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Thompson L, Wilson P. Mellow Babies: A Randomised Feasibility Trial of an Intervention to Improve the Quality of Parent-Infant Interactions and Parental Mental Wellbeing. CHILDREN (BASEL, SWITZERLAND) 2024; 11:510. [PMID: 38790505 PMCID: PMC11119448 DOI: 10.3390/children11050510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/26/2024]
Abstract
Mellow Babies aims to improve mothers' mental wellbeing and the quality of their interactions with their baby. The feasibility of a definitive trial of Mellow Babies was assessed using a waiting-list randomised pilot trial (Clinicaltrials.gov: NCT02277301). Mothers with substantial health/social care needs and a child aged <13 months were randomly allocated either to a 14-week Mellow Babies programme or to receive usual care whilst on a waiting list for the intervention. Rates of recruitment and retention as well as participants' views of their experience in this study were recorded. Outcomes were parenting behaviour, assessed by the blind-rated Mellow Parenting Observation System (primary) and self-report maternal wellbeing pre- and post-intervention/waiting period. We recruited 38 eligible participants: 36 (95%; 18 intervention, 18 control) completed baseline measures, and 28 (74%; 15 intervention, 13 control) provided post-intervention data. Two practitioners took part in feedback interviews. Intervention participants had significantly more positive interactions with their babies at post-intervention compared to those in the control group (p = 0.019), adjusted for pre-intervention scores. There was no significant improvement in mothers' mental wellbeing on any measure. A definitive trial of Mellow Babies is feasible and should include longer follow up of mothers and the opportunity for fathers to take part.
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Affiliation(s)
- Lucy Thompson
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UK;
| | - Philip Wilson
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UK;
- Section of General Practice, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
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Clarke A, Rose TA, Meredith PJ. Language skills and interpersonal trust in adolescents with and without mental illness. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:589-607. [PMID: 35614858 DOI: 10.1080/17549507.2022.2075466] [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
PURPOSE The primary aim was to compare adolescents with mental illness and non-clinical adolescents on vocabulary, social problem-solving, trust in parents, attachment and mentalisation. A secondary aim was to investigate whether adolescents' language skills were associated with trust in parents. METHOD Seventy-eight adolescents (16-18 years) participated in this cross-sectional quantitative study: a clinical sample (n = 28, M = 16.7 years, 19F) recruited from a mental health service and a non-clinical sample (n = 50, M = 17.0 years, 28F). Standardised language measures and self-report measures of trust in parents; communication quality; attachment; and mentalisation were used. Primary and secondary aims were addressed through independent samples t-tests and Pearson's correlation analyses, respectively. RESULT Adolescents experiencing mental illness reported significantly poorer vocabulary, less trust in mother/father, greater attachment anxiety/avoidance, and poorer reflective functioning, than non-clinical adolescents. Expressive vocabulary of clinical (but not non-clinical) adolescents significantly negatively correlated with trust in mother (but not father). CONCLUSION Results highlight a role for speech-language pathologists (SLPs) in supporting communication needs of adolescents with mental illness. SLPs should consider trust by: i) understanding adolescents with mental illness may have difficulty trusting them potentially impacting therapeutic engagement; and ii) delivering services in ways that might build trust, such as involving adolescents in treatment planning.
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Affiliation(s)
- Angela Clarke
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Assertive Mobile Youth Outreach Service, Child and Youth Mental Health Services, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Pamela J Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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Bachmann CJ, Humayun S, Stevens M, O'Connor TG, Scott S. Secure attachment predicts lower societal cost amongst severely antisocial adolescents. Child Adolesc Psychiatry Ment Health 2023; 17:56. [PMID: 37161491 PMCID: PMC10170786 DOI: 10.1186/s13034-023-00598-8] [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: 01/27/2023] [Accepted: 03/27/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Social and economic costs associated with antisocial behaviour are well-established, but little is known about the potential costs savings/benefits of secure attachment in this high-risk group. We aimed to provide the first test of attachment quality as a distinct predictor of economic costs. METHODS 111 adolescents (10-17 years of age, M = 15.0, SD = 1.6; 71% male) referred to young offender services due to high levels of antisocial behaviour were included. Costs were measured by detailed service-use interview, and attachment security to mother and father elicited through the Child Attachment Interview. The level of antisocial behaviour and callous-unemotional traits were assessed. Cost predictors were calculated using generalised linear models. RESULTS Mean 12-months service costs were £5,368 (sd 5,769) per adolescent, with justice system and educational service costs being the main components. After adjusting for covariates, economic costs were predicted by attachment quality to fathers, with a difference of £2,655 per year between those with secure (£3,338) versus insecure attachment (£5,993); significant cost effects were not found for attachment quality to mothers. Higher levels of callous-unemotional traits, lower verbal IQ, higher levels of antisocial behaviour, and older age were also significant cost predictors. CONCLUSIONS Secure attachment to fathers is a predictor of reduced public cost in adolescents with severe antisocial behaviour. This novel finding for severely antisocial youth extends previous findings in less antisocial children and underscores the public health and policy benefits of good caregiving quality and the value of population-level dissemination of evidence-based interventions that improve caregiving quality.
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Affiliation(s)
- Christian J Bachmann
- Department of Child and Adolescent Psychiatry, University of Ulm, Steinhövelstr. 5, 89075, Ulm, Germany.
| | - Sajid Humayun
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, Avery Hill, London, SE9 92UG, UK
| | - Madeleine Stevens
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Thomas G O'Connor
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA
| | - Stephen Scott
- National Academy for Parenting Research, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
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Hayre RS, Sierra Hernandez C, Goulter N, Moretti MM. Attachment & School Connectedness: Associations with Substance Use, Depression, & Suicidality Among at-Risk Adolescents. CHILD & YOUTH CARE FORUM 2023. [DOI: 10.1007/s10566-023-09743-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Del Giudice M, Haltigan JD. A new look at the relations between attachment and intelligence. DEVELOPMENTAL REVIEW 2023. [DOI: 10.1016/j.dr.2022.101054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Smith AR, Hagan J, Walden M, Brickley A, Biard M, Rhee C, McIver P, Shoemark H, Brand MC. The Effect of Contingent Singing on Infants with Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit. J Music Ther 2023; 60:98-119. [PMID: 36592139 DOI: 10.1093/jmt/thac019] [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: 01/03/2023]
Abstract
A significant component of care for infants with bronchopulmonary dysplasia (BPD) is providing an optimal environment for supporting neurodevelopment and growth. Interventions that support the behavioral and physiologic stability of this population may play an important role in improving overall outcomes. Contingent singing is a music intervention that allows the caregiver to tailor certain musical elements, such as rhythm and tempo, to match behavioral and physiologic cues and support the infant in achieving optimal stabilization. A randomized crossover design was used to study the effect of contingent singing on the behavioral state and physiologic measures compared to standard care practices in the neonatal intensive care unit (NICU). Data were collected on a sample of 37 infants diagnosed with BPD. There were no significant differences in the physiologic measures or behavioral states of infants in the contingent singing sessions compared to control sessions. Parents and staff reported favorable views of music therapy in the NICU, and there were no adverse responses from infants during contingent singing. Further research is needed to determine the effectiveness of this intervention on the physiologic stability of infants with BPD.
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Affiliation(s)
| | - Joseph Hagan
- Texas Children's Hospital & Baylor College of Medicine
| | - Marlene Walden
- Arkansas Children's Hospital & University of Arkansas for Medical Sciences
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Wang KYH, Kealy D, Cox DW. A Pathway to Meaning in Life: Early Parental Support, Attachment, and the Moderating Role of Alexithymia. JOURNAL OF ADULT DEVELOPMENT 2022. [DOI: 10.1007/s10804-022-09418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bachmann CJ, Beecham J, O'Connor TG, Briskman J, Scott S. A good investment: longer-term cost savings of sensitive parenting in childhood. J Child Psychol Psychiatry 2022; 63:78-87. [PMID: 34187093 DOI: 10.1111/jcpp.13461] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan. The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested. METHODS Design: Longitudinal study with follow-up from 2012 to 2016. SETTING UK multicentre study cohort (London, South-East England). PARTICIPANTS 174 young people drawn from 2 samples, one at moderate risk of poor outcomes and one at high risk, assessed aged 4-6 years then followed up in early adolescence (mean age 12.1 years). MEASURES The primary outcome was total costs: health, social care, extra school support, out-of-home placements and family-born expenditure, determined through semistructured economic interviews. Early parenting quality was independently assessed through direct observation of parent-child interaction. RESULTS Costs were lower for youths exposed to more sensitive parenting (most sensitive quartile mean £1,619, least sensitive quartile mean £21,763; p < .001). Costs were spread across personal family expenditure and education, health, social and justice services. The cost difference remained significant after controlling for several potential confounders. These included demographic variables (family poverty, parental education); exposure to child abuse; and child/young person variables including level of antisocial behaviour in both childhood and adolescence, IQ and attachment security. CONCLUSIONS This study is the first showing that more sensitive early parental care predicts lower costs to society many years later, independent of poverty, child and youth antisocial behaviour levels and IQ. Savings are likely to increase as individuals grow older since early parenting quality predicts health, behavioural and occupational outcomes in adulthood. The findings provide novel evidence for the public health impact of early caregiving quality and likely financial benefits of improving it.
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Affiliation(s)
| | - Jennifer Beecham
- London School of Economics and Personal Social Services Research Unit, Cornwallis Central, University of Kent, Canterbury, Kent, UK
| | - Thomas G O'Connor
- Departments of Psychiatry, Psychology, Neuroscience, Obstetrics and Gynecology, Wynne Center for Family Research, University of Rochester, Rochester, NY, USA
| | - Jackie Briskman
- National Academy for Parenting Research, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Stephen Scott
- National Academy for Parenting Research, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Ali E, Letourneau N, Benzies K. Parent-Child Attachment: A Principle-Based Concept Analysis. SAGE Open Nurs 2021; 7:23779608211009000. [PMID: 34212075 PMCID: PMC8216337 DOI: 10.1177/23779608211009000] [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: 01/11/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Extensive evidence indicates that the quality of parent-child attachment is related to later socio-emotional and physical health outcomes. Yet, despite its clinical relevance, the parent-child attachment concept has been inconsistently applied across the disciplines of nursing, medicine and psychology and is often conflated with parent-child bonding in nursing literature. Objectives To provide readers with a critical analysis of the concept of parent-child attachment. Using a principle-based concept analysis, we clarify how parent-child attachment is understood from a multidisciplinary perspective to advance the use of this concept in nursing practice. Concept Description: Attachment is an affectionate, mutually satisfying relationship between a child and a caregiver that serves the purpose of making the child feel safe, secure, and protected. Discussion In this principle-based concept analysis, each definitional (i.e., epistemological, pragmatic, linguistic, and logical) principle contributes to an understanding of the strengths and limitations of the state of science about this concept. The discussion highlights how applying the concept of parent-child attachment security may offer exciting and promising opportunities for nursing clinical work with families. Conclusion The understanding of the concept of parent-child attachment differs among disciplines of nursing, medicine and psychology and offers exciting and promising opportunities for clarity and collaborative, multi-disciplinary work.
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Affiliation(s)
- E Ali
- University of Calgary, Calgary, Alberta, Canada
| | | | - K Benzies
- University of Calgary, Calgary, Alberta, Canada
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Linking Mother and Offspring Depressive Symptoms: The mediating role of child appearance contingent self-worth. J Affect Disord 2020; 273:113-121. [PMID: 32421591 DOI: 10.1016/j.jad.2020.03.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/03/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Adolescents exposed to maternal depression are more vulnerable to depressive symptoms. Less is known on the mediating role of children's self-worth construction processes, particularly those related to physical appearance. This study proposes and tests appearance contingent self-worth (ACSW) as a mediator linking depressive symptoms across generations. METHODS Our sample included 1,420 participants of the Great Smoky Mountain Study. Offspring depressive symptoms were prospectively assessed with DSM-IV for both the adolescent period (13-16) and adulthood period (19-26). Maternal depression was screened with the Short Mood and Feelings Questionnaire when the child was 13-16 years old. We used gender-stratified structural equation model in which offspring ACSW in adolescence and adulthood were specified as mediators linking maternal depression and offspring depressive symptoms in adolescence and adulthood, respectively. Mediation was tested using bias-corrected bootstrapped standard errors. RESULTS ACSW is associated with higher levels of depressive symptoms in both adolescent and adult females and males, but the link between maternal depressive symptoms and ACSW is only significant among females. ACSW partially mediates the effects of maternal depressive symptoms on adolescent and adult depressive symptoms in girls. LIMITATIONS Measurement of maternal depression was not based on diagnosis. Generalizability is limited due to the regional sample. CONCLUSION Our findings provide evidence that daughters of depressed mothers may stake their self-worth on body image, which may partially explain some of their higher susceptibility to depression.
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Abstract
Social anhedonia is well established as a transdiagnostic factor, but little is known about its development. This study examined whether temperament and parenting in early childhood predict social anhedonia in early adolescence. We also explored whether the relationships between early predictors and social anhedonia are moderated by a child's sex. A community sample of children participated in laboratory observations of temperament and parenting practices at age 3 (n = 275). The participants returned at age 12 and completed the Anticipatory and Consummatory Interpersonal Pleasure Scale-Child Version (ACIPS-C). Our results indicated that, at age 3, lower observed sociability predicted higher levels of social anhedonia at age 12. These associations were moderated by child sex, such that males with diminished sociability reported greater social anhedonia. These findings indicate that predictors of early adolescent social anhedonia are evident as early as 3 years of age. However, these effects were evident only for males, suggesting that the pathways to social anhedonia in early adolescence differ as a function of sex.
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Bachmann CJ, Beecham J, O'Connor TG, Scott A, Briskman J, Scott S. The cost of love: financial consequences of insecure attachment in antisocial youth. J Child Psychol Psychiatry 2019; 60:1343-1350. [PMID: 31495929 DOI: 10.1111/jcpp.13103] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Knowing that your parent or caregiver will be there for you in times of emotional need and distress is a core aspect of the human experience of feeling loved and being securely attached. In contrast, an insecure attachment pattern is found in many antisocial youth and is related to less sensitive caregiving. Such youth are often distrustful of adults and authority figures, and are at high risk of poor outcomes. As they become adults, they require extensive health, social and economic support, costing society ten times more than their well-adjusted peers. However, it is not known whether insecure attachment itself is associated with higher costs in at-risk youth, independently of potential confounders, nor whether cost differences are already beginning to emerge early in adolescence. METHODS Sample: A total of 174 young people followed up aged 9-17 years (mean 12.1, SD 1.8): 85 recruited with moderate antisocial behaviour (80th percentile) from a school screen aged 4-6 years; 89 clinically referred with very high antisocial behaviour (98th percentile) aged 3-7 years. MEASURES Costs by detailed health economic and service-use interview; attachment security to mother and father from interview; diagnostic interviews for oppositional and conduct problems; self-reported delinquent behaviour. RESULTS Costs were greater for youth insecurely attached to their mothers (secure £6,743, insecure £10,199, p = .001) and more so to fathers (secure £1,353, insecure £13,978, p < .001). These differences remained significant (mother p = .019, father p < .001) after adjusting for confounders, notably family income and education, intelligence and antisocial behaviour severity. CONCLUSIONS Attachment insecurity is a significant predictor of public cost in at-risk youth, even after accounting for covariates. Since adolescent attachment security is influenced by caregiving quality earlier in childhood, these findings add support to the public health case for early parenting interventions to improve child outcomes and reduce the financial burden on society.
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Affiliation(s)
| | - Jennifer Beecham
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.,Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Thomas G O'Connor
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Adam Scott
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jackie Briskman
- National Academy for Parenting Research, King's College London, London, UK
| | - Stephen Scott
- National Academy for Parenting Research, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Mónaco E, Schoeps K, Montoya-Castilla I. Attachment Styles and Well-Being in Adolescents: How Does Emotional Development Affect This Relationship? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2554. [PMID: 31319570 PMCID: PMC6678901 DOI: 10.3390/ijerph16142554] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 12/26/2022]
Abstract
Attachment relationships with parents, as well as emotional competencies, are protective factors against stress and other physical, mental, and relational health symptoms in adolescence. In this paper, we will examine the mediating role of emotional competencies in the relationship between attachment to parents and the well-being of adolescents, taking into account the influence of gender. There were 1276 Spanish adolescents between 12 and 15 years old (M = 13.48; SD = 1.09). We measured mother and father attachment relationships (trust, communication and alienation), emotional competencies (perceive and understand emotions, label and express emotions, manage and regulate emotions), and adolescent well-being using the indicators: somatic complaints, stress, satisfaction with life and affectivity. Descriptive analyses, Pearson correlations, and a multi-group path analysis were performed. The results indicated that emotional competencies partially mediate the relationship between attachment to parents and well-being variables. Attachment to one's mother and father, along with emotional competencies, are relevant variables in adolescent well-being. This highlights the importance of understanding the protective factors of well-being in adolescence, a time when levels of well-being are reduced compared to childhood.
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Affiliation(s)
- Estefanía Mónaco
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010 València, Spain
| | - Konstanze Schoeps
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010 València, Spain
| | - Inmaculada Montoya-Castilla
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010 València, Spain.
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