Biomedical subjects

Carol George

Publications and source records attributed to Carol George.

5 recordsLinked to original sources

PubMed2006

Measuring adult attachment representation in an fMRI environment: concepts and assessment.

Human attachment is defined as a biologically based behavioral system that influences motivational, cognitive, emotional, and memory processes with respect to intimate relationships (parents, life partner, own children). Recent neurobiological studies in this field have in common that they investigated social relationships by examining fMRI neuroimaging patterns while individuals viewed pictures of their beloved relationship partner versus friends, acquaintances, strangers, or mothers' responses to their young children. The researchers showed that the neural underpinnings of these unique intimate emotional states are linked to functionally specialized areas in the brain. Conceptualizing this work from a behavioral systems-attachment theory perspective, these studies did not directly address the subject's attachment representational system. Traditional attachment theory and research has been built on the analysis of attachment narratives, called 'attachment representation'. The Adult Attachment Projective developed by George and West in 2001 is a set of attachment-based schematic pictures. It is constructed to increasingly activate the participant's attachment system in the course of the task, that is, by the introduction of increasingly stressful attachment scenes concluding with pictures of individuals facing death and potential abuse alone. The attachment patterns are evaluated based on individuals' overall verbal response to the picture set. This paper proposes that the AAP is a fruitful measure to use in an fMRI environment to examine brain activation patterns in adults while they are speaking overtly about attachment stories in a standardized setting.

Adult↗

PubMed2006

Measuring attachment representation in an FMRI environment: a pilot study.

This exploratory study is the first to examine the neural correlates of attachment status in adults. The study examined the feasibility of assessing attachment narratives in the functional magnetic resonance imaging (fMRI) environment by challenging subjects to tell attachment stories to specific attachment pictures from the Adult Attachment Projective (AAP) while being scanned. We investigated theoretically derived hypotheses regarding predicted differences in the brain activation patterns of individuals whose attachment status was organized (resolved) versus disorganized (unresolved) with respect to attachment trauma (e.g., as associated with loss through death, abuse, threat of abandonment). Adult attachment was assessed using the AAP, a new representational attachment measure that we thought might be suitable for use in the fMRI environment. This measure was used to obtain a preliminary picture of the neural processes associated with the activation of attachment in 11 healthy female adults. Results are reported from a second-level analysis (p < 0.001 uncorrected) and confirm that the AAP is a feasible measure for use in a neuroimaging environment. Cerebral activation during continuous speech yielded results consistent with the literature. Brain activation was demonstrated in expected visual and semantic brain regions. Furthermore, we found that the rate of articulation was positively correlated with activation in the right superior temporal gyrus. The results of theoretically derived attachment hypotheses showed no differences at the chosen level of significance when comparing the 'all attachment pictures' effect between both groups (resolved vs. unresolved). More interestingly, we found a significant interaction effect between the sequence of pictures and attachment category. Only the unresolved participants showed increasing activation of medial temporal regions, including the amygdala and the hippocampus, in the course of the AAP task. This pattern was demonstrated especially at the end of the AAP task where the pictures are drawn to portray traumatic situations. We interpret these results as confirming our hypothesis, linking unresolved attachment to emotional dysregulation of the attachment system. These results are discussed in relation to assessing attachment in an fMRI environment and future research in this area.

Adult↗

PubMed2006

Development and implementation of a high-quality clinical database: the Australian and New Zealand Intensive Care Society Adult Patient Database.

OBJECTIVE: To describe the development of a binational intensive care database. SETTING: One hundred thirty-eight intensive care units (ICUs) in Australia and New Zealand. METHODS: A structure was developed to enable ICUs to submit data for central and local analysis. Reports were developed to allow comparison with similar ICU types and against published mortality prediction models. The database was evaluated according to (a) the criteria of the Directory of Clinical Databases (DoCDat) and (b) a proposed framework for data quality assurance in medical registries. RESULTS: Between January 1987 and December 2003, 444,147 data sets were collected from 121 (72.5%) of 167 Australian and 10 (37.0%) of 27 New Zealand ICUs. Data sets from more than 60000 ICU admissions were submitted in 2003. Overall hospital mortality was 14.5%. The mean quality level achieved according to DoCDat criteria was high as was performance against a proposed framework for data quality. The provision of no-cost software has been vitally important to the success of the database. CONCLUSION: A high-quality ICU database has successfully been implemented in Australia and New Zealand and is now used as a routine quality assurance and peer review tool. Similar developments may be both possible and desirable in other countries.

APACHE↗

PubMed2002

Attachment and dysthymia: the contributions of preoccupied attachment and agency of self to depression in women.

The present research evaluated a conceptual model that links preoccupied attachment to dysthymic disorder in women. From an original community sample of 420 women, 129 women were identified with depressive symptomatology as assessed by the Centre for Epidemiological Studies Depression scale (CES-D). Twenty-four of these 129 women were diagnosed as dysthymic disordered according to the Structured Clinical Interview for DSM-III-R-non-patient edition (SCID-NP). Attachment patterns were assessed using the Adult Attachment Projective (AAP). The results indicate that preoccupied attachment was associated with dysthymia. Discussion concerns the processes that may underlie the association between preoccupied attachment and depression, with attention to the possibly complicating factor of unresolved mourning.

Adult↗

PubMedDate not supplied

[The adult attachment projective (AAP) - psychometric properties and new reserach results].

George, West and Pettem developed a new measure, the Adult Attachment Projective (AAP) to assess attachment representation in adults. The AAP is comprised of a set of eight drawings, one neutral scene and seven scenes of attachment situations. Although the pictures were drawn as projective stimuli, the method of administration combines projective and interview techniques in the form of a semi-structured interview. In this paper the coding procedure and attachment classifications of the AAP will shortly be described. The current results on reliability and convergent validity are reported. Developmental studies examining correlates of attachment during the preschool-age years, as well as adult attachment classification and foster mothers' perceptions of their relationship with their at risk foster children give first evidence for the predicitve validity of the AAP. The results of a recent study with dysthymic women using the AAP add to the increasing number of studies that have identified an association between preoccupied attachment and depression. This study encourages the use of the AAP in a broader clinical context. The modified application of the AAP using functional MRI opens a new approach to assess neural correlates of attachment representation in patients with a Borderline Personality Disorder compared to controls, and other clinical groups.

Adult↗