Minde, Minde and Vogel (2006) have found
that verbal representations of attachment are closely linked to cultural variables. Therefore,
this research may have been limited in its ability to account for cultural variations in the
attachment stories. This is largely as a result of the instruments being used in the study not
having been adequately validated or standardised upon a South African study or population.
Consequently, the need for the instruments used in the study to be extensively validated on a
South African sample as it is unclear if the use of these specific tests impacted on the results.

58
The research relied on self-reports by the children regarding their experiences of emotion
during the last week, this may have impacted on the results gained, due to the defensiveness
of the children to expressing their use of negative, or more undesirable emotions. Therefore, a
different form of assessment of emotions and the frequency of their occurrence may be used
in further research into emotion during childhood to obtain more realistic results. This
research was also limited in that the diagnosis of the attachment story completion test
responses coupled with attachment security scales in some instances were classified to a large
extent with others in the profession, a more blind procedure with some method of checking
the diagnoses is required for more valid classifications. This may include using a system of
third party professionals to classify the children or a number of individuals discussing the
possible attachment classifications. Although the above research was intentionally and
specifically looking into the relationships between attachment, defense mechanisms and
emotion for children in children’s homes and from a clinical setting, it was limiting to the
extent to which the research would be applicable to all children within middle childhood
rather than the participants used within this specific research study.

5.4 Directions for Future Research

Future research into attachment, defense mechanisms and emotion, particularly during middle
childhood, need to use a larger sample size, as the sample size significantly impacted on the
statistical results obtained. Further and future research into the relationships and associations
between attachment, defense mechanisms and emotion during middle childhood will need to
look into samples which represent broader participants that extend from research purely into
children from children’s homes and clinical settings. More information needs to be collected
regarding the interactions and connections found between attachment, defenses and emotions
to allow for definite and generalizable conclusions to be made regarding the relationships.
This is important so as to provide more valid and reliable information regarding these
interactions that can be applied to larger groups of children and that are not limited to a select
group of relatively unique children. It is also important for further, more detailed and
expansive research to be conducted into attachment, defenses and emotions both globally and
within South Africa so as to determine if the findings of the above research are also occurring
in other countries or whether this is only a characteristic of South African children. Future
research should also look into researching the impact of cognitive ability of the child on these
variables as well as on how the child’s specific temperament and/or personality typology may
impact on the results found and discussed. As mentioned briefly above, research into the

59
applicability of the instruments used in the current study for use on a South African sample or
population needs to be conducted.

5.5 Conclusion

Therefore, in conclusion, the relationships between attachment type, defense mechanisms and
emotion were explored in the above research study. The results showed a number of
significant correlations in and between the defense mechanisms and the emotions as used
during middle childhood. However, no significant associations were found between
attachment type and the frequency of emotions used, between attachment type and the
frequency of emotions used as well as no significant associations between the frequency and
type of emotions with the frequency and maturity of defense mechanisms. However, the lack
of significant associations is most likely indicative of a relatively small sample size and a
number of important observations regarding the frequency distributions provided detailed
insight into the interactions between the different variables under investigation in this study.
Thus, the above study does suggest a complex interplay between attachment, defenses and
emotions within children from difficult backgrounds such as children’s homes and a clinical
setting within South Africa, but this needs to be investigated further with all populations.

60
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 7. Appendices

7.1 Child Demographics Questionnaire

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 7.2 Parent Information Letter for the Legal Guardians at the Hospital

School of Human and Community Development

Private Bag 3, Wits 2050, Johannesburg, South Africa

Tel: (011) 350-2632

Dear Parent or Legal Guardian,

My name is Renate Gericke, and I am doing research for the purposes of obtaining a Doctorate degree at the
University of the Witwatersrand. I would like invite you to participate in the study.

I am interested in understanding the way children aged between 8 and 12 feel inside themselves better by looking at
a number of variables. The variables I am looking at include how secure a child feels in his or her relationship with
you, the number of different feelings s/he tends to have, how intense s/he feels things, how your child manages his or
her feelings and how s/he views important people in his or her world. This will help me to answer how different
children manage their anxieties and conflicts, and how different children anticipate others will respond to them. Better
understanding of how children feel inside themself will aid psychologists in helping children.

Participation in this research will entail you and your child being interviewed by me or a student under my supervision,
namely Thato Mmatli, Nonhlanhla Nkosi, Megan Robinson or Lexi Plitt. The interview will last about 45 minutes and
will be done while you or your child are being interviewed during the initial history intake or psychological assessment.
Thus, while the clinic staff are interviewing your child, Thato, Nonhlanhla, Megan, Lexi or I will interview you and while
the clinic staff are interviewing you, we will interview your child. The parent questionnaire consists of 28 items and the
child questionnaire of 44 items. The parent questionnaire includes questions such as rating how true the following
statement is ‘Easily provoked, and reacts by loosing his temper.’ These questions will help me to answer how your
child manages his feelings. The child questions include ‘How often in your daily life do you feel mad at somebody?’
Should you wish to participate in the study but would prefer to do so on a different day, we will arrange a time more
convenient to you and provide transport costs to do so. Alternatively, you may choose to complete the additional tasks
during a follow up session to the clinic, for example before receiving assessment feedback or before doing the
psychological or psychiatric assessment. Approximately 100 parent-child couples will be interviewed from hospitals in
the greater Johannesburg region. Participation is voluntary, and no person will be advantaged or disadvantaged in
any way for choosing to participate or not participate in the study. You may refuse to answer any questions you would
prefer not to, and you may choose to withdraw from the study at any point.

All of your responses will be kept confidential. Although direct quotes might be used, no information that could identify
you would be included in the research report. Access to the questionnaires will be restricted to me, Nonhlanhla, Lexi
and Megan although only I will have access to all the information. I also ask for permission to access your hospital
records. For the duration of the study, all questionnaires will be stored safely in a location with restricted access.
These records will be kept for two years after the research has been examined should publications arise or six years if
no publications arise, and then destroyed. Where publications arise, group results and not your individual results will
be reported.

The results of the research will be reported in the research report, and may also be published in journal articles. After
completion of the project the clinic will receive a summarised copy of the research report which they can make
available to you. Alternatively you can contact me to discuss the findings.

Unfortunately children who have sustained a brain injury or who have been diagnosed with aspergers or autism are
excluded from this study as it introduces a unique set of circumstances that needs to be investigated separately.

68
If you agree to participate and provide permission for your child to participate in the research, you will be asked to
sign the attached consent form and your child the assent form. This research has been granted ethic clearance by the
Medical and the Human Research Ethics Committee of the University of the Witwatersrand (clearance number:
M10561). If you experience any problems with the research or would like to report any complaints, you can do so by
contacting Ms Anisa Keshav on 011 717 1234.

My research supervisor is Prof Carol Long, a lecturer at the Department of Psychology, University of the
Witwatersrand. Her contact telephone number is (011) 717-4510 and her e-mail address [email protected].

Your participation in this study would be greatly appreciated.

Yours faithfully,

Renate Gericke

T: 011 717 4555

Email: [email protected]

69
 7.3 Child Information Letter for of the Hospital

School of Human and Community Development

Private Bag 3, Wits 2050, Johannesburg, South Africa

Tel: (011) 350-2632

Hi.

My name is Renate Gericke, and I am doing research as part of a degree at the University of the
Witwatersrand and I would like to invite you to participate in the research.

Research is a way to learn the answer to a question. My questions are what kinds of feelings do you have,
what do you do with your feelings and how do you feel about people in your life. This will help me to
understand what goes on inside of you better. I will do this by asking a few questions and inviting you to
tell me some stories. I will ask you about your relationship with your mom and dad or whomever looks after
you the most, what feelings you have had in the past week and what feelings you have the most strongly,
for example, ‘How often in your daily life do you feel mad at somebody?’ In knowing the answers to these
questions we will be in a position to better help children with their feelings.

If you agree to answer the questions, Nonhlanhla, Thato, Megan, Lexi or I will sit with you. It will take about
45 minutes to complete while your mom or caregiver is being interviewed by the clinic staff. I also ask to
look at your hospital records. If you would like to participate in the study but would prefer to do so on a
different day, you can do so. Participating in the study is up to you, and you will not get into any trouble if
you choose not to. You may refuse to answer any questions you don’t want to, and you may choose to pull
out of the study at any time.

Even though Nonhlanhla, Thato, Megan, Lexi or I will know who you are, no-one else will know what your
answers are. The hospital clinic may ask me how you did overall in order to help you better with the things
you are struggling with but they won’t tell anyone else.

If you agree to participate in the research, please sign the attached assent form.

Thank-you,

Renate Gericke

T: 011 717 4555

Email: [email protected]

70
7.4 Information Letter for the Legal Guardians of the Children’s Homes

71
7.5 Information Letter for the children of the children’s homes

72
7.6 Consent form for the legal guardians at the hospital
Interview consent form

School of Human and Community Development

Private Bag 3, Wits 2050, Johannesburg, South Africa

Tel: (011) 350-2632

I, _____________________________________, consent to be interviewed by Renate Gericke,

Nonhlanhla Nkosi, Thato Mmatli, Lexi Plitt or Megan Robinson for their investigation of love, hate and
others feelings in relation to attachment security experienced by children, and I understand:

 the nature and purpose of this study;

 that Renate will access my hospital records;
 that participation in this interview is voluntary;
 that I may refuse to answer any questions I would prefer not to;
 that I may withdraw from the study at any time;
 that no negative consequences will arise if I decide to withdraw or if I decline participation;
 that no identifying information will be included in the research report, and my responses will
remain confidential;
 that direct quotes may be used in the published work based on this research; however, no
identifying information will be used so as to protect my identity;
 that there are no direct benefits to participating in this study;
 that there are no known risks associated with this study.

I confirm that I satisfy the research inclusion criteria, as specified in the participant information sheet.

Signed: _________________________________________

Date: __________________________________________

73
7.7 Assent form for the children at the hospital
Interview assent form

School of Human and Community Development

Private Bag 3, Wits 2050, Johannesburg, South Africa

Tel: (011) 350-2632

I, _____________________________________, assent to be interviewed by Renate Gericke,

Nonhlanhla Nkosi, Thato Mmatli, Lexi Plitt or Megan Robinson for their investigation of love, hate and
others feelings felt in relation to how secure I feel in the world, and I understand:

 what this research is about;

 that Renate will read my hospital file;
 that participation in this interview is voluntary;
 that I may refuse to answer any questions I would prefer not to;
 that I may withdraw from the study at any time;
 that there will be no negative consequences if I decide later that I don’t want to take part;
 that my name or any information that could identify me won’t be used in the research;
 where quotes are used no-one will be able to tell that they are my words;
 that there are no direct benefits to participating in this study;
 that there are no known risks associated with this study.

Signed: _________________________________________

Date: __________________________________________

74
7.8 Assent form for the children at the children’s homes

Interview assent form

School of Human and Community Development

Private Bag 3, Wits 2050, Johannesburg, South Africa

Tel: (011) 350-2632

I, _____________________________________, assent to be interviewed by Renate Gericke, Lexi

Plitt or Megan Robinson for their investigation of love, hate and others feelings felt in relation to how
secure I feel in the world, and I understand:

 what this research is about;

 that participation in this interview is voluntary;
 that I may refuse to answer any questions I would prefer not to;
 that I may withdraw from the study at any time;
 that there will be no negative consequences if I decide later that I don’t want to take part;
 that my name or any information that could identify me won’t be used in the research;
 where quotes are used no-one will be able to tell that they are my words;
 that there are no direct benefits to participating in this study;
 that there are no known risks associated with this study.

Signed: _________________________________________

Date: __________________________________________

75
7.9 Permission Letter from Rahima Moosa Mother and Child Hospital

76
7.10 Permission Letter from Johannesburg Children’s Home

77
7.11 Permission Letter from Abraham Kriel Children’s Home

78
7.12 Permission Letter from TLC children’s home

79
7.13 Permission Letter from Jacaranda Children’s home

80
81
7.14 Medical Ethics Clearance Certificate

82
7.15 Distribution Analyses: Tests for Normality

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Variable: TOTIMM

Basic Statistical Measures

Location Variability
Mean 16.97656 Std Deviation 4.77961
Median 17.50000 Variance 22.84468
Mode 17.50000 Range 22.00000
Interquartile Range 6.75000
Note: The mode displayed is the smallest of 2 modes with a count of 5.
Basic Confidence Limits Assuming Normality
Parameter Estimate 95% Confidence Limits
Mean 16.97656 15.78265 18.17047
Std Deviation 4.77961 4.07126 5.78868
Variance 22.84468 16.57517 33.50886
Tests for Location: Mu0=0
Test Statistic p Value
Student's t t 28.41497 Pr > |t| <.0001
Sign M 32 Pr >= |M| <.0001
Signed Rank S 1040 Pr >= |S| <.0001
Tests for Normality
Test Statistic p Value
Shapiro-Wilk W 0.984751 Pr < W 0.6156
Kolmogorov-Smirnov D 0.090927 Pr > D >0.1500
Cramer-von Mises W-Sq 0.073303 Pr > W-Sq >0.2500
Anderson-Darling A-Sq 0.397369 Pr > A-Sq >0.2500

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Fitted Normal Distribution for TOTIMM

Parameters for Normal Distribution

Parameter Symbol Estimate
Mean Mu 16.97656
Std Dev Sigma 4.779611
Goodness-of-Fit Tests for Normal Distribution
Test Statistic p Value
Kolmogorov-Smirnov D 0.09092734 Pr > D >0.150
Cramer-von Mises W-Sq 0.07330252 Pr > W-Sq >0.250
Anderson-Darling A-Sq 0.39736937 Pr > A-Sq >0.250
Quantiles for Normal Distribution
Percent Quantile

83
 Observed Estimated
1.0 5.50000 5.85752
5.0 9.00000 9.11480
10.0 10.00000 10.85124
25.0 13.25000 13.75276
50.0 17.50000 16.97656
75.0 20.00000 20.20036
90.0 22.00000 23.10188
95.0 24.00000 24.83832
99.0 27.50000 28.09560

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Variable: TOTMAT

Basic Statistical Measures

Location Variability
Mean 5.500000 Std Deviation 1.80827
Median 5.500000 Variance 3.26984
Mode 6.500000 Range 8.00000
Interquartile Range 2.00000
Basic Confidence Limits Assuming Normality
Parameter Estimate 95% Confidence Limits
Mean 5.50000 5.04831 5.95169
Std Deviation 1.80827 1.54028 2.19003
Variance 3.26984 2.37246 4.79624
Tests for Location: Mu0=0
Test Statistic p Value
Student's t t 24.33265 Pr > |t| <.0001
Sign M 32 Pr >= |M| <.0001
Signed Rank S 1040 Pr >= |S| <.0001
Tests for Normality
Test Statistic p Value
Shapiro-Wilk W 0.95577 Pr < W 0.0222
Kolmogorov-Smirnov D 0.118252 Pr > D 0.0246
Cramer-von Mises W-Sq 0.169102 Pr > W-Sq 0.0138
Anderson-Darling A-Sq 1.03218 Pr > A-Sq 0.0096

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Fitted Normal Distribution for TOTMAT

Parameters for Normal Distribution

Parameter Symbol Estimate
Mean Mu 5.5

84
 Std Dev Sigma 1.80827
Goodness-of-Fit Tests for Normal Distribution
Test Statistic p Value
Kolmogorov-Smirnov D 0.11825168 Pr > D 0.025
Cramer-von Mises W-Sq 0.16910250 Pr > W-Sq 0.014
Anderson-Darling A-Sq 1.03218020 Pr > A-Sq 0.010
Quantiles for Normal Distribution
Quantile
Percent Observed Estimated
1.0 1.00000 1.29333
5.0 2.00000 2.52566
10.0 2.50000 3.18261
25.0 4.50000 4.28034
50.0 5.50000 5.50000
75.0 6.50000 6.71966
90.0 8.00000 7.81739
95.0 8.00000 8.47434
99.0 9.00000 9.70667

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Variable: DEFTOT

Basic Statistical Measures

Location Variability
Mean 22.56250 Std Deviation 5.02494
Median 23.00000 Variance 25.25000
Mode 22.50000 Range 22.50000
Interquartile Range 7.00000
Basic Confidence Limits Assuming Normality
Parameter Estimate 95% Confidence Limits
Mean 22.56250 21.30731 23.81769
Std Deviation 5.02494 4.28023 6.08580
Variance 25.25000 18.32037 37.03702
Tests for Location: Mu0=0
Test Statistic p Value
Student's t t 35.92084 Pr > |t| <.0001
Sign M 32 Pr >= |M| <.0001
Signed Rank S 1040 Pr >= |S| <.0001
Tests for Normality
Test Statistic p Value
Shapiro-Wilk W 0.980496 Pr < W 0.4057
Kolmogorov-Smirnov D 0.120038 Pr > D 0.0218
Cramer-von Mises W-Sq 0.092956 Pr > W-Sq 0.1397
Anderson-Darling A-Sq 0.50333 Pr > A-Sq 0.2066

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

85
Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO
T_NEG
The UNIVARIATE Procedure

Fitted Normal Distribution for DEFTOT

Parameters for Normal Distribution

Parameter Symbol Estimate
Mean Mu 22.5625
Std Dev Sigma 5.024938
Goodness-of-Fit Tests for Normal Distribution
Test Statistic p Value
Kolmogorov-Smirnov D 0.12003810 Pr > D 0.022
Cramer-von Mises W-Sq 0.09295642 Pr > W-Sq 0.140
Anderson-Darling A-Sq 0.50332965 Pr > A-Sq 0.207
Quantiles for Normal Distribution
Quantile
Percent Observed Estimated
1.0 12.0000 10.8727
5.0 14.5000 14.2972
10.0 15.0000 16.1228
25.0 18.7500 19.1732
50.0 23.0000 22.5625
75.0 25.7500 25.9518
90.0 28.5000 29.0022
95.0 29.5000 30.8278
99.0 34.5000 34.2523

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Variable: EMTOT

Basic Statistical Measures

Location Variability
Mean 23.12500 Std Deviation 7.04521
Median 23.00000 Variance 49.63492
Mode 23.00000 Range 35.00000
Interquartile Range 8.00000
Basic Confidence Limits Assuming Normality
Parameter Estimate 95% Confidence Limits
Mean 23.12500 21.36516 24.88484
Std Deviation 7.04521 6.00109 8.53259
Variance 49.63492 36.01307 72.80512
Tests for Location: Mu0=0
Test Statistic p Value
Student's t t 26.25899 Pr > |t| <.0001
Sign M 32 Pr >= |M| <.0001
Signed Rank S 1040 Pr >= |S| <.0001

86
 Tests for Normality
Test Statistic p Value
Shapiro-Wilk W 0.984041 Pr < W 0.5774
Kolmogorov-Smirnov D 0.088231 Pr > D >0.1500
Cramer-von Mises W-Sq 0.069879 Pr > W-Sq >0.2500
Anderson-Darling A-Sq 0.420672 Pr > A-Sq >0.2500

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Fitted Normal Distribution for EMTOT

Parameters for Normal Distribution

Parameter Symbol Estimate
Mean Mu 23.125
Std Dev Sigma 7.045206
Goodness-of-Fit Tests for Normal Distribution
Test Statistic p Value
Kolmogorov-Smirnov D 0.08823124 Pr > D >0.150
Cramer-von Mises W-Sq 0.06987939 Pr > W-Sq >0.250
Anderson-Darling A-Sq 0.42067190 Pr > A-Sq >0.250
Quantiles for Normal Distribution
Quantile
Percent Observed Estimated
1.0 7.00000 6.73540
5.0 12.00000 11.53667
10.0 14.00000 14.09621
25.0 19.00000 18.37308
50.0 23.00000 23.12500
75.0 27.00000 27.87692
90.0 32.00000 32.15379
95.0 36.00000 34.71333
99.0 42.00000 39.51460

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Variable: TOT_POS

Basic Statistical Measures

Location Variability
Mean 6.921875 Std Deviation 2.40571
Median 7.000000 Variance 5.78745
Mode 6.000000 Range 11.00000
Interquartile Range 3.50000
Basic Confidence Limits Assuming Normality
Parameter Estimate 95% Confidence Limits

87
 Mean 6.92188 6.32095 7.52280
Std Deviation 2.40571 2.04918 2.91361
Variance 5.78745 4.19914 8.48910
Tests for Location: Mu0=0
Test Statistic p Value
Student's t t 23.01813 Pr > |t| <.0001
Sign M 32 Pr >= |M| <.0001
Signed Rank S 1040 Pr >= |S| <.0001
Tests for Normality
Test Statistic p Value
Shapiro-Wilk W 0.970962 Pr < W 0.1358
Kolmogorov-Smirnov D 0.102805 Pr > D 0.0912
Cramer-von Mises W-Sq 0.127752 Pr > W-Sq 0.0469
Anderson-Darling A-Sq 0.739634 Pr > A-Sq 0.0514

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Fitted Normal Distribution for TOT_POS

Parameters for Normal Distribution

Parameter Symbol Estimate
Mean Mu 6.921875
Std Dev Sigma 2.405712
Goodness-of-Fit Tests for Normal Distribution
Test Statistic p Value
Kolmogorov-Smirnov D 0.10280503 Pr > D 0.091
Cramer-von Mises W-Sq 0.12775172 Pr > W-Sq 0.047
Anderson-Darling A-Sq 0.73963358 Pr > A-Sq 0.051
Quantiles for Normal Distribution
Quantile
Percent Observed Estimated
1.0 1.00000 1.32535
5.0 3.00000 2.96483
10.0 4.00000 3.83883
25.0 5.50000 5.29925
50.0 7.00000 6.92188
75.0 9.00000 8.54450
90.0 10.00000 10.00492
95.0 11.00000 10.87892
99.0 12.00000 12.51840

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Variable: TOT_NEG

88
 Basic Statistical Measures
Location Variability
Mean 16.29688 Std Deviation 6.75578
Median 17.00000 Variance 45.64063
Mode 14.00000 Range 34.00000
Interquartile Range 8.50000
Basic Confidence Limits Assuming Normality
Parameter Estimate 95% Confidence Limits
Mean 16.29688 14.60933 17.98442
Std Deviation 6.75578 5.75456 8.18207
Variance 45.64063 33.11497 66.94624
Tests for Location: Mu0=0
Test Statistic p Value
Student's t t 19.29828 Pr > |t| <.0001
Sign M 31.5 Pr >= |M| <.0001
Signed Rank S 1008 Pr >= |S| <.0001
Tests for Normality
Test Statistic p Value
Shapiro-Wilk W 0.989394 Pr < W 0.8598
Kolmogorov-Smirnov D 0.101308 Pr > D 0.0992
Cramer-von Mises W-Sq 0.053428 Pr > W-Sq >0.2500
Anderson-Darling A-Sq 0.31166 Pr > A-Sq >0.2500

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

Distribution analysis of: TOTIMM, TOTMAT, DEFTOT, EMTOT, TOT_POS, TO

T_NEG
The UNIVARIATE Procedure

Fitted Normal Distribution for TOT_NEG

Parameters for Normal Distribution

Parameter Symbol Estimate
Mean Mu 16.29688
Std Dev Sigma 6.755785
Goodness-of-Fit Tests for Normal Distribution
Test Statistic p Value
Kolmogorov-Smirnov D 0.10130838 Pr > D 0.099
Cramer-von Mises W-Sq 0.05342846 Pr > W-Sq >0.250
Anderson-Darling A-Sq 0.31165981 Pr > A-Sq >0.250
Quantiles for Normal Distribution
Quantile
Percent Observed Estimated
1.0 0.0000 0.58057
5.0 4.0000 5.18460
10.0 7.0000 7.63899
25.0 12.5000 11.74017
50.0 17.0000 16.29688
75.0 21.0000 20.85358
90.0 23.0000 24.95476
95.0 27.0000 27.40915

89
 99.0 34.0000 32.01318

Generated by the SAS System ('Local', XP_PRO) on 19 September 2011 at 09:59:30 AM

90