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Concept: Attachment in adults

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BACKGROUND: This study examined predictors of parenting self-efficacy (PSE) in a sample of first-time mothers during the first year after childbirth and evaluated the effect of a brief, intensive, mother-infant residential intervention on PSE and infant behaviour. METHODS: 83 primiparous women with infants aged 0-12months admitted to a residential parent-infant program participated in a structured clinical interview for DSM-IV diagnosis of depressive and anxiety disorders and completed questionnaires assessing psychological distress, adult attachment and childhood parenting experiences. During their residential stay, nurses recorded infant behaviour using 24-hour charts. RESULTS: Results showed PSE to be inversely correlated with maternal depression, maternal anxiety and attachment insecurity. Low levels of parental abuse during childhood, avoidant attachment, male infant gender and depressive symptom severity were found to predict low PSE. Major depression mediated the relation between attachment insecurity and PSE, but there were no links between PSE and infant behaviour. After the intervention, there was a significant improvement in PSE, with abusive parenting during childhood and depressive symptom severity being predictive of change. CONCLUSIONS: This study highlights the links between maternal psychopathology and maternal background factors such as childhood parenting experiences and attachment style in the development of postnatal PSE. Directions for future research are discussed.

Concepts: Psychology, Infant, Selective serotonin reuptake inhibitor, Abnormal psychology, Child abuse, Diagnostic and Statistical Manual of Mental Disorders, Attachment in adults, John Bowlby

90

Despite the increasing interest in twin studies and the stunning amount of research on face recognition, the ability of adult identical twins to discriminate their own faces from those of their co-twins has been scarcely investigated. One’s own face is the most distinctive feature of the bodily self, and people typically show a clear advantage in recognizing their own face even more than other very familiar identities. Given the very high level of resemblance of their faces, monozygotic twins represent a unique model for exploring self-face processing. Herein we examined the ability of monozygotic twins to distinguish their own face from the face of their co-twin and of a highly familiar individual. Results show that twins equally recognize their own face and their twin’s face. This lack of self-face advantage was negatively predicted by how much they felt physically similar to their co-twin and by their anxious or avoidant attachment style. We speculate that in monozygotic twins, the visual representation of the self-face overlaps with that of the co-twin. Thus, to distinguish the self from the co-twin, monozygotic twins have to rely much more than control participants on the multisensory integration processes upon which the sense of bodily self is based. Moreover, in keeping with the notion that attachment style influences perception of self and significant others, we propose that the observed self/co-twin confusion may depend upon insecure attachment.

Concepts: Twin, Twins, Zygote, Attachment theory, Monozygotic, Attachment in adults, Cândido Godói

40

Social support is crucial for psychological and physical well-being. Yet, in experimental and clinical pain research, the presence of others has been found to both attenuate and intensify pain. To investigate the factors underlying these mixed effects, we administered noxious laser stimuli to 39 healthy women while their romantic partner was present or absent, and measured pain ratings and laser-evoked potentials to assess the effects of partner presence on subjective pain experience and underlying neural processes. Further, we examined whether individual differences in adult attachment style, alone or in interaction with the partner’s level of attentional focus (manipulated to be either on or away from the participant) might modulate these effects. We found that the effects of partner presence versus absence on pain-related measures depended on adult attachment style but not partner attentional focus. The higher participants' attachment avoidance, the higher pain ratings and N2 and P2 local peak amplitudes were in the presence compared to the absence of the romantic partner. As laser-evoked potentials are thought to reflect activity relating to the salience of events, our data suggest that partner presence may influence the perceived salience of events threatening the body, particularly in individuals who tend to mistrust others.

Concepts: Nervous system, Psychology, Mind, Developmental psychology, Attachment theory, Family therapy, Absenteeism, Attachment in adults

29

This cross-sectional, dyadic questionnaire study examined the contribution of romantic attachment and responsive caregiving to parenting style, investigating both gender and partner effects. One hundred and twenty-five couples with children aged 7 to 8 years completed measures of attachment styles, responsive caregiving toward partner, and parenting styles. Structural Equation Modeling was used to examine the intra- and interpersonal associations between romantic attachment, caregiving responsiveness, and parenting styles. Attachment avoidance and anxiety were both negatively associated with responsive caregiving to partner, which in turn was positively associated with authoritative (optimal) parenting styles and negatively associated with authoritarian and permissive (nonoptimal) parenting styles. Responsive caregiving mediated all links between attachment and parenting, with an additional direct association between attachment anxiety and nonoptimal parenting styles that was not explained by caregiving responsiveness. Findings are discussed with reference to attachment theory.

Concepts: Developmental psychology, Parenting, Love, Attachment theory, Attachment in adults, Attachment measures, Attachment parenting, John Bowlby

28

OBJECTIVE: The present study examined variables related to the quality of the therapeutic alliance in out-patients with schizophrenia. We expected recovery orientation and insight to be positively, and self-stigma to be negatively associated with a good therapeutic alliance. We expected these associations to be independent from age, clinical symptoms (i.e. positive and negative symptoms, depression), and more general aspects of relationship building like avoidant attachment style and the duration of treatment by the current therapist. METHODS: The study included 156 participants with DSM-IV diagnoses of schizophrenia or schizoaffective disorder in the maintenance phase of treatment. Therapeutic alliance, recovery orientation, self-stigma, insight, adult attachment style, and depression were assessed by self-report. Symptoms were rated by interviewers. RESULTS: Hierarchical multiple regressions revealed that more recovery orientation, less self-stigma, and more insight independently were associated with a better quality of the therapeutic alliance. Clinical symptoms, adult attachment style, age, and the duration of treatment by current therapist were unrelated to the quality of the therapeutic alliance. CONCLUSION: Low recovery orientation and increased self-stigma might undermine the therapeutic alliance in schizophrenia beyond the detrimental effect of poor insight. Therefore in clinical settings, besides enhancing insight, recovery orientation, and self-stigma should be addressed.

Concepts: Psychology, Mental disorder, Cognitive behavioral therapy, Schizophrenia, Bipolar disorder, Diagnostic and Statistical Manual of Mental Disorders, Family therapy, Attachment in adults

28

The attachment style of an infant with his caregiver can greatly influence his future development. Many interventions have been proposed to enhance early secure attachment styles, but few have characteristics that make them suitable for primary health care. The objective of the study wasto design a complex intervention for promoting secure attachment in dyads detected in Primary Health Care with altered patterns of attachment styles. The methodology proposed by the UK Medical Research Council was used: (1) theoretical phase: literature review; (2) modelling phase: the main components of the intervention were defined through qualitative research; and (3) exploration phase: pilot study of the preliminary intervention. The attachment style of the dyads was evaluated using the Massie-Campbell scale prior to and four months after the pilot intervention. The preliminary intervention was designed: a group workshop (five to seven dyads, with children aged between 6 and 12 months and two health care professional monitors) structured around various activities that specifically dealt with the skills associated with parental sensitivity and addressed relevant issues to child rearing. The intervention was then tested in a pilot study of 11 dyads in two primary health care centres. The analysis was done with nine dyads (two were lost in the second evaluation), and showed an improvement of 33 per cent in the secure attachment style in the dyads (not statistically significant). An original intervention is designed and proposed for dyads who have early indicators of altered styles of attachment in primary health care.

Concepts: Health care, Developmental psychology, Attachment theory, Attachment in adults, Attachment parenting

27

The association between cortisol and adult attachment style, an important indicator of social relationships, has been relatively unexplored. Previous research has examined adult attachment and acute cortisol responses to stress in the laboratory, but less is known about cortisol levels in everyday life. The present study examined adult romantic attachment style and cortisol responses across the day. Salivary cortisol was collected at six time points during the course of the day in 1,807 healthy men and women from a subsample of the Whitehall II cohort. Significant associations were found between attachment on cortisol across the day and slope of cortisol decline. The lowest cortisol output was associated with fearful attachment, with preoccupied attachment having the highest levels and a flatter cortisol profile. The results tentatively support the proposition that attachment style may contribute to HPA dysregulation.

Concepts: Present, Time, Epidemiology, The Association, Interpersonal relationship, Attachment theory, Attachment in adults, John Bowlby

26

The current study investigated associations between early mother-child attachment, as well as mother-child and teacher-child relationships, and internalizing and externalizing behaviors in middle childhood. Data from the NICHD Study of Early Child Care and Youth Development were used. Findings from a series of individual growth curve analyses revealed that attachment security was negatively related to internalizing and externalizing behaviors, while insecure/other and avoidant attachment were positively related to internalizing behaviors. In addition, longitudinal associations were found between mother-child and teacher-child relationships and internalizing and externalizing behaviors across middle childhood. Implications for attachment theory are discussed.

Concepts: Psychology, Sociology, Childhood, Interpersonal relationship, Developmental psychology, Youth, Attachment in adults, John Bowlby

26

Based on Bowlby’s attachment theory, Bartholomew proposed a four-category attachment typology by which individuals judged themselves and adult relationships. This explanatory model has since been used to help explain the risk of psychiatric comorbidity.

Concepts: Interpersonal relationship, Attachment theory, Attachment in adults, John Bowlby

25

This study examined the relationship between attachment style, coping flexibility, military/non-military cause of death, levels of grief reactions and posttraumatic growth (PTG), in 150 bereaved adult siblings in Israel. Insecurely attached participants, 72% of the sample, reported more grief and less PTG than did securely attached ones. Highly avoidant individuals exhibited the least amount of PTG. Securely attached siblings were more flexible and flexibly coping participants reported less grief and higher PTG. Cause of death was not related to grief and PTG. Discussion of these findings yields conditions enabling PTG after a sibling loss.

Concepts: Interpersonal relationship, Attachment in adults, Mary Ainsworth