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Saeed, Wedad H. (2010) The impact of maternal attachment on children's cooperative behaviour during dental examination and treatment in the United Arab Emirates. Doctoral thesis, London Metropolitan University.
This research project was an attempt to investigate the relationship between the child's attachment to the mother and the consequent behavioural outcomes during dental consultation with the child. The other main objectives of this research project were to assess the level of cooperativeness and the nature of parental attachment, mainly the mother-child relationship and its influence on cooperativeness during dental examination. Further aims of this study included the assessment of the child's anxiety during dental examination and how this might be related to the internal working model, maternal attachment styles etc. The latter is related to the question of whether parents re-enact their own childhood attachment experiences while caring for their children.
The research project provided an overview of the epidemiology of dental caries. It has mainly reflected on US and WHO reports and other evidence that previous literature highlighted on the applicability of attachment theory to child's dental anxiety or phobia.
The sample of the present study included 260 participants (parents and children between the age of 3 and 13 years old) who attended two primary health centres in Abu Dhabi. The sample was given various questionnaires (i.e. the Corah Dental Anxiety Scale or DAS, 1969; the Frankl Behaviour Rating Scale, Frankl et al., 1962; the Clinical Anxiety Rating Scale, Venham et al., 1979; and the Relation Questionnaire RQ, Bartholomew & Horowitz, 1991) to ascertain levels of anxiety and assess both child and parental attachment behaviour. Ethical issues, including informed consent and confidentiality were considered and addressed before the completion of the questionnaire.
Results of this investigation revealed that there was a sizeable number of children (of both national and Non-UAE national children) who were identified as uncooperative children. Further, slightly over 50% of the sample of both nationals and non-UAE included in this investigation were also identified as cooperative children. More girls manifested uncooperative behaviour than boys. This study also showed that 59 (63.4%) of those who were categorized as securely attached to their mothers also cooperative (positive), and 21 (77.8%) of the fearful children displayed uncooperative or negative behaviour.
On the other hand, 58.5% of the mothers (parents) included in this study were categorized as securely attached parents. Meanwhile, only 33.1% of parents included in this study have met the criteria for fearful attachment.
The pattern which is emerging from these results seems to indicate that the majority of both parents and children were categorized as securely attached individuals. Furthermore, this study reported that the majority of children arriving with their parents at dental clinics showed a low level of anxiety with only a few who can be described as out of control during dental examination. It was also revealed that most participating mothers manifested either low or moderate level of anxiety, with less than 10% of participants who could be described as having either high or severe anxiety.
This study discusses the above reported findings and highlights the association between mother anxiety and child anxiety and the implications of such outcomes in clinical, educational and public health settings. Generally, this study suggested that anxious children are more likely to have anxious mothers and hence children of parents with mental health problems are at greater risk for a range of psychosocial and developmental problems.
However, the interplay between biological and environmental factors of childhood anxiety is also discussed. As well as the aetiology, several approaches to the treatment of dental anxiety which have gained prominence in recent years (i.e. behavioural and cognitive approaches) are also highlighted in this thesis.
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