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Venta A, McLaren V, Sharp C, Abate A, Allman M, Cervantes B, Kerr S, Hernandez Ortiz J, Sumlin E, Walker J, Wall K. Does coding internal working models of attachment have to be so hard? Child Psychiatry Hum Dev 2024; 55:227-235. [PMID: 35838815 PMCID: PMC9283821 DOI: 10.1007/s10578-022-01385-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/21/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022]
Abstract
The Child Attachment Interview (CAI) has demonstrated promise in youth, yet widespread use is thwarted by the need for interview transcription, face-to-face training, and reliability certification. The present study sought to examine the empirical basis for these barriers. Thirty-five archival CAIs were re-coded by: (1) expert coders (i.e., trained and reliable) without access to transcripts, (2) trained coders who had not completed reliability training, and (3) novice coders who had no formal training. Agreement with consensus classifications was computed with the expectation of moderate agreement. Results supported coding by experts without transcription of the interview. Near-moderate agreement preliminarily supported the use of trained coders who have not attempted reliability certification with appropriate caveats. While moderate agreement was not achieved for novice raters, findings suggest that self-paced training options for the CAI may hold future promise. These contributions erode a number of significant barriers to the current use of the CAI.
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Affiliation(s)
- Amanda Venta
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA.
| | - Veronica McLaren
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Carla Sharp
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Anna Abate
- Department of Psychology & Philosophy, Sam Houston State University, Huntsville, TX, USA
| | - Madeleine Allman
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Breana Cervantes
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Sophie Kerr
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Jessica Hernandez Ortiz
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Eric Sumlin
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Jesse Walker
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
| | - Kiana Wall
- Department of Psychology, University of Houston, 4849 Calhoun Rd., Room 373, 77204-6022, Houston, TX, USA
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Bizzi F, Locati F, Parolin L, Goetz Yael S, Brusadelli E. Advancement in the child attachment interview and the child and adolescent reflective functioning scale using a PDM-2 framework: case reports. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2022; 25. [PMID: 35373961 PMCID: PMC9153759 DOI: 10.4081/ripppo.2022.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022]
Abstract
The Child Attachment Interview (CAI) is a well-established semi-structured interview, widely used to identify attachment representations in middle childhood and adolescence. The application of the Child and Adolescent Reflective Functioning Scale (CRFS) to CAI narratives allows for an assessment of child mentalization, considered a strong predictor of attachment security. The 2nd edition of the Psychodynamic Diagnostic Manual (PDM-2) includes CAI and CRFS as valid and reliable assessment measures in order to assess the dominion of the Mental Functioning axis. The aim of the present paper is to investigate the informative power of CAI and CRFS for the overall understanding of mental functioning and personality in a PDM-2 framework. The present report includes the discussion of two clinical cases of school-aged children in applying the Psychodiagnostic Chart-Second Edition (PDC-2) to the CAI transcript. The first case concerns a young male, aged 10, suffering from Oppositional-Provocative Disorder (externalizing disorder), while the second case concerns a young female, aged 15, suffering from Somatic Symptoms Disorder (internalizing disorder). PDC-2 for children and adolescents was used. Data from the scoring of CAI and CRFS were combined with a systematic evaluation of the qualitative contents emerging from CAI transcripts. A detailed analysis suggests that both the CAI and CRFS are useful attachment-oriented measures, able to explore child’s mental states, and together with the application of PDC-2 they provide an essential contribution in the understanding of developmental psychopathology. Implications of this innovative approach for clinical assessment, treatment design, and interventions are further discussed.
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Salaminios G, Morosan L, Toffel E, Tanzer M, Eliez S, Badoud D, Armando M, Debbané M. Associations between schizotypal personality features, mentalizing difficulties and thought problems in a sample of community adolescents. Early Interv Psychiatry 2021; 15:705-715. [PMID: 32573985 DOI: 10.1111/eip.13011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/02/2020] [Accepted: 05/24/2020] [Indexed: 12/01/2022]
Abstract
AIM Schizotypal trait expression and mentalizing impairments represent key factors associated with increased vulnerability for schizophrenia. In the current study, we analysed the nature of associations linking specific schizotypal personality features to mentalizing difficulties during adolescence. Furthermore, we examined the extent to which mentalizing difficulties mediate the relationship between schizotypal trait features and self-reported thought problems. METHODS One hundred and five community adolescents (Mage = 15.72; SD = 1.91) completed a recently developed self-report measure of mentalizing (Reflective Functioning Questionnaire [RFQ]), evaluating the degree of certainty (RFQc-scale) and uncertainty (RFQu-scale) with which individuals utilize mental state information to understand their own and others' behaviour. High scores on the RFQu-scale reflect poor usage of mental state information, while high scores on the RFQc-scale capture adaptive levels of certainty about mental states. Self-report questionnaires were also used to assess schizotypal trait expression, thought problems and symptoms of anxiety/depression. RESULTS Linear regression models indicated that schizotypal features of social anxiety and odd speech accounted for increased RFQu scores, while odd speech also accounted for reduced RFQc scores. RFQu partially mediated the effects of social anxiety and odd speech on the level of thought problems in the sample. CONCLUSIONS Present findings suggest that schizotypal features that impede interpersonal communication during adolescence are linked to difficulties in mental state understanding. Our study also provides original data suggesting that the effects of social anxiety and odd speech on psychosis-risk may partially depend upon the level of mentalizing uncertainty. Mentalizing difficulties may constitute important clinical assessment and early prevention treatment targets in adolescents who demonstrate schizotypal features.
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Affiliation(s)
- George Salaminios
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Larisa Morosan
- Developmental Clinical Psychology Unit, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Developmental Imaging and Psychopathology Lab, Office Medico-Pédagogique, University of Geneva 1 rue David-Dufour, Geneva, Switzerland
| | - Elodie Toffel
- Developmental Clinical Psychology Unit, Faculty of Psychology, University of Geneva, Geneva, Switzerland
| | - Michal Tanzer
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephan Eliez
- Department of Psychiatry, Developmental Imaging and Psychopathology Lab, Office Medico-Pédagogique, University of Geneva 1 rue David-Dufour, Geneva, Switzerland
| | - Deborah Badoud
- Developmental Clinical Psychology Unit, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Developmental Imaging and Psychopathology Lab, Office Medico-Pédagogique, University of Geneva 1 rue David-Dufour, Geneva, Switzerland
| | - Marco Armando
- Department of Psychiatry, Developmental Imaging and Psychopathology Lab, Office Medico-Pédagogique, University of Geneva 1 rue David-Dufour, Geneva, Switzerland
| | - Martin Debbané
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Developmental Clinical Psychology Unit, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Developmental Imaging and Psychopathology Lab, Office Medico-Pédagogique, University of Geneva 1 rue David-Dufour, Geneva, Switzerland
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Pena-Garijo J, Monfort-Escrig C. The centrality of secure attachment within an interacting network of symptoms, cognition, and attachment dimensions in persons with schizophrenia-spectrum disorders: A preliminary study. J Psychiatr Res 2021; 135:60-67. [PMID: 33450466 DOI: 10.1016/j.jpsychires.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Research in the field of psychosis broadly suggests that symptoms, neurocognitive deficits, social cognition, cognitive biases, and attachment experiences influence each other. However, little is known if any of these constructions play a more central role than others as they interact. METHOD To clarify this issue, we conducted a "network" analysis to explore the interplay among a set of variables related to attachment, cognition domains, and psychotic symptoms in a small sample of outpatients with stabilised schizophrenia-spectrum disorders (n = 25). Eighteen participants (72%) were first-episode patients. We assessed psychotic symptoms, attachment dimensions, neurocognitive performance, "theory of mind", emotion recognition, and "jumping to conclusions" bias using standardised instruments. RESULTS The study provides preliminary evidence about a network structure in which the secure attachment (SA) is the most central "node" within the interacting network considering all centrality measures, followed by general psychopathology. SA was closely connected to self-sufficiency (avoidant attachment) and child traumatism, as well as with neurocognition. Emotion recognition impairment was the most robust connection to positive symptoms and mediated the influence of SA on psychotic symptoms. CONCLUSIONS Beyond the importance of symptoms, our results, although preliminary, suggest the need to assess attachment experiences and cognition domains to improve specific interventions that can promote recovery in outpatients with psychosis.
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Affiliation(s)
- Josep Pena-Garijo
- Jaume I University. Castellon de la Plana, Spain; Mental Health Service. University Hospital Doctor Peset. Valencia, Spain.
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Bizzi F, Shmueli-Goetz Y, Castellano R, San Martini P, Cavanna D. Psychometric Properties of the Child Attachment Interview in Italian Context: A Focus on Normative and Specific Clinical Groups in School-Aged Children. Psychol Rep 2020; 124:382-410. [PMID: 32056493 DOI: 10.1177/0033294120905515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
While attachment assessments developed for infancy and adulthood are well established, no such gold standard measure exists for school years, where measures are not yet sufficiently robust. Nevertheless, the last decade has witnessed some progress in this field with the development of the Child Attachment Interview (CAI), a semistructured interview designed to access children's mental representations of their attachment relationships. This study aimed to test the validity and reliability of the CAI for an Italian population, using a normative group and a clinical group of disruptive behavior disorder and somatic symptom disorder patients. A total sample of 311 Italian children (213 normative and 98 clinical) aged 8 to 15 years completed a battery of measures assessing attachment, verbal IQ, and symptomatology. The psychometric properties of the CAI alongside other children (Kerns Security Scale, Inventory of Parent and Peer Attachment) and parents (Adult Attachment Interview) attachment measures in normative sample, as well as the distribution of attachment patterns in normative and clinical samples, were examined. The results revealed the CAI to have adequate interrater and test-retest reliability, as well as discriminant, and convergent validity. Significant differences in the CAI's distribution of attachment patterns for normative and specific clinical groups were found. Taken together, the findings show that the CAI Italian version is a reliable and valid measure for assessing attachment in school years and beyond.
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Affiliation(s)
- Fabiola Bizzi
- Department of Educational Science, 9302University of Genoa, Italy
| | - Yael Shmueli-Goetz
- 4785Anna Freud Centre, London, UK; Department of Clinical, Educational and Health Psychology, University College London, UK
| | | | - Pietro San Martini
- Department of Dynamic and Clinical Psychology, 9311University of Rome La Sapienza, Italy
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Schröder M, Lüdtke J, Fux E, Izat Y, Bolten M, Gloger-Tippelt G, Suess GJ, Schmid M. Attachment disorder and attachment theory - Two sides of one medal or two different coins? Compr Psychiatry 2019; 95:152139. [PMID: 31706154 DOI: 10.1016/j.comppsych.2019.152139] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 10/10/2019] [Accepted: 10/14/2019] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Currently, attachment quality and attachment disorder exist in parallel, but the mutual association is still insufficiently clarified. For policy makers and clinical experts, it can be difficult to differentiate between these constructs, but the distinction is crucial to develop mental-health services and effective treatment concepts. We aimed to investigate the association between attachment representations (AR) and attachment disorders (AD), including Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) in children aged between 5 and 9. METHODS A total of 135 children aged between 5 and 9 years (M=7.17 years, SD=1.40, 63% male) and their primary caregivers participated in the study. Children were interviewed with the story stem method to assess AR, and the primary caregiver completed diagnostic interviews and questionnaires on mental disorders, AD, emotional and behavioral problems, and intelligence and development. RESULTS The prevalence of AR in children with AD was 28.6% for the 'secure' form of AR, 17.1% for the 'insecure-avoidant' form, 25.7% for the 'insecure-ambivalent' form, and 28.6% for the 'disorganized' form. Prevalences of the various AR forms did not differ statistically significantly, indicating that AR is conceptionally distinct from AD. Children with disorganized attachment scored significantly lower on language and intelligence skills than children with secure attachment. AD was significantly associated with a higher number of comorbidities, emotional and behavioral problems, and lower language skills. CONCLUSIONS Longitudinal studies using standardized assessment instruments are needed to systematically provide comparable and reliable empirical findings to improve current understanding of AR and AD as well as their etiological models.
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Affiliation(s)
- Martin Schröder
- Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland; University of Lüneburg, Faculty of Education, Institute of Social work and Social Education, Universitätsallee 1, 21339, Lüneburg, Germany.
| | - Janine Lüdtke
- Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland
| | - Elodie Fux
- Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland
| | - Yonca Izat
- Vivantes Clinic Friedrichshain, Child and Adolescent Psychiatry Berlin, Child and Adolescent Psychiatry, Psychotherapy, Psychosomatic, Zadekstrasse 53, 12351, Berlin, Germany
| | - Margarete Bolten
- Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland
| | | | - Gerhard J Suess
- Hamburg University of Applied Sciences, Faculty Business & Social Sciences, Department Social Work, Alexanderstraße 1, 20099, Hamburg, Germany
| | - Marc Schmid
- Psychiatric University Clinics (UPK), Department of Child and Adolescent Psychiatry (UPKKJ), University of Basel, Research Department, Schanzenstrasse 13, 4056, Basel, Switzerland
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Venta A, Harmon J, Abate A, Marshall K, Mouton-Odum S. Pilot data supporting an attachment-based theory of adolescent social media use. Child Adolesc Ment Health 2019; 24:274-282. [PMID: 32677210 DOI: 10.1111/camh.12329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adolescents have virtually universal access to social media. Despite ample research linking attachment to social functioning in youth, neither this empirical research nor related theory has been extended to the virtual social context. The broad aim of this study was to test an attachment-based model of social media use in adolescents in order to address a gap in the literature during this developmental stage and examine attachment and the related process of mentalizing as correlates of online behavior. METHOD Online social comparison/feedback-seeking was selected as an outcome variable due to its known negative effects on adolescents. Analyses were conducted in a sample of 68 adolescents ranging in age from 15 to 18. RESULTS No evidence of a main effect of parent-child attachment on social comparison/feedback-seeking was found, but a significant mediational effect indicated that more insecure parent-child attachment is linked with hypermentalizing errors (i.e., overinterpretation of others' mental states) and that such errors explain increased social comparison/feedback-seeking. CONCLUSIONS The current study confirmed previously documented relations between parent-child attachment and hypermentalization as well as research demonstrating that parent-child attachment acts on an adolescent's social world - in this case their virtual social world - through anomalous mentalization.
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Affiliation(s)
- Amanda Venta
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Jennifer Harmon
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Anna Abate
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Kaisa Marshall
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Suzanne Mouton-Odum
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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de Sousa P, Sellwood W, Griffiths M, Bentall RP. Disorganisation, thought disorder and socio-cognitive functioning in schizophrenia spectrum disorders. Br J Psychiatry 2019; 214:103-112. [PMID: 30139394 DOI: 10.1192/bjp.2018.160] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Poor social cognition is prevalent in schizophrenia spectrum disorders. Some authors argue that these effects are symptom-specific and that socio-cognitive difficulties (e.g. theory of mind) are strongly associated with thought disorder and symptoms of disorganisation.AimsThe current review tests the strength of this association. METHOD We meta-analysed studies published between 1980 and 2016 that tested the association between social cognition and these symptoms in schizophrenia spectrum disorders. RESULTS Our search (PsycINFO, MEDLINE and Web of Science) identified 123 studies (N = 9107). Overall effect size as r = -0.313, indicating a moderate association between symptoms and social cognition. Subanalyses yielded a moderate association between symptoms and theory of mind (r = -0.349) and emotion recognition (r = -0.334), but smaller effect sizes for social perception (r = -0.188), emotion regulation (r = -0.169) and attributional biases (r = -0.143). CONCLUSIONS The association is interpreted within models of communication that highlight the importance of mentalisation and processing of partner-specific cues in conversational alignment and grounding.Declaration of interestsNone.
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Affiliation(s)
- Paulo de Sousa
- Department of Clinical Psychology,University of Liverpool,UK
| | - William Sellwood
- Division of Health Research,Faculty of Health and Medicine,Lancaster University,UK
| | | | - Richard P Bentall
- Clinical Psychology Unit,Department of Psychology,University of Sheffield,UK
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