Spitz was right. A Moroccan validation of the Alarm Distress Baby (ADBB) scale A comparison of social withdrawal behaviour levels between infants raised in children’s home and infants raised by their own families and a validation of René Spitz’s hypothesis on the causes of ‘hospitalism’ and ‘anaclitic depression’.

Meriem Chkirate, Ahmed Ahami, Khaoula Mammad, Ghizlane Chtabou, Asmaa Mdaghri Alaoui, Antoine Guedeney


Social withdrawal behaviour in infants is a key indicator of child distress and a risk factor for later pathologies. The present study provides results from a Moroccan study of the ADBB scale applied to two populations that were very different in terms of early separation experiences: babies living in a children’s home (n=46) and babies raised by their families (n=56). These 102 infants were assessed using the ADBB scale during routine paediatric check-ups between the ages of 2 and 18 months. Social withdrawal behaviour was significantly more marked among infants raised in a children’s home than among infants raised by their family, and more so among boys than among girls. This study comprising a control group confirmed the validity of Spitz’s description, which placed social withdrawal at the centre of anaclitic depression and of the causes of hospitalism, and attributed this withdrawal to the infants’ early and prolonged separation from their caregivers.

The use of the scale stay therefore be recommended for systematic detection during routine paediatric check-ups or for the follow-up of children at risk, to enable appropriate early interventions to take place.


ADBB scale, social withdrawal, infant, anaclitic depression

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DOI: http://dx.doi.org/10.18103/imr.v7i1.908


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