Background: Specific thematic content arising from children's doll play is often considered to give clinically meaningful information regarding their mental state, but has received little systematic enquiry. This exploratory study examined the negative and atypical content themes in the attachment story narratives of children with behaviour problems, and their associations with child symptomatology and parental depressed mood. Method: Videotaped mother-child attachment doll play completions of 77 children from a clinical sample were blind coded for negative content themes. Mothers completed questionnaires for maternal depression and child behaviour. Results: Children rating positive for behaviour disorder were more likely to represent maternal injury, role reversal and marked maternal sadness. Severe behavioural symptoms were associated with more pervasive negative themes. Half of the overall sample depicted child accidents and maternal unresponsiveness, whereas child aggression, child anger and maternal absence were rare. Girls with depressed mothers showed an absence of particular negative representations (e.g., child sadness) compared to boys. Conclusions: Specific atypical themes are associated with the extent of child psychopathology and may be modified by exposure to maternal depressed mood. The methodological limitations in this exploratory study are also discussed. © 2010 Association for Child and Adolescent Mental Health.