A controlled study of hostile-helpless states of mind among borderline and dysthymic women

The aim of this study was to determine whether women with borderline personality disorder (BPD) are more likely than those with dysthymia to manifest contradictory Hostile-Helpless (HH) states of mind. A reliable rater blind to diagnosis evaluated features of such mental representations in transcripts of Adult Attachment Interviews from 12 women with BPD and 11 women with dysthymia of similar socioeconomic status (SES), all awaiting psychotherapy. In keeping with three hierarchical (non-independent) a priori predictions regarding the mental representations of women with BPD, the results were that (a) all those with BPD, compared with half the group with dysthymia, displayed HH states of mind; (b) those with BPD manifested a significantly higher frequency of globally devaluing representations; and (c) they exhibited a strong trend toward identifying with the devalued hostile caregiver (58% BPD vs. 18% dysthymic). In addition, significantly more BPD than dysthymic patients made reference to controlling behavior towards attachment figures in childhood. These findings offer fresh insights into the nature of BPD and extend previous evidence concerning affected individuals' patterns of thinking and feeling about childhood attachment figures

The interface between attachment and intersubjectivity: Perspective from the longitudinal study of disorganized attachment

This article considers the interface between the concepts of attachment and intersubjectivity in light of accumulated research on infant development. Both Tomasello (1999) and Hobson (2002) have argued persuasively that the flexible human capability for sharing mental states with others reframes and revolutionizes our older, more highly channeled primate biological heritage. In contrast to this emphasis on discontinuity from primate to humanevolution, attachment theorists have stressed the continuities between human attachment and attachment in other primates. The implication of new work on infant intersubjectivity for reframing aspects of attachment theory is first explored. By the same token, however, the extent to which the infantcaregiver attachment relationship functions to maintain positive engagement and regulate the infant's fearful arousal will have escalating consequences over development for the organization of intersubjectivity. Therefore, attachment research has much to offer in understanding the development of joint attention and the sharing of mental states under conditions of increased emotional arousal. The potential contributions of attachment research for understanding the development of intersubjectivity are discussed in light of recent work from the author's lab on forms of young adult symptomatology associated -595 -with deviance in the early intersubjective dialogue between mother and infant. The clinical implication emerging from all these diverse areas of research is that fostering more collaborative forms of communication may lie at the heart of evolutionary change, developmental change, and changes resulting from psychodynamic psychotherapy. Rethinking Mechanisms of Attachment during the First Year: Evolution and Intersubjective Awareness Alot has been Written Recently about a Shift in the Basis of evolutionary change from biologic to what I will call dialogic mechanisms, or from -genes to memes.‖ For example, Tomasello (1999) has pointed out that with the relatively recent emergence of Homo sapiens as a species, more complex cultural innovations have been introduced in the last 200,000 years than were introduced in the previous 6 million years. He theorizes that a biological change occurred that shifted the basis for evolutionary change from the biological evolutionary mechanisms that had governed change for 6 million years to cultural evolutionary mechanisms that are many orders of magnitude faster than those of biologic evolution. He, as well as Hobson This capacity for social engagement is manifest first at the level of affective sharing and later at the level of explicit teaching and learning. In -596 -contrast to other primates, the human infant does not have to acquire first hand all the knowledge and experiences necessary to survival. Instead, the infant needs to develop the skills for sharing affective evaluations and intentional states with others. This allows the infant to participate in the cultural learning processes of humansociety. In contrast to the emphasis on discontinuity in evolutionary processes that is highlighted by Tomasello, Hobson, and others, attachment theorists have stressed thecontinuities between human attachment and attachment in other primates. As is well-known, John Bowlby thoroughly documented th

Risks and Outcomes Associated with Disorganized/Controlling Patterns of Attachment at Age Three in the NICHD Study of Early Child Care and Youth Development

Disorganized/controlling attachment in preschool has been found to be associated with maternal and child maladjustment, making it of keen interest in the study of psychopathology. Additional work is needed, however, to better understand disorganized/controlling attachment occurring as early as age three. The primary aims of this study were to evaluate risk factors and outcomes associated with disorganized/controlling behavior at age three and to evaluate the risk factors and outcomes differentiating the four subtypes of disorganized/controlling attachment. Analyses were conducted with the first two phases of the NICHD Study of Early Child Care and Youth Development, a prospective study of 1,364 children from birth. At 36 months of age, across the attachment-relevant domains of maternal well-being, mother-child interactions, and child social adaptation, the disorganized/controlling group evidenced the most maladaptive patterns in comparison to both secure and insecure-organized groups. At 54 months of age, the disorganized/controlling group displayed the highest levels of internalizing and externalizing behavior problems, as rated by mothers and teachers, and the lowest quality relationships with teachers. Significant differences found among the disorganized/controlling subtypes indicated that the behaviorally disorganized and controlling-punitive subtypes had more maladaptive patterns across variables than did the controlling-caregiving and controlling-mixed subtypes

Childhood Adversity is Associated with Left Basal Ganglia Dysfunction During Reward Anticipation in Adulthood

Background: Childhood adversity increases the risk of psychopathology, but the neurobiological mechanisms underlying this vulnerability are not well-understood. In animal models, early adversity is associated with dysfunction in basal ganglia regions involved in reward processing, but this relationship has not been established in humans. Methods: Functional magnetic resonance imaging was used to examine basal ganglia responses to (a) cues signaling possible monetary rewards and losses, and (b) delivery of monetary gains and penalties, in 13 young adults who experienced maltreatment before age 14 and 31 non-maltreated controls. Results: Relative to controls, individuals exposed to childhood adversity reported elevated symptoms of anhedonia and depression, rated reward cues less positively, and displayed a weaker response to reward cues in the left globus pallidus. There were no group differences in right hemisphere basal ganglia response to reward cues, or in basal ganglia response to loss cues, no-incentive cues, gains, or penalties. Conclusions: Results indicate that childhood adversity in humans is associated with blunted subjective responses to reward-predicting cues as well as dysfunction in left basal ganglia regions implicated in reward-related learning and motivation. This dysfunction may serve as a diathesis that contributes to the multiple negative outcomes and psychopathologies associated with childhood adversity. The findings suggest that interventions that target motivation and goal-directed action may be useful for reducing the negative consequences of childhood adversity.Psycholog

Attachment‑based parent–adolescent interaction linked to visual attention and autonomic arousal to distress and comfort stimuli

In infancy and in the early years of life, emotion regulation and attachment relationships with parents are tightly intertwined. However, whether this link persists into adolescence has not yet been established and requires exploration. This pilot study utilizes an experimental design to assess the patterns of parent–adolescent interactions that are hypothesised to be related to two specific aspects of adolescents’ emotion regulation, namely: visual attention and autonomic arousal to distress and comfort stimuli. Two innovative and ecologically valid methodologies were utilized to assess (a) patterns of attachment-based parent–adolescent interactions among 39 adolescent–parent dyads from the general population, using the Goal-corrected Partnership in Adolescence Coding System (Lyons-Ruth et al. Goal corrected partnership in adolescence coding system (GPACS), 2005) applied to a conflict discussion task; (b) the two aspects of adolescent emotion regulation were assessed with the Visual/Autonomic Regulation of Emotions Assessment (VAREA) (Vulliez-Coady et al. Visual/Autonomic Regulation of Emotions Assessment, VAREA) paradigm, an attachment-related, emotionally arousing experimental procedure, using a distress-then-comfort paradigm, in conjunction to an eye-tracker synchronized with a physiological device that measured gaze and skin conductance response, (SCR), or emotional reactivity. In line with research in infancy, as predicted, markers of secure parent–adolescent interaction were linked to higher amplitude of SCR for distress and comfort pictures, and with longer attention to comfort pictures. On the other hand, parental role-confusion was associated with less time spent on comfort pictures by the adolescent. Overall, this pilot study suggests that interventions supporting collaborative communication between adolescents and their parents, as well as working to reduce parental role-confusion, may improve adaptive adolescent emotion regulation as assessed via physiological measures

Hair cortisol in the perinatal period mediates associations between maternal adversity and disrupted maternal interaction in early infancy

Existing literature points to the possibility that cortisol could be one link between maternal adversity and poorer parenting quality, but most studies have examined salivary cortisol concentrations rather than hair cortisol concentrations. The current study examined hair cortisol concentration (HCC) during the third trimester of pregnancy as a mediator between maternal adversity indicators (childhood abuse, severe mental illness, symptomatic functioning) and maternal caregiving behavior at 4 months postpartum. Forty‐four women participated in the study: 30 with severe mental disorders, and 14 nonclinical controls. HCC was assessed during the third trimester of pregnancy (HCC‐P) and at 4 months postpartum (HCC‐4M). Sexual, physical, and emotional abuse were assessed by the Adverse Childhood Experiences Study Questionnaire. Maternal disrupted interaction was reliably coded from mother–infant video interactions during a Still‐Face Procedure. Mediation models indicated that maternal HCC‐P and HCC‐4M mediated associations between maternal psychopathology (severe mental illness, symptomatic functioning) and maternal disrupted interaction at 4 months. Maternal HCC at 4 months also mediated associations between experienced childhood abuse and overall disrupted interaction. Our findings indicate that HCC may be a potential early biomarker for future caregiving challenges among mothers with severe mental illness and histories of childhood abuse

Disorganized Attachment in Infancy: A Review of the Phenomenon and Its Implications for Clinicians and Policy-Makers

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

Contributions of the mother–infant relationship to dissociative, borderline, and conduct symptoms in young adulthood

Recent high-risk longitudinal studies have documented a unique contribution of the quality of the early mother–child relationship to diverse forms of psychopathology in young adulthood, even with family economic status, later traumatic experiences, and some genetic factors controlled. In addition, measures of attachment-related deviations in caregiver–infant interaction predict more than measures of infant attachment behavior alone. This article reviews those findings in the context of cross-disciplinary thinking on the importance of shared subjectivities in human evolution and development and in the context of recent studies beginning to map the intersection between processes of interaction and the development of the child's propensities to share mental states with others