Attachment-related psychodynamics: another shake to the kaleidoscope.
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The author delineates various patterns of psychopathology and impaired relationship capacities in persons referred to the Professionals in Crisis program, patterns that are often associated with failure to respond to prior treatment. He articulates a model of treatment that entails a synergy among three domains of intervention: enhancing mentalizing, strengthening impulse control, and promoting awareness of others' mental states. He addresses the challenges this approach poses for both patients and staff members as they develop attachment relationships that foster mentalizing.
This study examined the relation between attachment style and memory for emotionally-laden drawings by 180 students in introductory psychology. Attachment style was assessed using the Hazan and Shaver Attachment Style Questionnaire. Memory for 24 emotionally-laden drawings was assessed using a forced-choice recognition procedure. Analysis indicated that adults classified as having an Avoidant attachment style remembered the depictions of anger significantly better than those reporting either a Secure or Anxious/Ambivalent attachment style.
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The present study examined the relationship between attachment style and self-reported aggression in a sample of young women (N = 139). Analysis showed that 27.3% of the subjects classified themselves as insecurely, i.e., avoidantly or ambivalently, attached by means of the Adult Attachment Questionnaire of Hazan and Shaver. In addition, the insecurely attached subjects had elevated anger and hostility compared to securely attached subjects.
The author explores how clinicians may use the construct of the schizoid dilemma as a means to understand young adult punk rockers. The basic dilemma, in Fairbairn's formulation, is whether to withdraw from relational attachments because of a history of disappointments by others. The punk phenomenon may be understood as an object-relational stance resulting from a particular resolution of the schizoid dilemma. The author describes characteristics of punk individuals in terms of this construct, and discusses their relation to such possible pathology as depression and substance abuse. Finally, an explanation is offered for the phenomena that both drive an individual to treatment and lead to premature termination of it.
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OBJECTIVES: The present investigation examined clinical features of periodontal disease and patterns of attachment loss in adult periodontitis subjects who were current, past or never smokers. MATERIAL AND METHODS: 289 adult periodontitis subjects ranging in age from 20-86 years with at least 20 teeth and at least 4 sites with pocket depth and/or attachment level >4 mm were recruited. Smoking history was obtained using a questionnaire. Measures of plaque accumulation, overt gingivitis, bleeding on probing, suppuration, probing pocket depth and probing attachment level were taken at 6 sites per tooth at all teeth excluding 3rd molars at a baseline visit. Subjects were subset according to smoking history into never, past and current smokers and for certain analyses into age categories <41, 41-49, >49. Uni- and multi-variate analyses examined associations between smoking category, age and clinical parameters. RESULTS: Current smokers had significantly more attachment loss, missing teeth, deeper pockets and fewer sites exhibiting bleeding on probing than past or never smokers. Current smokers had greater attachment loss than past or never smokers whether the subjects had mild, moderate or severe initial attachment loss. Increasing age and smoking status were independently significantly related to mean attachment level and the effect of these parameters was additive. Mean attachment level in non smokers <41 years and current smokers >49 years was 2.49 and 4.10 mm respectively. Stepwise multiple linear regression indicated that age, pack years and being a current smoker were strongly associated with mean attachment level. Full mouth attachment level profiles indicated that smokers had more attachment loss than never smokers particularly at maxillary lingual sites and at lower anterior teeth. CONCLUSIONS: In accord with other studies, smokers had evidence of more severe periodontal disease than past or never smokers. At all levels of mean attachment loss, smokers exhibited more disease than never smokers. Difference in mean attachment level between smokers and never smokers at individual sites was not uniform. Significantly more loss was observed at maxillary lingual sites and lower anterior teeth suggesting the possibility of a local effect of cigarette smoking.
OBJECTIVE: To elicit bereaved multiple-birth parents' perceptions regarding support, disposition decisions, attachment to surviving multiples, discharge, and later coping. STUDY DESIGN: Narrative email survey of 70 bereaved parents with quantitative and qualitative analysis. RESULTS: Bereaved parents of multiples find neonatal hospitalization stressful. Not all caregivers acknowledged loss, although most parents would welcome brief loss discussions during survivors' hospitalization. Half of respondents felt social workers could help coordinate support or mental health care. Most participants recalled hospital support for loss, but only 43% recalled support for neonatal hospitalization. Respondents praised peer support and written materials. Parents felt ambivalent about disposition for deceased babies while comultiples were ill; most made prompt arrangements. Attachment to survivors was difficult for half. Breastfeeding and discharge planning were important, and 31% had difficulty coping at home. CONCLUSIONS: Caregivers must communicate better with bereaved multiple-birth parents, whose desires for support, loss discussions, disposition, and discharge vary considerably.