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Monin JK, Shah M, Chang W, Feeney BC, Birditt K, Gaugler JE, Vranceanu AM, Marottoli R. Associations Between Attachment and Depressive Symptoms Among Older Adults Living With Early-Stage Cognitive Impairment and Their Adult Children. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae137. [PMID: 39129484 PMCID: PMC11407828 DOI: 10.1093/geronb/gbae137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Indexed: 08/13/2024] Open
Abstract
OBJECTIVES This study examined the extent to which multiple relationship-specific attachment schemas (general, parent-child, and romantic) are interrelated and relate to depressive symptoms among older adults living with early-stage dementia and their adult children, a context likely to activate the attachment system. METHODS The study consisted of 150 early-stage cognitively impaired parents and one child. Both self-reported general, parent-child, and romantic attachment anxiety as well as avoidance and depressive symptoms. Parents' cognitive and functional impairment were assessed. RESULTS Most attachment variables were interrelated for individuals, except that the child's parent-child-specific avoidance was not associated with their general or romantic avoidance. The parent's worse functional, but not cognitive, impairment was associated with the child's greater parent-child-specific attachment anxiety. Using Actor Partner Interdependence Models, general attachment anxiety was associated with greater depressive symptoms (actor effects). When both dyad members were high in general avoidance, depressive symptoms were greatest (actor × partner effect). A parent had the greatest depressive symptoms when they were avoidantly attached to their child (role × actor effect) and their child was high in anxiety and low in avoidance toward them (role × partner effects). A child had the greatest depressive symptoms when they were low in avoidance toward the parent (role × actor effect) and the parent was low in anxiety and high in avoidance toward the child (role × partner effects). Romantic anxiety was associated with greater depressive symptoms (actor effects). DISCUSSION Psychosocial interventions that incorporate attachment theory as a framework may benefit parent-child dyads coping with dementia.
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Affiliation(s)
- Joan K Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Maya Shah
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Wei Chang
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Brooke C Feeney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Kira Birditt
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Joseph E Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ana Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Richard Marottoli
- Division of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Filosa M, Sharp C, Gori A, Musetti A. A Comprehensive Scoping Review of Empirical Studies on Earned Secure Attachment. Psychol Rep 2024:332941241277495. [PMID: 39207034 DOI: 10.1177/00332941241277495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Earned-Secure Attachment (ESA) can be defined as the process by which individuals with insecure childhood attachment rise above malevolent childhood experiences to develop secure relationships pattern in adulthood. To our knowledge, no previous review has summarized findings from empirical literature about this topic. To fill this gap, we conduct a preregistered scoping review (research published until 2023) following the PRISMA Extension for Scoping Reviews, to find how ESA has been defined, assessed, and studied in the empirical literature. Four databases were searched (Scopus, PsycInfo, PubMed and Web of Science), 24 studies were included in the review and were assessed using the Mixed Methods Appraisal Tool. Findings from our review reveal a more formal than substantial agreement on the conceptualization of ESA and the conclusions that can be made, considering the heterogeneity of our results, are only preliminary. Developmental factors, the association between ESA and depressive symptoms and the role of fathers remain poorly defined, although the importance of secondary attachment figures and reflective functioning as factors that may contribute to earned-security in attachment is clear. Recommendations and future steps for researchers and practitioners are highlighted.
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Affiliation(s)
- Maria Filosa
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Alessio Gori
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
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Hans SL, Herriott AL, Finger B, Edwards RC, McNeilly CG. Parenting Among Women in Methadone Treatment: Contributions of Mental Health Problems and Violence Exposure. Child Psychiatry Hum Dev 2024; 55:929-942. [PMID: 36308598 DOI: 10.1007/s10578-022-01463-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/30/2022]
Abstract
The aim of the current study is to explore factors associated with quality of parenting among women in treatment for opioid use disorders. 150 Black American women with 3-5 year old children were recruited through methadone treatment programs. Parenting representations were assessed through the Working Model of the Child Interview and parenting behavior through video recordings of mother-child interaction. Interviews were used to assess mothers' history of violence exposure and to make DSM diagnoses. Mothers' mood disorder was related to distorted representations and to expressions of concerned affect (anxiety, fear, guilt). Mothers' personality disorder was related to expressions of negative affect (anger and frustration) and inversely related to sensitive parenting behavior. Mothers' experience of family violence during childhood and partner violence during adulthood were related to concerned affect in their representations. Women in treatment for substance use disorder have complex and interconnected needs, including parenting supports and trauma-informed mental health services.
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Affiliation(s)
- Sydney L Hans
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA.
| | - Anna L Herriott
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA
| | - Brent Finger
- Department of Psychology, Montana State University, Billings, MT, USA
| | - Renee C Edwards
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, 969 E 60th Street, Chicago, IL, 60637, USA
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4
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Blake JA, Thomas HJ, Hurst CP, Pelecanos AM, McGee TR, Najman JM, Scott JG. A two-generation study of attachment in mothers and their young adult offspring: Latent classes of attachment and associations with anxiety and depression. J Affect Disord 2024; 358:361-368. [PMID: 38734244 DOI: 10.1016/j.jad.2024.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/26/2024] [Accepted: 05/08/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Evidence supports the conceptualization of adult attachment as existing along a continuum of attachment security and insecurity; however, ongoing debates persist regarding the use of categorical versus continuous approaches to studying attachment. Attachment data collected from a large community sample of mothers and their offspring in young adulthood were used to examine i) latent classes of adult attachment, ii) associations between mother and offspring attachment, iii) the relationship between adult attachment and mental health symptoms. METHODS Mothers and offspring were each administered the Attachment Style Questionnaire when offspring were aged 21-years. Latent class analyses (LCA) were performed to examine response patterns across ASQ items. Associations between mothers' and offspring attachment, and correlations between attachment domains and depression/anxiety subscales were examined. RESULTS LCA identified four latent classes across a continuum of secure and insecure attachment rather than four distinct adult attachment styles. Anxious attachment subscales correlated strongly with depression/anxiety symptoms in both cohorts. Mothers' attachment was significantly but weakly correlated with their young adult offspring attachment. LIMITATIONS Attachment was measured at one time point and as such, a causal maternal-offspring attachment relationship could not be established. CONCLUSIONS Findings support a dimensional view of attachment security and insecurity over a four-category model of adult attachment. Attachment correlated with anxiety and depressive symptoms and highlights the importance of considering adult attachment when addressing mental health. There was limited evidence of a relationship between middle aged mothers and their offspring in young adulthood, suggesting other factors influence attachment in adulthood.
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Affiliation(s)
- Julie A Blake
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, Qld, Australia; Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia; Child and Youth Mental Health Service, Queensland Children's Hospital, South Brisbane, QLD, Australia.
| | - Hannah J Thomas
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, Qld, Australia
| | - Cameron P Hurst
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, QLD, Australia
| | | | - Tara Renae McGee
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Jake M Najman
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, Qld, Australia; Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia; Child and Youth Mental Health Service, Queensland Children's Hospital, South Brisbane, QLD, Australia
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5
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Chong JY, Anderson GM, Fraley RC. Natural clues to danger: attachment behavior in threatening situations. Attach Hum Dev 2024; 26:366-382. [PMID: 38995104 DOI: 10.1080/14616734.2024.2376764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024]
Abstract
A fundamental principle of attachment theory is that threatening situations give rise to individual differences in the extent to which people seek proximity to close others. The current research examines the way in which attachment styles predict individual differences in attachment-relevant behavior during threatening events. We tested alternative theoretical perspectives concerning the association between adult attachment (specifically, attachment avoidance) and attachment behavior in the presence of natural clues to danger by observing couples (N = 204) when they were watching horror vs. control film excerpts. Results suggest that highly avoidant people engaged in less attachment behavior across both threatening and non-threatening situations. These findings have implications for the understanding of attachment-related processes and how working models of the self and others facilitate (or inhibit) the expression of attachment behavior.
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Affiliation(s)
- Jia Y Chong
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Gabrielle M Anderson
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
| | - R Chris Fraley
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
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6
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Blake JA, Thomas HJ, Pelecanos AM, Najman JM, Scott JG. Does attachment anxiety mediate the persistence of anxiety and depressive symptoms from adolescence to early adulthood? Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02737-8. [PMID: 39088095 DOI: 10.1007/s00127-024-02737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 07/21/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVES Depression and anxiety often emerge in adolescence and persist into early adulthood. Developing a greater understanding of the factors that influence their persistence may inform psychological interventions. Their association with an insecure attachment style is well established although the mediating role of attachment anxiety in the persistence of depression and anxiety over time has not been examined. This study aimed to examine if anxious attachment mediated depression and anxiety from adolescence to early adulthood. METHODS Data from 3,436 participants in a longitudinal birth cohort study were examined. At 14-years and 21-years, participants completed the Achenbach Youth Self Report (YSR) and the Achenbach Young Adult Self-Report (YASR) respectively. At 21-years, participants completed the Attachment Style Questionnaire (ASQ). Attachment anxiety as a mediator for the persistence of anxiety/depressive symptoms from 14- to 21-years was examined. RESULTS Attachment anxiety accounted for approximately 60% of the persistence of anxiety and depressive symptoms at 14- and 21- years after adjusting for covariates. Results were similar when stratifying by males and females. CONCLUSIONS Attachment anxiety significantly contributes to the persistence of anxiety and depressive symptoms from adolescence into early adulthood for both males and females. Incorporating interventions that address attachment anxiety in adolescents may improve the response to therapy for anxiety and depression.
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Affiliation(s)
- Julie A Blake
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
- Centre for Children's Health Research, Children's Health Queensland, South Brisbane, Queensland, Australia.
- School of Public Health, The University of Queensland, Herston, Queensland, Australia.
| | - Hannah J Thomas
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Anita M Pelecanos
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Jake M Najman
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland, South Brisbane, Queensland, Australia
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Groh AM, Haydon KC. The Attachment Script Assessment: Introduction of a coding system to evaluate deactivation, hyperactivation, and anomalous content. Attach Hum Dev 2024; 26:203-211. [PMID: 38989773 PMCID: PMC11346300 DOI: 10.1080/14616734.2024.2367324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Although research on adult attachment has yielded insight into the legacy of attachment for functioning in adulthood, methodological challenges persist in the assessment of adult attachment. The Adult Attachment Interview (AAI) offers a rich assessment of secure, insecure, and unresolved states of mind. However, it is resource intensive to administer and code. Attachment Script Assessment (ASA) offers a resource-effective alternative to the AAI. However, the ASA coding system only yields a single, security-like dimension: secure base script knowledge. Here, we introduce a complementary coding system for the ASA to assess attachment deactivation (i.e. script characterized by limited interpersonal connection and minimization of attachment problems/emotions), hyperactivation (i.e. script in which attachment-relevant problems and negative emotions are heightened), and anomalous content (i.e. script in which attachment problems contain elements of fear and/or disorientation); and we discuss the conceptual convergence of these scripts with corresponding patterns of attachment insecurity and disorganization.
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Affiliation(s)
- Ashley M Groh
- Department of Psychological Sciences, University of Missouri, Columbia, USA
| | - Katherine C Haydon
- Psychology & Education Department, Mount Holyoke College, South Hadley, USA
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8
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Taylor P, DiTommaso E, Scott-Storey K, O’Donnell S, Busolo D, Vincent CD, Malcolm J. Attachment, Mental Health, and Alcohol Use by Men: The Mediating Role of Cumulative Lifetime Violence Severity. Am J Mens Health 2024; 18:15579883241255829. [PMID: 38819019 PMCID: PMC11143826 DOI: 10.1177/15579883241255829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Cumulative lifetime violence (CLV) encompasses many different types and contexts of violence that occur across the lifespan and is associated with negative mental health outcomes in men; however, little attention has been paid to other factors that can influence these relationships such as attachment style. In this analysis, our focus is to understand how attachment styles directly and indirectly through CLV affect men's mental health, specifically depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol use. Data from 597 Canadian men with lifetime experiences of violence who participated in our national online survey focusing on violence and health were used for mediation analysis. Results indicated that CLV severity mediated the relationship between attachment anxiety (but not attachment avoidance) and depression, anxiety, PTSD, and alcohol use. Although attachment anxiety and attachment avoidance each directly affected depression, anxiety, and PTSD, neither directly affected alcohol use. Importantly, these findings provide the first evidence that the mechanism by which anxious attachment affects alcohol use is through CLV severity. These findings highlight the importance of anxious attachment on mental health outcomes for men who have experienced CLV.
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Affiliation(s)
- Petrea Taylor
- Faculty of Nursing, University of New Brunswick, Moncton, New Brunswick, Canada
| | - Enrico DiTommaso
- Department of Psychology, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Kelly Scott-Storey
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Sue O’Donnell
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - David Busolo
- Faculty of Nursing, University of New Brunswick, Moncton, New Brunswick, Canada
| | - Charlene D. Vincent
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Jeannie Malcolm
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
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9
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Zalaznik D, Zlotnick E, Barzilay S, Ganor T, Sorka H, Ebert DD, Andersson G, Huppert JD. Interpersonal factors in internet-based cognitive behavioral therapy for depression: Attachment style and alliance with the program and with the therapist. Psychother Res 2024:1-16. [PMID: 38581409 DOI: 10.1080/10503307.2024.2325510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/27/2024] [Indexed: 04/08/2024] Open
Abstract
Objective This open-trial study examined effects of a culturally-adapted Hebrew version of guided internet-based cognitive behavioural therapy (ICBT) for depression. We examined therapeutic alliance with the therapist and with the programme (content) as potential predictors of outcomes. Furthermore, we examined whether anxious and avoidant attachment styles improved, although relationships were not the focus of treatment. Method: We examined alliance with therapist and alliance with programme and their time-lagged (1 week), longitudinal relationship with depression outcomes, and change in anxious and avoidant attachment during treatment. Results: Depression and insomnia improved significantly (Cohen's d: depression = 1.34, insomnia = 0.86), though dropout was relatively high (49%). Alliance with programme and with the therapist predicted adherence and dropout, whereas only alliance with therapist predicted symptom improvement. Avoidant attachment decreased over treatment whereas anxious attachment did not. Conclusion: A culturally-adapted version of ICBT for depression showed that alliance with therapist and alliance with programme both can play an important role in its effectiveness: alliance with programme and the therapist drive adherence and dropout and alliance with therapist is related to symptom improvement. Although the focus of treatment is not interpersonal, avoidant attachment style can improve following ICBT.
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Affiliation(s)
- Dina Zalaznik
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elad Zlotnick
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Snir Barzilay
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Ganor
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hila Sorka
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Daniel Ebert
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Ozdemir E, MacBeth A, Griffiths H. Pathways from childhood trauma to aberrant salience: A structural equation approach to mentalization model. Psychol Psychother 2024; 97:157-172. [PMID: 37811853 DOI: 10.1111/papt.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE The aim of this study was to explore the relationship between affective disturbances and aberrant salience in the context of childhood trauma, attachment, and mentalization in an analogue study. METHODS Using a cross-sectional design, an online community sample completed self-report measures of key variables. Structural equation modelling was used to test childhood trauma's influence on aberrant salience via a set of intermediate risk factors (depression, negative schizotypy, and insecure attachment). These intermediate risk factors were assumed to lead to the proximal risk factors of aberrant salience (i.e., disorganized schizotypy and disorganized attachment) depending on the vulnerability of mentalizing capacity to elevated stress. RESULTS The sample (N = 1263) was 78% female and aged between 18 and 35 years. The tested models closely fitted the observed data, revealing significant pathways from childhood trauma to aberrant salience via the hypothesized pathways. The direct effect of childhood trauma on aberrant salience was significant. CONCLUSION Findings suggest that the pathway to aberrant salience may be characterized by disorganization of self-state and intersubjectivity as a function of diminishment in mentalizing ability. This may relate to changes in attachment organization and socio-cognitive capacity, which could constitute possible risk factors signalling development of aberrant salience.
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Affiliation(s)
- Ercan Ozdemir
- Section of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Angus MacBeth
- Section of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Helen Griffiths
- Section of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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Gu Y, Waters TEA, Zhu V, Jamieson B, Lim D, Schmitt G, Atkinson L. Attachment expectations moderate links between social support and maternal adjustment from 6 to 18 months postpartum. Dev Psychopathol 2024:1-13. [PMID: 38273665 DOI: 10.1017/s0954579423001657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Significant links exist between one's perception of available social support and mental health outcomes, including during the transition to motherhood. Yet, attachment theory posits that individuals do not benefit equally from social support. As such, we examined the influence of attachment representations (i.e., secure base script knowledge) as they potentially moderate links between social support and psychological distress in a 1-year longitudinal study of an ethnically diverse (56% White) sample of infant-mother dyads. We hypothesized that higher social support would predict lower maternal psychological distress and this relation would be strongest in those with higher secure base script knowledge. Results indicated that maternal perceptions of social support were significantly negatively correlated with psychological distress. Analyses revealed that secure base script scores significantly moderated these associations. Interestingly, for those high in script knowledge, low social support predicted greater psychological distress. For those low in script knowledge, social support was unrelated to psychological distress. This pattern suggested that those who expect care (i.e., high secure base script knowledge) but receive minimal support (i.e., low perceived social support) find motherhood uniquely dysregulating. Practitioners may do well to examine individuals' attachment expectations in relation to their current social support.
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Affiliation(s)
- Yufei Gu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Theodore E A Waters
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Victoria Zhu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Brittany Jamieson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Danielle Lim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Gabrielle Schmitt
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
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12
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Greenman PS, Renzi A, Monaco S, Luciani F, Di Trani M. How Does Trauma Make You Sick? The Role of Attachment in Explaining Somatic Symptoms of Survivors of Childhood Trauma. Healthcare (Basel) 2024; 12:203. [PMID: 38255090 PMCID: PMC10815910 DOI: 10.3390/healthcare12020203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/21/2023] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Exposure to traumatic events during childhood is common, and the consequences for physical and mental health can be severe. Adverse childhood experiences (ACEs) such as physical abuse, sexual abuse, emotional abuse, and neglect appear to contribute to the onset and severity of a variety of somatic inflictions, including obesity, diabetes, cancer, and heart disease. The aim of this scoping review was to try to gain insight into how this might occur. Given the evidence of indirect (i.e., through unhealthy behaviours such as excessive drinking or poor eating habits) and direct (i.e., through its impact on the endocrine, immune, and cardiovascular systems as well as on the brain) effects of attachment on health, we examined the possibility that insecure attachment might contribute to the development of somatic symptoms in adult survivors of childhood trauma. Eleven studies met our inclusion criteria. Findings from this review suggest that insecure and disorganized attachment orientations are related to DNA damage, metabolic syndrome and obesity, physical pain, functional neurological disorder, and somatization in adults exposed to childhood trauma. We discuss the implications of this for the conceptualization and treatment of trauma and stress disorders.
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Affiliation(s)
- Paul Samuel Greenman
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada;
- Institut du Savoir Montfort, Ottawa, ON K1K 0T2, Canada
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, University of Rome, 00185 Rome, Italy; (S.M.); (F.L.); (M.D.T.)
| | - Silvia Monaco
- Department of Dynamic and Clinical Psychology and Health Studies, University of Rome, 00185 Rome, Italy; (S.M.); (F.L.); (M.D.T.)
| | - Francesca Luciani
- Department of Dynamic and Clinical Psychology and Health Studies, University of Rome, 00185 Rome, Italy; (S.M.); (F.L.); (M.D.T.)
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, University of Rome, 00185 Rome, Italy; (S.M.); (F.L.); (M.D.T.)
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Qiao Z, Lafit G, Lecei A, Achterhof R, Kirtley OJ, Hiekkaranta AP, Hagemann N, Hermans KSFM, Boets B, Reininghaus U, Myin-Germeys I, van Winkel R. Childhood Adversity and Emerging Psychotic Experiences: A Network Perspective. Schizophr Bull 2024; 50:47-58. [PMID: 37318106 PMCID: PMC10754171 DOI: 10.1093/schbul/sbad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND HYPOTHESIS Childhood adversity is associated with a myriad of psychiatric symptoms, including psychotic experiences (PEs), and with multiple psychological processes that may all mediate these associations. STUDY DESIGN Using a network approach, the present study examined the complex interactions between childhood adversity, PEs, other psychiatric symptoms, and multiple psychological mediators (ie, activity-related and social stress, negative affect, loneliness, threat anticipation, maladaptive cognitive emotion regulation, attachment insecurity) in a general population, adolescent sample (n = 865, age 12-20, 67% female). STUDY RESULTS Centrality analyses revealed a pivotal role of depression, anxiety, negative affect, and loneliness within the network and a bridging role of threat anticipation between childhood adversity and maladaptive cognitive emotion regulation. By constructing shortest path networks, we found multiple existing paths between different categories of childhood adversity and PEs, with symptoms of general psychopathology (ie, anxiety, hostility, and somatization) as the main connective component. Sensitivity analyses confirmed the robustness and stability of the networks. Longitudinal analysis in a subsample with Wave 2 data (n = 161) further found that variables with higher centrality (ie, depression, negative affect, and loneliness) better predicted follow-up PEs. CONCLUSIONS Pathways linking childhood adversity to PEs are complex, with multifaceted psychological and symptom-symptom interactions. They underscore the transdiagnostic, heterotypic nature of mental ill-health in young people experiencing PEs, in agreement with current clinical recommendations.
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Affiliation(s)
- Zhiling Qiao
- Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Ginette Lafit
- Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
- Department of Psychology, Group on Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | - Aleksandra Lecei
- Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Robin Achterhof
- Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Olivia J Kirtley
- Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Anu P Hiekkaranta
- Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Noëmi Hagemann
- Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Karlijn S F M Hermans
- Strategy and Academic Affairs, Administration and Central Services, Leiden University, Leiden, The Netherlands
| | - Bart Boets
- Department of Neurosciences, Research Group Psychiatry, Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany
- ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King’s College London, London, UK
| | - Inez Myin-Germeys
- Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Ruud van Winkel
- Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
- University Psychiatric Center (UPC), KU Leuven, Leuven, Belgium
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Skidmore SJ, Sorrell SA, Lefevor GT. Attachment, Minority Stress, and Health Outcomes Among Conservatively Religious Sexual Minorities. JOURNAL OF HOMOSEXUALITY 2023; 70:3171-3191. [PMID: 35767460 DOI: 10.1080/00918369.2022.2087483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual minority (SM) members of the Church of Jesus Christ of Latter-day Saints (LDS) face increased exposure to minority stressors as well as concerns of attachment injuries relative to their heterosexual counterparts. The Integrated Attachment and Sexual Minority Stress Model outlines the mutually reinforcing associations between adult attachment and sexual minority stress, positing that adult attachment is both influenced by experiences of minority stress and simultaneously capable of shaping minority stress experiences in adulthood. The present study explored how adult attachment style directly and indirectly affects minority stressors and health outcomes for LDS SMs. A sample of 602 LDS SMs completed a quantitative survey assessing attachment, minority stress, and health. Results indicated that an insecure attachment style related to increased minority stressors and depression, whereas a secure attachment style related to decreased minority stressors and increased life satisfaction. Further, attachment moderated the relationship between minority stressors and health outcomes, such that experiences of minority stress were related to a decrease in life satisfaction only for securely attached LDS SMs. However, securely attached LDS SMs still reported better health than insecurely attached LDS SMs, even when reporting high degrees of minority stressors. These findings add to the growing body of literature suggesting that attachment style has direct and indirect effects on health outcomes for SMs, including those from conservative religious backgrounds.
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Affiliation(s)
| | - Sydney A Sorrell
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - G Tyler Lefevor
- Department of Psychology, Utah State University, Logan, Utah, USA
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Asgarizadeh A, Sharp C, Ghanbari S. Shame-coping clusters: comparisons regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for general emotion dysregulation. Borderline Personal Disord Emot Dysregul 2023; 10:25. [PMID: 37679853 PMCID: PMC10485966 DOI: 10.1186/s40479-023-00231-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/05/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND General Emotion Dysregulation (GED) is increasingly implicated as an underlying factor in personality pathology; however, the regulation of specific emotions, such as shame, has been relatively overlooked in the literature. We aimed to identify distinct clusters of shame-coping/regulation and compare them regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for GED. METHODS A convenience sample of 600 participants (351 females and 249 males) from the general population with ages ranging from 18 to 65 (M = 33.78, SD = 12.80) completed a battery of self-report instruments, measuring shame-coping styles, GED, attachment insecurities, mentalizing deficits, criteria A and B of the alternative model for personality disorders, and borderline personality traits. A two-stage clustering method was employed, with shame-coping styles as the clustering variables. The identified clusters were then compared for their effects on dependent variables using multivariate and univariate analyses. These comparisons were also performed after controlling for GED. RESULTS Multiple determination methods suggested a two-cluster solution: maladaptive and adaptive shame-coping. Attack-self, withdrawal, and attack-other styles were the main discriminators. Compared with the adaptive cluster, the maladaptive cluster was characterized by higher use of maladaptive and lower use of adaptive shame-coping styles. Multivariate analyses demonstrated significant differences for all the between-cluster comparisons, with and without GED as the covariate (p < .001). CONCLUSIONS The current study provides evidence for the presence of homogenous clusters of shame-coping in community-based adults. Between-cluster contrasts after controlling for GED suggest that addressing shame-coping could have incremental utility over and above GED.
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Affiliation(s)
- Ahmad Asgarizadeh
- Faculty of Education and Psychology, Shahid Beheshti University, Shahid Shahriari Square, Daneshjou Boulevard, Shahid Chamran Highway, Tehran, Iran
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Saeed Ghanbari
- Faculty of Education and Psychology, Shahid Beheshti University, Shahid Shahriari Square, Daneshjou Boulevard, Shahid Chamran Highway, Tehran, Iran.
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16
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Van Vlierberghe L, Diamond G, Bosmans G. Middle childhood attachment-based family therapy: Theory and model description. FAMILY PROCESS 2023; 62:1040-1054. [PMID: 37070348 DOI: 10.1111/famp.12887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
In middle childhood, the first manifestations of mental health problems can emerge and become a precursor of mental health issues in adolescence. Given that weak parent-child attachment can contribute to this distress, it is possible that strengthening the attachment bond could reduce risk trajectory. Unfortunately, evidence-based attachment-focused interventions are lacking at this age. Attachment-based family therapy (ABFT) is a well-studied intervention for troubled adolescents and has the potential to be extended downward to children. However, ABFT for adolescents focuses on mentalization and trauma conversation strategies that may be developmentally advanced for children's capacities. Therefore, we modified the intervention strategies to be more developmentally sensitive to childhood. Middle childhood ABFT (MCABFT) builds on the theory that insecure attachment develops through a learning process that can be interrupted and reorganized to promote secure attachment development. MCABFT uses less conversation and more play and puts parents more at the center of the therapy compared with ABFT for adolescents. In this article, we describe MCABFT's theoretical and clinical model.
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Affiliation(s)
- Leen Van Vlierberghe
- Clinical Psychology Research Group, KULeuven (University of Leuven), Leuven, Belgium
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Guy Bosmans
- Clinical Psychology Research Group, KULeuven (University of Leuven), Leuven, Belgium
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Georg AK, Meyerhöfer S, Taubner S, Volkert J. Is parental depression related to parental mentalizing? A systematic review and three-level meta-analysis. Clin Psychol Rev 2023; 104:102322. [PMID: 37572565 DOI: 10.1016/j.cpr.2023.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 08/14/2023]
Abstract
This systematic review and meta-analysis is aimed to summarize the state of research on the relation between parental depression and parental mentalizing. To account for the multifaceted nature of parental mentalizing, several conceptualizations and measures were included and compared. The last database search was conducted on March 13, 2023. Using three-level meta-analytic modelling, we analyzed a total of 12,665 participants from 63 studies with 233 effect sizes. Taken together, higher depression was only weakly associated with lower mentalizing (r = -0.06). Specifically, parents with higher depression scored lower on questionnaire measures of parental reflective functioning (r = -0.11). No significant correlations were found for interview measures of parental reflective functioning, the observational and interview measure of mind-mindedness, or insightfulness. The data showed substantial heterogeneity. The mean effect size for self-reported pre-mentalizing (r = -0.23 for reverse-coded subscale scores) was significantly stronger compared to other self-report subscales. In studies including parents with diagnosis and controls, there was limited evidence suggesting a larger negative correlation between depression, mind-mindedness, and insightfulness. Therefore, more research is needed in clinical samples. Due to their correlational nature, our results do not allow causal inferences. Future studies should target moderators that explain variability (e.g., comorbid psychological problems, coparenting, child behavior).
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Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany.
| | | | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany
| | - Jana Volkert
- Department of Psychology, MSB Medical School Berlin, Germany
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Altamura M, Leccisotti I, De Masi L, Gallone F, Ficarella L, Severo M, Biancofiore S, Denitto F, Ventriglio A, Petito A, Maruotti G, Nappi L, Bellomo A. Coping as a Mediator between Attachment and Depressive Symptomatology Either in Pregnancy or in the Early Postpartum Period: A Structural Equation Modelling Approach. Brain Sci 2023; 13:1002. [PMID: 37508934 PMCID: PMC10377438 DOI: 10.3390/brainsci13071002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Peripartum depression (PPD) is a major complication of pregnancy, and numerous risk factors have been associated with its onset, including dysfunctional coping strategies and insecure attachment styles, both during pregnancy and postpartum. The aim of our study was to investigate the role of coping strategies in mediating the relationship between women's attachment style and depressive symptomatology in pregnancy and one week after giving birth in a large sample of women (N = 1664). Our hypothesis was that the relationship between anxious and avoidant attachment and depressive symptomatology would be mediated by use of maladaptive coping strategies. The assessment instruments were Edinburgh Postnatal Depression Scale (EPDS), Brief Coping Orientation for Problem Experiences (COPE), and Experiences in Close Relationship Scale (ECR). The results indicated that the effect of insecure attachment styles (anxious and avoidant attachment) on antepartum depressive symptomatology was partially mediated by dysfunctional coping styles. Anxious attachment also has an indirect significant effect on postpartum depressive symptomatology through emotional coping; however, avoidant attachment does not seem to be significantly related to postpartum depressive symptoms. Our findings revealed that not only is it important to consider attachment in understanding peripartum depressive symptomatology, but also that coping plays an important role in these relationships. These findings would help a preventive coping-based intervention strategy to enhance the capacity of women with insecure attachment styles to use more adaptive coping during and after pregnancy.
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Affiliation(s)
- Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Ivana Leccisotti
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Laura De Masi
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Fiammetta Gallone
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Livia Ficarella
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Melania Severo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Simona Biancofiore
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Francesca Denitto
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Giuseppe Maruotti
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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19
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Arikan G, Ustundag-Budak AM, Toz N, Senturk G. Do Turkish mothers' emotion regulation, psychological symptoms and caregiving helplessness vary based on attachment states of mind? Attach Hum Dev 2023; 25:417-436. [PMID: 37265061 DOI: 10.1080/14616734.2023.2219657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/26/2023] [Indexed: 06/03/2023]
Abstract
Mothers' emotion regulation, mental health, and feeling of helplessness in caring for their child may vary based on maternal attachment classifications. Particularly, insecure attachment and unresolved state of mind can act as risk factors. Therefore, we examined how emotion regulation strategies of suppression and cognitive reappraisal, maternal symptoms of depression and anxiety, and caregiving helplessness differ based on maternal attachment classifications in the Adult Attachment Interview (AAI). Fifty mothers of children in the early childhood (AgeRange = 12-56 months) completed a pack of questionnaires, including Emotion Regulation Questionnaire, Brief Symptom Inventory, and Caregiving Helplessness Questionnaire. Then AAI interview protocol was administered and coded. Mothers did not vary in emotion regulation strategies, indicating emotion regulation balance. However, mothers with secure/autonomous AAIs reported less anxiety than mothers whose AAIs were judged to show unresolved loss or unresolved trauma. The mothers who provided AAIs judged to be secure/autonomous scored lower in depression and caregiving helplessness than mothers whose AAIs were judged to show unresolved loss or unresolved trauma. To our knowledge, this is one of the first studies conducting AAI in Turkish mothers. We revealed the critical role of secure attachment for mental health and caregiving helplessness that can facilitate interventions targeting maternal attachment mind state.
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Affiliation(s)
- Gizem Arikan
- Department of Psychology, Ozyegin University, Istanbul, Turkey
| | | | - Naz Toz
- Counseling Services, Bilgi University, Istanbul, Turkey
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20
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Galbally M, Watson S, Lewis AJ, Power J, Buus N, van IJzendoorn M. Maternal attachment state of mind and perinatal emotional wellbeing: Findings from a pregnancy cohort study. J Affect Disord 2023; 333:297-304. [PMID: 37062497 DOI: 10.1016/j.jad.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. METHODS This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). LIMITATIONS Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. CONCLUSIONS This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing.
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Affiliation(s)
- Megan Galbally
- School of Health Sciences, Monash University, Australia; Health Futures Institute, Murdoch University, Australia; Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, UK.
| | - Stuart Watson
- School of Health Sciences, Monash University, Australia; Health Futures Institute, Murdoch University, Australia
| | - Andrew J Lewis
- Institute of Health and Wellbeing, Federation University, Australia
| | | | - Niels Buus
- School of Nursing and Midwifery, Monash University, Australia; Department of Regional Health Research, University of Southern Denmark, Denmark
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21
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Whittington D. Disorganized attachment in emerging adulthood: Measurement comparisons and relations to childhood maltreatment and emotion dysregulation. FAMILY PROCESS 2023. [PMID: 36740785 DOI: 10.1111/famp.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 01/06/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
There is an abundance of research examining disorganized attachment in childhood. However, few researchers have worked to advance the study of disorganized attachment in the context of emerging adult romantic relationships. As such, consistent and clear measurement of this attachment dimension is lacking. In the current study, emerging adult college students (N = 318) completed two previously designed self-report measures for assessing adult disorganized attachment in the context of romantic relationships. The two scales were compared in a factor analytic framework to create a single cohesive measure of romantic disorganized attachment, which captures the unique features of disorganized attachment, including fear, distrust and suspicion of attachment figures, as well as odd and disoriented behaviors. The result was a 15-item measure, which showed good reliability and factorial validity, and was moderately related to existing measures of attachment anxiety and avoidance. Additionally, the new measure demonstrated good test-retest reliability in a follow-up (n = 52). Finally, path analysis was used to provide evidence that disorganized attachment mediates the relation of childhood maltreatment to difficulties in emotion regulation, above what is captured by anxious and avoidant attachment. The current findings suggest the revised measure is a reliable self-report measure of disorganized adult romantic attachment to be used to further the study of disorganized attachment in emerging adulthood.
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Yu S, Zhang C, Wang Y, Liu T, Chen X, Guo J, Zhang G, Xu W. Parental neglect, anxious attachment, perceived social support, and mental health among Chinese college students with left-behind experience: A longitudinal study. Psych J 2023; 12:150-160. [PMID: 36223893 DOI: 10.1002/pchj.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
The harm of childhood parental neglect to emerging adults' maladjustment has garnered empirical support. For college students who have left-behind experience (LBE), this relationship is rarely discussed and the psychological process underlying this relationship is not well understood. Using a longitudinal study and guided by the Risky Families model, this study aimed to explore the mediating roles of anxious attachment and perceived social support in the link between parental neglect and maladjustment of LBE college students. We used two-wave longitudinal data, with a time lag of 3 months, collected among Chinese college students with LBE in Chongqing (N = 391). The results revealed that parental neglect in wave one was positively associated with maladjustment (depression, anxiety, and stress) in wave two. Anxious attachment and perceived social support in wave two separately mediated the relationship between parental neglect in wave one and maladjustment in wave two. Anxious attachment and perceived social support in wave two only sequentially mediated the pathway from parental neglect to later depression. These findings emphasize the importance of anxious attachment and social support in resilience and have significant implications for LBE college students' social work practice in China.
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Affiliation(s)
- Si Yu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Chunyang Zhang
- China Academy of Civil Aviation Science and Technology, Beijing, China
| | - Yi Wang
- Department of Linguistics, University of Victoria, Victoria, Canada
| | - Tianyuan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiaoxi Chen
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jiaxin Guo
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Gaozheng Zhang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China.,School of Psychology, Nanjing Normal University, Nanjing, China
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23
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Emran A, Iqbal N, Dar KA. Attachment orientation and depression: A moderated mediation model of self-silencing and gender differences. Int J Soc Psychiatry 2023; 69:173-181. [PMID: 35102764 DOI: 10.1177/00207640221074919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While the effect of insecure attachment on depression is well established, findings pertaining to the relationship between specific attachment dimensions (anxious and avoidant) and depression are inconsistent. The role of interpersonal factors underlying this effect has been little explored. 'Silencing the Self', a socio-cognitive construct may provide important insights as a mediating pathway from insecure attachment to depression and help resolve the inconsistencies. AIMS The present study explored the mediating effect of self-silencing and the role of gender as a moderator in the relation between insecure attachment orientation (i.e. avoidant and anxious) and depressive symptoms. METHOD Data was collected via an online survey, from 121 adults who were in a relationship. The participants were asked to complete three self-report questionnaires, assessing attachment orientation, silencing the self and depressive symptoms. Moderated mediation analysis was performed using conditional process analysis. RESULTS The results indicated that the effect of both insecure attachment dimensions on depressive symptoms was mediated by silencing the self. In addition, gender moderated the association between insecure attachment and self-silencing. CONCLUSIONS This study adds to the literature on mediating pathways between insecure attachment and depression, and provides a new perspective for therapeutic interventions in the context of depression. It indicates that professionals should focus on current social context and relational schemas of individuals with an insecure attachment, especially women, while treating cases of depression in clinical settings.
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Affiliation(s)
- Ashti Emran
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | - Naved Iqbal
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | - Kaiser Ahmad Dar
- Department of Psychology, Government Degree College, Baramulla, Jammu and Kashmir, India
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Hippocampal volume and parahippocampal cingulum alterations are associated with avoidant attachment in patients with depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lee JYS, Whittingham K, Mitchell AE. Childhood experiences of being parented, adult attachment, psychological inflexibility, social engagement, and mental health of autistic adults. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 130:104343. [PMID: 36152473 DOI: 10.1016/j.ridd.2022.104343] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/15/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Autistic adults have an increased risk of poor mental health. Although parental care and overprotection in childhood influence later attachment and mental health in the general adult population, this has not been investigated in the autistic population. Likewise, the roles of psychological inflexibility and social engagement in influencing mental health outcomes for autistic adults have yet to be examined. AIMS To examine if retrospectively recalled childhood experiences of parental care and overprotection, as well as current adult attachment, psychological inflexibility and social engagement are associated with mental health in autistic adulthood. Further, to examine mediators of the association between parental care and overprotection and mental health in autistic adults. METHODS AND PROCEDURES A community-recruited convenience sample of 126 Australian autistic adults completed an online survey assessing childhood experiences of parental care and overprotection and current adult attachment, psychological inflexibility, social engagement, and mental health. OUTCOMES AND RESULTS Linear regressions showed that psychological inflexibility was the strongest predictor of depression, anxiety, and stress, followed by attachment anxiety (depression, anxiety) and attachment avoidance (anxiety, stress). Mediation analyses revealed that psychological inflexibility and attachment anxiety mediated the associations between parental care and overprotection and mental health outcomes in autistic adulthood. CONCLUSIONS AND IMPLICATIONS Psychological inflexibility and adult attachment (anxious and avoidant attachment) are important to understanding mental health of autistic adults. Psychological inflexibility and attachment anxiety mediate associations between recalled childhood experiences of parental care and overprotection and mental health in autistic adulthood.
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Affiliation(s)
- Jia Ying Sarah Lee
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Amy E Mitchell
- School of Psychology, The University of Queensland, Brisbane, Australia; School of Nursing and Midwifery, Griffith University, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Talia A, Taubner S, Miller-Bottome M, Muurholm SD, Winther A, Frandsen FW, Harpøth T, Onofri A, Kongerslev MT, Simonsen S, Poulsen S, Duschinsky R. The in-session discourse of unresolved/disorganized psychotherapy patients: An exploratory study of an attachment classification. Front Psychol 2022; 13:985685. [PMID: 36275246 PMCID: PMC9581270 DOI: 10.3389/fpsyg.2022.985685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022] Open
Abstract
The Unresolved/disorganized (U/d) attachment classification has generated considerable interest among clinicians. This is in part based on its empirical associations with adult mental health, parenting practices, and treatment outcomes. Despite decades of theorizing, however, we have little empirical information regarding how patients with a U/d classification assigned by accredited coders actually behave or speak in psychotherapy sessions. Here, we take a step towards bridging this gap by reporting our observations of the psychotherapy session transcripts of 40 outpatients who were independently classified as U/d on the Adult Attachment Interview (AAI), the gold standard measure of adult attachment research. These patients were extracted from a larger sample of 181 and compared to others without a U/d classification. In this paper, we discuss two different discourse styles associated with a U/d classification. Some U/d patients did not seem to sufficiently elicit the therapist's endorsement of what they said. For example, they did not justify their claims with examples or explanations, or did not consider others' intentions or experiences. Other U/d patients were credible, but left the listener uncertain as to the underlying point of their discourse, for example, by glaringly omitting the consequences of their experiences, or interrupting their narratives mid-way. In the discussion, we place these observations in the context of recent thinking on attachment and epistemic trust, and discuss how this study may form the basis for future quantitative studies of psychotherapy.
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Affiliation(s)
- Alessandro Talia
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Svenja Taubner
- Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg,
Germany
| | | | | | - Anna Winther
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Tine Harpøth
- Department of Psychiatry Mental Health Services East, Region Zealand, Roskilde, Denmark
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Antonio Onofri
- School of Specialization in Psychotherapy Training School of Rome and Jesi, Rome, Italy
| | - Mickey T. Kongerslev
- Department of Psychiatry Mental Health Services East, Region Zealand, Roskilde, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Sebastian Simonsen
- Stolpegaard Psychotherapy Centre Mental Health Services, Capital Region of Denmark, Gentofte, Denmark
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Robbie Duschinsky
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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The effect of attachment style on long-term outcomes in psychogenic nonepileptic seizures: Results from a prospective study. Epilepsy Behav 2022; 135:108890. [PMID: 36037581 DOI: 10.1016/j.yebeh.2022.108890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Insecure and fearful attachment styles have been reported in psychogenic nonepileptic seizures (PNES). We have investigated associations between long-term clinical outcome in PNES, parenting and attachment styles and demographic, clinical, and neuropsychiatric factors. MATERIAL AND METHODS Patients aged at least 16 years and with documented PNES, according to criteria from the International League Against Epilepsy, were prospectively recruited to this study. They were assessed at baseline to determine clinical characteristics, experience of attachment and perceptions of experienced parenting styles, trauma history, dissociation, and health-related quality of life. At a mean of 70.45 (SD 29.0, range 22-130) months after inclusion, participants were contacted by telephone and asked about their current medical status and psychiatric/psychological interventions. RESULTS Of 53 patients included in the study, 51 (96 %) provided follow-up data. Most (84.9 %) patients were female, and the mean age of PNES onset was 25.6 years. At follow-up, 20 patients (39 %) were free of PNES. Those patients that had achieved PNES freedom at follow-up had lower levels of attachment anxiety (p = 0.01) and reported to have experienced their fathers as less controlling (p = 0.02) and their mothers as more caring (p = 0.04) at baseline compared with those patients still suffering from PNES. Seizure freedom at follow-up was predicted by male gender, younger age at PNES onset, and less attachment anxiety. CONCLUSION In our cohort from a tertiary epilepsy center the long-term prognosis of PNES is poor. Attachment anxiety is a risk factor for persistent PNES. It may be of therapeutic relevance to assess attachment patterns in patients with PNES.
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The responses of soil organic carbon and total nitrogen to chemical nitrogen fertilizers reduction base on a meta-analysis. Sci Rep 2022; 12:16326. [PMID: 36175419 PMCID: PMC9522798 DOI: 10.1038/s41598-022-18684-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/17/2022] [Indexed: 11/09/2022] Open
Abstract
Soil organic carbon (SOC), total nitrogen (TN), and their ratio (C:N) play important roles in preserving soil fertility, and their values are closely related to fertilizer use. However, the overall trend and magnitude of changes in SOC, TN and C:N in response to chemical nitrogen fertilizers reduction remain inconclusive. Here, the meta-analysis conducted comparisons at 48 sites covering various cropping system, soil type, and climatic regions of China to investigate the responses of SOC, TN and C:N to chemical nitrogen fertilizers reduction. The results showed that chemical nitrogen fertilizers reduction decreased SOC by 2.76 ± 0.3% and TN by 4.19 ± 0.8%, and increased the C:N by 6.11 ± 0.9% across all the database. Specifically, the reduction of chemical nitrogen without adding organic nitrogen fertilizers would reduce SOC and TN by 3.83% and 11.46% respectively, while they increased SOC and TN by 4.92% and 8.33% respectively with organic fertilizers supplement, suggesting that organic fertilizers could cover the loss of SOC, TN induced by chemical nitrogen fertilizers reduction. Medium magnitude (20-30%) of chemical nitrogen fertilizers reduction enhanced SOC by 6.9%, while high magnitude (≧30%) and total (100%) of chemical nitrogen fertilizers reduction significantly decreased SOC by 3.10% and 7.26% respectively. Moreover, SOC showed a negative response to nitrogen fertilizers reduction at short-term duration (1-2 years), while the results converted under medium-long-termThis system analysis fills the gap on the effects of fertilizer reduction on soil organic carbon and nitrogen at the national scale, and provides technical foundation for the action of reducing fertilizer application while increase efficiency.
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Brown CC, Durtschi JA, Rosenkranz S, Yorgason J, Topham G, McPhee D. Attachment, Depression, and Health: A Longitudinal Analysis of Those with A Chronic Disease. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-022-09647-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Depressive symptoms and attachment with mother and father in Iranian young adults: The mediating role of reflective functioning and loneliness. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Climate Change Related Depression, Anxiety and Stress Symptoms Perceived by Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159142. [PMID: 35897512 PMCID: PMC9332784 DOI: 10.3390/ijerph19159142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022]
Abstract
Climate change has drastic consequences on human physical and mental health. However, research on the psychological effects of climate change awareness is still inconclusive. To examine the mental burden posed by climate change awareness and potential resilience factors, n = 203 medical students were surveyed about their awareness of the implications of climate change. Furthermore, well-established mental health questionnaires (PHQ-9, GAD-7, PTSS-10, PSQ-20) were presented twice, in their original form and in a modified version to specifically ask about the respective psychological burden regarding climate change. For identification of potential resilience factors, measures for attachment style (RQ), structural abilities (OPD-SF), and sense of coherence (SOC-13) were used. The results of our study suggest that medical students in Germany have an increased risk to suffer from mental health problems and predominantly experience significant perceived stress in regard to climate change. However, the reported stress does not yet translate into depressive, anxious, or traumatic symptoms. Climate-related perceived stress correlates negatively with potential resilience factors preventing the development of mental disorders such as attachment style, structural abilities, and sense of coherence.
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Childhood maltreatment and depressive symptoms among Chinese college students: A moderated mediation model of adult attachment styles and physical activity. J Affect Disord 2022; 309:63-70. [PMID: 35461818 DOI: 10.1016/j.jad.2022.04.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/13/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous research has investigated the independent effects of childhood maltreatment, adult attachment, and physical activity, on depressive symptoms. However, explanatory mechanisms linking childhood maltreatment to current depressive symptoms are poorly understood. This study investigated the mediating role of adult attachment between childhood maltreatment and depressive symptoms among college students and explored the moderating effect of physical activity in the mediating pathway. METHODS The data for the present study were gathered in three waves with 6-month lags. A total of 3662 Chinese college students completed anonymous questionnaires concerning demographic variables, childhood maltreatment, and depressive symptoms in Wave 1, adult attachment and physical activity in Wave 2, and depressive symptoms in Wave 3. RESULTS Childhood maltreatment and adult attachment were significantly associated with depressive symptoms, identifying a mediating role of adult attachment in the relationship between childhood maltreatment and depressive symptoms, and a moderating role of physical activity between attachment anxiety and depressive symptoms in the mediating pathway. LIMITATIONS This study utilized self-reported questionnaires for data collection purposes, which could constitute key study limitations. CONCLUSIONS These findings highlight the need to consider early stress factors (childhood maltreatment), social psychological factors (adult attachment), and potential protective factors (physical activity) simultaneously when evaluating the occurrence and development of depressive symptoms.
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Békés V, Aafjes-Van Doorn K. Patients’ attachment avoidance and their perceived quality of the real relationship predict patients’ attitudes towards telepsychotherapy. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2075324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
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Wendołowska A, Steć M, Czyżowska D. Supportive, Delegated, and Common Dyadic Coping Mediates the Association between Adult Attachment Representation and Relationship Satisfaction: A Dyadic Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8026. [PMID: 35805682 PMCID: PMC9266237 DOI: 10.3390/ijerph19138026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
The aim of this study was to examine intrapersonal (actor) and interpersonal (partner) associations between attachment, assessed by the Adult Attachment Interview, and satisfaction with the relationship, as well as to establish the possibility of the mediatory effect of supportive, delegated, and common dyadic coping on the aforementioned associations. A dyadic approach has been introduced, using the actor-partner interdependence mediation model and data from 114 heterosexual couples, aged 26 to 60. It has been shown that one's own secure attachment can be perceived as the predictor of one's own relationship satisfaction in women and men and the predictor of a partner's relationship satisfaction in men. The findings support the partially mediating role of dyadic coping in the association between attachment and relationship satisfaction and are a significant contribution to the issue of dyadic coping in general. Adults' secure representations of their childhood experiences may be effective in using their partners as a secure base and also in serving as a secure base themselves, but it is not the sole influence on the quality of the couple's experience together. The we-ness phenomenon and resulting clinical implications were discussed.
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Affiliation(s)
- Anna Wendołowska
- Institute of Psychology, Jagiellonian University, 30-060 Kraków, Poland;
| | - Małgorzata Steć
- Institute of Psychology, Jesuit University Ignatianum, 26 Kopernika Street, 31-501 Kraków, Poland;
| | - Dorota Czyżowska
- Institute of Psychology, Jagiellonian University, 30-060 Kraków, Poland;
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Yao J, Lin Q, Zheng Z, Chen S, Wang Y, Jiang W, Qiu J. Characteristics of implicit schemas in patients with major depressive disorder. Gen Psychiatr 2022; 35:e100794. [PMID: 35866002 PMCID: PMC9240893 DOI: 10.1136/gpsych-2022-100794] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/02/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many psychotherapy theories emphasise the importance of self-schema and other-schema, but most previous studies focused on the explicit self-schema in major depressive disorder (MDD). However, the limited studies of implicit self-schema in MDD have shown inconsistencies in their findings. Furthermore, only a few studies have investigated the implicit other-schema, and the pathway illustrating how implicit schemas influence depression remains unclear. Aims The primary aim of our study was to explore the characteristics of implicit self-schema and other-schema in patients with MDD. We also examine the chain-mediating effect of attachment relationships and interpersonal trust. Methods The present study included 88 patients with MDD and 88 healthy controls (HCs). The Hamilton Depression Rating Scale-17, Experiences in Close Relationships Inventory-Revised Questionnaire, Trust Scale and the Extrinsic Affective Simon Task (EAST) were used to assess depressive symptoms, attachment relationships, interpersonal trust and implicit schemas, respectively. Paired sample t-test was used to compare the reaction time (RT) for positive and negative words within the two groups. Analysis of covariance was used to explore the difference between two groups from the perspective of implicit schemas and interpersonal patterns. The chain mediation model was verified by bootstrap. Results (1) For interpersonal patterns, patients with MDD scored significantly higher on attachment anxiety (F=82.150, p<0.001) and attachment avoidance (F=23.192, p<0.001) and scored significantly lower on the predictability (F=30.297, p<0.001), dependence (F=39.728, p<0.001) and faith (F=60.997, p<0.001) dimensions of interpersonal trust. (2) As for implicit schemas, no significant difference was found between the RT for positive self-words and negative self-words in patients with MDD (t=-1.056, p=0.294). However, the HC responded faster to positive self-words than negative self-words (t=-3.286, p=0.001). The RT for positive other-words and negative other-words were significantly different in both patients with MDD (t=2.943, p=0.004) and HCs (t=-2.482, p=0.015), with opposite directions. The EAST effect of other-schema in patients with MDD was significantly different from that in HCs (F=13.051, p<0.001). (3) For the total sample, the EAST effect of other-schema significantly correlated with attachment avoidance, interpersonal trust and depressive symptoms. Attachment avoidance and interpersonal trust were the chain mediators between the EAST effect of other-schema and depressive symptoms (95% CI: -0.090 to -0.008). However, no significant results were found for the EAST effect of other-schema when correlation and mediation analyses were performed for HCs and patients with MDD separately. Conclusions This study verified that patients with MDD have abnormal interpersonal patterns and negative implicit schemas. However, no mediating effect of attachment relationships and interpersonal trust was found.
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Affiliation(s)
- Jiayu Yao
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingqing Lin
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ziwei Zheng
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyi Chen
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Wang
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenhui Jiang
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Department of Psychological Counseling & Psychotherapy, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Stern JA, Jones JD, Nortey B, Lejuez CW, Cassidy J. Pathways linking attachment and depressive symptoms for Black and White adolescents: do race and neighborhood racism matter? Attach Hum Dev 2022; 24:304-321. [PMID: 34528475 PMCID: PMC8924014 DOI: 10.1080/14616734.2021.1976924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Decades of evidence demonstrate that insecure attachment is associated with increased risk for depressive symptoms. Yet research has focused on predominantly White samples, with little attention to whether developmental pathways vary by social-contextual factors like racial identity and neighborhood racism. This study examines whether longitudinal links between attachment style and depressive symptoms differ for White and Black American adolescents or by exposure to neighborhood racism (N = 171, Mage at Time 1 = 14 years). Multigroup measured variable path analyses controlling for gender and household income revealed that attachment avoidance predicted relative increases in depressive symptoms for White adolescents, but not for Black adolescents. Links between attachment style and depressive symptoms did not differ based on exposure to neighborhood racism. Experiences of neighborhood racism were associated with greater attachment avoidance but not anxiety. Results highlight the importance of examining attachment in different socioecological contexts to illuminate the unique pathways characterizing Black youth development.
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Affiliation(s)
| | - Jason D. Jones
- Children’s Hospital of Philadelphia
- University of Pennsylvania Perelman School of Medicine
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Cortés-García L, Martínez Calvo C, Senra C. Mediational Effect of Fairburn's Transdiagnostic Mechanisms Between Attachment to the Mother and Eating Disorder Symptoms in a Clinical Sample. Front Psychol 2022; 13:852977. [PMID: 35519625 PMCID: PMC9062175 DOI: 10.3389/fpsyg.2022.852977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Research has supported a link between insecure attachment and eating disorders (EDs); however, little is known about how this influence is exerted in young female EDs patients. This study tested, for the first time, a multiple mediational model, wherein the four Fairburn’s transdiagnostic mechanisms mediated the relationship between attachment to the mother and ED symptoms. Methods A total of 101 female young EDs patients aged 15–24 were administered the Inventory of Parent and Peer Attachment, Eating Disorder Inventory-3 and Eating Attitudes Test-26 to assess attachment, the four transdiagnostic maintaining mechanisms and ED symptoms, respectively. Results Comparison analyses showed that there were no significant differences between the diagnostic groups in terms of attachment and the transdiagnostic variables. Multiple mediational analyses indicated that low self-esteem and clinical perfectionism were significant mediators between insecure attachment to the mother and ED symptoms, while controlling for depressive symptoms. Conclusion These findings suggest that the distal risk influence of insecure attachment to the mother in the development of ED symptoms might be explained by low self-esteem and high clinical perfectionism, controlling for depressive symptoms. Further investigation into the efficacy of cognitive-behavioral treatments targeting insecure attachment representations for young EDs patients is recommended.
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Affiliation(s)
- Laura Cortés-García
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Carmen Martínez Calvo
- Unit of Eating Disorders, Provincial Hospital of Conxo, Santiago de Compostela, Spain
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Castellini G, Tarchi L, Cassioli E, Rossi E, Sanfilippo G, Innocenti M, Gironi V, Scami I, Ricca V. Attachment Style and Childhood Traumatic Experiences Moderate the Impact of Initial and Prolonged COVID-19 Pandemic: Mental Health Longitudinal Trajectories in a Sample of Italian Women. Int J Ment Health Addict 2022; 21:1-20. [PMID: 35316933 PMCID: PMC8929455 DOI: 10.1007/s11469-022-00798-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 12/03/2022] Open
Abstract
The impact of the COVID-19 pandemic on mental health has not been clarified yet, with multiple studies warranting a special focus on women and young adults. A sample of 101 Italian women recruited from the general population was evaluated a few weeks before the onset of the pandemic and during the first and the second wave of the pandemic. Depression values at the Brief Symptom Inventory showed an initial increase followed by a stabilization on higher values in respect to the baseline, whereas Phobic Anxiety was stably worsened. Participants with insecure attachment styles and childhood trauma showed higher levels of distress at all timepoints. In many psychopathological domains, moderation analysis showed an unfavorable trend over time for younger participants. The present study seems to confirm a high burden on mental health for women during the COVID-19 pandemic, highlighting young age, insecure attachment style, and childhood trauma as negative prognostic factors.
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Affiliation(s)
- Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
- Padiglione 8b, Cliniche Chirurgiche Primo Piano, AOU Careggi, Viale della Maternità, 50134 Firenze, FI Italy
| | - Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giulia Sanfilippo
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Matteo Innocenti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Veronica Gironi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Irene Scami
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Tan TX, Liu Y, Zhang Q, Li G, Chen X, Li J. Affective Representation of Early Relationships with Parents and Current Anxiety and Depression. The Journal of Genetic Psychology 2022; 183:235-249. [PMID: 35220918 DOI: 10.1080/00221325.2022.2043231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Research on the role of early relationships with parents on youth's anxiety and depression, especially in collectivist societies such as China, is limited. To fill this gap, we investigated the unique role of early relationship with mothers and fathers, respectively, in Chinese youth's anxiety and depression outcomes. The participants were 347 Chinese college students from 20 provinces. They first separately rated the frequency of experiencing 13 emotions (e.g., anger) from recalling early relationships with their mothers and fathers, then completed the Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale. Logistic regression was performed to determine the unique contribution of early relationships with mothers and fathers, respectively, to the participants' clinical-level anxiety and depression. Based on the final model of our logistical regression, we found that an increase in negative affective representation of early relationship with the mother was associated with a higher likelihood of clinical level anxiety (OR = 3.58; 95% CI = 1.32-9.70), while an increase in positive affective representation of early relationship with the mother was associated with a lower likelihood of clinical-level depression (OR = 0.47; 95% CI = 0.25-0.87). Furthermore, an increase in negative affective representation of early relationship with the father was associated with a higher likelihood of clinical-level anxiety (OR = 3.36; 95% CI = 1.37-8.26) and depression (OR = 3.68; 95% CI = 1.59-8.52), above and beyond their affective representation of early relationship with the mother.
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Affiliation(s)
- Tony Xing Tan
- Educational and Psychological Studies, University of South Florida, Tampa, USA
| | - Yanhong Liu
- Department of Counseling & Human Services, Syracuse University, Syracuse, USA
| | - Qiumei Zhang
- School of Public Health, Jining Medical University, Jining, China
| | - Gen Li
- Educational and Psychological Studies, University of South Florida, Tampa, USA
| | - Xiongying Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & the Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, School of Mental Health, Capital Medical University, Beijing, China
| | - Jun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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Brandão T, Brites R, Hipólito J, Nunes O. Perceived emotional invalidation, emotion regulation, depression, and attachment in adults: A moderated-mediation analysis. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02809-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nowalis S, Godleski SA, Schenkel LS. Attachment as a Moderator in the Relation Between Child Maltreatment and Symptoms of Depression. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1516-NP1543. [PMID: 32532172 DOI: 10.1177/0886260520933050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Experiencing child maltreatment is a risk factor for later psychopathology; however, not all survivors of child maltreatment go on to develop mental health diagnoses. There are likely important risk factors that act as moderators interacting with child maltreatment to contribute to the development of psychopathology. The present study examined the attachment dimensions of anxiety and avoidance as potential moderators in the association between child maltreatment and depressive symptomatology in a sample of college students. An attachment style high in anxiety or avoidance was expected to exacerbate the effect of child maltreatment on depressive symptomatology across both primary and secondary caregiver attachment relationships. This study was conducted at a private university in the northeastern United States in a sample of college students (N = 203; 52% male; Mage = 19.85, SDage = 2.19). Participants completed online measures of attachment, current mood symptoms, and demographic information. Two moderation models were tested, one for attachment to primary caregivers and one for attachment to secondary caregivers. Anxious attachment to primary caregivers moderated the relationship between child maltreatment and depressive symptoms (B = -0.16, p < .01, R2 =.44). However, moderation was not significant in the secondary caregiver attachment relationship. Maladaptive attachment styles, as well as child maltreatment itself, may result in disruptions in the development of positive internal working models of the self and others and adaptive emotion regulation. In cases of child maltreatment, interventions focused on the parent-child attachment relationship may have long-lasting effects and implications for the child's future mental health. This research highlights important areas of intervention in cases of child maltreatment as well as important differences in the anxiety and avoidance dimensions of attachment.
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Affiliation(s)
- Sarah Nowalis
- University at Buffalo, The State University of New York, USA
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Dupont K, Gervai J, Danis I, Tóth I, Koren R, Török S. Factor Structure, Psychometric Properties, and Validation of the Hungarian Version of the Experiences in Close Relationships Revised (ECR-R-HU) Questionnaire in a Nationally Representative Community Sample. J Pers Assess 2022; 104:747-758. [DOI: 10.1080/00223891.2021.2019054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kinga Dupont
- Mental Health Sciences Doctoral School, Semmelweis University, Budapest, Hungary
| | - Judit Gervai
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Ildikó Danis
- Faculty of Health and Public Services, Institute of Mental Health, Semmelweis University, Budapest, Hungary
| | - Ildikó Tóth
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Réka Koren
- Mental Health Sciences Doctoral School, Semmelweis University, Budapest, Hungary
| | - Szabolcs Török
- Faculty of Health and Public Services, Institute of Mental Health, Semmelweis University, Budapest, Hungary
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43
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Krámská L, Hrešková L, Krámský D, Vojtěch Z. Attachment style of patients diagnosed with psychogenic non-epileptic seizures at a tertiary Epilepsy Center in the Czech Republic. Front Psychiatry 2022; 13:1065201. [PMID: 36465292 PMCID: PMC9712441 DOI: 10.3389/fpsyt.2022.1065201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Quality and type of early relationships with primary caregivers is considered one of the key factors in the etiopathogenesis of many mental disorders including depression, anxiety, and conversion disorders. This study focused on the type and quality of attachment style in adult patients with psychogenic non-epileptic seizures (PNES). MATERIALS AND METHODS We evaluated the demographic data and profiles of PNES patients (n = 262) and group of healthy volunteers (n = 51) measured by the Parental Bonding Inventory (PBI) and Experiences in Close Relationships (ECR) and Experiences in Close Relationships-Relationship Structure (ECR-RS). RESULTS Significant differences in measured values between the two groups were identified; specifically, differences in the caregiver style-father and mother overprotection (PBI) was higher in the PNES group. The most frequent type of attachment in PNES was type 2 (preoccupied). Correlations between the PBI and ECR results were also found. CONCLUSION This study highlighted certain attachment styles in patients with PNES and statistically significant differences between patients with PNES and a healthy sample. Some correlations between the results of the questionnaires with socio-demographic factors were found. The identification of specific patterns in attachment may be useful for further use in reaching a differential diagnosis and administering tailored psychotherapy of patients with PNES.
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Affiliation(s)
- Lenka Krámská
- Department of Clinical Psychology, Na Homolce Hospital, Prague, Czechia.,Epilepsy Center, Na Homolce Hospital, Prague, Czechia
| | - Lucia Hrešková
- Kúpele pre dušu, s.r.o., Bardejov Spa, Bardejov, Slovakia
| | - David Krámský
- Department of Social Science, Police Academy, Prague, Czechia
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44
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Jang S, Choi SW, Ahn R, Lee JY, Kim J, Seok JH. Relationship of Resilience Factors With Biopsychosocial Markers Using a Comprehensive Home Evaluation Kit for Depression and Suicide Risk: A Real-World Data Analysis. Front Psychiatry 2022; 13:847498. [PMID: 35711598 PMCID: PMC9196636 DOI: 10.3389/fpsyt.2022.847498] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 04/14/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) are fundamental factors in developing depression with increased suicide risk. Resilience is considered an important protective factor that can prevent trauma survivors from developing depression. We developed a home evaluation kit for a comprehensive assessment of bio-psycho-social factors related to depression and suicide. This kit contained a psycho-social evaluation battery, named the Protective and Vulnerable factors battery questionnaire (PROVE) comprising depressive symptoms and suicide risk, as well as various depression-related psychosocial factors, such as ACE, resilience, mentalization capacity, and attachment, via online survey tools. Furthermore, salivary cortisol levels were used as biological indicators to assess the hypothalamus-pituitary-adrenal axis function. METHODS Real-world data analysis was made out of data collected from participants who visited CHEEU Counseling center or Gangnam Severance hospital for mental health check-ups. The participants were put into three mental state groups (green-normal, yellow-borderline, and red-risk) depending on the result of PROVE battery. The difference between psychosocial factors and salivary cortisol indicators by the group was identified by analysis of covariance with sex and age as covariates. Linear regression analysis was conducted to find a significant association of resilience score with other bio-psycho-social variables, such as ACE, attachment, mentalization, or post-awakening cortisol concentrations (area under the curve with respect to ground, AUCg). A partial correlation analysis was performed to evaluate the relationship of AUCg with psychosocial factors. RESULTS Depression-related psycho-social indicators were significantly different among groups. Insecure attachment and the mentalization problem are negatively influencing factors to resilience. Furthermore, the severity of depression in participants with ACE was also influenced by mentalization problems. AUCg was different according to the PROVE group, presence of ACE, or resilience level. In addition, AUCg showed a positive correlation with resilience score but negative correlations with depressive symptoms, ACE, mentalization problems, and anxiety or avoidance attachment. CONCLUSION This study suggests that there are some key factors negatively affecting resilience: insecure attachment and mentalization problems. In groups with ACE, a mentalization problem was suggested as a factor that can increase depressive symptoms. AUCg was associated with resilience as well as several other vulnerable factors of depression, showing its potential as a promising biomarker.
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Affiliation(s)
- Sooah Jang
- Research Institute of Minds AI, Co. Ltd., Seoul, South Korea
| | - Sun-Woo Choi
- Research Institute of Minds AI, Co. Ltd., Seoul, South Korea
| | - Ryunsup Ahn
- Research Institute of Minds AI, Co. Ltd., Seoul, South Korea.,Institue of Behavioral Sciences in Medicine, College of Medicine, Yonsei University, Seoul, South Korea
| | - Ju-Yeal Lee
- Research Institute of Minds AI, Co. Ltd., Seoul, South Korea
| | - Joohan Kim
- Department of Communications, Yonsei University, Seoul, South Korea
| | - Jeong-Ho Seok
- Research Institute of Minds AI, Co. Ltd., Seoul, South Korea.,Institue of Behavioral Sciences in Medicine, College of Medicine, Yonsei University, Seoul, South Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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45
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Fischer-Kern M, Tmej A, Naderer A, Zimmermann J, Nolte T. Failure to resolve loss and compromised mentalizing in female inpatients with major depressive disorder. Attach Hum Dev 2021; 24:503-524. [PMID: 34952561 DOI: 10.1080/14616734.2021.2015794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Attachment and mentalizing are central concepts in research on the etiology, course, and treatment of depression. The goal of this cross-sectional study was to clarify the unique value of these constructs in characterizing the presence, severity, and chronicity of depression. We examined 50 female inpatients suffering from Major Depressive Disorder (MDD) in comparison to 47 matched healthy controls regarding their attachment states of mind, mentalizing capacities, and clinical variables indicating depression severity and chronicity (e.g. illness duration, number of hospitalizations). In the group of depressed patients, unresolved attachment with regard to loss was significantly overrepresented. Dimensionally, patients were more disorganized and more insecure, whereas there was no difference on the dismissing-preoccupied dimension between the two groups. Mentalizing was significantly lower in patients than in healthy controls. Logistic regression analysis revealed attachment insecurity, mentalizing deficits, and unresolved loss to be incrementally relevant to predict MDD. Correlations with clinical parameters in the group of depressed patients showed positive associations between mentalizing deficits, attachment insecurity, and variables indicating illness chronicity. Our findings highlight the relevance of the inability to resolve or reappraise loss experiences in depressive states.
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Affiliation(s)
- Melitta Fischer-Kern
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Anna Tmej
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Andrea Naderer
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | | | - Tobias Nolte
- University College London, Welcome Centre for Human Neuroimaging, Institute of Neurology, London, UK.,Anna Freud National Centre for Children and Families, UK
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46
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Herstell S, Betz LT, Penzel N, Chechelnizki R, Filihagh L, Antonucci L, Kambeitz J. Insecure attachment as a transdiagnostic risk factor for major psychiatric conditions: A meta-analysis in bipolar disorder, depression and schizophrenia spectrum disorder. J Psychiatr Res 2021; 144:190-201. [PMID: 34678669 DOI: 10.1016/j.jpsychires.2021.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/04/2021] [Accepted: 10/10/2021] [Indexed: 01/15/2023]
Abstract
Insecure attachment has been suggested as a major risk factor for mental health problems as well as a key element for the development and trajectory of psychiatric disorders. The aim of this meta-analysis was to assess whether insecure attachment constitutes a global transdiagnostic risk factor in bipolar disorder, depression, and schizophrenia spectrum disorders. We conducted a PRISMA-based systematic quantitative review to explore the prevalence of insecure attachment among patients of three representative psychiatric disorders - major depression, schizophrenia spectrum disorders and bipolar disorder - in comparison with healthy controls (HC) from a transdiagnostic point of view. Effect sizes on differences of anxious, avoidant and insecure prevalence were calculated based on 40 samples including a total of n = 2927 individuals. Overall, results indicated a large effect on prevalence of insecure attachment across all disorders compared to HC (k = 30, g = 0.88, I2 = 71.0%, p < 0.001). In a transdiagnostic comparison, the only difference was found in avoidant attachment, which was significantly lower (p = 0.04) compared to HC in the schizophrenia spectrum disorder subgroup (k = 10, g = 0.31, I2 = 76.60%, p < 0.0001) than the depression subgroup subgroup (k = 12, g = 0.83, I2 = 46.65%, p < 0.0001). The lack of further transdiagnostic differences between three distinct psychiatric disorders corroborates insecure attachment as a general vulnerability factor to psychopathology. Our findings warrant further investigations, which should explore the pathways from attachment insecurity towards psychopathology. Insecure attachment likely has implications on assessment, prediction and treatment of psychiatric patients.
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Affiliation(s)
- Simon Herstell
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Nußbaumstraße 7, 80336, Munich, Germany.
| | - Ruth Chechelnizki
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Laura Filihagh
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Linda Antonucci
- Department of Education, Psychology and Communication - University of Bari Aldo Moro, Piazza Umberto I, 1, 70121, Bari BA, Italy; Department of Basic Medical Sciences, Neuroscience and Sense Organs - University of Bari Aldo Moro, Piazza Umberto I, 1, 70121, Bari BA, Italy.
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
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47
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Tironi M, Charpentier Mora S, Cavanna D, Borelli JL, Bizzi F. Physiological Factors Linking Insecure Attachment to Psychopathology: A Systematic Review. Brain Sci 2021; 11:1477. [PMID: 34827476 PMCID: PMC8615918 DOI: 10.3390/brainsci11111477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/24/2022] Open
Abstract
Although many studies have documented associations between insecure attachment and psychopathology, attachment may not confer risk for psychopathology independently, but rather through its interaction with emotional, social, and biological factors. Understanding the variables through which attachment may lead to psychopathology is therefore important. Within this domain of research, the role of physiological factors is poorly investigated. What are the relevant domains and why, when, or for whom do they influence mental disorders relating to attachment? The current systematic review aims to answer these questions. Results reveal that physiological indices of emotional regulation play a role in explaining and/or determining the relationship between attachment and psychopathology. Specifically: (1) combined with insecure attachment, higher skin conductance level (SCL), lower cardiac slowing, and respiratory sinus arrhythmia modulation (RSA) contribute to different psychopathological indicators and behavioral/psychological dysfunctions, although the latter predicts a contradictory pattern of findings; (2) insecure-avoidant attachment is more consistently linked with stress and emotional dysregulation when combined with RSA, while anxious attachment confers risk of depressive symptoms when combined with SCL. We concluded our discussion of the results of seven studies by outlining a plan to move the field forward. We discuss the quality of the assessment, methodological limitations, and future directions, highlighting the need to extend the research to clinical samples.
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Affiliation(s)
- Marta Tironi
- Department of Educational Science, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy; (M.T.); (S.C.M.); (D.C.)
| | - Simone Charpentier Mora
- Department of Educational Science, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy; (M.T.); (S.C.M.); (D.C.)
| | - Donatella Cavanna
- Department of Educational Science, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy; (M.T.); (S.C.M.); (D.C.)
| | - Jessica L. Borelli
- Department of Psychology and Social Behavior, University of California, Irvine, CA 92697, USA;
| | - Fabiola Bizzi
- Department of Educational Science, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy; (M.T.); (S.C.M.); (D.C.)
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48
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Madsen EB, Smith-Nielsen J, Egmose I, Lange T, Vaever MS. The impact of childhood adversity on parenting stress is mediated by adult attachment and depressive symptoms. Scand J Psychol 2021; 63:47-54. [PMID: 34743339 DOI: 10.1111/sjop.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences can have far-reaching implications for later mental health, including in parenthood. Research suggests that childhood adversity is a risk factor for later parenting stress, yet the underlying mechanisms are only just being uncovered. Uncovering these mechanisms is important to diminish heightened levels of parenting stress and thereby reduce adverse effects of elevated parenting stress on child and parent outcomes. In a cross-sectional study using a sample of mothers of 2-10 month-old infants (N = 367) we first examined depressive symptoms as a mediator, and then, the indirect effect of adult attachment through depressive symptoms between childhood adversity and parenting stress. Results showed that the effect of childhood adversity on parenting stress was mediated by an indirect pathway through depressive symptoms alone, and an indirect pathway of adult attachment through depressive symptoms. The indirect effect of adult attachment through depressive symptoms was found to be stronger than the indirect effect of depressive symptoms alone, supporting the hypothesis that adult attachment insecurity together with depressive symptoms are particularly important risk factors to be considered in this relationship. Results suggest that childhood adversity is a risk factor for parenting stress, and not a determinant of later parenting stress per se. Instead, mediators in this association, adult attachment, and depressive symptoms, were identified as potential targets of intervention to prevent negative effects of childhood adversity on parenting stress. A limitation of the study lies in its cross-sectional design. Future studies should examine these associations longitudinally to allow for interpretation of causality.
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Affiliation(s)
- Eva Back Madsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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49
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Békés V, Aafjes-van Doorn K, Spina D, Talia A, Starrs CJ, Perry JC. The Relationship Between Defense Mechanisms and Attachment as Measured by Observer-Rated Methods in a Sample of Depressed Patients: A Pilot Study. Front Psychol 2021; 12:648503. [PMID: 34646189 PMCID: PMC8503562 DOI: 10.3389/fpsyg.2021.648503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Despite many theoretical and clinical writings, the theorized connection between defense mechanisms and adult attachment in depressed patients has received little empirical attention. This is the first study to examine patients’ defense mechanisms in relation to their attachment in a clinical sample of depressed patients and also the first to use observer-rated measures for assessing both defense mechanisms and attachment. In this pilot study, we aimed to investigate the relationship between patients’ attachment and their use of defense mechanisms in psychotherapy sessions, as well as patterns of change over treatment. We conducted a secondary analysis of data from a randomized controlled trial of 30 patients receiving psychotherapy for major depression. Session transcripts were previously coded for defense mechanisms using the Defense Mechanisms Rating Scales, and depression severity data were collected by the clinician-rated HRSD-17 and the self-report BDI-II. Patients’ attachment was assessed in two transcripts, one in an early session and a second in a late session, using the novel observer-rated Patient Attachment Coding System. In contrast with expectations, in the early phase of therapy, preoccupied attachment-related characteristics were significantly positively related to overall defensive functioning and negatively related to Depressive immature defenses. In the late phase of treatment, preoccupied attachment-related characteristics were negatively correlated with Non-depressive immature defenses. Moreover, as expected, early-phase defense use was related to late phase attachment; specifically, early neurotic and immature Depressive and Non-depressive defenses predicted an increase in avoidant, whereas immature Non-depressive defenses predicted a decrease in preoccupied attachment-related characteristics over the course of treatment, after controlling for early attachment effects. The results imply a longitudinal relationship between defenses and change in attachment-related characteristics over the course of treatment in a depressed sample and warrant further research about the relationship between defenses and attachment during psychotherapy.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, United States
| | | | - Daniel Spina
- Department of Clinical Psychology, Pennsylvania State University, University Park, PA, United States
| | - Alessandro Talia
- Institute for Psychosocial Prevention, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Claire J Starrs
- Department of Psychology, SUNY Potsdam, Potsdam, NY, United States
| | - J Christopher Perry
- Department of Psychiatry, Canada Institute of Community and Family Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada
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50
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Dagan O, Buisman RSM, Nivison MD, Waters TEA, Vaughn BE, Bost KK, Bleil ME, Vandell DL, Booth-LaForce C, Roisman GI. Does secure base script knowledge mediate associations between observed parental caregiving during childhood and adult romantic relationship quality and health? Attach Hum Dev 2021; 23:643-664. [PMID: 33107784 PMCID: PMC8076343 DOI: 10.1080/14616734.2020.1836858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Increasingly, attachment representations are being assessed via secure base script knowledge - the degree to which individuals show awareness of the temporal-causal schema that summarizes the basic features of seeking and receiving effective support from caregivers during times of need. Limited research has assessed the links between secure base script knowledge and aspects of adult functioning and the role that secure base script knowledge may play in accounting for associations between early caregiving quality and adulthood functioning. We used follow-up assessments of the NICHD Study of Early Child Care and Youth Development cohort (N = 585) to examine whether secure base script knowledge at age 18 years: (a) is associated with later romantic relationship quality, depressive symptoms, and body mass index (BMI) at age 26 years, and (b) mediates expected associations between the quality of maternal and paternal sensitivity across the first 15 years of life and age-26 outcomes. More access to, and elaborated knowledge of the secure base script predicted less extreme hostility with romantic partners, and better emotional and physical health. Moreover, secure base script knowledge mediated the links between early maternal and paternal sensitivity and both later romantic partner hostility and depressive symptoms, but not BMI.
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Affiliation(s)
- Or Dagan
- Department of Psychology, Stony Brook University, New York, NY, USA
| | | | - Marissa D. Nivison
- Institute of Child Development, University of Minnesota, Minnesota, MN, USA
| | | | - Brian E. Vaughn
- Department of Human Development and Family Studies, Auburn University, Auburn, AL, USA
| | - Kelly K. Bost
- Human and Community Development, University of Illinois, Champaign, IL, USA
| | - Maria E. Bleil
- School of Nursing, University of Washington, Seattle, WA, USA
| | | | | | - Glenn I. Roisman
- Institute of Child Development, University of Minnesota, Minnesota, MN, USA
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