Attachment as an organizer of behavior: implications for substance abuse problems and willingness to seek treatment

BACKGROUND: Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. METHODS: Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208). The Semi-Structured Assessment of the Genetics of Alcohol-II [41] was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; [16]]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. RESULTS: Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. CONCLUSION: The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery

Measuring the impact and costs of a universal group based parenting programme : protocol and implementation of a trial

Background Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base. Methods/Design A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures. Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these

Wait Up!: Attachment and Sovereign Power.

Sociologists and feminist scholars have, over many decades, characterised attachment as a social construction that functions to support political and gender conservatism. We accept that attachment theory has seen use to these ends and consider recent deployments of attachment theory as justification for a minimal State within conservative political discourse in the UK since 2009. However, we contest that attachment is reducible to its discursive construction. We consider Judith Butler's depiction of the infant attached to an abusive caregiver as a foundation and parallel to the position of the adult citizen subjected to punitive cultural norms and political institutions. We develop and qualify Butler's account, drawing on the insights offered by the work of Lauren Berlant. We also return to Foucault's Psychiatric Power lectures, in which familial relations are situated as an island of sovereign power within the sea of modern disciplinary institutions. These reflections help advance analysis of three important issues: the social and political implications of attachment research; the relationship between disciplinary and sovereign power in the affective dynamic of subjection; and the political and ethical status of professional activity within the psy disciplines.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s10767-014-9192-

Family-Centered Preventive Intervention for Military Families: Implications for Implementation Science

In this paper, we report on the development and dissemination of a preventive intervention, Families OverComing Under Stress (FOCUS), an eight-session family-centered intervention for families facing the impact of wartime deployments. Specific attention is given to the challenges of rapidly deploying a prevention program across diverse sites, as well as to key elements of implementation success. FOCUS, developed by a UCLA-Harvard team, was disseminated through a large-scale demonstration project funded by the United States Bureau of Navy Medicine and Surgery (BUMED) beginning in 2008 at 7 installations and expanding to 14 installations by 2010. Data are presented to describe the range of services offered, as well as initial intervention outcomes. It proved possible to develop the intervention rapidly and to deploy it consistently and effectively

The lived experience of discrimination by white women in committed interracial relationships with black men

Abstract: This study explores the experiences of discrimination by white women in committed interracial relationships with black men within the South African context from a descriptive phenomenological perspective. Three white females in committed interracial relationships with black males were recruited and interviewed. Open-ended interviews were conducted in order to elicit rich and in-depth first-person descriptions of the participants’ lived experiences of discrimination as a result of being in committed interracial relationships. The data analysis entailed a descriptive phenomenological content analysis and description. The results of this study suggest that white women in committed interracial relationships with black men experienced discrimination in various contexts where discrimination manifests as either a negative or a positive encounter; in addition, discrimination evokes various emotional responses and is coped with in either maladaptive or adaptive ways. Finally the experience of discrimination, although personal, necessarily impacts on the interracial relationship. Discrimination experienced by white women in committed interracial relationships with black men is thus multi-layered and both an intra-personal and inter-personal phenomenon

Ghosts in the nursery revisited

In the last decades new research findings have illuminated many of the factors that affect the mental health development of the pre-verbal child. Attachment theory has emerged as a central concept which has great applicability to the clinical field of infant-mental health. The new knowledge base has been utilized by clinical research programs to develop new models of clinical intervention programs with infants-at-risk and their families. This article describes some of the theoretical and research findings which can be translated to, and enhance, traditional child welfare practice. The theoretical considerations are illustrated by case examples.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44244/1/10560_2004_Article_BF00755708.pd

Automotive Industry Response to its Global QMS Standard ISO/TS-16949

With increasing globalization, the intense competition and customer-pressure have spurred many producers from developing/ emerging countries to adopt the best management and organizational practices. The quality issues are paramount for automotive manufacturing. The multiplicity of Quality Management System (QMS) Standards prevalent till the 1990s finally gave way to development of a harmonized automotive industry-specific QMS, namely ISO/TS-16949. This paper analyzes the major factors motivating firms to adopt this Standard: its quality signaling function, especially in international business, and facilitative role in moving up the supply chain. We investigate the inter-national and inter-regional concentration of ISO/TS-16949 certificates and relate those changes to the automotive industry dynamics. Among the top certifying nations - China, India and Brazil included - these certificates and ‘cars and commercial vehicles’ produced are highly correlated. A moderate-to-high worldwide growth of this certification is probable in near future with its gaining popularity among Tier-2 suppliers and for two/ three-wheeler automotive production. The Indian evidence indicates a sizeable proportion of car and commercial vehicle plants being ISO/TS-16949 certified and a high certification incidence among large and medium-large auto component firms. We suggest the creation of a Centre to encourage and prepare SMEs and provide financial assistance for ISO/TS-16949 certification

Development of atypical parental behavior during an inpatient family preservation intervention program

Since failed reunification is a detrimental outcome for children, particularly infants and toddlers, the aim of this study was to gain insight into support to families in multiple-problem situations to help them achieve sustainable good-enough parenting. Therefore, we examined outcomes of an assessment-based inpatient family preservation program. We prepared a thorough target-population description (n = 70) using file analysis. Next, we examined atypical parental behavior during the intervention using the Atypical Maternal Behavior Instrument for Assessment and Classification with a repeated measures design (n = 30). The family files revealed a great number of issues at the family, parent, and child levels, such as practical matters, problems in parent functioning and between parents, and difficulties in the broader environment. We found a significant decline in three dimensions of atypical parental behavior over time. This program has great potential in supporting vulnerable families in their pursuit of family preservation

Improving the outcome of infants born at <30 weeks' gestation - a randomized controlled trial of preventative care at home

Background: Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems