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PubMed2005

Psychological factors associated with persistent postnatal depression: past and current relationships, defence styles and the mediating role of insecure attachment style.

BACKGROUND: This study prospectively investigated the factors underlying the maintenance and persistence of postnatal depression beyond the first year after birth. METHOD: One hundred primiparous women who were admitted to a parentcraft hospital for a week were assessed after discharge at 4 and 12 months postpartum. Various measures of mood, interpersonal relationships and defence styles were administered at 4 months and the relation between these measures and clinically elevated symptoms of depression at 12 months was examined. RESULTS: At 12 months, 30% of all mothers and 60% of those diagnosed depressed at 4 months continued to report clinically significant levels of depressive symptomatology. The strongest predictor of depression at 12 months was severity of symptoms at 4 months, and women from a non-English speaking background were significantly more likely to remain depressed. Reports of low maternal care in childhood, marital dissatisfaction at 4 months, an attachment style characterised by anxiety over relationships and immature defence styles were significant predictors of clinically elevated depression scale scores at 12 months. Furthermore, an insecure attachment style was shown to mediate the effect of low maternal care in childhood, while other cognitive and interpersonal factors appeared to contribute additively in maintaining depressive symptoms. LIMITATIONS: Self-report measures were used to measure insecure attachment styles and depression at 12 months. CONCLUSIONS: Findings demonstrate that both childhood and concurrent relationship difficulties contribute to the maintenance of postpartum depression. Interventions for persistent depression need to address relationship difficulties as well as depressive symptomatology.

Adult↗

PubMedDate not supplied

[The Adult Attachment Scale (AAS) - psychometric evaluation and normation of the German version].

Based on conceptualizations and assessment instruments of adult attachment research, the development of the adult attachment scale is outlined. The AAS scale is a self report instrument reflecting attachment-related attitudes. The dimensional scales of the AAS assess to what extent a person feels close to his partner, to what extent he is able to rely on others, and how much someone is afraid of losing an intimate partner. The German version of the AAS was normed in a representative study and its psychometric properties were investigated. The reliability of all scales was satisfactory (alpha = 0.72 - 0.79), however, the scale structure only acceptable. Thus, the current version might be integrated in studies to analyze the convergence of adult attachment measures. Findings on the convergent and discriminant validity of the scales (sociodemographic data, the SOC-S, the HADS-D, the SOMS and the Whiteley-Index were included) suggest a high prognostic relevance of the scales in the fields of health psychology and psychosomatics.

Adult↗

PubMed2003

Ewe-lamb bonding behaviours at birth are affected by maternal undernutrition in pregnancy.

Maternal undernutrition in pregnancy results in low birth-weights and impaired postnatal survival in sheep. Largely anecdotal evidence suggests that the expression of appropriate maternal and neonate behaviours may also be disrupted by undernutrition. In the present study, we investigated the effect of a moderate (35 %) reduction in ewe nutritional intake in pregnancy on the expression of ewe-lamb bonding behaviours in primiparous Scottish Blackface ewes. Low-intake (L) ewes had significantly higher plasma progesterone than high-intake (H) ewes from mid-gestation onwards (e.g. plasma progesterone at 20 weeks (ng/ml): H 15.72, L 22.38, sed 1.80, P<0.001), and a lower oestradiol: progesterone value than H ewes at delivery (H 0.46, L 0.35, sed 0.05, P<0.05). Lamb birth-weight was reduced in the L lambs compared with H lambs (mean body weight (kg): H 3.31, L 3.00, sed 0.14, P<0.05), but the incidence of malpresentation at delivery was greater in L lambs. L ewes spent significantly less time licking their lambs than H ewes after delivery (time grooming in 2 h after birth (%): H 56.12, L 48.17, sed 2.639, P<0.01) and were more aggressive towards the lambs. Lamb behaviours were not directly affected by maternal nutritional treatment, but lamb birth-weight had a significant effect on neonatal developmental progress. Low-birth-weight lambs were slower than heavier lambs to stand and sucked less frequently. In tests of maternal attachment to the lamb, H ewes received higher scores than L ewes at both 24 h after birth (ewes receiving high scores (%): H 41.3, L 21.4, P<0.05) and at 3 d postnatal. We conclude that even a moderate level of undernutrition impairs the attachment between ewes and lambs by affecting maternal behaviours expressed at birth. In addition, the results suggest that levels of nutrition resulting in a decrease in birth weight will affect neonatal lamb behavioural progress.

Animals↗

PubMedDate not supplied

Earned-secure attachment status in retrospect and prospect.

Past research with the Berkeley Adult Attachment Interview demonstrates that retrospectively defined earned-secures (who coherently describe negative childhood experiences) parent as effectively as do continuous-secures (who coherently describe positive childhood experiences), but manifest liabilities in the form of depressive symptomatology. This article presents data from a 23-year longitudinal study that replicate and extend prior research, testing a key premise that earned-secures so defined actually have a history of insecure attachments that change over time and/or endure consistently harsh or ineffective parenting in their youth. Discrepant with assumptions, retrospective earned-secures were not more likely than continuous-secures to have been anxiously attached in infancy and were observed in childhood and adolescence to have encountered among the most supportive and structured maternal parenting in a high-risk sample. Prospectively defined earned-secures (operationalized using participants' infant attachment classifications) did indeed go on to have success in their close relationships, many without reporting relatively high levels of internalizing distress in adulthood.

Adaptation, Psychological↗

PubMed1990

Quality of infants' attachments to professional caregivers: relation to infant-parent attachment and day-care characteristics.

75 infants (mean age 15 months) were observed 3 times in the Strange Situation with their professional caregivers, mothers, and fathers. Sensitivity of these attachment figures to the infant's signals during free play, as well as a number of day-care characteristics, were assessed. Attachment classification distribution of infant-caregiver dyads did not differ significantly from infant-mother or infant-father attachment classification distributions. The quality of infant-caregiver attachment was independent of both infant-mother and infant-father attachments. About 10% of the infants had 3 insecure attachments. Professional caregivers observed with more than 1 infant did not have similar types of attachment classifications to all infants with whom they were observed. Infants who were securely attached to their professional caregivers spent more hours per week in day-care, and came from a middle-class background. Their caregivers appeared to be younger and more sensitive during free play than caregivers with whom the infants developed an insecure relationship.

Child Day Care Centers↗

PubMed1992

The contribution of mother-child and father-child relationships to the quality of sibling interaction: a longitudinal study.

Although several studies have now examined the relations between mother-child and sibling interaction, the role of fathers in the development of sibling relationships is noticeably absent. The present study included assessments of both mother-child and father-child interaction in order to examine the correlates of sibling conflict and cooperation. Home observations of parent-child and sibling interaction and reports of differential parental treatment were obtained for 30 families with 2 preschool children when the firstborns were approximately 6 years old. Earlier assessments of infant-mother and infant-father attachments when firstborns were 12 and 13 months old, respectively, were also available, as were prior laboratory assessments of mothering and fathering when the oldest child was 3 years of age. Results suggested that sibling conflict and aggression were related to high levels of conflict between the mother and the 2 children at 6 years, intrusive and overcontrolling mothering at 3 years, and an insecure infant-mother attachment. Facilitative and affectionate fathering, on the other hand, was associated with prosocial sibling interaction. Early relationship experiences between parents and their firstborn children had an enduring effect on the quality of sibling relationships and interacted with differential parental treatment in predicting sibling relationship outcomes.

Child↗

PubMed1994

Avoidant attachment as a risk factor for health.

A style of coping with stress is described which has been observed in cancer patients and in highly dependent, insecurely attached individuals. This coping style includes the suppression of negative emotions and avoidance of support seeking. It is suggested that this pattern of responses is potentially dysfunctional insofar as it tends to perpetuate distress and may increase vulnerability to a broad range of illnesses. These considerations provide the basis for a provisional conceptual model, which links avoidant attachment style to the regulation of negative affect and to symptoms of psychological and physical ill-health. This is tested on a sample of young adults under stress and predictions from the model are largely supported.

Adaptation, Psychological↗

PubMed2003

Mapping the intimate relationship mind: comparisons between three models of attachment representations.

This study compared three models of how attachment working models might be cognitively represented. Model 1 posits that attachment representations consist of a single global working model summarizing attachment across specific relationships and domains. Model 2 proposes three independent working models for the relationship domains of family, platonic friendships, and romantic partners. Model 3 postulates that specific relationship models are nested under relationship domain representations that are, in turn, nested under an overarching global working model. Participants completed standard attachment scales for the relationship domains of family, platonic friendships, and romantic partners and also provided attachment ratings for three specific relationships within each domain. As expected, confirmatory factor analyses showed that Model 3 attained the best fit, regardless of analysis strategy, measurement strategy, gender, and relationship status. Implications are discussed.

Adolescent↗

PubMed1991

Student contact with patients in hospital: frequency, duration and effects.

Student-patient contacts on the wards were monitored by having students keep daily logs of patient contacts during a 5-week period of routine clinical attachments in a teaching hospital. After being discharged patients were followed up by postal questionnaire. Results indicated that on average students spend substantially less time with patients than is allowed for in the curriculum. Variability in contact time was high both within and between attachments to different wards. Patient satisfaction with student contact was high. The duration of student-patient contact was not significantly related to patient satisfaction. There was a significant relationship between patient satisfaction and the number of different topics patients recalled discussing with students.

Consumer Behavior↗

PubMed1993

[Importance and determinants of early mother-child relations].

In a prospective longitudinal study on child development from birth to age eight 362 first-born infants and their families were investigated. The subjects were distributed across the nine cells of a two-factorial design, factor 1 representing the degree of organic, factor 2 the degree of psychosocial risk. At age 3 months mother-child interaction was videotaped and evaluated with microanalytic technique. The quality of MCI could be demonstrated to be as predictive for later cognitive development as early developmental tests. Social-emotional problems of the toddler and preschool child was predicted better by parameters of early MCI than by temperament. Disturbed interactions were associated with later cognitive retardation and enhanced behavior problems. MCI is significantly determined by neglect and rejection, which showed typical behavioral patterns. The early separation of mother and high risk newborn itself did not lead to alterations in maternal attachment. Compared with mother daughter dyads early interaction of mother and son was characterized by more reactivity and positive emotion.

Affect↗

PubMed1997

Theory testing, effect-size evaluation, and differential susceptibility to rearing influence: the case of mothering and attachment.

It is important to distinguish theory testing from effect-size evaluation when considering the impact of mothering on attachment security discerned in the De Wolff and van Ijzendoorn meta-analysis. Moreover, the possibility exists that this analysis both over- and underestimates mothering effects, as would be the case if infants vary in their susceptibility to rearing influence.

Child Rearing↗

PubMed2006

Interpersonal correlates of generalized anxiety disorder: Self versus other perception.

The present investigation examined the interpersonal functioning of undergraduate students who met self-report criteria for generalized anxiety disorder (GAD), both as they perceive it and as perceived by their self-nominated friends. Forty-eight participants who met self-report criteria for GAD endorsed greater global severity of interpersonal problems on the 64-item version of the Inventory of Interpersonal Problems [Horowitz, L. M., Alden, L. E., Wiggins, J. S., Pincus, A. L. (2000). Inventory of Interpersonal Problems: Manual. San Antonio, TX: The Psychological Corporation] than 53 control participants. However, friends of GAD participants did not attribute significantly greater interpersonal problems to them than did friends of control participants. GAD participants reported less secure attachment to their parents than control participants but reported similar levels of attachment to peers and perceived social support. Furthermore, there were no significant differences between the friends of the GAD participants and friends of the control participants on ratings of their friendships quality. Findings are discussed in the context of their relevance to the etiology, maintenance, and treatment of GAD.

Adult↗

PubMed2002

Psychopathy in juvenile offenders. Can temperament and attachment be considered as robust developmental precursors?

Attempts to predict adult psychopathy generally focus on aggressive and antisocial behavior exhibited in childhood and adolescence. Yet, children with conduct problems constitute a heterogeneous group, and many of the unique interpersonal and affective features associated with the construct of psychopathy only apply to a small subset of children displaying antisocial behavior. The current review seeks to derive an understanding of the specific precursors of the apparently amoral, affectionless, and self-centered orientation that psychopathic youngsters display towards other people. The focus is on the notions of temperament and attachment in early childhood, and their links to the emergence of moral emotions later in life. Based on a developmental perspective, the data currently available are examined, highlighting the insights gained from this body of work and outlining the conceptual and methodological challenges that still need to be addressed.

Adolescent↗

PubMed2001

Attachment stability and emotional and behavioral regulation from infancy to preschool age.

Relations between attachment and child emotional and behavioral regulation were studied longitudinally in a sample of 223 children from urban, low-income families. Attachment in the Strange Situation at 12 and 18 months was scored using the infant classification system and at 24 months was scored using a preschool classification system. Only modest stability was found in attachment whether within or across classification systems, with the percentage of insecure attachments consistently increasing over time. Results indicated both concurrent and predictive associations with indices of child regulation based on observer ratings or maternal report. However, only the 24-month classification predicted maternal report of externalizing and internalizing behavior problems at age 3.5 years. with additional variance accounted for by selected measures of child emotional and behavior regulation from the same assessment. Attachment security (B) and atypical attachment classifications (D, A/C, and AD) appear to provide the most consistently useful information about child functioning. Results are discussed in terms of continuity and change from the perspective of developmental psychopathology.

Affect↗

PubMed2004

The link between marital conflict and child adjustment: parent-child conflict and perceived attachments as mediators, potentiators, and mitigators of risk.

Parent-child conflict and perceived attachments to parents were examined as predictors, mediators, and moderators in the marital conflict-child adjustment connection in a sample of older children and young adolescents. After controlling for marital conflict, parent-child conflict predicted additional unique variance mainly for children's externalizing problems, and attachments to parents accounted for unique variance in children's externalizing and internalizing problems. Moderation effects illustrated that a higher level of parent-child conflict was a vulnerability factor, whereas a secure attachment was a protective factor, for behavior problems associated with marital conflict. Mediation effects were also evident and supported the proposition that parent-child conflict and attachment to parents mostly are partial mediators of effects in the marital conflict-child outcomes link. The findings illustrate the aggregation, potentiation, and amelioration of risk for adjustment problems associated with marital conflict, and highlight the importance of assessing multiple systems within the family.

Child↗

PubMed1999

Attachment in boys with early onset conduct problems.

Few studies have examined the association between attachment and psychopathology in samples of clinically diagnosed children or the relation between attachment variables and the continuity of clinical symptoms. Clinic-referred preschool boys (n = 80) with early onset conduct problems (as indicated by diagnoses of Oppositional Defiant Disorder) were compared with a case-matched group of 80 nonproblem boys to determine whether observed attachment behaviors could: (a) differentiate the groups, (b) explain concurrent variation in problem severity within the clinic group, and (c) predict the outcomes of clinic boys 1 and 2 years later. Over half of the clinic boys with early onset conduct problems (54%) exhibited an insecure attachment strategy during reunion, as opposed to 18% of comparison group boys. All insecure patterns were overrepresented in the clinic group. Clinic boys were more likely than comparison boys to engage in provocative behavior when separated from their mothers. Contrary to our hypothesis, attachment variables showed little ability to explain concurrent or future variation in the problem severity or diagnostic status of clinic boys. We conclude that observable attachment behaviors exhibited during the preschool years are related to the initial identification of early onset conduct problems but may have little value by themselves in predicting the subsequent course and severity of problems in the 2 years following clinic referral.

Avoidance Learning↗

PubMed2004

Mothering in a foreign land.

The process of becoming a mother in an adopted land presents unique challenges in identity formation of immigrant mothers. The bidirectional influence of the mother's own transformation and that of the larger family system has significant implications for child development. This article addresses the ways in which cultural displacement has an impact on the dilemmas of motherhood, as evident in adaptation to the immigration process, changing conceptions of gender roles and attachment, bicultural conflicts, and changing family structure and social network. Mothers' attempts to integrate the old and the new cultural frameworks are explored, particularly in the context of psychotherapy. Clinical cases are discussed to illustrate the intrapsychic and interpersonal conflicts faced by immigrant mothers.

Adult↗

PubMed2006

Limits of symhedonia: the differential role of prior emotional attachment in sympathy and sympathetic joy.

Seven studies tested the hypothesis that compared with sympathy symhedonia (sympathy for another's good fortune) is inherently more contingent on prior emotional attachment to its targets. As predicted, Studies 1-4 found that reported attachment was higher for past episodes of symhedonia than for those of sympathy and that recalled incidence of sympathy exceeded that of symhedonia when the target was a stranger. Study 5 showed that whereas symhedonia was significantly higher for high- versus low-attachment targets sympathy was not. Study 6 found that sympathy is more likely than symhedonia when a relationship is strained. Study 7 found that both sympathy and symhedonia are weaker for nonclose (vs. close) others, but the disparity is significantly smaller for sympathy than for symhedonia.

Adolescent↗