Emotional and behavioral problems in residential-care adolescents: links with attachment and alexithymia

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What predict binge eating disorder in non-clinical female adolescents? Exploring peer attachment and emotional regulation

The Binge Eating Disorder [BED] is the prevalent eating disorder among community adolescents, but little is known about its specific correlates in this developmental stage. Clinical research underlined associations between ED in adolescence and the peer attachment, as well as higher use of potentially disadaptive Emotional Regulation (ER) strategies, such Expressive Suppression (ES; Gross & John, 2003). This is the preliminary report of a larger pilot study \u2014including narrative measures such Friends and Family Interview [FFI]\u2014 that aim to investigate the role of these variables with respect to the level of BED symptoms showed by non-clinical adolescents, as to our knowledge there are no studies that have done it before. Participants were 44 girls, aged 14-18 (M = 15.68, SD = 1.1), came from Italian intact families with medium-higher SES. Measures were: 1) the Binge Eating Scale (BES) to measure the levels of BED; 2) the Inventory of Peer and Parent Attachment (IPPA) to assess the levels of Peer attachment, also in terms of Trust, Communication and Alienation, and 3) The Emotional Regulation Questionnaire for Children and Adolescents (ERQ-CA) to assess the use of ER strategies (Expressive Suppression and Cognitive Reappraisal). Main results showed that higher levels of BED symptoms correlated with lower levels of Peer attachment (rs = \u2013.370, p = .14), higher Alienation to peers (rs = .476, p = .001) and use of ES (rs = .424, p = .004). However, the multiple regression accounted only the Alienation to Peer and the ES as predictor of BED symptoms (adjusted-R2 = .27 p = .01), excluding Peer Attachment (p > .78). Discussing the implications in terms of prevention and health promotion, the authors underline the utility to foster in community female teenagers positive peer relationships, social competences and the reduction of disadaptive ER strategies, such Expressive Suppression

Attachment Representations and Emotion Regulation Strategies in Parents of Children with Disruptive Behaviour Disorders

Although a growing body of research suggests a robust association between insecure attachment, emotion regulation problems and externalizing problems, as Disruptive Behaviour Disorders (DBD), in children, only a few studies have explored these constructs in their parents. Moreover, the role of the father is often neglected. The current study aimed to investigate attachment representations and emotion regulation strategies in parents with DBD children (considering mothers and father separately), compared with a comparison group. The research involved 100 Italian parents: 36 clinical parents (18 mothers and 18 fathers) of children aged 8-12 years with a diagnosis of DBD, and 64 parents (32 mothers and 32 fathers) of children with no clinical symptoms. Parents\u2019 attachment representations were assessed through the Adult Attachment Interview and their emotional regulation strategies through the Emotion Regulation Questionnaire. The clinical status of children was the result of an evaluation by two mental health experts and a compilation by both parents of the Child Behavior Checklist 6-18 Version. Our results pointed to a greater presence of Insecure-Entangled attachment in DBD mothers and a lower level of Cognitive Reappraisal in DBD fathers compared with comparison parents. Nevertheless, maternal Insecure and paternal Cognitive Reappraisal did not together predict children DBD as the outcome. These preliminary findings make a significant contribution to the topic of emotional functioning of DBD parents, suggesting the importance to further deepen the quality of parenting in the context of DBD children

Attachment in late-adopted, residential-care and community adolescents: a multi-method comparative study.

Introduction. Late-adopted and residential-care adolescents are supposed to be more at risk of insecurity or disorganization in attachment than their community peers, due to the higher adverse childhood experiences (Vorria et al., 2015). However, some studies suggested no differences in attachment between late-adoptees and community adolescents (Pace et al., 2018), while residential-care adolescents showed less security and more disorganization in attachment compared with peers (Bifulco et al., 2016; Vorria et al., 2015). Nevertheless, findings are controversial because few studies compared these high-risk groups during adolescence and results obtained with interviews and self-reports often diverge (McSherry et al., 2016). In this multi-method study, we compared the attachment in late-adopted, residential-care and community adolescents, using both semi-structured interviews and self-reports. Methods. Participants were 75 adolescents (aged 11-19y, M=15.5, 53% boys), 25 each group (late-adopted, residential-care and community). Measures were: 1) the Friends and Family Interview (FFI, Steele and Steele, 2005), a semi-structured interview to assess adolescents\u2019 attachment representations as Secure-Autonomous, Insecure-Dismissing, Insecure-Preoccupied, Disorganized-Disoriented, both in terms of classifications and scores, focusing on narrative\u2019s coherence; 2) the Inventory of Parent and Peer Attachment (IPPA, Armsden and Greenberg, 1987), a well-known self-report used to measure attachment\u2019 security towards mother, father and peers. Results. There were no differences among groups in FFI\u2019s attachment classifications (Table1, p>.09). Comparing the scales (Table2), the residential group showed scores significantly lower in security, and higher in disorganization and dismissing on FFI (p<.04), showing also poorest coherence (p=.005). Using the IPPA, both late-adoptees and residential adolescents reported lower scores only in attachment to mother (p<.01). Discussion. Residential-care adolescents are confirmed to be more at risk of insecurity or disorganization in attachment, while late-adoptees overlapped with community peers. Authors discussed the differences among groups, highlighting the utility of a multi-method approach

Risk factors for emotional- behavioral problems in residential-care and late-adopted adolescents: a pilot study with narrative interviews for attachment and alexithymia

Adolescents in residential-care and late-adopted ones resulted high-risk to emotional-behavioural problems, showing vulnerability to risk-factors as insecure/disorganized attachments and difficulties in emotional regulation, such alexithymia. Moreover, findings suggested higher risk for residential adolescents. However, there are no studies that investigated jointly the role of attachment and alexithymia with respect to emotional-behavioural problems displayed by adolescents in those high-risk groups, as we aim to do in a larger pilot study with a multi-method approach. In this preliminary report, we subsampled 20 adolescents (aged 13-17, M = 14.95, SD = 1.4; 80% boys) with traumatic past experiences, dividing 10 late-adoptees and 10 residential-care, equalling for age and gender. We used the Child Behavior Checklist (CBCL 6-18) to assess emotional-behavioral problems; the Friends & Family Interview (FFI) to assess attachment representations, in terms of classifications and scales; the Toronto Structured Interview for Alexithymia (TSIA) to detect the levels of alexithymia. U-Mann Whitney confirmed that residential showed higher levels of emotional-behavioral problems - especially externalizing ones (p = .03) - less security (p = .003) and more avoidance (p = .03) in attachment and higher levels of alexithymia (p = .009) than adoptees. In the total group, correlations were found between psychopathology, less security in attachment and higher alexithymia, which also showed associations each other (p =.029). However, a stepwise regression only accounted the poor attachment\u2019 security as predictor of 29.9% of the variance in externalizing problems (adjusted-R2 = .255, p = .019). Larger samples are needed, but both variables seem correlated to high-risk adolescent\u2019s adjustment: in particular, attachment security resulted a key-feature to promote especially in residential-care contexts, where the adolescents seem more vulnerable than in adoptive families

A proposal for a brief-term post-adoption intervention in the attachment-perspective. A single case study with a late-adopted child and his adoptive mother

A growing body of attachment literature has focused on bridging the gap between research and clinical applications, even in clinical work with adoptive families. A brief-term clinical intervention focused on a multi-method assessment of attachment relationships and representations was performed in the first year after placement. This single case study aimed at analysing the attachment outcomes, through a long-term follow-up, both for the adoptive mother and her late-adopted son. We assumed that this five-session attachment oriented intervention could help the mother enhance her sensitivity skills and her ability to understand both her own past attachment experiences and her child’s insecure attachment as a consequence of the failures of his previous experiences of care, supporting her six year old child in acquiring a positive image of himself and of others and the security of the caregiver’s availability up to adolescence

Peer Power! Secure Peer Attachment Mediates the Effect of Parental Attachment on Depressive Withdrawal of Teenagers

Adolescents\u2019 depressive social withdrawal is a relevant concern for mental health professionals, and it is widespread among community teenagers in form of subclinical symptoms. Different studies suggest that insecure attachment representations increase the adolescents\u2019 likelihood to show symptoms of withdrawal (e.g., loneliness). This study explored the effect of the general attachment internal working model (IWM) and the independent and cumulative effects of the specific attachment representations of parents\u2014in terms of secure base/safe haven\u2014and peers on adolescents\u2019 withdrawal. Additionally, the mediation of peer attachment on the effect of parental attachment on symptoms was explored. All analyses were conducted controlling for the difference between teenagers living with parents together or divorced/separated, as children of divorcees are considered more exposed to stressors. Ninety-one adolescents aged 12\u201317 years old were assessed online during the COVID pandemic period, employing the Youth Self-Report to assess withdrawal and the Friends and Family Interview to assess attachment-general IWM and attachment-specific representations. Results show no influence of parents together/separated or of the general IWM on withdrawal, but higher parent secure base/safe haven and peer attachment cumulatively predicted 10\u201321% less withdrawal. Moreover, more positive peer attachment mediated 61% of the effect of the parental secure attachment on withdrawal, revealing an indirect effect of parental attachment on withdrawal through peer attachment. In conclusion, both parents and peers are influential on adolescent mental health, and fostering positive peer relationships can buffer the effect of dysfunctional family relationships on teenagers\u2019 withdrawal

Self-criticism and attachment: A systematic review and meta-analysis

Several contributions argue that insecure attachment accounts for the development of self-criticism. However, advances in the field are replete with theoretical issues that limit the integration of past results. This work estimates the strength of the associations between attachment and self-criticism and examines which theoretical and methodological features impact these estimations. A PRISMA systematic search was conducted. A three-level meta-analytic approach has been used to estimate effect sizes and the role of theoretical and methodological moderators. Low levels of secure attachment and high levels of insecure attachment were both positively associated with self-criticism. The type of insecure attachment significantly moderated this result, with attachment anxiety being more strongly associated with self-criticism than avoidant attachment. In some cases, the conceptualization and operationalization of both attachment and self-criticism were significant moderators. Self-criticism is likely to be rooted in insecure attachment, supporting most theoretical models and clinical indications. However, results regarding anxious attachment call for an additional theoretical effort to extend the current model. Furthermore, the bi-dimensional conceptualization of insecure attachment may lead to an overestimation of the association between avoidant attachment and self-criticism. The different nature of the emotional components involved may impact observations, suggesting the need to use multidimensional measures

Late-adopted children grown up:A long-term longitudinal study on attachment patterns of adolescent adoptees and their adoptive mothers

This paper reports on a long-term follow-up of a longitudinal study conducted in Italy that assessed attachment patterns of late-adopted children (placed between 4 and 8 years old) and their adoptive mothers, in three phases: T1, at placement; T2, in childhood (7\u20138 months after adoption); and T3, in adolescence (current study). The following hypotheses were tested: 1) children\u2019 IWMs will shift from insecurity towards security in a long-term follow-up; and 2) there will be a significant association between adoptees\u2019 and adoptive mothers\u2019 IWMs in adolescence. Participants were 22 late-adopted adolescents (aged 11\u201316) and their adoptive mothers, all assessed in previous phases. Participants completed several measures of attachment, including the Separation-Reunion Procedure (T1, T2), Manchester Child Attachment Story Task (T2), Friends and Family Interview (T3), and Adult Attachment Interview (T1, T3). Late-adopted adolescents showed both an increase in attachment security and a decrease in disorganized attachment from childhood to adolescence. Adoptive mothers\u2019 (T3) secure states of mind were associated significantly to their adopted children attachment security in adolescence. These findings reinforce the importance of taking attachment into account for adoptive families from the beginning of adoption

Qualitative research in adolescent psychotherapy: attachment and reflective functioning as psychotherapy's outcomes of an adolescent with anorexia nervosa

The aim of this study was to examine both the change in attachment state of mind and mentalization competencies as outcomes of a two-year weekly psychodynamic psychotherapy of a female adolescent with anorexia nervosa. The Attachment Interview for Childhood and Adolescence (AICA) was administered at pre and post-treatment, and coded both with the attachment coding system and the Reflective Functioning (RF) scale. At the pre-treatment, the anorexic adolescent was assessed as insecure dismissing with very low level of RF, while in the post-treatment a secure attachment model and higher RF were highlighted. The AICA can be considered a useful method to assess the outcomes in adolescent psychotherapy, like the AAI is useful in adult psychotherapy