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PubMed2004

Early detection of core deficits in autism.

The goal of this review of the research literature is to discuss approaches to the early detection of autism in infancy. Early detection would enable diagnoses to be made before 18 months of age rather than at 24-30 months, the age where diagnoses start to be made now. After summarizing the criteria for a deficit to be considered "core" to the disorder, the literature on research strategies used in early detection is examined. In order to guide the design of future studies, the review then turns to an overview of what is known about the processes of early social development in typically developing children that underlie the domains in which core deficits are manifested in young children with autism. The social domains covered in the review are those that show development in typically developing infants below 18 months of age: dyadic interaction and imitation; emotion discrimination; and attachment. The review concludes that all of these areas are worthy of investigation in young children, particularly those at higher risk of showing some of the core deficits of autism such as the infant siblings of children with autism.

Affect↗

PubMed1984

Horneyan developmental psychoanalytic theory and its application to the treatment of the young.

The early work of Dr. Karen Horney has been reviewed, including her ideas concerning neurotogenesis, the formation of basic anxiety, basic conflict as a result of disordered attachment, and various conflict solutions. In addition, her pioneering ideas regarding the real self and self-realization have been mentioned. It has been shown that the application of her ideas in clinical work with the young results in a rational approach to suffering children and their families.

Adult↗

PubMed2002

Affective disorders in the aftermath of miscarriage: a comprehensive review.

We review the research literature regarding affective symptomatology and disorders following miscarriage, with an emphasis on controlled studies and those that have been published since the last review article in 1996. The current review draws a sharp distinction between controlled and uncontrolled designs and clarifies the proper inferences that may be drawn from each, as only with an appropriate comparison group can it be determined whether the affective reactions following miscarriage are a specific consequence of the reproductive loss or of other life events common in women of reproductive age. In addition to providing an update of the literature on depression in the aftermath of miscarriage and associated risk factors, we also discuss reproductive loss in the context of attachment theory and grief, and present information on topics that were not covered extensively (or at all) by prior reviews, such as issues related to a pregnancy subsequent to miscarriage and the impact of miscarriage on the partners of miscarrying women. In the final section, treatment options relevant to miscarriage are presented.

Abortion, Spontaneous↗

PubMed2003

Attachment-based family therapy for depressed adolescents: programmatic treatment development.

Few effective psychosocial treatment models for depressed adolescents have been developed, let alone ones that use the developmentally potent context of the family as the focus of intervention. Attachment-based family therapy (ABFT) is a brief, manualized treatment model tailored to the specific needs of depressed adolescents and their families. Attachment theory serves as the main theoretical framework to guide the process of repairing relational ruptures and rebuilding trustworthy relationships. Empirically supported risk factors for depression are the primary problem states that therapists target with specific treatment strategies or tasks. Parent problem states include criticism/hostility, personal distress, parenting skills, and disengagement. Adolescent problem states include motivation, negative self-concept, poor affect regulation, and disengagement. Intervention tasks include relational reframing, building alliances with the adolescent and with the parent, addressing attachment failures, and building competency. A small, randomized clinical trial provides initial support for the model. Several process research studies, using both qualitative and quantitative methods, have helped refine the clinical guidelines for each treatment task. ABFT is a promising new treatment for depressed adolescents and more research on it is warranted.

Adolescent↗

PubMed2000

Maternal versus nonmaternal care and seven domains of children's development.

A series of meta-analyses was conducted on findings from 59 studies to examine the linkage between maternal versus nonmaternal care, 7 indices of child behavior, and 10 potential moderators. Results indicate that children receiving nonmaternal care do not differ from children receiving maternal care on any of the 7 indices. Year of publication and psychometrics of outcome index were found to moderate the linkage between maternal versus nonmaternal care and attachment classification and between maternal versus nonmaternal care and child adjustment, respectively. Examination of the simultaneous impact of extent of care and age of entry on attachment behaviors revealed the moderating impact of the latter. Although it cannot be concluded that nonmaternal care has no impact on children, most of the analyses suggest that in and of itself, or in interaction with one factor at a time, nonmaternal care does not affect child development.

Caregivers↗

PubMed2005

Attachment and adolescent depression: the impact of early attachment experiences.

Bowlby's (1969/1982) ideas of attachment as an interactional system provide the basis for an understanding of the development of adaptive and maladaptive working models of the self and other. More specifically, attachment theory can offer an in-depth understanding into the development of a depressotypic self-schema. Attachment theory is set alongside research into adolescent depression in order to illustrate the importance of the primary attachment relationship in protecting adolescents in our society from developing depressive symptomatology. Therefore, current research in adolescent depression is viewed through the lens of attachment theory. This view is complemented by an exploration of the role of culture in the production of gender differences in depression. Thus, a tripartite model of adolescent depression, including the individual, family relationships, and socio-cultural factors is offered as being of potential value for clinicians and researchers in this area.

Adolescent↗

PubMed1982

Factors affecting attachment between infants and mothers separated at birth.

A sample of 24 healthy Neonatal Intensive Care Unit (NICU) survivors separated from their mothers for a period of more than 10 days after birth were studied at approximately 1 year postconceptional age to assess mother-infant attachment. The 24 infants were classified into secure-attached (N = 17) and insecure-attached (N = 7) groups according to Ainsworth categories. No differences were found between the groups in birth weight, gestation, length of NICU hospitalization, Bayley developmental scores, and 1-year physical measurements. Secure-attached infants, however, tended to be from younger, working mothers and had more day-care experiences. The data do not support the hypothesis that prolonged neonatal separation has detrimental effects on later mother-child interaction.

Adult↗

PubMed1991

A Rorschach investigation of attachment and anxiety in antisocial personality disorder.

We investigated the constructs of anxiety and attachment in a group of 42 offenders who met the DSM-III-R criteria for antisocial personality disorder. Each antisocial subject's level of psychopathy was assessed with the Hare Psychopathy Checklist (PCL). Three Rorschach variables related to attachment, anxiety, and coping were compared between subjects scoring greater than or equal to 30 (N = 21) on the PCL and subjects scoring less than 30 (N = 21). Comparison Rorschach variables are also presented from a sample of 60 antisocial personality-disordered offenders. Moderate psychopaths (PCL score, less than 30) produced texture and diffuse shading responses at a significantly greater frequency than severe, or primary, psychopaths (PCL score, greater than or equal to 30). There was no significant difference in the two groups' propensity for producing vista responses. Although there were no significant differences between the coping index scores, the trend suggests less conflictual functioning in the severe psychopaths. A virtual absence of texture responses in the severe psychopaths, and a significantly greater frequency of diffuse shading responses in the moderate psychopaths, add construct validity to the lack of attachment in psychopaths and the role of anxiety in differentiating secondary from primary psychopathy. We view the presence of vista responses in this population as a measure of a failed grandiose self-structure, and note that it often occurs in the records of moderate psychopaths who also present achromatic color responses.

Adult↗

PubMed1985

Attachment classification from the perspective of infant-caregiver relationships and infant temperament.

Recently a number of investigators have suggested that classification differences in the Ainsworth Strange Situation (anxious and secure patterns of attachment) may be due largely or in part to endogenous temperamental variation. In doing so, these investigators have suggested a dimensional-trait approach in place of a qualitatively different taxonomic approach. Moreover, much evidence is directly contrary to a strong temperament interpretation of attachment patterns (changing attachments, differing attachments with different caregivers, prospective data on the early characteristics of infants later classified as securely or anxiously attached). Other interactionist temperament models currently have not been tested sufficiently. At the same time, a host of research findings support the interpretation that Ainsworth assessments capture aspects of the relationship between infant and caregiver, as derived from the history of their interaction. This includes direct evidence from observations of infants and mothers over time, the influence of varying patterns of care within and between cultures, the impact of factors presumed to influence quality of care (e.g., social support, life stress, caregiver family history), and predictions of later parent behavior from strange situation assessments of infant behavior. The importance of understanding attachment as a relational concept is twofold: it represents a theoretical and paradigmatic shift of importance for many aspects of developmental psychology, and it opens the way for more productive research on temperament, the interaction between temperament and experience, and important process studies of the unfolding of the infant-caregiver relationship.

Anxiety, Separation↗

PubMedDate not supplied

Attachment status in children prenatally exposed to cocaine and other substances.

Attachment status of children exposed in utero to cocaine, opiates, and other substances was examined at 18 months (n=860) and 36 months (n=732) corrected age. Children exposed to cocaine and opiates had slightly lower rates of attachment security (but not disorganization), and their insecurity was skewed toward ambivalent, rather than avoidant, strategies. Continued postnatal alcohol use was associated with higher rates of insecurity and disorganization at 18, but not 36, months of age. Stability of attachment across the 18-month period was barely above chance expectation. Attachment status at 18 months was associated with child temperament and caregiver-child interaction; at 36 months, attachment was associated with child temperament, child behavior problems, and caregivers' parenting self-esteem.

Adult↗

PubMed1996

Proximity and sociable behaviours in autism: evidence for attachment.

Sixteen autistic, 16 normal and 16 Down syndrome children (aged 3-6 years) were observed with their mother and a female stranger in a laboratory playroom. Proximity and sociable behaviours were recorded continuously during three observation sessions. The autistic children showed behaviours indicating that they were clearly attached to their mothers: like the normal and Down syndrome children, they showed all behaviours preferentially to the mother and directed proximity behaviours almost exclusively to her. These attachments were functionally similar to those of the comparison children. The deficits identified in the autistic group were restricted to a set of behaviours which have to do with social interaction such as Show, Give and Mutual Play. Descriptions of the aloof, unattached autistic child were not confirmed.

Autistic Disorder↗

PubMedDate not supplied

The nurse role in parent-infant bonding. Overview, assessment, intervention.

The recognition of appropriate and inappropriate attachment behavior is vital to maternal health and self-esteem and effective infant growth and development. An overview of parent-infant bonding is presented, followed by a discussion of the principles and methods of assessment and intervention.

Adoption↗

PubMed1988

Child care and attachment: a new frontier the second time around.

A review of the research reveals that older studies show no group differences in mother-child attachment between children cared for at home by their mothers and children in substitute child care, and that newer studies do report differences. Along with other methodological limitations, most fail to consider interaction of family and child care systems. An ecological model is considered with suggestions for future research.

Child Day Care Centers↗

PubMed1982

The changeling myth and the pre-psychology of parenting.

Most European cultures, especially in rural areas, and until recently, routinely used ritual magic procedures to protect new-born children and their mothers from fairies, demons, and other supernatural beings. There seemed general recognition that this was a hazardous period for mother and child even if the dangers were seen as external, rather than internal (Hastings, 1910; Krappe, 1930). In this paper, several of these legends will be recounted, which illustrate a number of recurring themes which are of considerable interest to the student of human development. It is proposed that the changeling legend explained, by attribution to supernatural forces, such pathological developmental problems as early failure of attachment, rejection, projective and identificatory problems, and or course, the developmental process in which many of these issues are subsumed, the separation-individuation process (Mahler et al., 1975). A case is presented which illustrates important elements of the legend and an attempt is made to show how the legends may be understood in the light of developmental theory.

Folklore↗

PubMedDate not supplied

[Encouraging mother-child attachment in premature situations: nursing interventions at the Ribeirao Preto clinical hospital].

This study aims at describing nursing actions performed in the high-risk neonatal units at a university hospital of the University of São Paulo at Ribeirão Preto so as to favor mother-child attachment in prematurity situations. The nurse accompanies parents in their first visit, giving them support as well as information concerning the equipment surrounding the newborn and encouraging skin-to-skin contact, touching and talking. Parents' access to and staying with high-risk newborns is permanently allowed. A visiting program by grandparents and siblings of pre-term newborns was implemented, even when under intensive care, which encourages family contact. Parents participate in a support group with other parents who experienced the situation of having their pre-term children in serious conditions and hospitalized. We consider that our experience has favored the establishment of mother-child and family attachment, observing greater interaction between the family and the newborn, particular involving the mother. Greater interest in learning about care as well as satisfaction concerning the assistance received have also been expressed by families.

Brazil↗

PubMed2001

Reminiscence and its relationship to attachment and personality in geropsychiatric patients.

The relationships between reminiscence functions and attachment styles; reminiscence and personality factors; and attachment and personality were examined in forty patients attending a geropsychiatric outpatient clinic. They were administered the Reminiscence Functions Scale, NEO-FFI, and the Relationship Questionnaire. Compared with insecurely attached older patients, securely attached older patients score higher on the teach/inform reminiscence function. Consistent with prior research, relationships were found between the extraversion personality factor and conversation reminiscence; and between the openness personality factor and both identity and problem-solving reminiscence functions.

Adaptation, Psychological↗

PubMed2005

[When mothers take care alone].

This study demonstrates the difficult life situation of many single mothers and their children on the basis of important studies on the problematical social status, elevated health risks and particularly, on the mental/psychosomatic strain of single mothers. From these investigations, potential impact on the development of the children and the necessity of attachment-oriented prevention-programs in terms of a training of the intuitive parental competences are derived. In spite of the increasing number of single mothers, a sufficient amount of such offers does not yet exist in Germany. A first group-program, especially adapted to the needs and conflicts of single mothers, will be presented.

Child↗

PubMedDate not supplied

[Development, attachment and relationship: new psychoanalytical concepts].

Authors present the evolution of psychoanalytical views of how a child perceives and contruct the world. They begin with Freud's thought and go through works of Klein, Spitz, Mahler, Bowlby, ending with modern thought of Stern. Developments in understanding of the infant by observations taken through the last thirty years are outlined and implications for psychoanalytical theory and treatment of mental problems are described.

Humans↗