Stranger anxiety

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Crying is a common sign of anxiety in children Crying child with blonde hair.jpg
Crying is a common sign of anxiety in children

Stranger anxiety is a form of distress that children experience when exposed to strangers. Stranger anxiety and stranger fear are two interchangeable terms. Stranger anxiety is a typical part of the developmental sequence that most children experience. It can occur even if the child is with a caregiver or another person they trust. [1] It peaks from six to 12 months [2] but may recur afterwards until the age of 24 months. [3] As a child gets older, stranger anxiety can be a problem as they begin to socialize. Children may become hesitant to play with unfamiliar children. [1] Foster children are especially at risk, particularly if they experienced neglect early in their life. [1]

Contents

The anxiety children experience when meeting a stranger is based on the sensation of fear they develop when introduced to an unfamiliar factor in their life that elicits the feeling of fear. They are not born with the awareness that meeting a stranger for the first time will cause them to be fearful. The child discovers this feeling when facing the stimulus, in this case a stranger, for the first time. Experiencing fear causes toddlers to sense they are in a potentially threatened position and therefore, they go towards their caregiver in order to seek protection from the stranger. This reaction enables children to develop instincts to guide them when they feel endangered and seek the protection of a familiar and trusted individual to ensure their safety and survival. The stimuli which provoke a child's anxiety in the presence of a stranger are influenced by the individual's age, gender and his or her distance from the toddler. When a child is in the company of an unknown child, they are less frightened than if they were with an unknown adult. This is due to the height of the individual. The taller the person, the more frightening they seem. In addition, children are more fearful of a stranger when they are standing in close proximity to them, while their caregiver is farther away or completely out of their sight. The gender of the stranger contributes to the level of anxiety a child experiences. When in the presence of a male, the child feels more anxious than in front of a female. [4]

The anxiety a child feels when facing a stranger is based on various fears that arise in them. A few of these are based on the actions the stranger could unexpectedly take. For example, the child worries they can be taken away from their caregiver or harmed. The fear of the unknown elicits the anxiety. Although anxiety can go away in few minutes, it could also last a long time. [5] As children reach the age of two, their feelings of anxiety in the presence of strangers are nearly gone. However, some children can still experience apprehension up until the age of four. [6] It is less probable for toddlers to experience anxiety in the presence of a stranger if a figure they trust, such as their caregivers, perform positive interactions with this person. For example, they employ a calm tone of voice, they smile and hug the stranger. This enables the child to feel a certain reassurance seeing that their caregiver does not show any sign of fear in the presence of this individual. [7]

Onset

Stranger anxiety develops slowly; it does not just appear suddenly. It typically first starts to appear around four months of age with infants behaving differently with caregivers than with strangers. In fact, there is a difference between their interactions with their caregiver and the stranger. They become cautious when strangers are around; therefore, preferring to be with their caregiver instead of the stranger. Around 7–8 months, stranger anxiety becomes more present; therefore, it occurs more frequently at this point. Infants start to be aware of their environment and they are aware of their relationships with people; so, stranger anxiety is clearly displayed. Around this time, children choose and prefer to be with their primary caregiver. As a child's cognitive skills develop and improve, typically around 12 months, their stranger anxiety can become more intense. They display behaviors like running to their caregiver, grabbing at the caregiver's legs, or demanding to be picked up. [1] Children seem also to respond more positively to a person who gives positive reinforcements and more negatively to a person who gives negative reinforcements. [8]

Fearfulness within the sight of outsiders is thought to be developed around 6 months of age. In fact, that fear of strangers increases throughout their first year of life. The beginning of stranger fear is accepted to be adaptive, offering balance to infants' tendencies toward approach and exploration and adding to the developing attachment system. However, in extreme cases of stranger fear, this can be a warning sign to the emergence of social anxiety. [9] According to the University of Pittsburgh, stranger anxiety tends to be seen before separation anxiety. [10]

Infants may be afraid of strangers

Signs of stranger anxiety

According to the University of Pittsburgh [1] based on the child, signs of stranger anxiety can differ from one to child the other. For example;

  1. In the presence of a stranger, some infants can abruptly go quiet and look at the stranger with fear.
  2. Certain emotions will increase in other children while in the presence of a stranger such as loud crying and fussiness.
  3. And others will have the tendency to bury themselves in their caregiver's arms or even place themselves away from the stranger by placing the caregiver between themselves and the stranger.

Modeling and stranger anxiety

Infancy

Parental attitudes also have an effect on a child's fear acquisition. [11] In their early months and years, infants acquire most of their behavioral information for their direct family and often, their primary caregivers. [12] Young infants are more selective and preferentially learn about new threats for their mother's responses. [12] High risk mothers can easily influence their child's responses since are more likely to mimic their actions. [12] [11] For example, a child who sees their mother demonstrating negative reactions towards a specific person, then the child is more likely to have a negative response towards that same person. While most studies have researched the effect of mothers' behaviors on their children, it is important to note that the effect of parental modeling is not unique to mothers, but the phenomenon occurs for both mothers and fathers. [13]

Implications

Fear beliefs that occur vicariously can be reversed using the same form of acquisition through a vicarious counter-conditioning procedure. For example, a parent can show a stranger's angry face with happy face or a scared-paired animal with happy faces as well and vice versa. [12] Also, feared responses seem to decrease with time if infants are provided with opportunities to have physical contact with the stimuli which helps alleviate the stimuli's fearful properties. [11]

Childhood

Stranger fear is less likely in older children (i.e. at least six years old) since there is a greater readiness for them to accept behavioral information from outside the family. [12] However, studies show that older children do exhibit increased anxiety to new threats and avoidant responses following discussion with parents. [13] The effect of parental modeling of anxiety on children may go beyond influencing anxious behaviors in children, but also affect their subjective feelings and cognition during middle childhood. [13]

Implications

This has important implications for parents and those working with school-age children because it suggests that they can potentially prevent or reverse fear developing if they recognize a child is involved in a fear-related vicarious learning event. [12] In cases where infants become fearful of strangers or unknown entities (such as foreign objects), parents should respond positively towards the stranger, only after the child has a phobic response to it. [12]

Dealing with stranger anxiety

Since stranger anxiety can manifest itself suddenly or happen gradually throughout the development of the toddler, dealing with it can be hard sometimes because people are often not prepared to react to it or they don't even know what stranger anxiety is. Stranger anxiety should be viewed as a normal, common part of a child's development. Since it is often characterized by negative emotions and fear, multiple steps were created to induct a feeling of trust and safety between the child and the strangers.

The child's feelings should always be valued Crying-girl.jpg
The child's feelings should always be valued

Extreme anxiety can affect development, especially if a child is so terrified that they will not explore new environments and hinder themselves from learning. Also, research shows that exposure to circumstances that produce persistent fear and chronic anxiety can have a lifelong effect on a child's brain by disrupting its developing architecture. While stranger anxiety is a normal part of child development, if it becomes so severe that it restricts normal life professional help might be necessary. Seeking the help of a pediatrician is recommended if the situation doesn't improve, or even regresses in time. Often, pediatricians will be able to find the origin of the child's anxiety and create a plan of action in order to rectify the situation. [1]

Stranger anxiety and autism spectrum disorder

According to the American Psychiatric Association, autism spectrum disorder (ASD) is defined as "a developmental disorder characterized by troubles with social interaction and communication, and by restricted and repetitive behavior". [14] There is a significant overlap between the behaviors that characterize ASD and those observed in stranger anxiety, which makes diagnoses and research more difficult. [14] However, individuals with ASD often have a rigid understanding of the world and behave in a very rule-based and compartmentalized manner, depending on their placement on the spectrum. Thus, the social interactions and stranger approaches seen in children are often modeled from their caretakers and are based on the rules they are told.

Modelling in stranger anxiety in ASD

Children with developmentally appropriate behavior also model their parents' behavior and can exhibit stranger anxiety until they are about six years old, but children with ASD have difficulty accepting behavioral information and understanding how to behave with certain people and strangers. [15] Thus, if caretakers/parents demonstrate negative behavior, like facial expressions, verbal communications, or physical retractions, towards strangers, children with autism will often imitate this behavior. Although children with ASD often have difficulty with imitation, children are often taught that strangers are "dangerous". Moreover, if caretakers teach children with autism that strangers are unsafe, they will demonstrate stranger anxiety and have difficulty understanding otherwise as they grow. [16] For example, caretakers may teach children to never speak to strangers, but children with ASD will understand this literally and may fear and be anxious around all strangers.

Strategies

Therefore, it is crucial to appropriately teach children with autism who they may expect to meet in a given location and situation and what those people look like, in order for them to be self-sufficient and not anxious wherever they are. Individuals with ASD need to understand not only who they should be interacting with in the community, but also what the expected behaviors are during these interactions. [17] Moreover, caretakers/parents are cautioned to not reinforce negative reactions when strangers are seen and to teach "stranger danger" precariously. Thus, children with autism should be taught strategies that slightly differ than a developmentally appropriate child. One example of a strategy is the Circles Program, which color coordinates individuals that a child may encounter by titling them in different colored circles and outlining the expected social boundaries with these people. Another strategy used for children with ASD and stranger anxiety is to use social stories, this includes pictures and audio tapes which makes understanding possible changes they may encounter with strangers. [17]

Stranger terror

Child afraid of new women in classroom

Stranger terror is extremely severe stranger anxiety that inhibits the child's normal functioning. The DSM- V describes stranger terror as infants with a reactive attachment disorder, inhibited type and do not respond to or initiate contact with others, but rather show extreme trepidation and ambivalence about unknown adults. [18] Anxiety and fear around strangers usually appears around six months of age and it slowly increases throughout the first year of life. This increase in stranger anxiety correlates with the same time as when the child starts crawling, walking and exploring its surroundings. The age of the child seems to play an important role in the development of stranger terror in infants. [19] Older infants (i.e. at least 12 months) seem to be more affected than younger infants because their cognitive development to know and remember has matured more than younger infants and their attachment to caregivers is stronger than younger infants.

Stranger anxiety and stranger terror is associated with Attachment Theory, the attachment to the caregiver. Seen across different species, attachment increases the chances of the infant's survival in the world. In a research conducted by Tyrrell and Dozier (1997), [20] they found that infants in foster care show more attachment-related difficulties than control infants in their families. Those foster children were sometimes unsoothable after the contact or even just the presence of a stranger. There have been hypotheses that for these infants the appearance of the stranger represented a potential loss of the new attachment figure and it was the fear of re-experiencing this loss that prompted their behavior. Those children with stranger anxiety will rarely go beyond their caregiver to explore their surroundings. Stranger terror elicits strong reactions from children as described below, most likely due to the degree of traumatic event which causes their strong reactions such as the loss of a mother. In order to cope with attachment-related traumas, children with stranger terror develop abnormal means of coping with these events by viewing all adults as threatening and avoiding contact with everyone, for example. [19]

Strange situation

In a Strange Situation experiment, a child of the age of 20 months was in a room with their mother and a stranger would enter. The child would go hide behind the legs of the mother. The mother was then asked to leave the room and leave the child with the stranger. After the first separation, the child began to scream and was extremely upset. He refused all contact with the stranger and when the adult tried to pick up the child he would scream louder until put back down. Any attempts by the stranger to sooth the child was unsuccessful. When the mother came back in the room for the first reunion, the child somewhat calmed down, but he was still very upset and distressed. For the second part of the experiment, the child was left alone in the room for a couple of minutes before the stranger entered again. The second the stranger entered the room the child began crying loudly again even if no contact was made.[ citation needed ]

To conclude, although resistance to a stranger is common for children, the extreme reactions was far more urgent and depicted terror. In addition, most babies in the experiment show some evidence of settling when the stranger enters the room the second time. In contrast, children with stranger terror showed an increase in distress upon the stranger's entry.

Children go and hide when a stranger enters their home Hide n Seek.jpg
Children go and hide when a stranger enters their home

Some signs of stranger terror

See also

Related Research Articles

Attachment disorder is a broad term intended to describe disorders of mood, behavior, and social relationships arising from unavailability of normal socializing care and attention from primary care giving figures in early childhood. Such a failure would result from unusual early experiences of neglect, abuse, abrupt separation from caregivers between three months and three years of age, frequent change or excessive numbers of caregivers, or lack of caregiver responsiveness to child communicative efforts resulting in a lack of basic trust. A problematic history of social relationships occurring after about age three may be distressing to a child, but does not result in attachment disorder.

Reactive attachment disorder (RAD) is described in clinical literature as a severe and relatively uncommon disorder that can affect children, although these issues do occasionally persist into adulthood. RAD is characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way—known as the "inhibited form". In the DSM-5, the "disinhibited form" is considered a separate diagnosis named "disinhibited attachment disorder".

<span class="mw-page-title-main">Attachment theory</span> Psychological ethological theory about human relationships

Attachment theory is a psychological, evolutionary and ethological theory concerning relationships between humans. The most important tenet is that young children need to develop a relationship with at least one primary caregiver for normal social and emotional development. The theory was formulated by psychiatrist and psychoanalyst John Bowlby (1907-1990).

<span class="mw-page-title-main">Maternal bond</span> Relationship between mother and child

A maternal bond is the relationship between a mother and her child. While typically associated with pregnancy and childbirth, a maternal bond may also develop in cases where the child is unrelated, such as an adoption.

Social inhibition is a conscious or subconscious avoidance of a situation or social interaction. With a high level of social inhibition, situations are avoided because of the possibility of others disapproving of their feelings or expressions. Social inhibition is related to behavior, appearance, social interactions, or a subject matter for discussion. Related processes that deal with social inhibition are social evaluation concerns, anxiety in social interaction, social avoidance, and withdrawal. Also related are components such as cognitive brain patterns, anxious apprehension during social interactions, and internalizing problems. It also describes those who suppress anger, restrict social behavior, withdraw in the face of novelty, and have a long latency to interact with strangers. Individuals can also have a low level of social inhibition, but certain situations may generally cause people to be more or less inhibited. Social inhibition can sometimes be reduced by the short-term use of drugs including alcohol or benzodiazepines. Major signs of social inhibition in children are cessation of play, long latencies to approaching the unfamiliar person, signs of fear and negative affect, and security seeking. Also in high level cases of social inhibition, other social disorders can emerge through development, such as social anxiety disorder and social phobia.

In psychology, an affectional bond is a type of attachment behavior one individual has for another individual, typically a caregiver for their child, in which the two partners tend to remain in proximity to one another. The term was coined and subsequently developed over the course of four decades, from the early 1940s to the late 1970s, by psychologist John Bowlby in his work on attachment theory. The core of the term affectional bond, according to Bowlby, is the attraction one individual has for another individual. The central features of the concept of affectional bonding can be traced to Bowlby's 1958 paper, "The Nature of the Child's Tie to his Mother".

<span class="mw-page-title-main">Attachment in children</span> Biological instinct

Attachment in children is "a biological instinct in which proximity to an attachment figure is sought when the child senses or perceives threat or discomfort. Attachment behaviour anticipates a response by the attachment figure which will remove threat or discomfort". Attachment also describes the function of availability, which is the degree to which the authoritative figure is responsive to the child's needs and shares communication with them. Childhood attachment can define characteristics that will shape the child's sense of self, their forms of emotion-regulation, and how they carry out relationships with others. Attachment is found in all mammals to some degree, especially primates.

In psychology, the theory of attachment can be applied to adult relationships including friendships, emotional affairs, adult romantic and carnal relationships, and, in some cases, relationships with inanimate objects. Attachment theory, initially studied in the 1960s and 1970s primarily in the context of children and parents, was extended to adult relationships in the late 1980s. The working models of children found in Bowlby's attachment theory form a pattern of interaction that is likely to continue influencing adult relationships.

Attachment measures, or attachment assessments, are the various procedures used to assess the attachment system in children and adults. These procedures can assess patterns of attachment and individual self-protective strategies. Some assessments work across the several models of attachment and some are model-specific. Many assessments allow children and adults' attachment strategies to be classified into three primary attachment pattern groups: B-pattern, A-pattern, C-pattern. In most models, each pattern group is further broken down into several sub-patterns. Some assessments are capable of finding additional information about an individual, such as unresolved trauma, depression, history of family triangulation, and lifespan changes in the attachment pattern. Some assessments specifically or additionally look for caregiving behaviors, as caregiving and attachment are widely considered two separate systems for organizing thoughts, feelings, and behavior. Some methods assess disorders of attachment or romantic attachment.

Co-regulation is a term used in psychology. It is defined most broadly as a "continuous unfolding of individual action that is susceptible to being continuously modified by the continuously changing actions of the partner". An important aspect of this idea is that co-regulation cannot be reduced down to the behaviors or experiences of the individuals involved in the interaction. The interaction is a result of each participant repeatedly regulating the behavior of the other. It is a continuous and dynamic process, rather than the exchange of discrete information.

Cupboard love is a popular learning theory of the 1950s and 1960s based on the research of Sigmund Freud, Anna Freud, Melanie Klein and Mary Ainsworth. Rooted in psychoanalysis, the theory speculates that attachment develops in the early stages of infancy. This process involves the mother satisfying her infant's instinctual needs, exclusively. Cupboard love theorists conclude that during infancy, our primary drive is food which leads to a secondary drive for attachment.

Attachment-based therapy applies to interventions or approaches based on attachment theory, originated by John Bowlby. These range from individual therapeutic approaches to public health programs to interventions specifically designed for foster carers. Although attachment theory has become a major scientific theory of socioemotional development with one of the broadest, deepest research lines in modern psychology, attachment theory has, until recently, been less clinically applied than theories with far less empirical support. This may be partly due to lack of attention paid to clinical application by Bowlby himself and partly due to broader meanings of the word 'attachment' used amongst practitioners. It may also be partly due to the mistaken association of attachment theory with the pseudo-scientific interventions misleadingly known as attachment therapy. The approaches set out below are examples of recent clinical applications of attachment theory by mainstream attachment theorists and clinicians and are aimed at infants or children who have developed or are at risk of developing less desirable, insecure attachment styles or an attachment disorder.

The strange situation is a procedure devised by Mary Ainsworth in the 1970s to observe attachment in children, that is relationships between a caregiver and child. It applies to children between the age of nine and 30 months. Broadly speaking, the attachment styles were (1) secure and (2) insecure. Later, Mary Ainsworth and her husband Erik Hesse introduced the 4th category, disorganized. The procedure played an important role in the development of attachment theory.

<span class="mw-page-title-main">Daniel Schechter</span> American neuroscientist

Daniel S. Schechter is an American and Swiss psychiatrist known for his clinical work and research on intergenerational transmission or "communication" of violent trauma and related psychopathology involving parents and very young children. His published work in this area following the terrorist attacks on the World Trade Center in New York of September 11, 2001 led to a co-edited book entitled "September 11: Trauma and Human Bonds" (2003) and additional original articles with clinical psychologist Susan Coates that were translated into multiple languages and remain among the first accounts of 9/11 related loss and trauma described by mental health professionals who also experienced the attacks and their aftermath Schechter observed that separation anxiety among infants and young children who had either lost or feared loss of their caregivers triggered posttraumatic stress symptoms in the surviving caregivers. These observations validated his prior work on the adverse impact of family violence on the early parent-child relationship, formative social-emotional development and related attachment disturbances involving mutual dysregulation of emotion and arousal. This body of work on trauma and attachment has been cited by prominent authors in the attachment theory, psychological trauma, developmental psychobiology and neuroscience literatures

Patricia McKinsey Crittenden is an American psychologist known for her work in the development of attachment theory and science, her work in the field of developmental psychopathology, and for creation of the Dynamic-Maturational Model of Attachment and Adaptation (DMM).

<span class="mw-page-title-main">Maternal sensitivity</span>

Maternal sensitivity is a mother's ability to perceive and infer the meaning behind her infant's behavioural signals, and to respond to them promptly and appropriately. Maternal sensitivity affects child development at all stages through life, from infancy, all the way to adulthood. In general, more sensitive mothers have healthier, more socially and cognitively developed children than those who are not as sensitive. Also, maternal sensitivity has been found to affect the person psychologically even as an adult. Adults who experienced high maternal sensitivity during their childhood were found to be more secure than those who experienced less sensitive mothers. Once the adult becomes a parent themselves, their own understanding of maternal sensitivity will affect their own children's development. Some research suggests that adult mothers display more maternal sensitivity than adolescent mothers who may in turn have children with a lower IQ and reading level than children of adult mothers.

Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment. Separation anxiety is a natural part of the developmental process. It is most common in infants and little children, typically between the ages of six to seven months to three years, although it may pathologically manifest itself in older children, adolescents and adults. Unlike SAD, normal separation anxiety indicates healthy advancements in a child's cognitive maturation and should not be considered a developing behavioral problem.

Social emotional development represents a specific domain of child development. It is a gradual, integrative process through which children acquire the capacity to understand, experience, express, and manage emotions and to develop meaningful relationships with others. As such, social emotional development encompasses a large range of skills and constructs, including, but not limited to: self-awareness, joint attention, play, theory of mind, self-esteem, emotion regulation, friendships, and identity development.

Daniel Messinger is an American interdisciplinary developmental psychologist, and academic. His research works span the field of developmental psychology with a focus on emotional and social development of children and infants, and the interactive behavior of children in preschool inclusive classroom.

The diagnosis of autism is based on a person's reported and directly observed behavior. There are no known biomarkers for autism spectrum conditions that allow for a conclusive diagnosis.

References

  1. 1 2 3 4 5 6 7 8 Stranger anxiety
  2. ↑ Deterding, Robin R.; William Winn Hay; Myron J. Levin; Judith M. Sondheimer (2006). Current Diagnosis and Treatment in Pediatrics. New York: McGraw-Hill Medical. p. 200. ISBN   978-0-07-146300-3.
    - Williams, Sears (August 2011). "bye-bye BABY". Baby Talk. 76 (6): 22–24. Retrieved October 2, 2011.[ permanent dead link ]
  3. ↑ What to Expect. Toddler Stranger Anxiety.
  4. ↑ Lampinen, James Michael; Sexton-Radek, Kathy (2010-09-13). Protecting Children from Violence: Evidence-Based Interventions. Psychology Press. ISBN   9781136980046.
  5. ↑ Pantley, Elizabeth (2010-03-26). The No-Cry Separation Anxiety Solution: Gentle Ways to Make Good-bye Easy from Six Months to Six Years. McGraw Hill Professional. ISBN   9780071747073.
  6. ↑ Martin, Carol Lynn; Fabes, Richard (2008-01-25). Discovering Child Development. Cengage Learning. ISBN   9781111808112.
  7. ↑ Shaffer, David (2008-09-19). Social and Personality Development. Cengage Learning. ISBN   9781111807269.
  8. ↑ Greenberg, David (1973). "Infant and Stranger Variables Related to Stranger Anxiety in the First Year of Life". Developmental Psychology. 9 (2): 207–212. doi:10.1037/h0035084.
  9. ↑ Brooker, R. J., Buss, K. A., Lemery-Chalfant, K., Aksan, N., Davidson, R. J., & Goldsmith, H. H. (2013). (2013). "The Development of Stranger Fear in Infancy and Toddlerhood: Normative Development, Individual Differences, Antecedents, and Outcomes". Developmental Science. 16 (6): 864–78. doi:10.1111/desc.12058. PMC   4129944 . PMID   24118713.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  10. ↑ "Stranger Anxiety" (PDF).
  11. 1 2 3 Dubi, Kathrin; Rapee, Ronald M.; Emerton, Jane L.; Schniering, Carolyn A. (2008-05-01). "Maternal Modeling and the Acquisition of Fear and Avoidance in Toddlers: Influence of Stimulus Preparedness and Child Temperament" (PDF). Journal of Abnormal Child Psychology. 36 (4): 499–512. doi:10.1007/s10802-007-9195-3. ISSN   0091-0627. PMID   18080181. S2CID   32984992.
  12. 1 2 3 4 5 6 7 Dunne, Güler; Askew, Chris (2013). "Vicarious learning and unlearning of fear in childhood via mother and stranger models". Emotion. 13 (5): 974–980. doi:10.1037/a0032994. PMID   23795591.
  13. 1 2 3 Burstein, Marcy; Ginsburg, Golda S. (2010). "The effect of parental modeling of anxious behaviors and cognitions in school-aged children: An experimental pilot study". Behaviour Research and Therapy. 48 (6): 506–515. doi:10.1016/j.brat.2010.02.006. PMC   2871979 . PMID   20299004.
  14. 1 2 Tuchman, R (2003). "Autism". Neurologic Clinics. 21 (4): 915–932. doi:10.1016/S0733-8619(03)00011-2. PMID   14743656.
  15. ↑ Dunne, G. (2013). "Vicarious learning and unlearning of fear in childhood via mother and stranger models". Emotion. 13 (5): 974–980. doi:10.1037/a0032994. PMID   23795591.
  16. ↑ Dubi, K (2008). "Maternal modeling and the acquisition of fear and avoidance in toddlers: influence of stimulus preparedness and child temperament" (PDF). Journal of Abnormal Child Psychology. 36 (4): 499–512. doi:10.1007/s10802-007-9195-3. PMID   18080181. S2CID   32984992.
  17. 1 2 Wood, J. J. (2009). "Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial". Journal of Child Psychology and Psychiatry. 50 (3): 224–234. doi:10.1111/j.1469-7610.2008.01948.x. PMC   4231198 . PMID   19309326.
  18. ↑ Diagnostic and statistical manual of mental disorders . Washington, DC: American Psychiatric Association. 2013. ISBN   978-0-89042-554-1.
  19. 1 2 Albus, Kathleen E.; Dozier, Mary (1999). "Indiscriminate friendliness and terror of strangers in infancy: Contributions from the study of infants in foster care". Infant Mental Health Journal. 20: 30–41. doi:10.1002/(SICI)1097-0355(199921)20:1<30::AID-IMHJ3>3.0.CO;2-J.
  20. ↑ Tizard, B. (1977). Adoption: A second chance. New York: The Free Press.
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