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Fuertes M, Faria A, Gonçalves JL, Antunes S, Dionisio F. Antibiotic Consumption, Illness, and Maternal Sensitivity in Infants with a Disorganized Attachment. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1232. [PMID: 37508729 PMCID: PMC10378158 DOI: 10.3390/children10071232] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/05/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
Prior research found an association between mother-infant attachment and antibiotic use. Ambivalent-attached infants are more likely to take antibiotics than other infants, and their mothers tend to be less sensitive to their needs than most. This finding is important because it shows the association between psychological processes, early relationships, and health outcomes. We aim to learn about children with high-risk attachment relationships, such as disorganized-attached infants. This study compares antibiotic use, infant-mother interactive behavior, and health indicators according to infant attachment patterns (including disorganized attachment). For this purpose, we observed mothers-infants' interactive behavior in free play at nine months and infants' attachment in the Ainsworth Strange Situation at twelve months. Participants included 77 girls and 104 boys (full-term and preterm) and their mothers. Paradoxically, mothers of disorganized-attached infants reported that their children were ill only 1.56 times on average, but 61% of their children used antibiotics in the first nine months. The other mothers reported that their children were sick 5.73 times on average, but only 54% of their children used antibiotics in the same period. Infants with disorganized attachment had mothers who were more literate and less sensitive. These results add to a body of research that shows that early high-risk relationships affect children's lives at multiple levels.
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Affiliation(s)
- Marina Fuertes
- Centro de Psicologia, University of Porto, 4200-135 Porto, Portugal
- Escola Superior de Educação de Lisboa, Instituto Politécnico de Lisboa, 1549-020 Lisboa, Portugal
| | - Anabela Faria
- Hospital de Santo Espírito da Ilha Terceira, 9700-049 Angra do Heroísmo, Portugal
| | - Joana L Gonçalves
- Instituto de Psicologia e Ciências da Educação, Universidade Lusíada de Lisboa, 1349-001 Lisboa, Portugal
- inED-Centro de Investigação e Inovação em Educação, Escola Superior de Educação, Instituto Politécnico do Porto, 4200-465 Porto, Portugal
- Department of Social and Behavior Sciences, University of Maia-ISMAI, 4475-690 Maia, Portugal
| | - Sandra Antunes
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
| | - Francisco Dionisio
- cE3c-Centre for Ecology, Evolution and Environmental Changes & CHANGE-Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
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Murphy M, Savage E, O'Donoghue K, Leary JO, Leahy-Warren P. Trying to conceive: An interpretive phenomenological analysis of couples' experiences of pregnancy after stillbirth. Women Birth 2020; 34:e475-e481. [PMID: 33176997 DOI: 10.1016/j.wombi.2020.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/12/2020] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Stillbirth affects 1:200 pregnancies in high income countries. Most women are pregnant again within 12 months. Little is known about how couples negotiate a subsequent pregnancy. This paper presents findings from a study exploring the experiences of couples' in pregnancy after stillbirth. METHODS Qualitative, interpretive phenomenological analysis was used to conduct in-depth interviews with eight heterosexual couples in the immediate pregnancy after stillbirth. Couples were interviewed together to explore their dyadic, lived experiences of stillbirth and the pregnancy that follows. RESULTS Hoping for a born alive baby was one superordinate theme and Trying to conceive one of its subordinate themes, is presented here. Couples jointly negotiated their decision to get pregnant again, varying upon their individual circumstances, including their experiences of stillbirth. Gender differences were apparent in a couple's agreement to pursue a pregnancy after stillbirth and may be explained by the desire of men to fully parent the baby who died before reaching a decision about a subsequent pregnancy. Sexual intercourse often became less about emotional connection and more about a means to achieve a pregnancy. CONCLUSION Couples spoke of the need for each partner to be in agreement with the decision for a pregnancy. The experiences of trying to conceive after stillbirth impacted the couple relationships. Couples who were able to discuss their feelings with one another appeared more cohesive than those who experienced communication challenges in the aftermath of loss. New insights into men's thinking about the decision to get pregnant after stillbirth were revealed.
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Affiliation(s)
- Margaret Murphy
- School of Nursing and Midwifery, University College Cork, Ireland. http://www.twitter.com/@mgtmurphy1
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Ireland. http://www.twitter.com/@EileenSavage20
| | - Keelin O'Donoghue
- School of Nursing and Midwifery, University College Cork, Ireland. http://www.twitter.com/@keelinodonoghue
| | - Joann O Leary
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Patricia Leahy-Warren
- School of Nursing and Midwifery, University College Cork, Ireland. http://www.twitter.com/@Pleahy_w
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3
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Flowers AGD, Mcgillivray JA, Galbally M, Lewis AJ. Perinatal maternal mental health and disorganised attachment: A critical systematic review. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12145] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Jane A. Mcgillivray
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria, Australia,
| | - Megan Galbally
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia,
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia,
- Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Western Australia, Australia,
| | - Andrew J. Lewis
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
- Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Western Australia, Australia,
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4
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Preconception and perinatal predictors of offspring attachment disorganization: Advancing the replicated evidence. Dev Psychopathol 2020; 33:240-251. [PMID: 32299518 DOI: 10.1017/s095457941900172x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Attachment disorganization in early childhood is an influential yet modifiable risk factor for later mental health problems. Beyond established transmission through parents' unresolved attachment representations and caregiving sensitivity, little replicated evidence exists for wider determinants of offspring attachment disorganization. This study examined the replicated evidence for psychosocial risk factors in the preconception, prenatal, and postnatal periods. We identified all relevant longitudinal studies, and examined all risk relationships for which evidence existed in two or more cohorts (48 effects, 17 studies, N = 6,099). Study-specific and pooled risk associations were estimated and a range of moderators evaluated. Mothers' low socioeconomic status (r = .28, k = 2), perinatal loss of a child (r = .26, k = 2), caregiving intrusiveness (r = .31, k = 2), and infant male sex (r = .26, k = 4) predicted offspring attachment disorganization. Maternal sensitivity (r = -.25, k = 6) and higher metacognition during pregnancy (r = -.23, k = 3) predicted lower risk of offspring attachment disorganization. Findings suggest the origins of offspring disorganized attachment include but extend beyond maternal unresolved attachment representations and caregiving. We discuss implications for theory and for identification of modifiable risk pathways in the perinatal window.
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Aktar E, Qu J, Lawrence PJ, Tollenaar MS, Elzinga BM, Bögels SM. Fetal and Infant Outcomes in the Offspring of Parents With Perinatal Mental Disorders: Earliest Influences. Front Psychiatry 2019; 10:391. [PMID: 31316398 PMCID: PMC6610252 DOI: 10.3389/fpsyt.2019.00391] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/17/2019] [Indexed: 12/16/2022] Open
Abstract
Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents' behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.
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Affiliation(s)
- Evin Aktar
- Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Jin Qu
- Department of Psychology, Clarion University of Pennsylvania, Clarion, PA, United States
| | - Peter J Lawrence
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Marieke S Tollenaar
- Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Bernet M Elzinga
- Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Developmental Psychology, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
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Granqvist P, Sroufe LA, Dozier M, Hesse E, Steele M, van Ijzendoorn M, Solomon J, Schuengel C, Fearon P, Bakermans-Kranenburg M, Steele H, Cassidy J, Carlson E, Madigan S, Jacobvitz D, Foster S, Behrens K, Rifkin-Graboi A, Gribneau N, Spangler G, Ward MJ, True M, Spieker S, Reijman S, Reisz S, Tharner A, Nkara F, Goldwyn R, Sroufe J, Pederson D, Pederson D, Weigand R, Siegel D, Dazzi N, Bernard K, Fonagy P, Waters E, Toth S, Cicchetti D, Zeanah CH, Lyons-Ruth K, Main M, Duschinsky R. Disorganized attachment in infancy: a review of the phenomenon and its implications for clinicians and policy-makers. Attach Hum Dev 2017; 19:534-558. [PMID: 28745146 PMCID: PMC5600694 DOI: 10.1080/14616734.2017.1354040] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/07/2017] [Indexed: 02/07/2023]
Abstract
Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static "trait" of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.
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Affiliation(s)
- Pehr Granqvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - L. Alan Sroufe
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Mary Dozier
- Department of Psychological and Brain Sciences, University of Delaware, Newark, NY, USA
| | - Erik Hesse
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Miriam Steele
- Psychology Department, The New School, New York, NY, USA
| | - Marinus van Ijzendoorn
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Judith Solomon
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Carlo Schuengel
- Clinical Child and Family Studies and Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College of London, London, UK
| | | | - Howard Steele
- Psychology Department, The New School, New York, NY, USA
| | - Jude Cassidy
- Psychology Department, University of Maryland, WashingtonDC, USA
| | - Elizabeth Carlson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | | | - Sarah Foster
- Faculty of Health and Life Sciences, University of Northumbria, Newcastle, UK
| | - Kazuko Behrens
- Department of Social and Behavioral Sciences, SUNY Polytechnic Institute, Utica, NY, USA
| | - Anne Rifkin-Graboi
- the Neurodevelopmental Research Center, the Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Naomi Gribneau
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Gottfried Spangler
- Developmental and Educational Psychology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mary J Ward
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - Mary True
- Psychology Department, St Mary’s College of California, Moraga, NY, USA
| | - Susan Spieker
- Center on Human Development and Disability, University of Washington, Seattle, MA, USA
| | - Sophie Reijman
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Samantha Reisz
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
- the Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Anne Tharner
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Frances Nkara
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Ruth Goldwyn
- Child and Adolsecent Mental Health Service, Trafford Children and Young Peoples Service, Manchester, UK
| | - June Sroufe
- Minnesota Institute for Contemporary Psychotherapy and Psychoanalysis, Minneapolis, MI, USA
| | - David Pederson
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | | | - Robert Weigand
- T. Denny Sanford School of Social & Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Daniel Siegel
- School of Medicine, University of California, Los Angeles, CA, USA
| | - Nino Dazzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Kristin Bernard
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College of London, London, UK
| | - Everett Waters
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Sheree Toth
- The Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Charles H Zeanah
- Institute of Infant and Early Childhood Mental Health, Tulane University, New Orleans, LA, USA
| | | | - Mary Main
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Robbie Duschinsky
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
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7
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Hasson-Ohayon I, Peri T, Rotschild I, Tuval-Mashiach R. The Mediating Role of Integration of Loss in the Relationship Between Dissociation and Prolonged Grief Disorder. J Clin Psychol 2017; 73:1717-1728. [PMID: 28380271 DOI: 10.1002/jclp.22479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 02/17/2017] [Accepted: 03/05/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Findings from the field of trauma have shown that there is a negative relationship between dissociation and integration of loss into the self-narrative. At the same time, an increasing amount of literature on grief has stressed the importance of an integrated self-narrative in the grieving process. Accordingly, the current study examined the possible mediating role played by the extent to which individuals have integrated their loss into their self-narrative in the relationship between dissociation and symptoms of prolonged grief disorder (PGD). METHOD The Prolonged Grief Disorder Scale (PGD-13), the Outcome Questionnaire, the Integration of Stressful Life Experiences Scale, the Dissociative Experiences Scale, and a sociodemographic questionnaire were administered to 66 individuals who had lost a loved one. RESULTS The hypothesized mediation model of integration was confirmed. CONCLUSION The effect of people's dissociative tendencies on their PGD symptoms seems to occur via the impairment of their ability to integrate the memory of their loss into their general autobiographical memory. Empirical and clinical implications are discussed.
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Affiliation(s)
| | - Tuvia Peri
- Bar-Ilan University, Department of Psychology, Ramat-Gan, Israel
| | - Itai Rotschild
- Bar-Ilan University, Department of Psychology, Ramat-Gan, Israel
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Christiansen DM. Posttraumatic stress disorder in parents following infant death: A systematic review. Clin Psychol Rev 2016; 51:60-74. [PMID: 27838460 DOI: 10.1016/j.cpr.2016.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 11/19/2022]
Abstract
Parents who have lost an infant prior to, during, or following birth often interpret the event as highly traumatic. The present systematic review included 46 articles based on 31 different studies of posttraumatic stress disorder (PTSD) in parents bereaved by infant death. The PTSD prevalence in mothers differed widely across studies with estimated rates at 0.6-39%. PTSD in fathers following infant loss has been less extensively studied but PTSD levels were generally much lower than in mothers with reported prevalence rates at 0-15.6% across studies. PTSD symptoms were not found to differ much depending on whether the death occurred prior to, during, or following birth and nor was gestational age consistently associated with PTSD severity. A number of risk and protective factors have been found to be associated with PTSD severity. Relevant focus areas for future research are presented along with considerations for future pregnancies and children. The suffering associated with PTSD following infant loss is overwhelming because of the rates at which such losses occur around the world. For this reason, it is problematic that not all types of infant loss resulting in sufficient symptoms of re-experiencing, avoidance, and arousal can elicit a DSM-5 PTSD diagnosis.
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Affiliation(s)
- Dorte M Christiansen
- Institute of Psychology, Aarhus University, Bartholins Allé 9, 8000 Aarhus C, Denmark; National Center for Psychotraumatology, Institute of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
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9
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van Ee E, Kleber RJ, Jongmans MJ. Relational Patterns Between Caregivers With PTSD and Their Nonexposed Children: A Review. TRAUMA, VIOLENCE & ABUSE 2016; 17:186-203. [PMID: 25964276 DOI: 10.1177/1524838015584355] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The question as to whether or not children can be affected by the traumatization of their parents has been the topic of a long-standing debate. This article provides a critical review of 72 research studies on traumatized parents with symptoms of posttraumatic stress disorder (PTSD), the parent-child interaction, and the impact on their nonexposed child (0-18 years). The evidence suggests that traumatization can cause parenting limitations, and these limitations can disrupt the development of the young child. From the studies reviewed several patterns emerged: Relational patterns of traumatized parents who are observed to be emotionally less available and who perceive their children more negatively than parents without symptoms of PTSD; relational patterns of children who at a young age are easily deregulated or distressed and at an older age are reported to face more difficulties in their psychosocial development than children of parents without symptoms of PTSD; and relational patterns that show remarkable similarities to relational patterns between depressed or anxious parents and their children. Mechanisms such as mentalization, attachment, physiological factors, and the cycle of abuse offer a valuable perspective to further our understanding of the relational patterns. This article builds on previous work by discussing the emerged patterns between traumatized parents and their nonexposed children from a relational and transactional perspective.
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Affiliation(s)
- Elisa van Ee
- Reinier van Arkel, Psychotraumacentrum Zuid Nederland, Den Bosch, the Netherlands
| | - Rolf J Kleber
- Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands
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Sette G, Coppola G, Cassibba R. The transmission of attachment across generations: The state of art and new theoretical perspectives. Scand J Psychol 2015; 56:315-26. [DOI: 10.1111/sjop.12212] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 01/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Giovanna Sette
- Department of Education; Psychology and Communication; University of Bari; Italy
| | - Gabrielle Coppola
- Department of Neuroscience; Imaging, and Clinical Sciences; University “G. D'Annunzio”; Chieti-Pescara Italy
| | - Rosalinda Cassibba
- Department of Education; Psychology and Communication; University of Bari; Italy
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Belt RH, Kouvo A, Flykt M, Punamäki RL, Haltigan JD, Biringen Z, Tamminen T. Intercepting the intergenerational cycle of maternal trauma and loss through mother-infant psychotherapy: a case study using attachment-derived methods. Clin Child Psychol Psychiatry 2013; 18:100-20. [PMID: 22569679 DOI: 10.1177/1359104512444116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Some mothers who have recently lost a significant attachment figure may become mentally incoherent and sporadically even enter a trancelike, dissociative state. Such states of mind have been shown to predict infant attachment disorganization. Infants born close to the time of a parental loss are at a greater risk for intergenerational trauma. A background of maternal substance abuse is also known to increase such risk. We illustrate by way of a case study how a mother-infant group psychotherapy programme aimed at substance-abusing mothers may help to prevent the transmission of mother's unresolved trauma to the infant. Another goal was to discuss how attachment-derived methods (namely, Adult Attachment Interview, Strange Situation Procedure and the Emotional Availability Scales) may aid in understanding the effects of the intervention.
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Affiliation(s)
- Ritva H Belt
- Department of Child Psychiatry, University of Tampere, Läkkisepänkatu 2 F 18, Tampere, Finland.
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12
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Belt RH, Flykt M, Punamäki RL, Pajulo M, Posa T, Tamminen T. Psychotherapy groups and individual support to enhance mental health and early dyadic interaction among drug-abusing mothers. Infant Ment Health J 2012; 33:520-534. [DOI: 10.1002/imhj.21348] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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13
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Cowchock FS, Meador KG, Floyd SE, Swamy GK. Spiritual needs of couples facing pregnancy termination because of fetal anomalies. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2011; 65:1-10. [PMID: 21928497 DOI: 10.1177/154230501106500204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The spiritual needs of couples (9 mothers and 5 fathers) who were planning to terminate wanted second trimester pregnancies because of serious fetal anomalies were surveyed. Their greatest needs were for a "guidance from a higher power" and for "someone to pray for them." Unlike other reported groups of patients, they did not want or expect their healthcare team to discuss their faith, or to pray with them. Most would prefer support from their own pastors, but their religious community was involved to only a small extent. They would welcome support from hospital chaplains, who could play a substantive and unique pastoral role in this clinical context.
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Affiliation(s)
- F Susan Cowchock
- Center for Spirituality, Theology & Health, Duke University Medical Center, North Carolina, USA.
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Abstract
In this article, it is hypothesized that disorganizing, disorienting, and unresolved states of mind about loss experiences, as classified by the Adult Attachment Interview (AAI) coding system, may offer insight into the bereaved mind and may guide clinical treatment approaches. This article discusses pre-loss attachment organizations and the disorganizing/disorienting markers of unresolved loss found in the AAI. Although sometimes subtle in nature, the unresolved, disorganized, and disorienting indices--defined as lapses in monitoring of reason, discourse and behavior--provide concrete markers for assessing the degree of resolution for loss experiences. An attachment-based grief treatment model can add to existing models implemented in prolonged grief disorder treatment.
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Affiliation(s)
- Paula Thomson
- Department of Kinesiology, College of Health and Human Development, California State University, Northridge, California 91330, USA.
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15
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The impact of maternal psychopathology on child-mother attachment. Arch Womens Ment Health 2009; 12:123-34. [PMID: 19337701 DOI: 10.1007/s00737-009-0066-5] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 03/04/2009] [Indexed: 10/20/2022]
Abstract
This review aims to consider evidence for the impact of maternal psychopathology on the child's attachment to the mother, and the role of this in mediating the known transmission of developmental and clinical risk to children. The studies reviewed focus on mothers with depression and psychotic disorder. A number of studies (mainly of mothers with depression) demonstrate an association between insecure/disorganised infant attachments and severe maternal psychopathology, whether chronic or current, in the presence of comorbid disorder, maternal insecure or unresolved attachment state of mind, trauma/loss, or low parenting sensitivity. Whether such effects last into middle childhood, however, is unclear. Our understanding of the role of attachment in determining developmental trajectories in this group is at an early stage. Some evidence suggests that attachment may have a role in mediating the intergenerational transmission of internalizing and other problems in this group, although the presence of co-occurring contextual risk factors may account for the variability in findings. A multifactorial longitudinal approach is needed to elucidate such factors. However, the current literature highlights which subgroups are likely to be vulnerable and provides an evidence-based rationale for taking an attachment-based approach to intervention in this group.
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Caspers KM, Paradiso S, Yucuis R, Troutman B, Arndt S, Philibert R. Association between the serotonin transporter promoter polymorphism (5-HTTLPR) and adult unresolved attachment. Dev Psychol 2009; 45:64-76. [PMID: 19209991 DOI: 10.1037/a0014026] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Research on antecedents of organized attachment has focused on the quality of caregiving received during childhood. In recent years, research has begun to examine the influence of genetic factors on quality of infant attachment. However, no published studies report on the association between specific genetic factors and adult attachment. This study examined the link between the 5-HTTLPR promoter polymorphism of the serotonin transporter gene and adult unresolved attachment assessed with the Adult Attachment Interview. Genetic material and information on attachment-related loss or trauma were available for 86 participants. Multivariate regression analyses showed an association between the short 5-HTTLPR allele and increased risk for unresolved attachment. Temperament traits and psychological symptoms did not affect the association between 5-HTTLPR and unresolved attachment. The authors hypothesize that the increased susceptibility to unresolved attachment among carriers of the short allele of 5-HTTLPR is consistent with the role of serotonin in modulation of frontal-amygdala circuitry. The findings challenge current thinking by demonstrating significant genetic influences on a phenomenon previously thought to be largely environmentally driven.
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Affiliation(s)
- Kristin M Caspers
- Department of Psychiatry, Carver College of Medicine, University of Iowa, USA.
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Abstract
This review examines an age-old approach to parenting recently rediscovered in Western industrialized societies and known by names such as natural parenting, attachment parenting, and instinctive parenting. Its leading principle is utmost sensitivity to the child's innate emotional and physical needs, resulting in extended breastfeeding on demand, extensive infant carrying on the caregiver's body, and cosleeping of infant and parents. The described practices prevailed during the evolutionary history of the human species and reflect the natural, innate rearing style of the human species to which the human infant has biologically adapted over the course of evolution. An overview of research from diverse areas regarding psychological as well as physiological aspects of early care provides evidence for the beneficial effects of natural parenting. Cross-cultural and historical data is cited to reveal the widespread use of the investigated parenting style. It is concluded that the described approach to parenting provides the human infant with an ideal environment for optimal growth both psychologically and physiologically. It is yet to be determined how much departure from this prototype of optimal human parenting is possible without compromising infant and parental wellbeing. The review also invites a critical reevaluation of current Western childrearing practices.
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Affiliation(s)
- Regine A. Schön
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Maarit Silvén
- Department of Psychology, University of Tampere, Tampere, Finland
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