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Berthelot N, Larouche K, Garon-Bissonnette J, Deschênes K, Drouin-Maziade C, Lemieux R. Spillover effects on the relationship with the partner of a mentalization-based intervention for pregnant women. Infant Ment Health J 2024; 45:369-381. [PMID: 38598747 DOI: 10.1002/imhj.22113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social-emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma-informed mentalization-based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment-as-usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners' emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization-based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant.
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Affiliation(s)
- Nicolas Berthelot
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Karl Larouche
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Julia Garon-Bissonnette
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Kim Deschênes
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
| | - Christine Drouin-Maziade
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Roxanne Lemieux
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
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Matanova VL, Stoyanov DS, Strizhitskaya O. Editorial: Mentalization and clinical psychopathology, volume II. Front Psychol 2024; 15:1424088. [PMID: 38895498 PMCID: PMC11184141 DOI: 10.3389/fpsyg.2024.1424088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Affiliation(s)
| | - Drozdstoy S. Stoyanov
- Department of Psychiatry and Medical Psychology, Medical University, Plovdiv, Bulgaria
- Research Institute, Medical University, Plovdiv, Bulgaria
| | - Olga Strizhitskaya
- Department of Developmental and Differential Psychology, Saint-Petersburg State University, Saint Petersburg, Russia
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Mattheß J, Koch G, Keil T, Roll S, Berghöfer A, Ludwig-Körner C, Schlensog-Schuster F, Sprengeler MK, von Klitzing K, Kuchinke L. Past attachment experiences, the potential link of mentalization and the transmission of behavior to the child by mothers with mental health problems: cross-sectional analysis of a clinical sample. Eur Child Adolesc Psychiatry 2024; 33:1883-1894. [PMID: 37668699 PMCID: PMC11211145 DOI: 10.1007/s00787-023-02291-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023]
Abstract
Maternal capacity to mentalize (= reflective functioning, RF), secure attachment and emotionally available parenting has an impact on the child's development. The transmission of mothers' past attachment experiences gained with both her caregivers in her own childhood and the impact on current mother-child interaction is part of the 'transmission gap.' This study explores the transgenerational transmission mechanisms and the potential moderating effect of RF in a clinical sample of 113 mother-child dyads suffering from mental health problems. In a cross-sectional study, the associations between maternal attachment experiences, RF (coded based on Adult Attachment Interviews) and current mother-child interaction (Emotional Availability Scales) were examined with univariate correlation, moderator analyses, and structural equation models. We found relationships between attachment experiences and mother-child interaction, but RF had no moderating effect. Past loving experiences and perceived neglection, particularly with the own father in childhood, were predictors for the present mother-child interaction. There seems to be an intergenerational transmission of attachment experiences to the ongoing generation. Particularly past adverse childhood experiences with the own father seem to explain currently disruptive interactions with the child.Trial registration: DRKS00017008 and DRKS00016353.
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Affiliation(s)
- Janna Mattheß
- International Psychoanalytic University, Stromstr. 3B, 10555, Berlin, Germany.
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany.
| | - Gabriele Koch
- International Psychoanalytic University, Stromstr. 3B, 10555, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Mona Katharina Sprengeler
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - Lars Kuchinke
- International Psychoanalytic University, Stromstr. 3B, 10555, Berlin, Germany
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Martin-Gagnon G, Normandin L, Fonagy P, Ensink K. Adolescent mentalizing and childhood emotional abuse: implications for depression, anxiety, and borderline personality disorder features. Front Psychol 2023; 14:1237735. [PMID: 37539005 PMCID: PMC10394633 DOI: 10.3389/fpsyg.2023.1237735] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Background There is preliminary evidence that childhood emotional abuse (CEA) is a risk factor for adolescent mentalizing difficulties (Uncertainty/Confusion about mental states) and borderline personality features and that Uncertainty/Confusion about mental states mediate the relationship between CEA and adolescent borderline personality features, but these findings need replication. Furthermore, no previous studies have examined the relationship between adolescent mentalizing deficits, anxiety, and depression in the context of CEA. Objectives This study examined the associations between CEA, adolescent borderline personality features, depression and anxiety symptoms and tested a pathway model where Uncertainty/Confusion about mental states mediates the relationships between CEA and adolescent borderline personality features, depression and anxiety symptoms. Method A clinical sample of 94 adolescents completed the Reflective Function Questionnaire for Youth (RFQY) to assess mentalizing, the Childhood Experiences of Care and Abuse Questionnaire (CECA-Q), the Borderline Personality Disorders Features Scale (BPFS-C), and the Beck Youth Inventories for Depression (BDI-Y) and Anxiety (BAI-Y). Results Uncertainty/Confusion about mental states partially mediated the relationship between CEA and borderline traits as well as anxiety. In addition, there was an indirect effect where CEA predicted Uncertainty/Confusion about mental states, which then predicted depression. Discussion The findings are consistent with the mentalizing model of psychopathology and provide new evidence that Uncertainty/Confusion about mental states might be a critical mentalizing deficit that characterizes the associations between CEA and adolescent BPD features and depression and anxiety symptoms. Uncertainty/Confusion may be a transdiagnostic risk factor for adolescent psychological distress and dysfunction. We discuss the clinical implications.
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Affiliation(s)
| | - Lina Normandin
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Peter Fonagy
- Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Karin Ensink
- École de Psychologie, Université Laval, Québec, QC, Canada
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Ensink K, Bégin M, Martin-Gagnon G, Biberdzic M, Berthelot N, Normandin L, Fonagy P, Bernazzani O, Borelli JL. Post-traumatic-stress in the context of childhood maltreatment: pathways from attachment through mentalizing during the transition to parenthood. Front Psychol 2023; 14:919736. [PMID: 37359870 PMCID: PMC10289889 DOI: 10.3389/fpsyg.2023.919736] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction This study aimed to clarify the role of mentalizing in pathways from attachment to Post Traumatic Stress Symptoms (PTSS) in survivors of childhood maltreatment (CM). We focused on the transition to parenting, a critical period for reworking parenting representations to reduce intergenerational maltreatment cycles. Method Study participants included 100 pregnant CM survivors. We assessed PTSS with the SCID and attachment and mentalizing with the Adult Attachment Interview (AAI), which was rated for Attachment and Reflective Functioning (RF). Results Regarding Re-experiencing trauma symptoms, the results of the path analysis were consistent with mediation. CM survivors' mentalizing about their early relationships with their parents (RF-Other) directly impacted Re-experiencing trauma symptoms, and attachment had an effect on Re-experiencing trauma symptoms through mentalizing (RF-Other). Regarding Arousal/Reactivity symptoms, the results of the pathways analysis were consistent with partial mediation by mentalizing about early relationships with parents (RF-Other). In addition to the pathway from attachment via mentalizing (RF-Other) to Arousal/Reactivity, the pathway between attachment and Arousal/Reactivity also remained significant. Discussion This study provides new evidence of a mentalizing and attachment model of PTSS in CM survivors. The findings indicate that increased mentalizing about early relationships with parents is an important process associated with lower PTSS. Finally, we discuss the implications of developing interventions for CM survivors to reduce PTSS. Scaffolding the development of mentalizing regarding attachment relationships in which CM occurred may help CM survivors reduce the intrusion of traumatic memories and decrease trauma-related arousal and reactivity symptoms. Interventions to help CM survivors mentalize regarding parents and attachment relationships in which trauma occurred may be particularly important during the transition to parenting when activation of representations of parenting can trigger PTSS.
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Affiliation(s)
- Karin Ensink
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Michaël Bégin
- Département de Psychologie, Université de Sherbrooke, Québec, QC, Canada
| | | | - Marko Biberdzic
- Department of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Nicolas Berthelot
- Department of Nursing, Université du Québec à Trois-Rivières, Québec, QC, Canada
| | - Lina Normandin
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Peter Fonagy
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Odette Bernazzani
- Department of Psychiatry, Université de Montréal, Québec, QC, Canada
| | - Jessica L. Borelli
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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De Palma M, Rooney R, Izett E, Mancini V, Kane R. The relationship between parental mental health, reflective functioning coparenting and social emotional development in 0-3 year old children. Front Psychol 2023; 14:1054723. [PMID: 37325734 PMCID: PMC10267873 DOI: 10.3389/fpsyg.2023.1054723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/03/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction The transition to parenthood is a high-risk period for many parents and is an important period for child development. Research has identified that parental mental health, reflective functioning (capacity to consider mental states of oneself and others) and coparenting (capacity to work together well as a parenting team) may be particularly significant predictors of later child outcomes, however these factors have seldom been considered together. The present study therefore aimed to investigate the relationship between these factors and the extent to which they predict child social emotional development. Methods Three hundred and fifty parents of infants aged 0 to 3 years 11 months were recruited to complete an online Qualtrics questionnaire. Results Results indicate that both positive coparenting and parental reflective functioning (Pre-mentalizing and Certainty subscales) were found to significantly predict child development. General reflective functioning (Uncertainty subscale) predicted parental depression and anxiety, however unexpectedly, parental mental health was not a significant predictor of child development, but did predict coparenting. General reflective functioning (Certainty subscale) was also found to predict coparenting, which in turn was found to predict parental reflective functioning. We found an indirect effect of general reflective functioning (Certainty) on child SE development via parental reflective functioning (Pre-mentalizing). We also found an indirect effect of negative coparenting on child development via parental reflective functioning (Pre-mentalizing). Discussion The current results support a growing body of research highlighting the important role reflective functioning plays in child development and wellbeing as well as parental mental health and the interparental relationship.
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Affiliation(s)
- Mia De Palma
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Rosanna Rooney
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Elizabeth Izett
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Vincent Mancini
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- Division of Paediatrics, UWA Medical School, University of Western Australia, Perth, WA, Australia
| | - Robert Kane
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
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Flykt M, Belt R, Salo S, Pajulo M, Punamäki RL. Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From Two Different RF Measures. Front Psychol 2022; 13:909414. [PMID: 35959038 PMCID: PMC9359121 DOI: 10.3389/fpsyg.2022.909414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.
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Affiliation(s)
- Marjo Flykt
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, Department of Psychology, Tampere University, Tampere, Finland
- *Correspondence: Marjo Flykt
| | - Ritva Belt
- Department of Social Services, Tampere, Finland
| | - Saara Salo
- Faculty of Education, University of Helsinki, Helsinki, Finland
| | - Marjukka Pajulo
- Faculty of Medicine, Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Raija-Leena Punamäki
- Faculty of Social Sciences, Department of Psychology, Tampere University, Tampere, Finland
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