AUTHOR=Coughlan Barry , van IJzendoorn Marinus H. , Woolgar Matt , Weisblatt Emma J. L. , Duschinsky Robbie TITLE=Differentiating “Attachment Difficulties” From Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder: Qualitative Interviews With Experienced Health Care Professionals JOURNAL=Frontiers in Psychology VOLUME=12 YEAR=2022 URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.780128 DOI=10.3389/fpsyg.2021.780128 ISSN=1664-1078 ABSTRACT=Objectives

“Attachment difficulties” is an umbrella term often used to describe various forms of non-secure attachment. Differentiating “attachment difficulties” from autism spectrum disorder (hereafter autism) and attention deficit hyperactivity disorder (ADHD) has been characterized as challenging. Few studies have explored how this happens in practice, from the perspective of professionals.

Design

Qualitative study.

Methods

We conducted in-depth semi-structured interviews with (n = 17) healthcare professionals from five NHS Foundation Trusts in the United Kingdom. Participants were recruited using a combination of snowballing, convenience and purposive sampling. Data were analyzed using a thematic approach.

Results

We identified six interrelated themes that might reflect difficulties with differential conceptualization. These include: a clinical lexicon of attachment; approaching attachment with caution; contextual factors; perceived characteristic behaviors; assessing attachment and adjacent supports; spotlighting intervention and dual conceptualization.

Conclusion

Our results indicate some of the ways suspicions around attachment are raised in practice. We advocate for more dialogue between research and practice communities on issues of differential conceptualization. We call for collaboration between a panel of experts consisting of attachment and neurodevelopmental orientated practitioners and researchers, to clarify issues around differentiating between attachment difficulties, ASD, and ADHD.