A new clinical measure of overdependence, detachment, and healthy dependency: the Relationship Profile Test.
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Adult↗
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Results for “Reactive Attachment Disorder”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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The development of a computerized linguistic analysis instrument of the reflective functioning measure.
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Diagnosis, Computer-Assisted↗
Forming attachments in foster care: infant attachment behaviors during the first 2 months of placement.
This study investigated the development of attachment relationships in 38 foster infant-caregiver dyads over the first 2 months of placement. We used the Parent Attachment Diary to measure foster infants' daily attachment behaviors, the Adult Attachment Interview to examine foster parents' attachment states of mind, and Ainsworth's Strange Situation to capture attachment classifications. We examined differences in diary scales (secure, avoidant, resistant, and coherence) as they related to age at placement and foster parent attachment, using hierarchical linear modeling and analyses of variance. The results indicated infants with autonomous foster parents and infants placed at younger ages showed higher early and overall levels of secure behavior, less avoidant behavior, and more coherent attachment strategies compared to infants placed with nonautonomous foster parents. Changes in attachment behaviors over time were not predicted by the models; however, there was a significant decrease in the daily coherence of attachment behaviors associated with Strange Situation disorganization. Finally, we found significant concordance between the diary and Strange Situation scales for secure and avoidant behaviors.
Age Factors↗
[Children's drawings: a case study of the psychotherapeutic treatment of a seven year old boy].
The paper explores the meaning of childrens' pictures as a symbol for growing autonomy. The psychotherapy of a 7-years old turkish boy, who came to treatment with a destroyed identity, will be described. The parents failed to support the boy's development by adequate mothering. The aggressive symptomatic as it emerged at the beginning of the psychotherapy is shown in a shipwreck. During therapy he succeeds to develop age-appropriate autonomy that is shown in a series of drawings.
Aggression↗
The psychobiological theory of attachment: a viable frame of reference for early intervention providers.
Psychobiological Attachment Theory (PAT) (Kraemer, 1992) provides a way of thinking about caregiver-infant relationships for use in clinical practice. This manuscript describes how the theory translates into a frame of reference that can be used in practice within the context of natural environments. A discussion of the theoretical base, function/dysfunction criteria, postulates regarding change, and presentation of an evaluation guide, provides a practical tool for use in early intervention practice.
Adaptation, Psychological↗
"What is genuine maternal love"? Clinical considerations and technique n psychoanalytic parent-infant psychotherapy.
The question of what is genuine maternal love was posed by a mother struggling to understand and value the nature of her bond with her small baby. The question surfaced time and again in the context of this dyad's long-term parent-infant psychotherapy and has challenged me to examine my thinking and, indeed, has produced impassioned discussions within the Parent Infant Project team at The Anna Freud Centre. In this paper I will address this question through sessional material of this mother and baby and discuss issues of technique in response to it, including my countertransference and conceptualization.
Adult↗
Critical issues for practice in residential treatment: the view from within.
A large proportion of children in residential treatment engage in extreme acting-out behavior and suffer from severe attachment disorders and abuse reactivity. At the same time, practice is increasingly alienated from theory and public policy. The challenges to practitioners posed by these difficulties are described and illustrated by vignettes, their impact on residential group care practice is discussed, and their implications for the redesign of practice and for the development of a new theoretical base are examined.
Acting Out↗
[Depression in the child: internal reaction or psychological elaboration?].
The question of a child's depressive suffering is at the heart of psychopathology. The concept of a "fundamental depressive affect" and the notion of "depressive reaction", defended by many authors, are here discussed as reductionist. The notions of "depressive movement" and "depressive system" are described so as to take into account both the characteristics of the depressive experience and its unexpected appearance in different clinical contexts. The psychic work of the depressive movement is envisaged based on the notion of object loss, the existence of a denial constitutive of the depressing experience and in function of the modalities of the incorporation of the shadow of the object... This work leads to the organisation and the maintenance of a particular internal object: the depressive object.
Adjustment Disorders↗
[Not Available].
Theoretical issues and research emphasis within the field of attachment theory have shifted from attachment behavior "to the level of representation" (Bretherton, 1985) since the middle of the 80ies. The paper presents an overview on basic assumptions, research methodology and empirical findings in the field of attachment research. Four issues are addressed, which are relevant for psychosomatic research. These concern: (1) The prevalence of insecure attachment representation in psychosomatic disorders; (2) the association between insecure attachment representation and an increased psychophysiological reactivity; (3) the potential link between attachment and affect regulation and (4) the question, whether the classification of attachment representations may increase our understanding of specific aspects of illness behavior in psychosomatic conditions such as somatoform disorders.
Affect regulation↗
Abuse and deprivation in failing adoptions.
Twelve children seen in psychiatric consultation by the authors over a 3-year period were failing in their adoptive placements. All twelve had been adopted as older children (average age at adoption 5 1/2 years). Ten out of the 12 were males. A retrospective case review demonstrated that all the children shared several common characteristics: (1) a history of both neglect and abusive treatment during at least the first two years of life, (2) a behavioral pattern that was intermittently provocative and punishment seeking, and (3) an ability to elicit a sense of bewilderment and betrayal in the adoptive parents. Twenty-one months was the average duration of the adoption before the families sought the consultation. These adoptive families were all considered competent by the agencies involved. All had raised other natural and adoptive children successfully. Treatment offered by the authors seemed to be helpful in salvaging 4 of the 12 adoptive placements. The authors present these cases as a way of drawing attention to much needed research, both in better understanding the early attachment process in "older child" adoptions, and in better understanding the relative impact of abuse in influencing the child's subsequent attachment capacities.
Adoption↗
Child and adolescent anxiety disorders and early attachment.
OBJECTIVE: The major aim of this research is to determine whether infants who were anxiously/resistantly attached in infancy develop more anxiety disorders during childhood and adolescence than infants who were securely attached. To test different theories of anxiety disorders, newborn temperament and maternal anxiety were included in multiple regression analyses. METHOD: Infants participated in Ainsworth's Strange Situation Procedure at 12 months of age. The Schedule for Affective Disorders and Schizophrenia for School-Age Children was administered to the 172 children when they reached 17.5 years of age. Maternal anxiety and infant temperament were assessed near the time of birth. RESULTS: The hypothesized relation between anxious/resistant attachment and later anxiety disorders was confirmed. No relations with maternal anxiety and the variables indexing temperament were discovered, except for a composite score of nurses' ratings designed to access "high reactivity," and the Neonatal Behavioral Assessment Scale clusters of newborn range of state and inability to habituate to stimuli. Anxious/resistant attachment continued to significantly predict child/adolescent anxiety disorders, even when entered last, after maternal anxiety and temperament, in multiple regression analyses. CONCLUSION: The attachment relationship appears to play an important role in the development of anxiety disorders. Newborn temperament may also contribute.
Anxiety Disorders↗
["I tried to be as defiant as possible". Case histories with autobiographical diaries: relationship with the custodial parent during childhood as recalled by young adults].
The predominant structural orientation of divorce research which either ignores or under represents to a great extent the child's perspective and his/her agency is criticized. As a consequence of these methodological shortcomings not only the production of scientific knowledge but also professional practice working with children from divorced families might be negatively affected--especially the regulation of custody and visiting issues. Therefore, the aim of this article is to give children a voice in describing their own experiences of visits and relationships with the non-residential father or mother during childhood and adolescence (sometimes until adulthood). By presenting numerous detailed autobiographical narratives from children of divorced parents, the study revealed a great diversity of visiting patterns as well as different relationship qualities ranging from loving to negative. In addition, visiting patterns and relationship qualities were not always static but were dynamic and changed over time, whereby the child's personality and agency contributed to this diversity and these processes. Finally, methodological recommendations are offered and it is suggested that the child's perspective and agency should be included in research about children of divorce.
Adolescent↗
Prognosis in paranoid disorders and mortality in reactive psychoses.
The present paper shows that the short-term prognosis of patients with paranoid disorders hospitalized nowadays is poor for the majority. The best prognosis is attached to patients with affective or other not specified psychotic disorders. Socio-vocational variables at the time of first admission contain more predictive value than clinical variables. The term reactive psychosis as a term with good prognosis is questioned and the findings of a mortality study are presented in support of this view when concerned with hospital populations.
Adolescent↗
Factorial structure of traits delineating personality disorders in clinical and general population samples.
Categorical and dimensional models for classifying personality disorders were evaluated by comparing the structure of personality pathology in a clinical sample (n = 158) with the structure in a general population sample (n = 274). Subjects completed 100 personality scales. Separate factor analyses revealed similar structures in the 2 samples. An underlying structure in a combined sample showed limited agreement with the concepts of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987). Fifteen factors were retained: Generalized Distress, Rejection, Restricted Expression, Compulsivity, Stimulus Seeking, Insecure Attachment, Diffidence, Intimacy Problems, Oppositionality, Interpersonal Disesteem, Conduct Problems, Cognitive Dysfunction, Affective Reactivity, Narcissism, and Social Apprehensiveness. The results are consistent with a dimensional representation of personality disorder.
Adult↗
Treatment of attachment disorder of infancy in a neonatal intensive care unit.
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Anxiety, Separation↗
Separation anxiety disorder in children and adolescents: epidemiology, diagnosis and management.
This paper provides an overview of the phenomenology, longitudinal outcome data, assessment and management of separation anxiety disorder (SAD) in children and adolescents. SAD is qualitatively different from early worries, and is characterised by an abnormal reactivity to real or imagined separation from attachment figures, which significantly interferes with daily activities and developmental tasks. Different epidemiological studies indicate a prevalence of 4 to 5% in children and adolescents. In contrast to other anxiety disorders, 50 to 75% of children with SAD come from homes of low socioeconomic status. The severity of symptomatology ranges from anticipatory uneasiness to full-blown anxiety about separation, but children are usually brought to the clinician when SAD results in school refusal or somatic symptoms. School refusal is reported in about 75% of children with SAD, and SAD is reported to occur in up to 80% of children with school refusal. Longitudinal studies have suggested that childhood SAD may be a risk factor for other anxiety disorders, but whether this link is specific to, for example, panic disorder and agoraphobia, or whether SAD represents a general factor of vulnerability for a broad range of anxiety disorders is still debated. Most relevant data are reported on nonpharmacological treatments (psychoeducational, behavioural, cognitive-behavioural, family and psychodynamic), and these are the first choice approach in SAD. Controlled studies show efficacy of cognitive-behavioural therapy in children with anxiety disorders and specifically in SAD-school phobia, supporting this approach as the best proven treatment. Pharmacotherapy should be used in addition to behavioural or psychotherapeutic intervention when the child's symptoms have failed to respond to those treatments, and he/she is significantly impaired by the symptoms. Selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRI) have a good adverse effect profile and may be considered as first choice drugs in SAD. When different SSRIs fail to improve symptomatology, a trial with a tricyclic antidepressant (TCA) is indicated, with careful monitoring of cardiac functioning. Because of the adverse effect profile and the potential for abuse and dependence, benzodiazepines should be used only when a rapid reduction of symptomatology is needed, until the SSRI or the TCA have begun to be effective (few weeks). Buspirone should be considered in children who have not responded to other treatments. Further research is needed to confirm efficacy of newer antidepressants (venlafaxine, mirtazapine, nefazodone) in childhood anxiety disorders.
Adolescent↗
Classification of elective mutism.
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Adolescent↗
Elective brief psychotherapy with children.
There does not as yet exist a clearly unifying concept of brief psychotherapy with children. Various forms of shortened treatment have been reported as successful. The technique described in this paper is a form of individual therapy based on psychoanalytic principles, especially those of ego psychology. It is primarily recommended for children who have suffered a real of symbolic object loss. Distinctive features include the early definition of a focus, a predetermined time limit, and careful attention to termination issues. The goals are relatively ambitious. When successful the therapy results in persistent psychodynamic changes. Case examples are used to illustrate how these positive results may occur through the medium of identification with the therapist, which permits a resolution or lessening of ambivalent dependence. This in turn allows the treatment experience to act as a model for future relationships with limited givers.
Adolescent↗