Assessing attachment: convergent validity of the adult attachment interview and the parental bonding instrument

Assessment of Unresolved/Disorganized State of Mind in Relation to Attachment: A ROC Curve Study Using the Adult Attachment Interview and the Measure of Parental Style

OBJECTIVE

The main objective of the present study was to use the Receiver Operating Characteristic (ROC) curve analysis to identify cut-off points for a self-report measure assessing parental style, i.e., the Measure of Parental Style (MOPS), that are able to discriminate individuals with disorganized internal working models (IWMs) of attachment with adequate accuracy, in terms of sensitivity and specificity. Establishing cut-off points for the MOPS could provide clinicians and researchers with a valuable tool to investigate the role of disorganized IWMs as a link between parental styles and mental health.

METHOD

A sample of 90 university students (mean age = 21.21 ± 2.05, females = 66) was enrolled in the study. We used the Adult Attachment Interview (AAI) to assess disorganized IWM and the MOPS to assess parental styles. Subsequently, we used ROC curve analysis to pursue the objective of the study.

RESULTS

The ROC curve analysis showed that the MOPS total score (i.e., the combination of maternal and paternal dimensions) was able to discriminate individuals with disorganized IWMs from individuals with organized IWMs (AUC= 0.77). Specifically, a score ≥ 25 (Youden index= 0.497) categorized individuals with a sensitivity of 0.69 (69% of participants with disorganized IWMs were correctly identified) and a specificity of 0.81 (19% of participants were incorrectly identified as having disorganized IWMs).

CONCLUSIONS

Although the AAI has demonstrated high psychometric properties for assessing attachment representations in adulthood, its use is difficult when studies with large samples are to be conducted. As an alternative to the AAI, the MOPS can be used in studies with large populations, but no cut-off has yet been proposed. Here, we have identified cut-off points for the MOPS that are capable of detecting disorganized IWMs of attachment with adequate accuracy, and we suggest that this self-report is a useful brief instrument for detecting disorganized IWMs when time constraints prevent the use of the AAI (e.g., in studies with large samples or epidemiological studies).

Parental Bonding and Relationships with Friends and Siblings in Adolescents with Depression

According to attachment theory, the quality of the early child-parent bond determines the child's interpersonal relationships later in life. Utilising data from The First Experimental Study of Transference Work-In Teenagers (FEST-IT), the current paper investigated the connection between the self-reported quality of bonding with mother and father and the self-reported importance of relationships with friends and siblings in adolescents with depression. The scales employed were the Parental Bonding Instrument (PBI) and the Adolescent Relationship scale (ARS). A Pearson's correlation tested the relationship between the reported levels of maternal and paternal care and control, and the reported importance of friendship and relationship with siblings. Results revealed a statistically significant negative correlation between high levels of maternal control and importance of friendship, and a statistically significant positive correlation between high levels of paternal care and importance of relationships with siblings. The results are in line with Bowlby's theory of attachment.

Decreased brain network global efficiency after attachment memories retrieval in individuals with unresolved/disorganized attachment-related state of mind

The main aim of the study was to examine how brain network metrics change after retrieval of attachment memories in individuals with unresolved/disorganized (U/D) attachment-related state of mind and those with organized/resolved (O/R) state of mind. We focused on three main network metrics associated with integration and segregation: global (E_glob) efficiency for the first function, local (E_loc) efficiency and modularity for the second. We also examined assortativity and centrality metrics. Electroencephalography (EEG) recordings were performed before and after the Adult Attachment Interview (AAI) in a sample of 50 individuals previously assessed for parenting quality. Functional connectivity matrices were constructed by means of the exact Low-Resolution Electromagnetic Tomography (eLORETA) software and then imported into MATLAB to compute brain network metrics. Compared to individuals with O/R attachment-related state of mind, those with U/D show a significant decrease in beta E_glob after AAI. No statistically significant difference among groups emerged in E_loc and modularity metrics after AAI, neither in assortativity nor in betweenness centrality. These results may help to better understand the neurophysiological patterns underlying the disintegrative effects of retrieving traumatic attachment memories in individuals with disorganized state of mind in relation to attachment.

Serotonin Transporter Gene Polymorphisms and Maternal Overprotection Regulate Adult Social Expectations on Close Relationships

Humans are evolutionary-driven to adult mating and conceive social expectations on the quality of their affiliations. The genetic susceptibility to adverse environments in critical periods can alter close relationships. The current research investigates how the promoter region of the Serotonin Transporter Gene (5-HTTLPR) and perceived caregiving behavior in childhood could influence the social expectations on close adult relationships. For this purpose, 5-HTTLPR data was collected from the buccal mucosa of 65 Italian individuals (33 males). The participants filled (a) the Parental Bonding Instrument (PBI) to provide the levels of care and overprotection from mother and father, and (b) the Experience in Close Relationships-Revised (ECR-R) to report the social expectations on the intimate relationship assessed in terms of anxiety and avoidance from the partner. An interaction effect between 5-HTTLPR and PBI dimensions on the ECR-R scores was hypothesized. Results confirmed that the interplay between the genetic groups and history of maternal overprotection predicted avoidance experienced in romantic relationships in adulthood. Moreover, both adult anxiety and avoidance felt in an intimate relationship were found to covary as a function of maternal overprotection. The present work proposes further evidence of the genetic and parental mechanisms regulating social expectations involved in close relationships.

[Prenatal bonding and effect of recalled maternal overprotection in its development]

OBJECTIVES

Explore the relationship between the recalled bond of pregnant women to their own mothers and the development of prenatal attachment.

METHODS

Women with a single-fetal pregnancy who consulted the outpatient service of the maternity "C" ward of the center of maternity and neonatology of Tunis and had perceived fetal movements were included. Maternal-fetal attachment was assessed by the Prenatal Attachment Inventory (PAI), and the Parental Bonding Instrument (PBI) was used to evaluate experienced bond to mother. Socio demographic and clinical data were collected on a pre-established form.

RESULTS

Eighty respondents were retained from 95 recruited pregnant women. Their ages ranged from 19 to 44 with an average of 32 years. The rate of primiparity was of 28.7 % and half of pregnancies were identified at risk. The mean score of PAI was 55.3 (ET=10.79). Means scores of PBI "care" dimension and "overprotection" dimension were respectively of 26.26 (ET=5.82) and 17 (ET=6.38). The four types of maternal bonding according to the PBI scores were distributed as follow: affectionate constraint (31.3 %), affectionless control (35 %), optimal bonding (21.3 %) and weak bonding (12.5 %). The two PBI dimensions "care" and "overprotection" were significantly and negatively correlated (P<0.05). The PAI scores were not correlated with the PBI "care" dimension scores but were significantly and negatively correlated with the "overprotection" dimension scores (P<0.,01). In order to better explore this association, the "overprotection" dimension scores were studied according to the 21 items of the PAI. A negative and significant correlation was found only with three of the PAI items: item 12 (P<0;01), 15, and 20 (P<0;05).

CONCLUSIONS

Our findings suggest that pregnant women whose mothers showed more overprotective and controlling behaviors could be at risk of developing a weak maternofetal attachment. Further research is needed.

Perception of Caregiving During Childhood is Related to Later Executive Functions and Antisocial Behavior in At-Risk Boys

Executive functions are considered essential for effective navigation in the social world. Parental responsiveness is a critical ingredient for normative social development and, as such, may be connected with the development of executive functions. Disruption of this development may, in turn, lead to maladaptive and antisocial behaviors. The purpose of this study was to evaluate the nature of the connections among perceived patterns of caregiving experienced in childhood, executive functions, and antisocial behaviors in at-risk adolescents. Seventy-one adolescent boys were recruited from two high-schools for adolescents who were not deemed suitable for regular schooling due to behavioral and emotional issues. Executive functions were tested using a computer-administered neuropsychological battery (CANTAB), and maternal parenting experiences and antisocial behaviors were assessed using retrospective and current questionnaires. Structural equation modeling (SEM) approach was employed to examine whether executive functions mediated the relationship between children's perceived patterns of maternal care and subsequent development of antisocial behaviors. Although maternal care had a significant direct effect on executive function (standardized coefficient = .49, p = .03) and antisocial behavior (standardized coefficient = .53, p = .05), SEM demonstrated no mediating relationships among these variables. Instead, maternal care predicted unique variance in both executive functions (standardized coefficient = .61, p = .02) and antisocial behavior (standardized coefficient = .51, p = .05). This study suggests a link between the experience of childhood caregiving and adolescent executive functions and delinquency and highlights the importance of early parenting interventions to aid executive function development. Such early interventions could potentially enhance long-term pro-social behavior.

Maternal and Paternal Warmth Impact Recovery Support and Social Network Composition for Substance Dependent African American and Non-African American Women

Poor early relationship experiences during the first 16 years of life may negatively impact adults' capacity to establish and utilize social support (Suchman, McMahon, Slade, & Luthar, 2005). This is especially of concern for women with substance use disorders (SUD) for whom social support is associated with recovery maintenance and treatment retention (Gregoire & Snively, 2001). The purpose of this study was to examine the influence of early relationship experiences, specifically paternal and maternal warmth, on recovery related social support and personal network characteristics among African American (AA) and non-AA women in treatment for SUD. Data were collected from 254 women in substance abuse treatment, 146 AA and 108 non-AA. Ordinal logistic, Poisson or multiple linear regressions were fitted to predict the impact of maternal and paternal warmth during childhood on adult social network composition and recovery support. Greater maternal warmth was associated with greater recovery-specific social support for both AA (β = 0.12) and non-AA (β = 0.15) women. Paternal, but not maternal, warmth significantly predicted the number of social network members who supported recovery for non-AA women (AOR = 1.04), and number of network members who used drugs and alcohol for AA women (IRR = 0.99). Developmental experiences associated with fathers appear to affect different domains of adult functioning than those associated with mothers, and those effects are different for AA versus non-AA women. Attention to these differences may inform culturally relevant substance abuse prevention and treatment efforts.

Design, rationale and feasibility of a multidimensional experimental protocol to study early life stress

There is a rapidly accumulating body of evidence regarding the influential role of early life stress (ELS) upon medical and psychiatric conditions. While self-report instruments, with their intrinsic limitations of recall, remain the primary means of detecting ELS in humans, biological measures are generally limited to a single biological system. This paper describes the design, rationale and feasibility of a study to simultaneously measure neuroendocrine, immune and autonomic nervous system (ANS) responses to psychological and physiological stressors in relation to ELS. Five healthy university students were recruited by advertisement. Exclusion criteria included chronic medical conditions, psychotic disorders, needle phobia, inability to tolerate pain, and those using anti-inflammatory medications. They were clinically interviewed and physiological recordings made over a two-hour period pre, during and post two acute stressors: the cold pressor test and recalling a distressing memory. The Childhood Trauma Questionnaire and the Parental Bonding Index were utilised to measure ELS. Other psychological measures of mood and personality were also administered. Measurements of heart rate, blood pressure, respiratory rate, skin conductance, skin blood flow and temporal plasma samples were successfully obtained before, during and after acute stress. Participants reported the extensive psychological and multisystem physiological data collection and stress provocations were tolerable. Most (4/5) participants indicated a willingness to return to repeat the protocol, indicating acceptability. Our protocol is viable and safe in young physically healthy adults and allows us to assess simultaneously neuroendocrine, immune and autonomic nervous system responses to stressors in persons assessed for ELS.

Attachment theory in adult psychiatry. Part 1: Conceptualisations, measurement and clinical research findings

Since its original conception by Bowlby to explain an important evolutionary function of the child–caregiver relationship, attachment theory has been supported by much empirical research in a variety of settings. However, although attachment theory began as a clinical enterprise, its wider application to the everyday clinical understanding of adult mental health problems has lagged behind the available research. The theory can afford valuable insight not only into the developmental nature of common psychiatric disorders, but also into the development of the therapeutic relationship. This article gives an overview of (a) the current conceptualisations of attachment and the measurement of attachment for clinical research purposes and (b) the application of attachment theory to different psychopathologies. The importance of attachment to the therapeutic relationship will be discussed in a future article.

Memories of paternal relations are associated with coping and defense mechanisms in breast cancer patients: an observational study

BACKGROUND

Breast cancer diagnosis and treatment represent stressful events that demand emotional adjustment, thus recruiting coping strategies and defense mechanisms. As parental relations were shown to influence emotion regulation patterns and adaptive processes in adulthood, the present study investigated whether they are specifically associated to coping and defense mechanisms in patients with breast cancer.

METHODS

One hundred and ten women hospitalized for breast cancer surgery were administered questionnaires assessing coping with cancer, defense mechanisms, and memories of parental bonding in childhood.

RESULTS

High levels of paternal overprotection were associated with less mature defenses, withdrawal and fantasy and less adaptive coping mechanisms, such as hopelessness/helplessness. Low levels of paternal care were associated with a greater use of repression. No association was found between maternal care, overprotection, coping and defense mechanisms. Immature defenses correlated positively with less adaptive coping styles, while mature defenses were positively associated to a fighting spirit and to fatalism, and inversely related to less adaptive coping styles.

CONCLUSIONS

These data suggest that paternal relations in childhood are associated with emotional, cognitive, and behavioral regulation in adjusting to cancer immediately after surgery. Early experiences of bonding may constitute a relevant index for adaptation to cancer, indicating which patients are at risk and should be considered for psychological interventions.

Positive parenting predicts cortisol functioning six years later in young adults

Research which indicates that adverse experiences influence hypothalamic-pituitary-adrenal (HPA) axis functioning illustrates the social environment 'getting under the skin'. The present study extended this literature by examining whether positive social forces within the caregiving environment can also impact cortisol functioning. We conducted a prospective investigation of over 300 youth, half of whom were White and half were Black. Attachment, bonding and parental rewards for positive behaviors were observed or reported by the youth as an 8th grader. Twelve repeated measures of salivary cortisol were examined six years later when youth were young adults (mean age 20). Race differences were explored. Stronger attachment, bonding and teen-reported positive parenting were predictive of high waking cortisol and steeper diurnal slopes six years later. This effect was nonlinear and additive, such that youth whose social contexts were characterized by the strongest attachment, bonding and rewarding parental relationships had the highest waking cortisol. When effects were moderated by race, findings were such that links of positive parenting with HPA functioning were more consistent for White than Black youth. Findings suggest that positive aspects of the caregiving environment can also 'get under the skin' and these effects are additive across a range of caregiving indices. These findings dovetail with an emerging literature on the powerful role of social support for shaping the body's stress response system and are interpreted as consistent with the Adaptive Calibration Model which suggests that cortisol regulation can have adaptive significance. A video abstract of this article can be viewed at: https://youtu.be/8evHXpt_TXM.

Interactive effects of 5-HTTLPR genotype and rearing environment on affective attitude towards own infant in Japanese mothers

Maternal positive attitude towards one's own infant is the cornerstone of effective parenting. Previous research has revealed an influence of both genetic and environmental factors on maternal parenting behavior, but little is known of the potential gene-environment interaction in shaping a mother's affective attitude. To address this gap, we investigated the effect of a mother's childhood rearing environment and a serotonin transporter gene polymorphism (5-HTTLPR) on affective attitude towards her infant. Our analyses found an interactive effect between rearing environment and 5-HTTLPR genotype on maternal attitude. Specifically, a poor rearing environment (characterized by low maternal care and high paternal overprotection) decreased positive attitude towards one's own infant in mothers with homozygous short allele genotype. In contrast, this detrimental effect was almost eliminated in long allele carriers. Altogether, our results indicate that the 5-HTTLPR gene moderates the influence of experienced rearing environment on maternal parental behavior in a manner consistent with the notion that the short 5-HTTLPR allele amplifies environmental influence.

Insecure attachment and maladaptive schema in disordered eating: The mediating role of rejection sensitivity

AIM

The current study aimed to assess insecure attachment and the disconnection and rejection domain of maladaptive schema in the context of disordered eating. Rejection sensitivity (RS) was proposed as a mediator between maladaptive schema and disordered eating.

METHOD

The sample consisted of 108 female participants with a lifetime eating disorder diagnosis and 508 female control participants. Participants were asked to complete a number of self-report measures related to insecure attachment (anxious and avoidant), maladaptive schema (emotional deprivation, abandonment, mistrust, social isolation, and defectiveness), RS (interpersonal and appearance-based), and disordered eating.

RESULTS

Path analysis indicated that anxious attachment was associated with disordered eating through multiple pathways involving emotional deprivation, abandonment, interpersonal RS, and appearance-based RS. Avoidant attachment was not related to disordered eating behaviours.

CONCLUSION

The results indicate that both interpersonal and appearance-based RS are important mediators for the relationships between insecure attachment, maladaptive schema, and disordered eating.

KEY PRACTITIONER MESSAGE

The results from the current study suggest that insecure attachment leads to maladaptive schema, which in turn leads to sensitivity to rejection and subsequent disordered eating behaviour. Attachment anxiety, but not attachment avoidance, was related to greater endorsement of all five schemas in the disconnection and rejection domain. Path analysis revealed that, of the schema in the disconnection and rejection domain, only emotional deprivation and abandonment were related to disordered eating. Interpersonal and appearance-based rejection sensitivity were significant mediators of the relationship between emotional deprivation and disordered eating as well as the relationship between abandonment and disordered eating. Differentiating between schemas within schema domains has clinical value in further understanding the pathway to disordered eating. The schemas of emotional deprivation and abandonment are implicated in disordered eating, suggesting the need to target these schemas in schema therapy.

Anxious adult attachment may mediate the relationship between childhood emotional abuse and borderline personality disorder

BACKGROUND

Childhood trauma has been associated with borderline personality disorder (BPD). However, research has not yet provided conclusive evidence concerning the mediating mechanisms.

METHODS

Seventy women diagnosed with BPD were compared with other 60 women who met DSM-IV criteria for other personality disorders on measures of childhood trauma and attachment.

RESULTS

Patients with BPD reported higher severity of emotional, physical and sexual abuse than patients with other personality disorders. Moreover, BPD patients also showed greater preoccupied-anxious adult attachment. At model 1, logistic regression analysis revealed that only childhood emotional abuse predicted the occurrence of BPD. At model 2, this association was no longer significant, and the addition of preoccupied-anxious adult attachment was significantly associated with a greater likelihood of BPD diagnosis.

CONCLUSIONS

These findings support a specific relationship between childhood emotional abuse and the occurrence of BPD, which may be accounted for by preoccupied-anxious adult attachment. Copyright © 2016 John Wiley & Sons, Ltd.

The Family-Couple-Parenting Questionnaire: Development of a Measure for Long-Term Couples and Young Adults

This work describes the construction of family-couple-parenting (FCP) questionnaire, a new measure of three aspects related to the developmental path toward parenting choices, within the perspective of the family life cycle and attachment theory. Two studies are reported. Study 1 reports the development of the FCP questionnaire and its psychometric properties. Study 2 assesses the FCP's nomological validity by investigating group differences on FCP factors and links between FCP factors and romantic attachment (experience in close relationships-revised) and recalled parental bonding (parental bonding instrument). Participants were 791 Italian participants: 405 young adults (203 students, 202 workers) and 193 couples (91 childless-by-choice, 102 parents-to-be). The results suggest that the FCP's stable psychometric structure and strong theoretical basis make FCP a useful instrument for research related to the path to parenthood.

A WEB-BASED SURVEY OF MOTHER-INFANT BOND, ATTACHMENT EXPERIENCES, AND METACOGNITION IN POSTTRAUMATIC STRESS FOLLOWING CHILDBIRTH

OBJECTIVE

Postnatal depression is linked to adverse outcomes for parent and child, with metacognition and parenting experiences key variables in the development and maintenance of depression. The attachment between mother and infant is especially vulnerable to the effects of untreated postnatal depression. Despite high levels of reported postnatal stress symptoms, less attention has been given the relationship between attachment, metacognition, and postnatal traumatic symptoms in the context of birth trauma. This study tested several hypotheses regarding the relationships between recalled parenting experiences, metacognition, postnatal symptoms of posttraumatic stress disorder and depression and perceptions of the mother-infant bond, confirming and extending upon metacognitive and mentalization theories.

METHOD

A Web-based, cross-sectional, self-report questionnaire design was employed in an analog sample of new mothers. Participants were 502 women recruited via open-access Web sites associated with birth organizations. Structural equation modeling was employed for the principal analysis.

RESULTS

Metacognition fully mediated the relationship between recalled parenting experiences and postnatal psychological outcomes. Posttraumatic stress was indirectly associated with maternal perceptions of the bond, with this relationship mediated by depression.

CONCLUSION

Metacognition may have a key role in postnatal psychological distress. Where postnatal depression or traumatic birth experiences are identified, screening for posttraumatic stress is strongly indicated.

Stress Exposure in Significant Relationships Is Associated with Lymph Node Status in Breast Cancer

Objective

Life stress exposure may impact on health and disease. Previous literature showed that stressful life events are associated with cancer incidence, survival and mortality. In animal models, patterns of maternal care have been shown to critically affect stress sensitivity and immunity trajectories later in life, by modifying DNA methylation during critical periods early in life. However, the role of parental care in breast cancer progression and survival has only limitedly been explored. Here, we investigated whether these factors may be linked to biological prognostic variables.

Methods

One hundred twenty-three women hospitalized for surgery of primary breast cancer completed a questionnaire assessing parental bonding. Stressful events throughout the life span were also assessed.

Results

We found that the absence of optimal parental relationships is significantly associated with an increased risk of lymph node involvement, adjusting for confounders, while cumulative stress in the area of sentimental relationships is borderline significantly associated with the same prognostic factor.

Conclusions

Our results suggest that parental bonding and sentimental relations may have a role in breast cancer progression. These variables represent an important evolutionary aspect which may modulate cancer progression through psycho-physiological stress pathways and influence the immune system.

Episodic memories of relationship quality, procedural knowledge of attachment scripts, and the experience of daughters caring for a parent with dementia

A caregiver's attachment history with their parents may affect the thoughts, feelings, and behavior they now have as they care for a parent with dementia. Participants were 77 daughters of a parent with dementia. The nature of participant conscious episodic memories of their parental figures and unconscious procedural knowledge of caregiving processes (secure base script knowledge) were identified as two aspects of the caregiver's relationship history that may impact their involvement in care, relationship conflict, critical attitudes, and strain. Our findings indicated that the nature of episodic memories of the caregiver relationship history with parental figures were significantly associated with stress and criticism of their parent. Greater unconscious procedural knowledge of the secure base script was associated with caregiver report of less conflict and less involvement in the caregiving tasks. Potential clinical implications of this pattern are also discussed.

Maternal Attachment Representation and Neurophysiological Processing during the Perception of Infants' Emotional Expressions

The perception of infant emotions is an integral part of sensitive caregiving within the mother-child relationship, a maternal ability which develops in mothers during their own attachment history. In this study we address the association between maternal attachment representation and brain activity underlying the perception of infant emotions. Event related potentials (ERPs) of 32 primiparous mothers were assessed during a three stimulus oddball task presenting negative, positive and neutral emotion expressions of infants as target, deviant or standard stimuli. Attachment representation was assessed with the Adult Attachment Interview during pregnancy. Securely attached mothers recognized emotions of infants more accurately than insecurely attached mothers. ERPs yielded amplified N170 amplitudes for insecure mothers when focusing on negative infant emotions. Secure mothers showed enlarged P3 amplitudes to target emotion expressions of infants compared to insecure mothers, especially within conditions with frequent negative infant emotions. In these conditions, P3 latencies were prolonged in insecure mothers. In summary, maternal attachment representation was found associated with brain activity during the perception of infant emotions. This further clarifies psychological mechanisms contributing to maternal sensitivity.

Maternal sensitivity, infant limbic structure volume and functional connectivity: a preliminary study

Mechanisms underlying the profound parental effects on cognitive, emotional and social development in humans remain poorly understood. Studies with nonhuman models suggest variations in parental care affect the limbic system, influential to learning, autobiography and emotional regulation. In some research, nonoptimal care relates to decreases in neurogenesis, although other work suggests early-postnatal social adversity accelerates the maturation of limbic structures associated with emotional learning. We explored whether maternal sensitivity predicts human limbic system development and functional connectivity patterns in a small sample of human infants. When infants were 6 months of age, 20 mother-infant dyads attended a laboratory-based observational session and the infants underwent neuroimaging at the same age. After considering age at imaging, household income and postnatal maternal anxiety, regression analyses demonstrated significant indirect associations between maternal sensitivity and bilateral hippocampal volume at six months, with the majority of associations between sensitivity and the amygdala demonstrating similar indirect, but not significant results. Moreover, functional analyses revealed direct associations between maternal sensitivity and connectivity between the hippocampus and areas important for emotional regulation and socio-emotional functioning. Sensitivity additionally predicted indirect associations between limbic structures and regions related to autobiographical memory. Our volumetric results are consistent with research indicating accelerated limbic development in response to early social adversity, and in combination with our functional results, if replicated in a larger sample, may suggest that subtle, but important, variations in maternal care influence neuroanatomical trajectories important to future cognitive and emotional functioning.

The Invalidating Childhood Environment Scale (ICES): psychometric properties and relationship to borderline personality symptomatology

The objective of this study was to examine the psychometric properties of the Invalidating Childhood Environment Scale (ICES; Mountford, Corstorphine, Tomlinson, & Waller, 2004), a measure designed to retrospectively assess exposure to parental invalidation. The ICES was administered to a sample of female college students along with measures of parental bonding and borderline personality disorder (BPD) symptomatology. In contrast with previous findings, the ICES demonstrated excellent internal consistency within a nonclinical sample. It also correlated in the predicted directions with measures of parental bonding and BPD symptomatology. Taken together, these findings suggest that the ICES is a promising retrospective measure of parental invalidation. They also provide some support for the hypothesized link between parental invalidation and BPD symptomatology and suggest that additional research with clinical samples is needed.

Dismissing children's perceptions of their emotional experience and parental care: preliminary evidence of positive bias

The tendency to perceive caregivers in highly positive terms and to perceive the self as strong and problem-free are two facets of the positive bias characteristic of a dismissing attachment classification in adulthood. However, this link has not yet been examined in children. We evaluated the association between dismissing attachment and positive bias in school-aged children's reports of their own emotional experience and their parental care, hypothesizing that: (1) compared to secure children, dismissing children would underreport their subjective distress relative to physiological indicators of distress, and (2) dismissing children would report that their parents were warmer/more caring than would secure children. Ninety-seven children between the ages of 8 and 12 completed the Child Attachment Interview, reports of maternal and paternal care, and a psychophysiological threat paradigm. Compared to secure children, dismissing children reported less distress than their startle responses during threat would suggest. In other words, dismissing children showed a greater divergence between subjective and physiological emotional response. Dismissing children rated their parents as warmer and more caring as compared to secure children's ratings. Results provide support for the association between dismissing attachment and inflated positivity on child-report measures of parental care and emotional experience. Implications of the study's findings for attachment theory are discussed.

The missing link: mothers' neural response to infant cry related to infant attachment behaviors

This study addresses a gap in the attachment literature by investigating maternal neural response to cry related to infant attachment classifications and behaviors. Twenty-two primiparous mothers and their 18-month old infants completed the Strange Situation (SS) procedure to elicit attachment behaviors. During a separate functional MRI session, mothers were exposed to their own infant's cry sound, as well as an unfamiliar infant's cry and control sound. Maternal neural response to own infant cry related to both overall attachment security and specific infant behaviors. Mothers of less secure infants maintained greater activation to their cry in left parahippocampal and amygdala regions and the right posterior insula consistent with a negative schematic response bias. Mothers of infants exhibiting more avoidant or contact maintaining behaviors during the SS showed diminished response across left prefrontal, parietal, and cerebellar areas involved in attentional processing and cognitive control. Mothers of infants exhibiting more disorganized behavior showed reduced response in bilateral temporal and subcallosal areas relevant to social cognition and emotion regulation. No differences by attachment classification were found. Implications for attachment transmission models are discussed.

Parental care and control during childhood: associations with maternal perinatal mood disturbance and parenting stress

This study examined the associations between perceived parental care and control in childhood and maternal anxiety, depression and parenting stress during the transition to parenthood. Eighty-eight women completed the Parental Bonding Instrument, self-report measures of anxiety and depression and a structured diagnostic interview (Mini-plus International Neuropsychiatric Interview) during the third trimester of pregnancy. The MINI-Plus and anxiety and depression measures were re-administered at 7 months postpartum. The Parenting Stress Index was also administered at this time. Significant associations were found between maternal 'affectionless control' and prenatal and postnatal symptom measures of anxiety and depression, p values <0.005. Compared to women who reported optimal parenting, women who recalled maternal 'affectionless control' were also six times more likely to be diagnosed with an anxiety disorder during pregnancy (OR = 6.1, 95% CI = 2.17-30.11) and seven times more likely to be diagnosed with postnatal major depression (OR = 6.8, 95% CI = 1.80-25.37). Paternal 'affectionless control' was associated with significantly higher scores on symptom measures of prenatal and postnatal anxiety, p values <0.005. This study suggests that assessing a woman's own parenting history is important in identifying and managing the risk of prenatal and postnatal affective disorders and parenting stress.

Clinical phenomenology of childhood abuse-related complex PTSD in a population of female patients: patterns of personality disturbance

OBJECTIVE

Complex posttraumatic stress disorder (PTSD) involves a variety of personality disturbances presumed to result from repeated interpersonal trauma such as child abuse. As Complex PTSD patients are a heterogeneous population, we searched for clinically relevant personality-based subtypes.

METHOD

This study used a cluster analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Axis II features within a sample of 71 female outpatients with systematically assessed child abuse-related Complex PTSD.

RESULTS

Two main subtypes were found: adaptive and nonadaptive. The latter was further differentiated into withdrawn, alienated, suffering, and aggressive subtypes, characterized by different levels of introversion and disinhibition. Among the nonadaptive subtypes, the severity of Complex PTSD symptoms was lowest in the withdrawn (introverted only) subtype. The subtypes differed in their level of dissociation and depression but did not differ regarding PTSD symptoms, trauma history, or parental bonding characteristics.

CONCLUSION

Confirming earlier findings, our study found personality-based Complex PTSD subtypes, which could implicate differential treatment needs and results.

Perceived quality of maternal care in childhood and structure and function of mothers' brain

Animal studies indicate that early maternal care has long-term effects on brain areas related to social attachment and parenting, whereas neglectful mothering is linked with heightened stress reactivity in the hippocampus across the lifespan. The present study explores the possibility, using magnetic resonance imaging, that perceived quality of maternal care in childhood is associated with brain structure and functional responses to salient infant stimuli among human mothers in the first postpartum month. Mothers who reported higher maternal care in childhood showed larger grey matter volumes in the superior and middle frontal gyri, orbital gyrus, superior temporal gyrus and fusiform gyrus. In response to infant cries, these mothers exhibited higher activations in the middle frontal gyrus, superior temporal gyrus and fusiform gyrus, whereas mothers reporting lower maternal care showed increased hippocampal activations. These findings suggest that maternal care in childhood may be associated with anatomy and functions in brain regions implicated in appropriate responsivity to infant stimuli in human mothers.

Adult attachment measures: a 25-year review

OBJECTIVE

Over the past 25 years, attachment research has extended beyond infant-parent bonds to examine dyadic relationships in children, adolescents, and adults. Attachment has been shown to influence a wide array of biopsychosocial phenomena, including social functioning, coping, stress response, psychological well-being, health behavior, and morbidity, and has thus emerged as an important focus of psychosomatic research. This article reviews the measurement of adult attachment, highlighting instruments of relevance to-or with potential use in-psychosomatic research.

METHODS

Following a literature search of articles that were related to the scales and measurement methods of attachment in adult populations, 29 instruments were examined with respect to their utility for psychosomatic researchers.

RESULTS

Validity, reliability, and feasibility were tabulated on 29 instruments. Eleven of the instruments with strong psychometric properties, wide use, or use in psychosomatic research are described. These include the following: Adult Attachment Interview (George, Kaplan, and Main); Adult Attachment Projective (George and West); Adult Attachment Questionnaire (Simpson, Rholes, and Phillips); Adult Attachment Scale (and Revised Adult Attachment Scale) (Collins and Read); Attachment Style Questionnaire (Feeney); Current Relationship Interview (Crowell and Owens); Experiences in Close Relationships (Brennan, Clark, and Shaver) and Revised Experiences in Close Relationships (Fraley, Waller, and Brennan); Parental Bonding Instrument (Parker, Tupling, and Brown); Reciprocal Attachment Questionnaire (West and Sheldon-Keller); Relationship Questionnaire (Bartholomew and Horowitz); and Relationship Scales Questionnaire (Grifiin and Bartholomew).

CONCLUSION

In addition to reliability and validity, investigators need to consider relationship focus, attachment constructs, dimensions or categories of interest, and the time required for training, administration, and scoring. Further considerations regarding attachment measurement in the context of psychosomatic research are discussed.

Behavioral response to methylphenidate challenge: influence of early life parental care

Rat studies have shown that pups subjected to suboptimal rearing conditions exhibited permanently dysregulated dopamine activity and altered behavioral responses to dopamine stimulation. In humans, heightened stress-induced mesoaccumbens dopamine release in adults reporting low maternal care experience has been shown. We explored the relationship between quality of parental care and behavioral responsivity to reward and 20 mg of the dopamine agonist methylphenidate (MPH). Forty-three male university students accomplished a monetarily rewarded card-sorting task in a placebo controlled between-subjects study design. In participants scoring above the cut-off score for high parental care as assessed by the Parental Bonding Inventory, MPH decreased performance accuracy in the reward condition of the task. Contrarily, reward-induced performance accuracy of low care participants was enhanced with MPH. Activity measures in response to reward and MPH were uninfluenced by parental care. This is the first human study to reveal that the behavioral MPH response interacts with early life parental care experience.

Spouse Similarity in Recollections of Parenting Received: A Study in a Nonclinical Sample

Despite a large body of research on both children’s relationships to their parents and adult dyadic relationships, associations between these types of relationships have rarely been studied. In this paper, spouse similarity in recollections of parenting received in childhood was assessed in a nonclinical sample. Parenting by the same- and opposite-sex parent was measured using the Parental Bonding Instrument (PBI). Spouse similarity was found with respect to the recalled level of care received from the same-sex parent. This correlation was independent of similarity in sociodemographic variables or current psychiatric symptomatology. The fact that spouse similarity did not increase with increasing age suggests that similarity is a result of assortative mating rather than convergence during marriage. These results suggest a significant association between parent-child relationships and the mating process.

Adverse parenting as a risk factor in the occurrence of anxiety disorders : a study in six European countries

OBJECTIVE

The aim of the study was to test the homogeneity of the association between adverse parenting and anxiety disorders within these disorders as well as among six European countries.

METHOD

Based on data from 8,232 respondents (part II sample) originating from the European study of the epidemiology of mental disorders (ESEMeD), we examined the association between three dimensions of parental rearing (care, overprotection, authoritarianism) measured by a short form of the parental bonding instrument (PBI) and anxiety disorders by computing one logistic regression model per disorder.

RESULTS

A similar pattern of recalled parenting behaviour across the four anxiety disorders assessed was found, with care and overprotection having the strongest associations. There were only minor country-specific variations of this pattern.

CONCLUSION

Our results suggest an association between adverse parenting and the risk of anxiety disorders in particular as well as psychiatric disorders in general that is rather non-disorder specific.

Perceived parental bonding, fear of failure and stress during class presentations

The purpose of the present studies was to test the hypothesis that students' perceptions of parental bonding may be predictive of how individuals approach achievement situations. It was hypothesized that reports of parental overprotection would be predictive of elevated fears and subsequent stress and low achievement compared to perceived parental care. No hypotheses were specified regarding the gender of the parent. In Study 1 participants were 230 elementary school students who were assessed on motivation, stress and affect prior to a “high stakes testing”. Results indicated that paternal caring scores and, to a lesser degree, maternal caring scores were associated with lower levels of fear of failure, anxiety and depression. In Study 2, 58 college students were monitored (physiologically) during a class presentation in order to test the hypothesis that perceived parental rearing is predictive of stress through influencing fear of failure. Results from Multilevel Random Coefficient Modeling showed that perceived parental caring was associated with significantly lessened stress compared to perceived overprotection. Modeling the relationships using Structural Equation Modeling indicated that students reporting an overprotective parental style approached the task with significantly elevated fears, had elevated stress during the task, and lower task performance. Another salient finding was that students' perceptions of their fathers' parenting style was highly predictive of the stress response. The discussion reviews these findings and examines possible implications for enhancing achievement motivation in educational contexts.

Maternal care modulates the relationship between prenatal risk and hippocampal volume in women but not in men

Smaller hippocampal volume is associated with psychiatric disorders. Variations in hippocampal volume are discussed as both a consequence of the neurotoxic effects of stress and as a pre-existing condition leading to increased vulnerability for cognitive and emotional impairments. To investigate whether early experience can account for variability in hippocampal volume in adulthood (vulnerability hypothesis), we assessed the relationship between birth weight and hippocampal volume in 44 subjects. The reported quality of maternal care in early childhood, as evaluated by the Parental Bonding Inventory, was used as index of the quality of the postnatal environment. Hippocampal volume was assessed from magnetic resonance images using a manual segmentation protocol. We show that birth weight significantly predicts hippocampal volume in adulthood only in female subjects reporting low maternal care. The results suggest that the postnatal environment modulates the neurodevelopmental consequences of prenatal risk and that this effect is sex-specific.

Relationship between parental bonding and mood disorder in six European countries

The linkage between adverse parental child-rearing styles and the occurrence of mood disorders in adulthood has been investigated in a number of studies from different countries and cultural backgrounds. However, as direct cross-cultural comparisons hardly exist, little is known about cultural variations of this relationship. The European Study of the Epidemiology of Mental Disorders (ESEMeD) is a cross-sectional study in a stratified multi-stage random sample of 21,425 adults (18 years or older) from the general population of six European countries (Belgium, France, Germany, Italy, Netherlands, and Spain). Parental child-rearing styles were measured by means of a short form of the Parental Bonding Instrument (PBI) in 8,232 of the respondents. Based on the extraction and confirmation of a three-factor model of the PBI in a previous study, the association between parental bonding and mood disorders was studied by computing hierarchical nested multiple logistic regression models. The relationship between parental child-rearing styles and mood disorders was mostly homogeneous across the six countries. The PBI dimensions maternal and paternal care had the strongest associations with mood disorders. A significant association of overprotection was observable only for the mother. There was no significant relationship between authoritarianism and the occurrence of mood disorders. In the European countries studied, the association between parental child-rearing styles and the occurrence of mood disorders appears not to be culture-dependent. It would be of interest to assess whether this also holds for the rest of Europe and non-European countries.