The infant disorganised attachment classification: "Patterning within the disturbance of coherence".

Since its introduction by Main and Solomon in 1990, the infant disorganised attachment classification has functioned as a predictor of mental health in developmental psychology research. It has also been used by practitioners as an indicator of inadequate parenting and developmental risk, at times with greater confidence than research would support. Although attachment disorganisation takes many forms, it is generally understood to reflect a child's experience of being repeatedly alarmed by their parent's behaviour. In this paper we analyse how the infant disorganised attachment classification has been stabilised and interpreted, reporting results from archival study, ethnographic observations at four training institutes for coding disorganised attachment, interviews with researchers, certified coders and clinicians, and focus groups with child welfare practitioners. Our analysis points to the role of power/knowledge disjunctures in hindering communication between key groups: Main and Solomon and their readers; the oral culture of coders and the written culture of published papers; the research community and practitioners. We highlight how understandings of disorganised attachment have been magnetised by a simplified image of a child fearful of his or her own parent

The infant disorganised attachment classification: “Patterning within the disturbance of coherence”

Since its introduction by Main and Solomon in 1990, the infant disorganised attachment classification has functioned as a predictor of mental health in developmental psychology research. It has also been used by practitioners as an indicator of inadequate parenting and developmental risk, at times with greater confidence than research would support. Although attachment disorganisation takes many forms, it is generally understood to reflect a child's experience of being repeatedly alarmed by their parent's behaviour. In this paper we analyse how the infant disorganised attachment classification has been stabilised and interpreted, reporting results from archival study, ethnographic observations at four training institutes for coding disorganised attachment, interviews with researchers, certified coders and clinicians, and focus groups with child welfare practitioners. Our analysis points to the role of power/knowledge disjunctures in hindering communication between key groups: Main and Solomon and their readers; the oral culture of coders and the written culture of published papers; the research community and practitioners. We highlight how understandings of disorganised attachment have been magnetised by a simplified image of a child fearful of his or her own parent

Child maltreatment under the skin: Basal activity and stress reactivity of the autonomic nervous system and attachment representations in maltreating parents

This dissertation comprises an empirical study and a meta-analytical study on autonomic nervous system (ANS) functioning and attachment representations in maltreating parents. For the empirical study we recruited a sample of 45 mothers with substantiated abuse and neglect and 45 non-maltreating control mothers. Mothers listened to infant cry sounds of varying pitches while their heart rate, vagal tone, pre-ejection period, skin conductance, and salivary α-amylase were measured. Maltreating mothers showed a blunted ANS response to the cry sounds, as well as a lack of coherence between ANS components, compared to the non-maltreating group. During a second appointment we conducted the Adult Attachment Interview. More maltreating mothers had an Unresolved/disoriented (U/d) attachment representation and maltreating mothers showed lower coherence of mind. In turn, U/d attachment was associated with a decrease in skin conductance during an attachment-related computer paradigm, while coherence of mind was associated with higher skin conductance during the paradigm. A meta-analysis of 11 studies (N = 524)showed that (risk for) child maltreatment was associated with higher levels of baseline ANS activity, while a second meta-analysis (k = 11, N = 503) showed no differences in ANS stress reactivity between maltreating parents/at-risk adults and non-maltreating/low-risk comparison groups.Development Psychopathology in context: famil

Restoration of former agricultural fields on acid sandy soils:Conversion to heathland, rangeland or forest?

Three restoration strategies on agricultural fields with acid sandy soil were evaluated after 18 and 25 years: conversion to heathland, rangeland and forest. Changes in soil microstructure, chemical characteristics, availability of N and P, and vegetation composition were analyzed in agricultural soils, three undisturbed reference sites and five types of restored former agricultural fields. Agricultural soils were characterized by organic slurry without much soil life. Soil nutrients were especially high for P, mostly in mineral form, and P-desorption rates were high. Partial and complete topsoil removal, aiming at heathland restoration, led to (much) lower soil organic matter and nutrients, but not to recovery of soil life, nor to P-limited soils. Heather was accompanied by many grassland species, even with complete topsoil removal. Conversion to rangeland did not decrease nutrient stocks, but led to improved soil life, although different from reference grasslands due to the higher pH. P-availability remained high, but net N-mineralization and plant N-content were clearly lower after 25 than after 18 years. Plant diversity was relatively high, and cover of eutrophic grasses decreased to 8–39% in intermediate and productive rangelands. Nutrient-poor species remained absent, but the slightly higher pH improved conditions for many grassland herbs. Afforestation did also not lead to nutrient-poor conditions, but soil life clearly increased and nutrients were used for rapid tree growth. Undergrowth species however remained eutrophic. It was impossible to retrieve the P-limited reference ecosystems within 25 years of restoration, not even with complete topsoil removal. Differences in plant diversity between expensive topsoil removal and much cheaper conversion to rangeland were also relatively small. For restoration on a landscape scale, it may thus be better to focus on conversion to semi-natural grasslands and afforestation. The half-open, nutrient-, mineral-, and species-rich landscape offers opportunities for large grazers, but also for many insects and birds

Determinants of progression of hip osteoarthritis

Osteoarthritis (OA) is the most frequent disorder of the locomotor system and the prevalence of OA will increase with the aging of the Western society. Especially when the hip or knee is involved, OA causes considerable difficulty in walking, stair climbing and other lower extremity tasks. OA of the hip can be especially disabling because of the pain and functional impairment. The identification of patients at high risk for progression of hip OA is important for at least two reasons. Firstly, well-characterized ‘high risk’ groups may be useful in clinical trials and, secondly, assuming that disease-modifying OA drugs may become available in the future, to identify primary target groups in need of such therapy. Additionally, in a clinical situation the identified non-progressors can be reassured. Until now the prognostic factors of progression of hip OA have been investigated in small studies, with a short follow-up time, and only in a hospital setting. The overall aim of this thesis was to determine the prognostic factors of osteoarthritis of the hip in a large open population with a long-term follow-up. Nearly all studies presented in this thesis were based on data from the Rotterdam Study, a large prospective population-based cohort study in the Netherlands. Participants of this study were men and women aged 55 years and over living in Ommoord, a suburb of Rotterdam

OARSI year in review 2023:Rehabilitation and outcomes

Objective: We systematically reviewed the literature to identify comparative studies of core treatments (exercise, education, or weight management), adjunct treatments (e.g. electrotherapeutical modalities, bracing), or multimodal treatments (core plus other treatments), for treating osteoarthritis (OA) complaints, published between 1 March 2022 and 1 March 2023. Design: We searched three electronic databases for peer-reviewed comparative studies evaluating core treatments, adjunct treatments, or multimodal treatments for OA affecting any joint, in comparison to other OA treatments. Two authors independently screened records. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. A narrative synthesis focusing on pain and function outcomes was performed in studies with a mean sample size of at least 46 participants per treatment arm. Results: 33 publications (28 studies), 82% with PEDro ratings of good or excellent, were eligible for narrative synthesis: 23 studies evaluated knee OA; one knee OA or chronic low back pain; two knee or hip OA; one hip OA only; and one thumb OA. No studies identified a dose, duration or type of exercise that resulted in better pain or function outcomes. Core treatments generally showed modest benefits compared to no or minimal intervention controls. Conclusions: Rehabilitation research continues to be focused on the knee. Most studies are not adequately powered to assess pain efficacy. Further work is needed to better account for contextual effects, identify treatment responder characteristics, understand treatment mechanisms, and implement guideline care.</p

Attachment histories and futures: reply to Vicedo's 'Putting attachment in its place'.

For Vicedo, 'putting attachment in its place' seems to entail two aspects. The first is working to understand the rise of attachment theory and its place within the history of knowledge practices. The second is to criticize the validity of attachment theory. In this reply, we appraise three criticisms made by Vicedo of attachment theory, chosen as points for sustaining a dialogue. Our main point in this reply is that, in excluding the work of attachment researchers after Ainsworth from consideration, Vicedo's work is not yet able to properly 'put attachment in its place', in either sense of the phrase. At most, she puts Bowlby in the 1950s-1960s in his place, but without speaking effectively to subsequent attachment research. In our view, not just the validity, but the very meaning of attachment as a scientific research programme cannot be understood outside of its temporal context, and the relationship this entails between theory and research, past and future