1
|
Granqvist P, Sroufe LA, Dozier M, Hesse E, Steele M, van Ijzendoorn M, Solomon J, Schuengel C, Fearon P, Bakermans-Kranenburg M, Steele H, Cassidy J, Carlson E, Madigan S, Jacobvitz D, Foster S, Behrens K, Rifkin-Graboi A, Gribneau N, Spangler G, Ward MJ, True M, Spieker S, Reijman S, Reisz S, Tharner A, Nkara F, Goldwyn R, Sroufe J, Pederson D, Pederson D, Weigand R, Siegel D, Dazzi N, Bernard K, Fonagy P, Waters E, Toth S, Cicchetti D, Zeanah CH, Lyons-Ruth K, Main M, Duschinsky R. Disorganized attachment in infancy: a review of the phenomenon and its implications for clinicians and policy-makers. Attach Hum Dev 2017; 19:534-558. [PMID: 28745146 PMCID: PMC5600694 DOI: 10.1080/14616734.2017.1354040] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/07/2017] [Indexed: 02/07/2023]
Abstract
Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static "trait" of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.
Collapse
Affiliation(s)
- Pehr Granqvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - L. Alan Sroufe
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Mary Dozier
- Department of Psychological and Brain Sciences, University of Delaware, Newark, NY, USA
| | - Erik Hesse
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Miriam Steele
- Psychology Department, The New School, New York, NY, USA
| | - Marinus van Ijzendoorn
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Judith Solomon
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Carlo Schuengel
- Clinical Child and Family Studies and Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College of London, London, UK
| | | | - Howard Steele
- Psychology Department, The New School, New York, NY, USA
| | - Jude Cassidy
- Psychology Department, University of Maryland, WashingtonDC, USA
| | - Elizabeth Carlson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | | | - Sarah Foster
- Faculty of Health and Life Sciences, University of Northumbria, Newcastle, UK
| | - Kazuko Behrens
- Department of Social and Behavioral Sciences, SUNY Polytechnic Institute, Utica, NY, USA
| | - Anne Rifkin-Graboi
- the Neurodevelopmental Research Center, the Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Naomi Gribneau
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Gottfried Spangler
- Developmental and Educational Psychology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mary J Ward
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - Mary True
- Psychology Department, St Mary’s College of California, Moraga, NY, USA
| | - Susan Spieker
- Center on Human Development and Disability, University of Washington, Seattle, MA, USA
| | - Sophie Reijman
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Samantha Reisz
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
- the Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Anne Tharner
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Frances Nkara
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Ruth Goldwyn
- Child and Adolsecent Mental Health Service, Trafford Children and Young Peoples Service, Manchester, UK
| | - June Sroufe
- Minnesota Institute for Contemporary Psychotherapy and Psychoanalysis, Minneapolis, MI, USA
| | - David Pederson
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | | | - Robert Weigand
- T. Denny Sanford School of Social & Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Daniel Siegel
- School of Medicine, University of California, Los Angeles, CA, USA
| | - Nino Dazzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Kristin Bernard
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College of London, London, UK
| | - Everett Waters
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Sheree Toth
- The Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Charles H Zeanah
- Institute of Infant and Early Childhood Mental Health, Tulane University, New Orleans, LA, USA
| | | | - Mary Main
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Robbie Duschinsky
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
2
|
Rifkin-Graboi A, Kong L, Sim LW, Sanmugam S, Broekman BFP, Chen H, Wong E, Kwek K, Saw SM, Chong YS, Gluckman PD, Fortier MV, Pederson D, Meaney MJ, Qiu A. Maternal sensitivity, infant limbic structure volume and functional connectivity: a preliminary study. Transl Psychiatry 2015; 5:e668. [PMID: 26506054 PMCID: PMC4930120 DOI: 10.1038/tp.2015.133] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 07/02/2015] [Accepted: 07/22/2015] [Indexed: 11/30/2022] Open
Abstract
Mechanisms underlying the profound parental effects on cognitive, emotional and social development in humans remain poorly understood. Studies with nonhuman models suggest variations in parental care affect the limbic system, influential to learning, autobiography and emotional regulation. In some research, nonoptimal care relates to decreases in neurogenesis, although other work suggests early-postnatal social adversity accelerates the maturation of limbic structures associated with emotional learning. We explored whether maternal sensitivity predicts human limbic system development and functional connectivity patterns in a small sample of human infants. When infants were 6 months of age, 20 mother-infant dyads attended a laboratory-based observational session and the infants underwent neuroimaging at the same age. After considering age at imaging, household income and postnatal maternal anxiety, regression analyses demonstrated significant indirect associations between maternal sensitivity and bilateral hippocampal volume at six months, with the majority of associations between sensitivity and the amygdala demonstrating similar indirect, but not significant results. Moreover, functional analyses revealed direct associations between maternal sensitivity and connectivity between the hippocampus and areas important for emotional regulation and socio-emotional functioning. Sensitivity additionally predicted indirect associations between limbic structures and regions related to autobiographical memory. Our volumetric results are consistent with research indicating accelerated limbic development in response to early social adversity, and in combination with our functional results, if replicated in a larger sample, may suggest that subtle, but important, variations in maternal care influence neuroanatomical trajectories important to future cognitive and emotional functioning.
Collapse
Affiliation(s)
- A Rifkin-Graboi
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore,Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Brenner Centre for Molecular Medicine 30 Medical Drive, Singapore 117609, Singapore. E-mail:
| | - L Kong
- Department of Biomedical Engineering and Clinical Imaging Research Center, National University of Singapore, Singapore, Singapore
| | - L W Sim
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - S Sanmugam
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - B F P Broekman
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - H Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - E Wong
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - K Kwek
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - S-M Saw
- Department of Epidemiology, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Y-S Chong
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - P D Gluckman
- Human Development, Singapore Institute for Clinical Sciences, Singapore, Singapore,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - M V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - D Pederson
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - M J Meaney
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore,Department of Neurosciences, Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada,Sackler Program for Epigenetics and Psychobiology, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - A Qiu
- Integrative Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Singapore,Department of Biomedical Engineering and Clinical Imaging Research Center, National University of Singapore, Singapore, Singapore,Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, Block EA #03-12, Singapore 117576, Singapore. E-mail:
| |
Collapse
|
3
|
Abstract
Do siblings develop similar attachment relationships with their mother? Attachment theory suggests that brothers and sisters growing up in the same family are likely to relate in similar ways to their parents, at least when parental attachment representations and interactive styles remain stable across time. In the current study, sibling attachment data from three research groups (from Pennsylvania State University, Leiden University, and the University of Western Ontario) have been pooled to assemble a sufficiently large sample of observations (N = 138 sibling pairs) for a detailed comparison of sibling attachment relationships. Spacing between the births, differences in maternal sensitivity, and gender of siblings were examined as possible sources of concordance of nonconcordance. Attachment security (including disorganized attachment) of each sibling was assessed with the Strange Situation procedure between 12 and 14 months after birth. Maternal sensitivity was observed with the same rating scale in a laboratory play session in one of the studies and in home observations in the others. Sibling relationships were found to be significantly concordant when classified as secure/nonsecure (62% concordance, p < .01, 1-tailed, intraclass correlation = .23) but not when further subcategorized. Maternal insensitivity to both siblings (shared environment) was associated with concordance of sibling nonsecurity. Siblings of the same gender were more likely to form concordant relationships with their mother (68%; p < .01, 1-tailed, intraclass correlation = .37) than those of opposite gender. Same-sex sibling concordance was comparable to the concordance found for monozygotic twins in earlier studies. Genetic factors may, therefore, play a relatively small role in the development of attachment.
Collapse
Affiliation(s)
- M H van Ijzendoorn
- Center for Child and Family Studies, Leiden University, The Netherlands.
| | | | | | | | | | | |
Collapse
|
7
|
Lee MA, Morady F, Kadish A, Schamp DJ, Chin MC, Scheinman MM, Griffin JC, Lesh MD, Pederson D, Goldberger J. Catheter modification of the atrioventricular junction with radiofrequency energy for control of atrioventricular nodal reentry tachycardia. Circulation 1991; 83:827-35. [PMID: 1999034 DOI: 10.1161/01.cir.83.3.827] [Citation(s) in RCA: 262] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The utility of transcatheter application of radiofrequency energy to eliminate atrioventricular nodal reentrant tachycardia (AVNRT) was investigated. METHODS AND RESULTS Thirty-nine patients (mean age, 53 +/- 20 years; range 14-86 years) with medically refractory AVNRT underwent perinodal ablation with radiofrequency energy. A custom-designed 6F catheter with a large (3-mm-long) distal electrode and interelectrode pacing of 2 mm was used in the majority of cases. The catheter used for ablation was initially positioned across the tricuspid anulus to obtain the largest His bundle electrogram, then withdrawn to obtain the largest atrial:ventricular electrogram ratio, with a small His bundle electrogram (less than or equal to 100 microV). Each application of radiofrequency energy (350-550 kHz, 16.2 +/- 5.2 W) was stopped after 60 seconds or if PR prolongation or an impedance rise was noted. The endpoints of the procedure were persistent modification of atrioventricular nodal conduction (either first-degree atrioventricular block or impairment of ventriculoatrial conduction) and noninducibility of AVNRT before and during isoproterenol administration. Radiofrequency energy was applied a mean of 6.8 +/- 3.5 times per session. After a mean follow-up of 8 +/- 3.0 months, 32 of the 39 patients (82%) have been free of AVNRT, and did not have high grade AV block. Three patients (8%) developed complete atrioventricular block and had pacemakers implanted. Two patients had unsuccessful initial procedures, and two patients had initially successful ablations but had recurrences of tachycardia 4-6 weeks later. Elimination of AVNRT appeared to be due to effects on the retrograde fast pathway in most patients. CONCLUSIONS Radiofrequency ablation of the perinodal right atrium appears to be safe and effective for treatment of typical AVNRT:
Collapse
Affiliation(s)
- M A Lee
- Department of Medicine, University of California, San Francisco
| | | | | | | | | | | | | | | | | | | |
Collapse
|