Neural Empathic Response in Drug-Addicted Mothers.

Several studies showed that a history of substance abuse can compromise mothers\u2019 competences of caring for their children (i.e., parenting). Indeed, it has been shown that neural circuits associated with parental behavior overlap with circuitry involved in addiction; in this vein, substance abuse may subtract neural resources for parenting. According to the neurocognitive model, empathy is the ability of sharing and understanding others\u2019 emotional states. At a neural level, these two aspects result to be dissociable at an either functional and temporal level. Empathy is a fundamental element of parental abilities as it allows to response properly to children\u2019s needs. Empathy deficits might explain the failure reported by drug addicted mothers in caring for their children. In the present study, we monitored event-related potentials (ERPs) during a pain decision task, which is classically used to activate an empathic response, with the aim to track the time-course of neural activity of mothers with (i.e., clinical) and without history of drug addiction (i.e., control group). Stimuli were pictures of adults\u2019 and children\u2019s hand depicted with a harmful tool either hurting the hand or placed nearby. At a behavioral level, drug addicted mothers showed a reduced reactivity to pain when compared to the control group. This difference has been corroborated at a neural level by ERPs results, starting from an early time-window. The neural reaction to pain in the control group correlated with some self-report scales of empathy, reinforcing the idea that the clinical group might report a lack of empathy when compared to a control group. These results are discussed in light of the two components of empathy proposed by the neurocognitive model

Attachment Theory and Maternal Drug Addiction: The Contribution to\ua0Parenting interventions.

Children\u2019s emotional and relational development can be negatively influenced bymaternal substance abuse, particularly through a dysfunctional caregiving environment. Attachment Theory offers a privileged framework to analyze how drug addiction can affect the quality of adult attachment style, parenting attitudes and behaviors toward the child, and how it can have a detrimental effect on the co-construction of the attachment bond by the mother and the infant. Several studies, as a matter of fact, have identified a prevalence of insecure patterns among drug-abusing mothers and their children. Many interventions for mothers with Substance Use Disorders have focused on enhancing parental skills, but they have often overlooked the emotional and relational features of the mother\u2013infant bond. Instead, in recent years, a number of protocols have been developed in order to strengthen the relationship between drug-abusing mothers and their children, drawing lessons from Attachment Theory. The present study reviews the literature on the adult and infant attachment style in the context of drug addiction, describing currently available treatment programs that address parenting and specifically focus on the mother\u2013infant bond, relying on Attachment Theory

Parental brain: cerebral areas activated by infant cries and faces. A comparison between different populations of parents and not.

Literature about parenting traditionally focused on caring behaviors and parental representations. Nowadays, an innovative line of research, interested in evaluating the neural areas and hormones implicated in the nurturing and caregiving responses, has developed. The only way to permit a newborn to survive and grow up is to respond to his needs and in order to succeed it is necessary, \ufb01rst of all, that the adults around him understand what his needs are. That is why adults\u2019 capacity of taking care of infants cannot disregard from some biological mechanisms, which allow them to be more responsive to the progeny and to infants in general. Many researches have proved that exist speci\ufb01c neural basis activating in response to infant evolutionary stimuli, such as infant cries and infant emotional facial expression. There is a sort of innate predisposition in human adults to respond to infants\u2019 signals, in order to satisfy their need and allow them to survive and become young adults capable of taking care of themselves. This article focuses on research that has investigated, in the last decade, the neural circuits underlying parental behavioral responses. Moreover, the paper compares the results of those studies that investigated the neural responses to infant stimuli under different conditions: familiar versus unknown children, parents versus non-parents and normative versus clinical samples (depression, addiction, adolescence, and PTSD)

Maternal Drug Addiction: Influences on mother-child relationship and on early child development.

Much literature has pointed out parental drug addiction as a risk factor at multiple levels for the dyad, affecting parenting quality, child development and more globally the adult-child relationship. Drug addicted mothers are often reported as less sensitive, more intrusive and less able to regulate negative affects during early adult-child interactions. On the other hand, children of addicted mothers are often described as more irritable or more passive. The aim of this research was to investigate longitudinally the quality of adult-child relationship and of child interactive and emotional development in a group of drug addicted mothers and their children prenatally exposed to substances. The study involved 25 mother-child pairs (with children aged between 2 and 24 months) with drug addicted mothers. The dyads were followed for a 15 months-period and assessed regularly (every 3 months) through the application of the Emotional Availability Scales (EAS \u2013 Biringen, 2008) to videotaped free play interactions. In this way it has been possible to consider both the mothers\u2019 and the children\u2019s contribution to the development of their relationship. The results were controversial, showing on one hand changes related only to specific EA dimensions and on the other hand patterns of changes that seemed characteristics of specific patterns of emotional availability. Dyads that initially showed interactions of better quality tended to improve their relationship during time, whereas dyads that exhibited more difficulties at the beginning of the study did not show improvements. Moreover, children of dyads which experienced interactions of better quality showed better interactive and emotional features than children of dyads characterized by more dysfunctional patterns of interaction. Dyads characterized by maternal drug addiction are often reported to be at higher risk for experiencing difficulties during everyday interactions and more likely to be associated to less optimal developmental outcomes. Anyway the results of our study highlight that, despite the condition of drug addiction, experiencing a relationship of good quality could be associated to better mother-child interactions and to more functional interactive and emotional development for children

Evaluating the efficacy of psychodynamic treatment on a single case of autism. A qualitative research.

Autism spectrum disorder refers to a group of diseases determined by multiple conditions and primarily defined on the basis of behavioral patterns. The literature and guidelines provide indications regarding adequate treatments, underlying how psychologically and behaviorally structured interventions, should be considered the best programs. Anyway, there is still a scarcity of studies evidencing the effectiveness of therapeutic and developmental approaches situated in a psychodynamic framework and researches aimed to evaluate the quality of psychodynamic interventions on autism are rare. The present study illustrate a qualitative research on the single-case intervention with an autistic adolescent, admitted to the Educational - Rehabilitation Centre Antenna 112. The Centre bases its intervention on a specific psychodynamic approach, Lacanian Psychoanalysis, named Pratique \ue0 Plusieurs. The efficacy of the psychodynamic intervention is evaluated by monitoring the therapeutic process with the adolescent from his admission. The evaluation took place in three different stages of the intervention: at the beginning of the treatment, after 6 months and after 12 months. In particular, the level of adaptive behaviors (Vineland Adaptive Behavior Scale), Social Communication (Social Communication Questionnaire), and the seriousness of behavioral patterns, specific for the autism disorders (Childhood Autism Rating Scale) have been assessed. Results highlight that the psychodynamic setting of the Centre and the therapeutic intervention, which takes place in it, foster an improvement of adaptive behavior, such as life skills and socialization. Limitations of the present study and clinical implications regarding residential psychodynamic treatments in cases of autism disorders are discussed

Attachment representations and early interactions in drug addicted mothers: a case study of four women with distinct Adult Attachment Interview classifications

open4Drug addiction is considered a major risk factor that can influence maternal functioning at multiple levels, leading to less optimal parental qualities and less positive interactive exchanges in mother-child dyads. Moreover, drug abusers often report negative or traumatic attachment representations regarding their own childhood. These representations might affect, to some extent, later relational and developmental outcomes of their children. This study explored whether the development of dyadic interactions in addicted women differed based on attachment status. The longitudinal ongoing of mother-child emotional exchanges was assessed among four mothers with four different attachment statuses (F-autonomous, E-preoccupied, Ds-dismissing, and U-unresolved/with losses). Attachment representations were assessed using the Adult Attachment Interview ( George et al., 1985), while mother-child interactions were evaluated longitudinally during videotaped play sessions, through the Emotional Availability Scales (Biringen, 2008). As expected, the dyad with the autonomous mother showed better interactive functioning during play despite the condition of drug-abuse; the mother proved to be more affectively positive, sensitive, and responsive, while her baby showed a better organization of affects and behaviors. On the other side,insecure mothers seemed to experience more difficulties when interacting with their children showing inconsistency in the ability to perceive and respond to their babies’ signals. Finally, children of insecure mothers showed less clear affects and signals. While differences between secure and insecure dyads appeared clear, differences between insecure patterns where less linear, suggesting a possible mediating role played by other factors. Clinical implications and suggestions for future research are discussed.openPorreca, A.; De Palo, F.; Simonelli, A.; Capra, N.Porreca, Alessio; DE PALO, Francesca; Simonelli, Alessandra; Capra, N

Childhood Traumatic Experiences and Post-Traumatic Stress Disorder in Female Adults: Which is the Role Played by Romantic Attachment?

Childhood traumatic experiences are known to have strong and durable effects on physical, mental and reproductive health. One of the most studied consequences of childhood trauma is the post-traumatic stress disorder (PTSD). The present study aims to investigate in a community sample of Italian female students: (1) the prevalence of PTSD; (2) the association between reported childhood traumatic experiences and the presence of PTSD in adulthood and the role played by the romantic attachment (anxiety, avoidance) on the relationship between childhood traumatic experiences and PTSD symptoms. Three hundred and twenty-seven female Italian students (mean age = 23.09 years; SD = 2.98) of the University of Padova participated in the study. Participants have been tested on childhood traumatic experiences (Childhood Trauma Questionnaire-Short Form, CTQ-SF); romantic attachment (Experience in Close Relationship-Revised, ECR-R) and post-traumatic stress disorder (Post-traumatic Stress Disorder Checklist for DSM-5, PCL-5). Results show that PTSD symptoms are significantly predicted by the experiences of emotional abuse and neglect. Moreover, anxiety and avoidance play a significant role in the relationship between the emotional forms of traumatic experiences and the current presence of PTSD symptoms. Clinical implications for the treatment of PTSD patients with history of interpersonal trauma are discussed

A psychological perspective on preterm children: the influence of contextual factors on quality of family interactions

Preterm birth has a critical influence on interactive, communicative, and expressive child behaviour, particularly during the first years of life. Few studies have stressed the assessment of mother-father-child interaction in families with preterm children, generating contradictory results. The present study wished to develop these fields: (i) comparing the quality of family interactions between families with preterm children and families with children born at full term; (ii) observing the development of family interactions after six months in the families with children born preterm; (iii) assessing family and contextual factors, as parental stress and social support, in parents of preterm children in order to observe their influence on the quality of family interactions. 78 families are recruited: 39 families with preterm children ( = 19,8 months, SD = 11,05) and 39 families with full-term children ( = 19,66 months; SD = 13,10). Results show that families with preterm children display a low quality of mother-father-child interactions. After six months, family interactions result is generally stable, except for some LTP-scales reflecting a hard adjustment of parenting style to the evolution of the child. In families with preterm children, the parenting stress seemed to be correlated with the quality of mother-father-child interactions

Infant massage and quality of early mother-infant interactions: Are there associations with maternal psychological wellbeing, marital quality, and social support?

Infant massage programs have proved to be effective in enhancing post-natal development of highly risk infants, such as preterm newborns and drug or HIV exposed children. Less studies have focused on the role of infant massage in supporting the co-construction of early adult–child relationships. In line with this lack of literature, the present paper reports on a pilot study aimed at investigating longitudinally the quality of mother–child interactions, with specific reference to emotional availability (EA), in a group of mother–child pairs involved in infant massage classes. Moreover, associations between mother–child EA, maternal wellbeing, marital adjustment, and social support were also investigated, with the hypothesis to find a link between low maternal distress, high couple satisfaction and high perceived support and interactions of better quality in the dyads. The study involved 20 mothers and their children, aged between 2 and 7 months, who participated to infant massage classes. The assessment took place at three stages: at the beginning of massage course, at the end of it and at 1-month follow-up. At the first stage of assessment self-report questionnaires were administered to examine the presence of maternal psychiatric symptoms (SCL-90-R), perceived social support (MSPSS), and marital adjustment (Dyadic Adjustment Scale); dyadic interactions were observed and rated with the Emotional Availability Scales (Biringen, 2008) at each stage of data collection. The results showed a significant improvement in the quality of mother–child interactions, between the first and the last evaluation, parallel to the unfolding of the massage program, highlighting a general increase in maternal and child’s EA. The presence of maternal psychological distress resulted associated with less optimal mother–child emotional exchanges, while the hypothesis regarding couple satisfaction and social support influence were not confirmed. These preliminary results, if replicated, seem to sustain the usefulness of infant massage and the importance of focusing on early mother–infant interactions

Effectiveness is the gold standard of clinical research

Psychological treatments have been shown to be at least as effective (and sometime even more effective) than psychotropic medications for many psychiatric disorders, in particular anxiety disorders, depressive disorders, and personality disorders (American Psychological Association, 2013; Cuijpers, 2017). Effective psychological treatments are also cost-effective: their implementation in public mental health services is convenient in financial terms, with decades of studies consistently demonstrating a reduction in public spending for psychological health (Abbass, Kisely, Rasic, Town & Johansson, 2015). Therefore, it could be critical that psychological treatments whose efficacy is supported by strong empirical evidence can be delivered as a primary choice in public mental health services. We hope and believe that the time when a psychologist or a psychiatrist (especially if paid by the public mental health system) could provide any treatment he or she thought fit, even in the absence of any scientific evidence of its efficacy, is coming to an end. However, a recommendation should be made to be very careful in not equating the empirical support of a given treatment with the sole presence of randomized controlled trials (RCTs) that show its efficacy. This would be a mistake from both an empirical and a theoretical perspective, as it runs the risk of throwing out the baby with the bathwater. In other words, endorsing a perspective according to which a specific treatment should be promoted or rejected on the sole basis of findings from RCT studies runs the risk of putting clinical science back almost twenty years from the current more advanced understanding of the efficacy, effectiveness, and usefulness of psychotherapy (Dazzi, 2006; Dazzi, Lingiardi, & Colli, 2006; Leichsenring et al., 2016; Silberschatz, 2017)