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Augustin M, Mall V, Licata-Dandel M. ADHD Symptoms in Middle Childhood: The Role of Child Attachment and Maternal Emotional Availability in an Inpatient Clinical Sample. Eur J Investig Health Psychol Educ 2024; 14:1572-1584. [PMID: 38921070 PMCID: PMC11202776 DOI: 10.3390/ejihpe14060104] [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: 04/30/2024] [Revised: 05/27/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Child ADHD symptoms are highly prevalent in middle childhood, alongside impairment in social functioning. The parent-child relationship has been shown to play an important role; however, studies investigating specific facets of the parent-child relationship in ADHD symptomatology in middle childhood have been neglected. We assumed that higher ADHD symptoms were associated with both (1) lower maternal emotional availability (EA) and (2) lower child attachment security. Moreover, (3) we aimed to explore which specific EA dimensions were associated with ADHD symptoms. METHODS In a socio-pediatric clinic in Germany, 71 inpatient mother-child dyads (child age: M = 7.70, SD = 1.06; n = 54 boys) were assessed. Clinical data about child ADHD symptoms (Child Behavior Checklist 6-18 subscale "attention deficit/hyperactivity problems"), maternal EA (free play), and child attachment representation (Attachment Story Completion Task, GEV-B) were analyzed cross-sectionally. RESULTS Controlling for child oppositional behavior and sex, child ADHD symptoms were associated with overall maternal EA, and more specifically non-hostility, but not with child attachment representation. CONCLUSIONS Our results imply that the role of parent-child interaction quality should be considered in the treatment of ADHD. Bidirectional effects cannot be ruled out.
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Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine and Health, Technical University of Munich, Heiglhofstr. 69, 81377 Munich, Germany; (V.M.); (M.L.-D.)
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine and Health, Technical University of Munich, Heiglhofstr. 69, 81377 Munich, Germany; (V.M.); (M.L.-D.)
- German Center for Child and Adolescent Health (DZKJ), Partner Site Munich, Heiglhofstr. 69, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine and Health, Technical University of Munich, Heiglhofstr. 69, 81377 Munich, Germany; (V.M.); (M.L.-D.)
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
- Department of Psychology, Charlotte Fresenius University, Infanteriestr. 11a, 80797 Munich, Germany
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Wessler J, Gebhard P, Zilcha-Mano S. Investigating movement synchrony in therapeutic settings using socially interactive agents: an experimental toolkit. Front Psychiatry 2024; 15:1330158. [PMID: 38380119 PMCID: PMC10877720 DOI: 10.3389/fpsyt.2024.1330158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Affiliation(s)
- Janet Wessler
- Affective Computing Group, Cognitive Assistants, German Research Center for Artificial Intelligence, Saarbruecken, Germany
| | - Patrick Gebhard
- Affective Computing Group, Cognitive Assistants, German Research Center for Artificial Intelligence, Saarbruecken, Germany
| | - Sigal Zilcha-Mano
- Psychotherapy Research Lab, Department of Psychology, University of Haifa, Haifa, Israel
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3
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Therriault D, Lemelin JP, Toupin J, Martin-Storey A, Déry M. Associations between externalizing behavior problems and risky sexual behaviors in adolescence: Attachment as a mediator. J Adolesc 2024; 96:394-410. [PMID: 38167998 DOI: 10.1002/jad.12285] [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: 07/04/2022] [Revised: 10/26/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Risky sexual behaviors in adolescence are associated with negative health and psychological functioning outcomes. Although the association between behavior problems and risky sexual behaviors is well established, addressing these problems requires understanding the mechanisms that help explain this association. Adolescent attachment, while related to risky sexual behavior, has not been extensively explored as an outcome of childhood externalizing problems. The two objectives of this study were to explore the links between parental and peer attachment and risky sexual behaviors and to examine the mediating effect of attachment on the links between behavior problems and risky sexual behaviors. METHODS Five hundred and ninety-eight French-Canadian adolescents (46.2% girls), Mage at T1 = 13.23; Mage at T2 = 14.28; Mage at T3 = 17.35) participated in this longitudinal study. RESULTS The quality of parental attachment at T2 was significantly and negatively associated with risky sexual behaviors 3 years later, at T3. More specifically, a lower quality parental attachment relationship was associated with having nonexclusive partners as well as with inconsistent condom use. Finally, parental attachment (T2) was a significant mediator between behavior problems (T1) and risky sexual behaviors (T3), but only for younger adolescents. CONCLUSIONS Findings suggest that in addition to behavior problems in adolescence, the quality of parental attachment relationships may help in understanding risky sexual behaviors in adolescence.
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Affiliation(s)
- Danyka Therriault
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Jean-Pascal Lemelin
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Jean Toupin
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Alexa Martin-Storey
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Michèle Déry
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
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4
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Smolar AI. The role of groups during individual development and within the clinical dyad. Am J Psychoanal 2023; 83:320-348. [PMID: 37553524 DOI: 10.1057/s11231-023-09412-y] [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] [Indexed: 08/10/2023]
Abstract
The author proposes that group identifications have been under-appreciated by individual psychodynamic psychotherapists in their conceptualization of normative individual development. He identifies the routes by which the child begins to internalize small and large groups during the early years of identity formation. Through individual therapy vignettes, the author suggests modifications to customary technique so that developmental shortcomings in group attachment security can be shored up. He offers some guidelines for the individual therapist so that group experiences are accounted for as the clinical narrative is written. Finally, he distinguishes patients who may require additional group-level interventions to address their avoidance of group participation.
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Affiliation(s)
- Andrew I Smolar
- , 300 E. Lancaster Ave., #209, Wynnewood, Philadelphia, PA, 19096, USA.
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5
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Topak OZ, Sinik Z, Oguzhanoglu NK, Ugurlu TT. An Evaluation of Psychogenic Predictors of Non-Organic Erectile Dysfunction. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1195. [PMID: 37512007 PMCID: PMC10385497 DOI: 10.3390/medicina59071195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/10/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Erectile dysfunction is a significant problem, which diminishes the quality of life. The aim of this study was to investigate the relationship of childhood trauma and attachment styles in the aetiology of psychogenic erectile dysfunction. Materials and Methods: The study included 80 participants (40 patients who presented with the complaint of erectile dysfunction, were not determined with an organic pathology, and were diagnosed with erectile dysfunction according to the DSM-5 criteria; and a control group of 40 healthy subjects.) The structured clinical interview form for DSM-5 (SCID-5) was applied to all the participants, together with the International Erectile Function Index (IIEF), the Childhood Trauma Questionnaire (CTQ), the Relationship Scale Questionnaire (RSQ), and the Beck Depression Inventory (BDI). Results: The emotional abuse (p = 0.002), physical abuse (p = 0.049), emotional neglect (p = 0.004), physical neglect (p = 0.002), and total scale points of the CTQ were determined to be significantly higher in the patient group than in the control group. Secure (p = 0.022) and dismissive (p = 0.009) attachment styles were found to be higher in the control group. As the time together with the current sexual partner increased, so the severity of erectile dysfunction increased, and sexual function, orgasmic function, sexual satisfaction, and general satisfaction decreased. As emotional abuse, sexual abuse, and physical neglect increased, the severity of erectile dysfunction increased. Childhood trauma (β = -0.275, t (73) = -2.704, p = 0.009) and the duration together with the partner (β = -0.249, t (73) = -2.512, p = 0.014) were found to be predictive of erectile dysfunction. Conclusions: The results of this study demonstrated that childhood trauma and the time elapsed without treatment are predictors of psychogenic erectile dysfunction severity, and secure attachment style and self-esteem play an important role in the aetiology of psychogenic erectile dysfunction.
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Affiliation(s)
- Osman Zulkif Topak
- Department of Psychiatry, School of Medicine, Pamukkale University, Denizli 20160, Turkey
| | - Zafer Sinik
- Department of Urology, Odak Hospital, Denizli 20100, Turkey
| | | | - Tugce Toker Ugurlu
- Department of Psychiatry, School of Medicine, Pamukkale University, Denizli 20160, Turkey
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6
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Slaughter A, Orth S. An Uncontrolled Case Study of a Tabletop Role-playing Therapy Group With Difficult-to-engage Patients. Int J Group Psychother 2023; 73:116-140. [PMID: 38446565 DOI: 10.1080/00207284.2023.2173602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Mental health organizations are increasingly adapting tabletop role-playing games (TTRPGs) into psychotherapy groups. Existing literature on therapeutic modalities with similar methods and theories of change suggest TTRPGs holds great promise in creating positive change for certain mental health populations, particularly those that have not responded well to traditional psychotherapy formats. At this time, no published, peer-reviewed research has examined TTRPG therapy groups offered to adults. Here we describe the application of one 8-week TTRPG therapy group with seven adults at a forensic facility. In this case study, we also describe the data we gathered and our findings regarding the feasibility, acceptability, and potential benefits of participating in this TTRPG. Our findings provide preliminary support of the feasibility and acceptability of this approach, and offer new directions on how to maximize benefits to group members. Limitations and future directions are discussed.
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7
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Burra N, Vrtička P. Association between attachment anxiety and the gaze direction-related N170. Attach Hum Dev 2023; 25:181-198. [PMID: 35924946 DOI: 10.1080/14616734.2022.2091337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Attachment theory suggests that interindividual differences in attachment security versus insecurity (anxiety and avoidance) contribute to the ways in which people perceive social emotional signals, particularly from the human face. Among different facial features, eye gaze conveys crucial information for social interaction, with a straight gaze triggering different cognitive and emotional processes as compared to an averted gaze. It remains unknown, however, how interindividual differences in attachment associate with early face encoding in the context of a straight versus averted gaze. Using electroencephalography (EEG) and recording event-related potentials (ERPs), specifically the N170 component, the present study (N = 50 healthy adults) measured how the characteristics of attachment anxiety and avoidance relate to the encoding of faces with respect to gaze direction and head orientation. Our findings reveal a significant relationship between gaze direction (irrespective of head orientation) and attachment anxiety on the interhemispheric (i.e. right) asymmetry of the N170 and thus provide evidence for an association between attachment anxiety and eye gaze processing during early visual face encoding.
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Affiliation(s)
- Nicolas Burra
- Faculté de Psychologie et des Sciences de l'Education, Université de Genève, Geneva, Switzerland
| | - Pascal Vrtička
- Department of Psychology, University of Essex, Colchester, UK
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8
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Azhari A, Gabrieli G, Bizzego A, Bornstein MH, Esposito G. Probing the association between maternal anxious attachment style and mother-child brain-to-brain coupling during passive co-viewing of visual stimuli. Attach Hum Dev 2023; 25:19-34. [PMID: 33357029 DOI: 10.1080/14616734.2020.1840790] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Brain-to-brain coupling during co-viewing of video stimuli reflects similar intersubjective mentalisation processes. During an everyday joint activity of watching video stimuli (television shows) with her child, an anxiously attached mother's preoccupation with her child is likely to distract her from understanding the mental state of characters in the show. To test the hypothesis that reduced coupling in the medial prefrontal cortex (PFC) would be observed with increasing maternal attachment anxiety (MAA), we profiled mothers' MAA using the Attachment Style Questionnaire and used functional Near-infrared Spectroscopy (fNIRS) to assess PFC coupling in 31 mother-child dyads while they watched three 1-min animation videos together. Reduced coupling was observed with increasing MAA in the medial right PFC cluster which is implicated in mentalisation processes. This result did not survive control analyses and should be taken as preliminary. Reduced coupling between anxiously-attached mothers and their children during co-viewing could undermine quality of shared experiences.
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Affiliation(s)
- Atiqah Azhari
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Andrea Bizzego
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Marc H Bornstein
- Institute for Fiscal Studies, London, UK.,Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Gianluca Esposito
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.,Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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9
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The influence of members’ attachment style on group cohesion in substance use therapy groups. DISCOVER PSYCHOLOGY 2022. [PMCID: PMC8785002 DOI: 10.1007/s44202-022-00022-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Group cohesion is an important factor in group therapy as it influences treatment outcomes and group processes. One’s attachment style has been found to impact experiences of group cohesion, however research into this relationship in substance use disorder (SUD) group treatment is lacking. This is of particular concern as insecure attachment presentations are more prevalent in this clinical population and group therapy is often treatment of choice. The current study sought to determine whether attachment style significantly predicted group cohesion. It also provided a qualitative exploration of factors that promote group cohesion in SUD group treatment. Participants (N = 38) attending a SUD therapy program completed self-report measures. Attachment avoidance was a significant negative predictor of positive bonding and positive working, and a significant positive predictor of negative relationships. Attachment anxiety was a significant negative predictor of negative relationships, however, unexpectedly did not significantly predict positive bonding or positive working. The current findings highlight the importance of group therapists tailoring group treatment to meet the attachment needs of individuals to promote a group therapy environment conducive to recovery.
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Alvarez-Subiela X, Castellano-Tejedor C, Villar-Cabeza F, Vila-Grifoll M, Palao-Vidal D. Family Factors Related to Suicidal Behavior in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9892. [PMID: 36011528 PMCID: PMC9408664 DOI: 10.3390/ijerph19169892] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: This research aims to investigate what type of family patterns (specifically attachment, bonding and family functioning) and stressful life events can trigger or protect adolescents from developing suicidal behavior. Methods: For these purposes, a case-control study (adolescents with suicidal behavior vs. paired adolescents with no suicidal behavior) was conducted with one hundred 12 to 17-year-old adolescents (50 controls, 50 cases, 74% females), assessed between 2018 and 2020. Results: Negligent (p < 0.001) or affection-less control bonding (p < 0.001), insecure attachment (p = 0.001) and stressful life events (p < 0.001) revealed to be significant risk factors for suicidal behavior. On the contrary, parents’ care (p < 0.001) and security (p < 0.001) were revealed as protective factors for suicidal behavior. Conclusions: Considering these results, family interventions and improving coping skills seem to be two essential targets for any suicide prevention intervention in adolescents.
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Affiliation(s)
- Xavier Alvarez-Subiela
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
- Doctoral Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Carmina Castellano-Tejedor
- Research Group on Stress and Health (GIES), Department of Basic Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
- RE-FIT Research Group, Parc Sanitari Pere Virgili & Vall d’Hebron Institute of Research, 08023 Barcelona, Spain
| | - Francisco Villar-Cabeza
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
| | - Mar Vila-Grifoll
- Suicide Conduct Unit, Psychiatry and Psychology Department, Sant Joan de Déu Hospital, 08950 Esplugues del Llobregat, Spain
| | - Diego Palao-Vidal
- Doctoral Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain
- Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, 08208 Barcelona, Spain
- Department of Mental Health, University Hospital Parc Taulí, Sabadell, 08208 Barcelona, Spain
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11
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Cerebellar engagement in the attachment behavioral system. Sci Rep 2022; 12:13571. [PMID: 35945247 PMCID: PMC9363408 DOI: 10.1038/s41598-022-17722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/29/2022] [Indexed: 11/08/2022] Open
Abstract
Brain structural bases of individual differences in attachment are not yet fully clarified. Given the evidence of relevant cerebellar contribution to cognitive, affective, and social functions, the present research was aimed at investigating potential associations between attachment dimensions (through the Attachment Style Questionnaire, ASQ) and cerebellar macro- and micro-structural measures (Volumetric and Diffusion Tensor Imaging data). In a sample of 79 healthy subjects, cerebellar and neocortical volumetric data were correlated with ASQ scores at the voxel level within specific Regions Of Interest. Also, correlations between ASQ scores and age, years of education, anxiety and depression levels were performed to control for the effects of sociodemographic and psychological variables on neuroimaging results. Positive associations between scores of the Preoccupation with Relationships (ASQ subscale associated to insecure/anxious attachment) and cortical volume were found in the cerebellum (right lobule VI and left Crus 2) and neocortex (right medial OrbitoFrontal Cortex, OFC) regions. Cerebellar contribution to the attachment behavioral system reflects the more general cerebellar engagement in the regulation of emotional and social behaviors. Cerebellar properties of timing, prediction, and learning well integrate with OFC processing, supporting the regulation of attachment experiences. Cerebellar areas might be rightfully included in the attachment behavioral system.
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12
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Antonucci LA, Raio A, Pergola G, Gelao B, Papalino M, Rampino A, Andriola I, Blasi G, Bertolino A. Machine learning-based ability to classify psychosis and early stages of disease through parenting and attachment-related variables is associated with social cognition. BMC Psychol 2021; 9:47. [PMID: 33757595 PMCID: PMC7989088 DOI: 10.1186/s40359-021-00552-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background Recent views posited that negative parenting and attachment insecurity can be considered as general environmental factors of vulnerability for psychosis, specifically for individuals diagnosed with psychosis (PSY). Furthermore, evidence highlighted a tight relationship between attachment style and social cognition abilities, a key PSY behavioral phenotype. The aim of this study is to generate a machine learning algorithm based on the perceived quality of parenting and attachment style-related features to discriminate between PSY and healthy controls (HC) and to investigate its ability to track PSY early stages and risk conditions, as well as its association with social cognition performance. Methods Perceived maternal and paternal parenting, as well as attachment anxiety and avoidance scores, were trained to separate 71 HC from 34 PSY (20 individuals diagnosed with schizophrenia + 14 diagnosed with bipolar disorder with psychotic manifestations) using support vector classification and repeated nested cross-validation. We then validated this model on independent datasets including individuals at the early stages of disease (ESD, i.e. first episode of psychosis or depression, or at-risk mental state for psychosis) and with familial high risk for PSY (FHR, i.e. having a first-degree relative suffering from psychosis). Then, we performed factorial analyses to test the group x classification rate interaction on emotion perception, social inference and managing of emotions abilities. Results The perceived parenting and attachment-based machine learning model discriminated PSY from HC with a Balanced Accuracy (BAC) of 72.2%. Slightly lower classification performance was measured in the ESD sample (HC-ESD BAC = 63.5%), while the model could not discriminate between FHR and HC (BAC = 44.2%). We observed a significant group x classification interaction in PSY and HC from the discovery sample on emotion perception and on the ability to manage emotions (both p = 0.02). The interaction on managing of emotion abilities was replicated in the ESD and HC validation sample (p = 0.03). Conclusion Our results suggest that parenting and attachment-related variables bear significant classification power when applied to both PSY and its early stages and are associated with variability in emotion processing. These variables could therefore be useful in psychosis early recognition programs aimed at softening the psychosis-associated disability. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00552-3.
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Affiliation(s)
- Linda A Antonucci
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Via Scipione Crisanzio 42, 70122, Bari, Italy. .,Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
| | - Alessandra Raio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giulio Pergola
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - Barbara Gelao
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Marco Papalino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
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13
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The Mediating Role of Dispositional Mindfulness in the Relationship Between Parental and Romantic Attachment. JOURNAL OF ADULT DEVELOPMENT 2020. [DOI: 10.1007/s10804-020-09362-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Kealy D, Aafjes‐van Doorn K, Ehrenthal JC, Weber R, Ogrodniczuk JS, Joyce AS. Improving social functioning and life satisfaction among patients with personality dysfunction: Connectedness and engagement in integrative group treatment. Clin Psychol Psychother 2020; 27:288-299. [DOI: 10.1002/cpp.2427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/11/2022]
Affiliation(s)
- David Kealy
- Department of PsychiatryUniversity of British Columbia Vancouver Canada
| | | | | | - Rainer Weber
- Clinic for Psychosomatics and PsychotherapyUniversity of Cologne Cologne Germany
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15
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Chi X, Becker B, Yu Q, Willeit P, Jiao C, Huang L, Hossain MM, Grabovac I, Yeung A, Lin J, Veronese N, Wang J, Zhou X, Doig SR, Liu X, Carvalho AF, Yang L, Xiao T, Zou L, Fusar-Poli P, Solmi M. Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic. Front Psychiatry 2020; 11:803. [PMID: 32848958 PMCID: PMC7427603 DOI: 10.3389/fpsyt.2020.00803] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To investigate the prevalence and risk factors for poor mental health of Chinese university students during the Corona Virus Disease 2019 (COVID-19) pandemic. METHOD Chinese nation-wide on-line cross-sectional survey on university students, collected between February 12th and 17th, 2020. Primary outcome was prevalence of clinically-relevant posttraumatic stress disorder symptoms. Secondary outcomes on poor mental health included prevalence of clinically-relevant anxiety and depressive symptoms, while posttraumatic growth was considered as indicator of effective coping reaction. RESULTS Of 2,500 invited Chinese university students, 2,038 completed the survey. Prevalence of clinically-relevant PTSD, anxiety, and depressive symptoms, and post traumatic growth (PTG) was 30.8, 15.5, 23.3, and 66.9% respectively. Older age, knowing people who had been isolated, more ACEs, higher level of anxious attachment, and lower level of resilience all predicted primary outcome (all p < 0.01). CONCLUSIONS A significant proportion of young adults exhibit clinically relevant posttraumatic stress disorder (PTSD), anxious or depressive symptoms, but a larger portion of individuals showed to effectively cope with COVID-19 pandemic. Interventions promoting resilience should be provided, even remotely, to those subjects with specific risk factors to develop poor mental health during COVID-19 or other pandemics with social isolation.
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Affiliation(s)
- Xinli Chi
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Benjamin Becker
- University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Yu
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | | | - Can Jiao
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Liuyue Huang
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | | | | | - Albert Yeung
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jingyuan Lin
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Nicola Veronese
- Primary Care Department, Azienda ULSS 3 (Unità Locale Socio Sanitaria) "Serenissima", Dolo-Mirano District, Venice, Italy
| | - Jian Wang
- Anhui Jianzhu University, Hefei, China
| | - Xinqi Zhou
- University of Electronic Science and Technology of China, Chengdu, China
| | - Scott R Doig
- Arkansas State University, Jonesboro, AR, United States
| | - Xiaofeng Liu
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Lin Yang
- Alberta Health Services, Calgary, AB, Canada.,University of Calgary, Calgary, AB, Canada
| | - Tao Xiao
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Liye Zou
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Paolo Fusar-Poli
- Early Psychosis: Intervention and Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marco Solmi
- Early Psychosis: Intervention and Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, London, United Kingdom.,Neuroscience Center, University of Padua, Padua, Italy
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Vandenberk T, Lanssens D, Storms V, Thijs IM, Bamelis L, Grieten L, Gyselaers W, Tang E, Luyten P. Relationship Between Adherence to Remote Monitoring and Patient Characteristics: Observational Study in Women With Pregnancy-Induced Hypertension. JMIR Mhealth Uhealth 2019; 7:e12574. [PMID: 31464190 PMCID: PMC6737887 DOI: 10.2196/12574] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/19/2019] [Accepted: 04/09/2019] [Indexed: 12/05/2022] Open
Abstract
Background Pregnancy-induced hypertension (PIH) is associated with high levels of morbidity and mortality in mothers, fetuses, and newborns. New technologies, such as remote monitoring (RM), were introduced in 2015 into the care of patients at risk of PIH in Ziekenhuis Oost-Limburg (Genk, Belgium) to improve both maternal and neonatal outcomes. In developing new strategies for obstetric care in pregnant women, including RM, it is important to understand the psychosocial characteristics associated with adherence to RM to optimize care. Objective The aim of this study was to explore the role of patients’ psychosocial characteristics (severity of depression or anxiety, cognitive factors, attachment styles, and personality traits) in their adherence to RM. Methods Questionnaires were sent by email to 108 mothers the day after they entered an RM program for pregnant women at risk of PIH. The Generalized Anxiety Disorder Assessment-7 and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and the severity of depression, respectively; an adaptation of the Pain Catastrophizing Scale was used to assess cognitive factors; and attachment and personality were measured with the Experiences in Close Relationships-Revised Scale (ECR-R), the Depressive Experiences Questionnaire, and the Multidimensional Perfectionism Scale, respectively. Results The moderate adherence group showed significantly higher levels of anxiety and depression, negative cognitions, and insecure attachment styles, especially compared with the over adherence group. The low adherence group scored significantly higher than the other groups on other-oriented perfectionism. There were no significant differences between the good and over adherence groups. Single linear regression showed that the answers on the PHQ-9 and ECR-R questionnaires were significantly related to the adherence rate. Conclusions This study demonstrates the relationships between adherence to RM and patient characteristics in women at risk of PIH. Alertness toward the group of women who show less than optimal adherence is essential. These findings call for further research on the management of PIH and the importance of individual tailoring of RM in this patient group. Trial Registration ClinicalTrials.gov NCT03509272; https://clinicaltrials.gov/ct2/show/NCT03509272
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Affiliation(s)
- Thijs Vandenberk
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Dorien Lanssens
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Valerie Storms
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium
| | - Inge M Thijs
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Lotte Bamelis
- Centre for Translational Psychological Research TRACE, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Lars Grieten
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Wilfried Gyselaers
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Eileen Tang
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.,Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Hoellen F, Wagner JF, Lüdders DW, Rody A, Banz-Jansen C. Anxiety in caregiving partners of breast cancer patients. Arch Gynecol Obstet 2019; 300:993-1005. [PMID: 31338658 DOI: 10.1007/s00404-019-05253-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/11/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of the present study was to determine the levels of anxiety of partners of breast cancer patients and to evaluate the differences of anxiety levels between patients and partners according to the stage of treatment, age and education level. METHODS 57 spouses or domestic partners of breast cancer patients and 148 breast cancer patients participated in this prospective cohort study and filled out the questionnaires including the Spielberger state-trait-anxiety-inventory, as well as questions based on stress-triggering procedures during breast cancer diagnosis and therapy. RESULTS State anxiety levels of partners were highest in partners who accompanied their patients when presenting for examinations and operations and tumorboard decisions (Mean State-Scores 52, 45 and 46.5). Anxiety scores were lowest at the stage of ongoing chemotherapy or follow-up. The 25% quartile of partners with the highest state anxiety levels had a significantly higher educational level (p = 0.023). Young men aged 18-35 years showed the highest levels of both trait and state anxiety. Partners showed significantly higher levels of anxiety than the patients for anesthetic complications (p < 0.001), e.g., fear of not waking up from general anesthetic and postoperative pain (p < 0.001). Patients showed significantly higher levels of anxiety for hairloss (p < 0.001), weight gain during chemotherapy (p < 0.001) and postoperative scars (p = 0.027). CONCLUSION Breast cancer patients are much more concerned about body image issues than their male partners. As these body image-associated concerns often arise from the fear of loosing attraction to their partner, these fears might be reduced by speaking about them openly. Partners are mostly concerned about surgery and anesthetic-related complications. Therefore, preoperative medical information to the partner is mandatory. Partners of breast cancer patients should be included in psycho-oncological support and medical briefings. Probably high anxiety levels of both partners and patients should be taken into account (due to younger age, lower educational level and procedures causing distress). These partners and patients should receive extra careful (clarification) counselling and (treatment support such as a psycho-oncologist) involvement of a psyco-oncologist.
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Affiliation(s)
- Friederike Hoellen
- Department of Gynecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Luebeck, 23538, Lübeck, Germany.
| | | | - Dörte W Lüdders
- Department of Gynecology and Obstetrics, Medical Campus Carl Von Ossietzky University Oldenburg, 26133, Oldenburg, Germany
| | - Achim Rody
- Department of Gynecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Luebeck, 23538, Lübeck, Germany
| | - Constanze Banz-Jansen
- Department of Gynecology and Obstetrics, Evangelisches Klinikum Bethel, 33617, Bielefeld, Germany
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An examination of the relationship between alexithymia and somatic complaints of mothers and obsessive-compulsive features of children. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/jcm.559584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Burra N, Massait S, Vrtička P. Differential impact of trait, social, and attachment anxiety on the stare-in-the-crowd effect. Sci Rep 2019; 9:1797. [PMID: 30742015 PMCID: PMC6370884 DOI: 10.1038/s41598-019-39342-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 01/22/2019] [Indexed: 02/06/2023] Open
Abstract
Eye gaze conveys crucial information for social interactions, with straight versus averted gaze triggering distinct emotional and cognitive processes. The "stare-in-the-crowd" effect exemplifies such differential visual processing of gaze direction, in more recent reports also in interaction with head orientation. Besides aiming at replicating the "stare-in-the-crowd" effect by means of an eye gaze by head orientation interaction, the present study intended to for the first time testing its susceptibility to inter-individual differences in trait, social, and attachment anxiety. Our findings reveal a significant relation between the "stare-in-the-crowd" effect and social and attachment, but not trait anxiety, and therefore provide preliminary cues for personality influences on visual processing of eye gaze and head orientation.
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Affiliation(s)
- Nicolas Burra
- Faculté de Psychologie et des Sciences de l'Education, Université de Genève, Geneva, Switzerland.
| | - Solene Massait
- Faculté de Psychologie et des Sciences de l'Education, Université de Genève, Geneva, Switzerland
| | - Pascal Vrtička
- Max Planck Institute for Human Cognitive and Brain Sciences, Research Group Social Stress and Family Health, Leipzig, Germany
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English LH, Wisener M, Bailey HN. Childhood emotional maltreatment, anxiety, attachment, and mindfulness: Associations with facial emotion recognition. CHILD ABUSE & NEGLECT 2018; 80:146-160. [PMID: 29605464 DOI: 10.1016/j.chiabu.2018.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 01/02/2018] [Accepted: 02/07/2018] [Indexed: 05/26/2023]
Abstract
The current study investigated factors thought to contribute to facial emotion processing. Female university students (N = 126) completed self-report measures of childhood emotional maltreatment, anxiety symptoms, attachment anxiety and avoidance, and trait mindfulness before completing a facial emotion recognition task, where they viewed sequences of faces that incorporated progressively more emotional content until they were able to correctly identify the emotion. They completed the task under low and high cognitive load conditions to distinguish between relatively effortful versus automatic processing abilities. Regression analyses revealed that under low cognitive load, attachment avoidance and mindfulness predicted quicker identification of fear (i.e., with less perceptual information), whereas anxiety predicted slower identification of fear (i.e., with more perceptual information). In the high cognitive load condition, emotional maltreatment and mindfulness predicted quicker identification of fear, and anxiety and mindfulness predicted faster identification of emotions overall. Although current findings are correlational, most of these effects were specific to fearful faces, suggesting that experiences of childhood emotional maltreatment and associated socio-emotional sequelae are related to heightened processing of threat-related information.
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Affiliation(s)
- Lianne H English
- University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1, Canada.
| | - Melanie Wisener
- McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada.
| | - Heidi N Bailey
- University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1, Canada.
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Smolar AI. Enhancing the Dyad: The Benefits of Combining Group Therapy with Psychoanalytic Treatment. PSYCHOANALYTIC INQUIRY 2018. [DOI: 10.1080/07351690.2018.1444848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Gans JS. The Leader's Illumination of Group Phenomena Hidden in Plain Sight: Why Is No One Talking About the Elephant in the Room? Int J Group Psychother 2017; 67:337-359. [PMID: 38475598 DOI: 10.1080/00207284.2016.1246946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article discusses an important leadership function: calling attention to phenomena in group therapy that are NOT observed or observed but not commented on by group members. The article includes group scenarios that often generate member omission, ways to mitigate shame that can result from uncovering members' blind spots, and misuses of this leadership function. Numerous clinical examples are provided. Concepts borrowed from attachment theory and interpersonal neurobiology help explain how the group's internalization of this leader function may help the group become a more potent therapeutic environment. The limited contribution of neurological findings to clinical decision-making is discussed.
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Miles JR, Mallinckrodt B. Establishing a Secure Base to Increase Exploration of Diversity in Groups. Int J Group Psychother 2017; 67:259-275. [PMID: 38449239 DOI: 10.1080/00207284.2016.1264721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
All groups can be considered multicultural, and group members often present with issues that stem from contextual factors related to cultural identities, including experiences with oppression. Therefore, group leaders must be able to effectively facilitate deep intercultural dialogues in psychotherapy groups, and we suggest that an understanding of attachment theory can help leaders engage group members in these dialogues. In order to demonstrate how attachment theory can be applied to the exploration of diversity in groups, we provide a case example from an intergroup dialogue group bringing together religious minorities, secular individuals, and Christians over the course of eight weeks. In this example, we focus on the two group members who scored the lowest (Jill) and highest (Sarah) on a measure of attachment anxiety and avoidance to illustrate the experiences of one member with more secure attachment and one with more preoccupied attachment. Specifically, we present data from their weekly reflective journals to explore their different experiences of the group over time. Finally, we discuss the case in terms of attachment theory and highlight implications for group leaders.
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Kivlighan DM, Lo Coco G, Gullo S, Pazzagli C, Mazzeschi C. Attachment Anxiety and Attachment Avoidance: Members' Attachment Fit with Their Group and Group Relationships. Int J Group Psychother 2017; 67:223-239. [PMID: 38449240 DOI: 10.1080/00207284.2016.1260464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We compared each individual group member's attachment fit with the attachment of the other group members. Participants were 201 members of 20 therapy groups who sought treatment because they were overweight or obese. Group members completed the Attachment Style Questionnaire before commencing treatment and the Group Questionnaire at three points during group treatment. Multilevel polynomial regression followed by response surface analysis was used to examine how the attachment anxiety and avoidance of the individual group member and the aggregated attachment anxiety and avoidance of the group members were related to individual group members' perceptions of the positive bonding, positive working relationships, and negative relationships in the group. The findings suggested that attachment heterogeneity in group is related to the perception of members' stronger bonding relationships and lower negative relationships. In addition, positive bonding can be increased when a patient high in attachment avoidance is added to a group whose patients are low in attachment avoidance; however, group members reported weaker negative relationships when their attachment anxiety or avoidance became increasingly higher or lower than other group members' attachment anxiety or avoidance.
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Vahedi S, Badri Gargari R, Gholami S. Mediating Role of Cognitive Emotion Regulation Strategies on the Relationship between the Attachment Styles and Emotional Problems: A Path Analysis. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016. [DOI: 10.17795/ijpbs-4013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Keating C, Castle DJ, Newton R, Huang C, Rossell SL. Attachment Insecurity Predicts Punishment Sensitivity in Anorexia Nervosa. J Nerv Ment Dis 2016; 204:793-798. [PMID: 27441458 DOI: 10.1097/nmd.0000000000000569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Individuals with anorexia nervosa (AN) experience insecure attachment. We investigated whether insecure attachment is associated with punishment and reward sensitivity in women with AN. Women with AN (n = 24) and comparison women (n = 26) (CW) completed The Eating Disorder Examination Questionnaire, Depression Anxiety Stress Scale, The Attachment Style Questionnaire, and Sensitivity to Punishment/Sensitivity to Reward Questionnaire. Participants with AN returned higher ratings for insecure attachment (anxious and avoidant) experiences and greater sensitivity to punishment (p = 0.001) than CW. In AN, sensitivity to punishment was positively correlated with anxious attachment and negative emotionality but not eating disorder symptoms. Regression analysis revealed that anxious attachment independently predicted punishment sensitivity in AN. Anxious attachment experiences are related to punishment sensitivity in AN, independent of negative emotionality and eating disorder symptoms. Results support ongoing investigation of the contribution of attachment experiences in treatment and recovery.
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Affiliation(s)
- Charlotte Keating
- *Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Art and Design, Swinburne University of Technology, Hawthorn; †Department of Psychiatry, St. Vincent's Hospital, Melbourne; ‡Department of Psychiatry, The University of Melbourne, Melbourne; §Austin Health, Heidelberg; ∥The Melbourne Clinic, Melbourne; and ¶Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Abstract
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorization of mental disorders places "separation anxiety disorder" within the broad group of anxiety disorders, and its diagnosis no longer rests on establishing an onset during childhood or adolescence. In previous editions of DSM, it was included within the disorders usually first diagnosed in infancy, childhood, or adolescence, with the requirement for an onset of symptoms before the age of 18 years: symptomatic adults could only receive a retrospective diagnosis, based on establishing this early onset. The new position of separation anxiety disorder is based upon the findings of epidemiological studies that revealed the unexpectedly high prevalence of the condition in adults, often in individuals with an onset of symptoms after the teenage years; its prominent place within the DSM-5 group of anxiety disorders should encourage further research into its epidemiology, etiology, and treatment. This review examines the clinical features and boundaries of the condition, and offers guidance on how it can be distinguished from other anxiety disorders and other mental disorders in which "separation anxiety" may be apparent.
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Abstract
BACKGROUND Attachment theory proposes that psychological functioning and affect regulations are influenced by the attachment we form with others. Early relationships with parents or caregivers lay the foundations for attachment styles. These styles are proposed to influence how we relate to others during our life can be modified by the relationships and events we experience in our lifespan. A secure attachment style is associated with a capacity to manage distress, comfort with autonomy and the ability to form relationships with others, whereas insecure attachment can lead to dysfunctional relationships, emotional and behaviour avoidance. Attachment theory provides a useful framework to inform our understanding of relationship difficulties in people with psychosis. This paper aims to complement recent systematic reviews by providing an overview of attachment theory, its application to psychosis, including an understanding of measurement issues and the clinical implications offered. METHOD A narrative review was completed of the measures of attachment and parental bonding in psychosis. Its clinical implications are also discussed. The paper also explores the link between insecure attachment styles and illness course, social functioning and symptomatology. The following questions are addressed: What are the key attachment measures that have been used within the attachment and psychosis literature? What are the results of studies that have measured attachment or parental bonding in psychosis and what clinical implications can we derive from it? What are some of the key questions for future research from these findings in relation to the onset of psychosis research field? RESULTS The most commonly used measures of attachment in psychosis research are reviewed. Self-report questionnaires and semi-structured interviews have mainly been used to examine attachment styles in adult samples and in recent years comprise a measure specifically developed for a psychosis group. The review suggests that insecure attachment styles are common in psychosis samples. Key relationships were observed between insecure, avoidant and anxious attachment styles and psychosis development, expression and long-term outcome. CONCLUSIONS Attachment theory can provide a useful framework to facilitate our understanding of interpersonal difficulties in psychosis that may predate its onset and impact on observed variability in outcomes, including treatment engagement. Greater attention should be given to the assessment of attachment needs and to the development of interventions that seek to compensate for these difficulties. However, further investigations are required on specifying the exact mechanisms by which specific attachment styles impact on the development of psychosis and its course.
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Raufman R, Nesher R, Weinberg H. Group Psychotherapy in Israel: History and Main Trends. Int J Group Psychother 2015; 65:606-16. [PMID: 26401803 DOI: 10.1521/ijgp.2015.65.4.606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In Israel, the sense of belonging carries special meaning for historical and contemporary reasons. Since its establishment, Israel, with a background of centuries of persecution of the Jews, has been subjected to a consistent threat of war and terror that makes it a traumatized society. On the one hand, this intensifies social cohesiveness, especially in times of war. Yet many of the threats pose existential, political, and ideological dilemmas. The trauma of the Holocaust coupled with the continuous existence of wars enhanced the development of special kinds of groups. No wonder group therapy in Israel flourishes, perhaps more than in any other Western country (Nuttman-Shwartz & Weinberg, 2002).
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Affiliation(s)
- Ravit Raufman
- Clinical psychologist and group therapist at the Graduate School of Creative Art Therapy, University of Haifa, Israel
| | - Ronit Nesher
- Group therapist and adjunct lecturer at the University of Haifa, Rambam Hospital, Advanced Nursing School
| | - Haim Weinberg
- Director of international programs at the Professional School of Psychology in Sacramento, California
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Nicholas MW. The compulsion to repeat relationships with abusive partners and how group therapy can help. Int J Group Psychother 2014; 63:346-65. [PMID: 23734919 DOI: 10.1521/ijgp.2013.63.3.346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The mystery of why some people are compelled to repeatedly engage in relationships with people who are cruel to them is frequently pondered in literature and psychology. The present paper posits that the etiology of this pathological relationship pattern derives from a parental relationship that was both highly exciting and highly frustrating. Spontaneous recapitulations of the passionate masochistic relationship in the therapy group allow the patient, the therapist and the group to appreciate the exact nature of the "bad" partner's appeal for the patient and its link to parental antecedents. In addition, the author suggests, group therapy can provide attachment experiences that are stimulating and rewarding enough to override the patient's attraction to the toxic partner(s) and build an enhanced capacity for intimacy. The cases of two patients are presented who spent three and a half years in the same long term psychodynamic group, and who, through the processes described above, successfully resolved their masochistic relationship patterns.
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Okello J, Nakimuli-Mpungu E, Musisi S, Broekaert E, Derluyn I. The association between attachment and mental health symptoms among school-going adolescents in northern Uganda: the moderating role of war-related trauma. PLoS One 2014; 9:e88494. [PMID: 24614005 PMCID: PMC3948618 DOI: 10.1371/journal.pone.0088494] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/06/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association between attachment and mental health symptoms in adolescents in a post-conflict low resource setting has not been documented. METHODS We investigated the relationship between parent and peer attachment and posttraumatic stress, depression and anxiety symptoms in a sample of 551 adolescents aged 13-21 years old. Attachment quality was assessed using the Inventory of Parent and Peer Attachment (IPPA). Post-traumatic stress, depression and anxiety symptoms were assessed using the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Gender differences in attachment relationships were determined using independent t-tests. Multivariate logistic regression was used to assess whether attachment relationships were independently associated with posttraumatic stress, depression and anxiety symptoms. Hierarchical linear regression analyses were conducted to explore the moderating role of war-related trauma. RESULTS Our analyses revealed gender differences in attachment to parents, with males reporting stronger attachment than females. Parental attachment was protective against depression and anxiety symptoms but not posttraumatic stress symptoms after adjusting for potential confounders. Alienation by parents was independently associated with an increase in these mental health symptoms while peer attachment was not associated with any of these symptoms. However, in situations of severe trauma, our analyses showed that peer attachment was significantly protective against post-traumatic stress symptoms. CONCLUSIONS Secure parental attachment is associated with better psychosocial adjustment in adolescents affected by war. Further, adolescents with secure peer attachment relationships in situations of severe war trauma may be less likely to develop posttraumatic stress symptoms. Interventions to enhance peer support in this post conflict setting would benefit this vulnerable population.
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Affiliation(s)
- James Okello
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Psychiatry, Gulu University, Gulu, Uganda
- Department of Social Welfare Studies and Centre for Children in Vulnerable Situations, Ghent University, Ghent, Belgium
- * E-mail:
| | | | - Seggane Musisi
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Eric Broekaert
- Department of Orthopedagogics, Ghent University, Ghent, Belgium
| | - Ilse Derluyn
- Department of Social Welfare Studies and Centre for Children in Vulnerable Situations, Ghent University, Ghent, Belgium
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A longitudinal study of maternal attachment and infant developmental outcomes. Arch Womens Ment Health 2013; 16:521-9. [PMID: 23737011 PMCID: PMC3796052 DOI: 10.1007/s00737-013-0357-8] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/20/2013] [Indexed: 10/26/2022]
Abstract
Extant research has demonstrated that compared to adults with insecure attachment styles, more securely attached parents tend to be more responsive, sensitive, and involved parents, resulting in improved outcomes for their children. Less studied is the influence of a mother's attachment style on her attachment to her unborn child during pregnancy and the consequent developmental outcomes of the child during early childhood. Thus, the aim of this prospective longitudinal study was to examine the relationship between maternal-fetal attachment (MFA) during pregnancy and infant and toddler outcomes and the role of mothers' attachment style on early childhood developmental outcomes in an economically disadvantaged sample of women and their children. Gamma regression modeling demonstrated that an avoidant maternal attachment style (b = .98, 95 % CI [.97, .98], p < 0.001) and post-partum depressive symptomatology (b = .97, 95 % CI [.96-.99], p = 0.03) were significant predictors of early childhood development. Women demonstrating higher avoidant attachment styles and greater depressive symptomatology were more likely to have children demonstrating early childhood developmental delays than those women with less avoidant attachment styles and less depressive symptomatology. Furthermore, women reporting higher MFA during pregnancy had more secure attachment styles, and their children had more optimal early childhood development than those women reporting lower MFA and less secure attachment styles. Findings have implications for enhancing early intervention programs aimed at improving maternal and childhood outcomes. An earlier identification of disruptions in attachment may be beneficial in tailoring interventions focused on the mother-child dyad.
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Abstract
Human infancy has been studied as a platform for hypothesis and theory testing, as a major physiological and psychological adjustment, as an object of adults' effects as well as a source of effects on adults, for its comparative value, as a stage of life, and as a setting point for the life course. Following an orientation to infancy studies, including previous reviews and a discussion of the special challenges infants pose to research, this article focuses on infancy as a foundation and catalyst of human development in the balance of the life course. Studies of stability and prediction from infancy illustrate the depth and complexity of modern research on infants and provide a long-awaited reply to key philosophical and practical questions about the meaningfulness and significance of infancy.
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Affiliation(s)
- Marc H Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service, Bethesda, Maryland 20892;
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Keating L, Tasca GA, Hill R. Structural relationships among attachment insecurity, alexithymia, and body esteem in women with eating disorders. Eat Behav 2013; 14:366-73. [PMID: 23910782 DOI: 10.1016/j.eatbeh.2013.06.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/04/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
Patients with eating disorders tend to experience low levels of body esteem. To assess the psychosocial processes that may predict low body esteem in these individuals, we assessed the structural interrelations among attachment anxiety, attachment avoidance, alexithymia, and body esteem in a cross-sectional sample of patients with eating disorders. We tested a model in which alexithymia mediates the relationship between attachment insecurity and body esteem. Participants were 300 women with anorexia nervosa (n = 109), bulimia nervosa (n = 130), and eating disorders not otherwise specified (n = 61) who completed pretreatment self-report questionnaires at intake for a day hospital treatment program. We found a direct and negative relationship between attachment anxiety and body esteem. Additionally, attachment avoidance had an indirect negative relationship to body esteem through alexithymia. These results indicate that therapists may attend to attachment insecurity and affective regulation strategies when addressing body image issues in patients with eating disorders.
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Affiliation(s)
- Leah Keating
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
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36
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Forsythe LP, Romano JM, Jensen MP, Thorn BE. Attachment style is associated with perceived spouse responses and pain-related outcomes. Rehabil Psychol 2012; 57:290-300. [PMID: 23148713 DOI: 10.1037/a0030083] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE Attachment theory can provide a heuristic model for examining factors that may influence the relationship of social context to adjustment in chronic pain. This study examined the associations of attachment style with self-reported pain behavior, pain intensity, disability, depression, and perceived spouse responses to pain behavior. We also examined whether attachment style moderates associations between perceived spouse responses and self-reported pain behavior and depressive symptoms, as well as perceived spouse responses as a mediator of these associations. METHOD Individuals with chronic pain (N = 182) completed measures of self-reported attachment style, perceived spouse responses, and pain-related criterion variables. RESULTS Secure attachment was inversely associated with self-reported pain behaviors, pain intensity, disability, depressive symptoms, and perceived negative spouse responses; preoccupied and fearful attachment scores were positively associated with these variables. In multivariable regression models, both attachment style and perceived spouse responses were uniquely associated with self-reported pain behavior and depressive symptoms. Attachment style did not moderate associations between perceived spouse responses to self-reported pain behavior and pain criterion variables, but negative spouse responses partially mediated some relationships between attachment styles and pain outcomes. CONCLUSIONS/IMPLICATIONS Findings suggest that attachment style is associated with pain-related outcomes and perceptions of spouse responses. The hypothesized moderation effects for attachment were not found; however, mediation analyses showed that perceived spouse responses may partially explain associations between attachment and adjustment to pain. Future research is needed to clarify how attachment style and the social environment affect the pain experience.
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Affiliation(s)
- Laura P Forsythe
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
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Martin LA, Vosvick M, Riggs SA. Attachment, forgiveness, and physical health quality of life in HIV + adults. AIDS Care 2012; 24:1333-40. [DOI: 10.1080/09540121.2011.648598] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Luci A. Martin
- a Department of Psychology , University of La Verne , La Verne , CA , USA
| | - Mark Vosvick
- b Department of Psychology , University of North Texas , Denton , TX , USA
| | - Shelley A. Riggs
- b Department of Psychology , University of North Texas , Denton , TX , USA
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Morley TE, Moran G. The origins of cognitive vulnerability in early childhood: mechanisms linking early attachment to later depression. Clin Psychol Rev 2011; 31:1071-82. [PMID: 21820386 DOI: 10.1016/j.cpr.2011.06.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 06/10/2011] [Accepted: 06/13/2011] [Indexed: 02/03/2023]
Abstract
This paper examines the theory and research linking attachment relationships to cognitive vulnerability to depression and assesses evidence that early attachment experiences contribute to the development of these cognitive processes. Most research in this area has involved adult participants using self-report measures of both attachment and depressive vulnerabilities and thus cannot convincingly speak to the existence of such a developmental pathway. Several studies, however, have followed individuals from infancy and examined the emergence of self-esteem and responses to failure throughout childhood and adolescence. These studies suggest that early experiences in non-secure attachment relationships place an individual at-risk for developing a cognitive framework that increases their vulnerability to depression following stressful life events. The paper concludes with a discussion of how future research might best explore specific mechanisms through which distinct attachment relationships may lead to divergent developmental pathways sharing the common outcome of cognitive processes that place individuals at risk for depression.
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Affiliation(s)
- Tara E Morley
- Department of Psychology, University of Western Ontario, Canada.
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Schmalisch CS, Bratiotis C, Muroff J. Processes in Group Cognitive and Behavioral Treatment for Hoarding. COGNITIVE AND BEHAVIORAL PRACTICE 2010. [DOI: 10.1016/j.cbpra.2009.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Flores PJ. Group psychotherapy and neuro-plasticity: an attachment theory perspective. Int J Group Psychother 2010; 60:546-70. [PMID: 21028976 DOI: 10.1521/ijgp.2010.60.4.546] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article selectively highlights relevant areas of neuroscience research which have direct application for attachment theory and group psychotherapy. Emerging evidence from the neurosciences is revealing that the developing brain of the infant, sculpted by the earliest attachment relationships, continues to be malleable in adulthood and can be profoundly influenced by ongoing relationships throughout one's lifespan. Advances in the neurosciences are also supporting the idea that strong attachment bonds and external interpersonal interactions that arise within the context of these attachments are registered as a person's neurophysiology and neurobiology. Attachment theory in particular provides a common language and conceptual framework from which the contributions from the neurosciences can be made applicable to group psychotherapy.
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Affiliation(s)
- Philip J Flores
- Private Practice, 6065 Lake Forrest Drive, Suite 150, Atlanta, Georgia 30328, USA.
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Kiesewetter S, Köpsel A, Köpp W, Kallenbach-Dermutz B, Pfeiffer AFH, Spranger J, Deter HC. Psychodynamic mechanism and weight reduction in obesity group therapy - first observations with different attachment styles. PSYCHO-SOCIAL MEDICINE 2010; 7. [PMID: 20930928 PMCID: PMC2940216 DOI: 10.3205/psm000066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives: Successful long-term results are extremely rare in non-surgical obesity treatment. Interactional difficulties with the attending physicians and the limited compliance of obese patients are a frequently described dilemma in repeated psychotherapeutic group treatment attempts. The type of relationship initiation and the attachment behavior probably play a central role in this connection but have not yet been systematically investigated. Methods: This paper focuses on the attachment styles of obese subjects and their effects on psychodynamic group therapy within the context of a weight-reduction program. Results: The attachment styles are characterized in 107 pre-obese and obese patients, and their effects on patients and therapists in group therapy are described. Conclusion: The paper surveys the motivational situation, clinical pictures, and repeated group topics.
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Affiliation(s)
- Sybille Kiesewetter
- Department of Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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Fisher HE, Brown LL, Aron A, Strong G, Mashek D. Reward, addiction, and emotion regulation systems associated with rejection in love. J Neurophysiol 2010; 104:51-60. [PMID: 20445032 DOI: 10.1152/jn.00784.2009] [Citation(s) in RCA: 208] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Romantic rejection causes a profound sense of loss and negative affect. It can induce clinical depression and in extreme cases lead to suicide and/or homicide. To begin to identify the neural systems associated with this natural loss state, we used functional magnetic resonance imaging to study 10 women and 5 men who had recently been rejected by a partner but reported they were still intensely "in love." Participants alternately viewed a photograph of their rejecting beloved and a photograph of a familiar, individual, interspersed with a distraction-attention task. Their responses while looking at their rejecter included love, despair, good, and bad memories, and wondering why this happened. Activation specific to the image of the beloved occurred in areas associated with gains and losses, craving and emotion regulation and included the ventral tegmental area (VTA) bilaterally, ventral striatum, medial and lateral orbitofrontal/prefrontal cortex, and cingulate gyrus. Compared with data from happily-in-love individuals, the regional VTA activation suggests that mesolimbic reward/survival systems are involved in romantic passion regardless of whether one is happily or unhappily in love. Forebrain activations associated with motivational relevance, gain/loss, cocaine craving, addiction, and emotion regulation suggest that higher-order systems subject to experience and learning also may mediate the rejection reaction. The results show activation of reward systems, previously identified by monetary stimuli, in a natural, endogenous, negative emotion state. Activation of areas involved in cocaine addiction may help explain the obsessive behaviors associated with rejection in love.
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Affiliation(s)
- Helen E Fisher
- Department of Anthropology, Rutgers University, Newark, New Jersey, USA
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Weingarten C, Chisholm J. Attachment and Cooperation in Religious Groups. CURRENT ANTHROPOLOGY 2009. [DOI: 10.1086/605767] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kirchmann H, Mestel R, Schreiber-Willnow K, Mattke D, Seidler KP, Daudert E, Nickel R, Papenhausen R, Eckert J, Strauss B. Associations among attachment characteristics, patients’ assessment of therapeutic factors, and treatment outcome following inpatient psychodynamic group psychotherapy. Psychother Res 2009; 19:234-48. [DOI: 10.1080/10503300902798367] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bindung und Gruppenprozesse: Wie nützlich ist die Bindungstheorie für die Gruppenpsychotherapie? GRUPPENPSYCHOTHERAPIE UND GRUPPENDYNAMIK 2007. [DOI: 10.13109/grup.2007.43.2.90] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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