Bailey, Heidi

DeOliveira, Carey Anne

Gleason, Karin

Moran, Greg

Pederson, David R.

English

Scholarship@Western

Western UniversityScholarship@WesternPsychology Presentations Psychology Department7-2006Why Did Mothers with Unresolved Trauma Fail toBenefit from an Attachment Based Intervention?Correlates of Unresolved Status in a High RiskSampleHeidi BaileyUniversity of Western OntarioGreg MoranUniversity of Western Ontario, gmoran2@uwo.caCarey Anne DeOliveiraUniversity of Western Ontario, Careyanne.deoliveira@css.gov.on.caKarin GleasonUniversity of Western Ontario, kgleason@uwo.caDavid R. PedersonUniversity of Western Ontario, pederson@uwo.caFollow this and additional works at: https://ir.lib.uwo.ca/psychologypresPart of the Developmental Psychology CommonsCitation of this paper:Bailey, Heidi; Moran, Greg; DeOliveira, Carey Anne; Gleason, Karin; and Pederson, David R., "Why Did Mothers with UnresolvedTrauma Fail to Benefit from an Attachment Based Intervention? Correlates of Unresolved Status in a High Risk Sample" (2006).Psychology Presentations. 4.https://ir.lib.uwo.ca/psychologypres/41WHY DID MOTHERS WITH UNRESOLVED TRAUMA FAIL TO BENEFIT FROM AN ATTACHMENT BASED INTERVENTION?  CORRELATES OF UNRESOLVED STATUS IN A HIGH RISK SAMPLEHeidi Bailey, Greg Moran, Carey Anne DeOliveira, Karin Gleason, and David R.  PedersonThe University of Western OntarioWAIMH Paris July 20062With more than a little assistance from…• Sandi Bento, Research Coordinator• Carey Anne DeOliveira (CPRI, London)• Heidi Neufeld Bailey (U of Guelph)• Jen Phillips• Karin Gleeson• Ann Krupka• Ann Robson• Erinn Hawkins• Sheri Madigan• Lindsey Forbes• Elspeth Evans• Acia Blank• Anneli Sepa• Deanne Pederson• and others, including countless London area mothers and their babiesGenerous funding from:  Health Canada, SSHRC, and OMHF3The Western Adolescent Parenting Study Determinants of Intervention Outcome• The Risks of Adolescent Parenthood? Jaffe (2001) New Zealand study on developmental outcome for children of adolescent mothers• Study Objectives• Identify factors related to intervention success and failure 4The Intervention Study - Goals• Improve the security of the attachment relationship by supporting the mother’s sensitivity? Build rapport with mother ? Affirm parenting strengths while viewing a  5-minute videotape of the mother and infant at play? Augment mother’s awareness of infant signals5Maternal Sensitivity Over the First Year(MBQS scores)00.050.10.150.20.250.30.353 months6 months13 months6Study Design• Adult Attachment Interview at 6-months• Maternal sensitivity assessed in home visits at: 6-months - baseline, 12-months - post-intervention24-months – follow-up• Strange Situation at 12-months• Comparison and Intervention Groups? 8 home visits between 7 & 12 mos7Maternal Sensitivity  by Intervention and Age00.10.20.30.40.50.66 Months 12 Months 24 MonthsAgeMaternal SensitivityInterventionComparison8Attachment Classifications Intervention and Contrast Groups0102030405060Avoidant Secure AmbivalentPercentInterventionComparison9Maternal Sensitivity Related to Intervention and Unresolved Adult Attachment Interview Classification-0.3-0.2-0.100.10.20.30.40.50.60.76-months 12-months 24-monthsMaternal SensitivityIntervention U/dIntervention Not U/dComparison U/dComparison Not U/d10With Success, a New Challenge • A developmentally based home visiting program that encourages young mothers’ skills supports sensitivity and security • This interaction-focused intervention appears to be most effective with mothers who are not Unresolved• A distinct approach seems necessary with mothers with Unresolved states of mind and a history of trauma – but what sort of approach??? Where Next!?• Pursue a better understanding of the psychological consequences of physical and sexual abuse11Unresolved Attachment and Trauma Symptoms• Questionnaires: ? Trauma Symptom Inventory (TSI)? Borderline scale of Personality Assessment Inventory (PAI)Unresolved Mothers reported MORE:Dissociative SymptomsIdentity ConfusionRelationship Problems*12Unresolved Attachment and Trauma SymptomsThe Problem:? Self-report measures are limited by people’s limited awareness.? Unresolved mothers: limited awareness.? -> Assessment validity? 13Assessing Relational Processes:Projective TechniquesTransference ThemesPerception of Infant Emotions14Assessing TransferenceKarin Gleason, Ph.D., C.Psych.15Assessing TransferencePrevious experiencewith  relationshipsCognitive representations of relationshipsExpectations for anew relationshipBehaviour in relationship16Core Conflictual Relationship Themes(Luborsky et al., 1986)• Within each narrative:? wishes, needs or intentions? response of the other ? response of the self• Overall scores:? identify repeated themes,? their congruence,? their inflexibility17• Do you see [your parents] very much? • I see my dad more than I see my mom. And I didn’t get to see them till B was 3 months old. • What happened when you told them about the pregnancy?• They told me not to call them back. ---• And how was that for you?• I don’t know, I have (partner’s) family so it wasn’t that bad.(wish to be close)(other rejecting)(self response: comfortable)18Recurring CCRT Themes: Rejection from Other AdultsNot Unresolved:  others were Rejecting: 58%Unresolved:  others were Rejecting: 94%Autonomous: others as understanding, helpful19Relationship Themes with Infants: Response of SelfUnresolved:  self as Disappointed and Depressed (28%)Not Unresolved:  self as Respected and Helpful (39%)20Congruence: Wishes & Others’ ResponseUnresolved:  42% congruenceNot Unresolved:  51% congruence21Inflexibility: Response of OthersUnresolved:  71% inflexibilityNot Unresolved:  56% inflexibilityOverall, wishes of adolescent mothers were rigid and inflexible22Transference: Implications for Intervention• Unresolved mothers:? themes of rejection, disappointment ? lack of flexibility• How will this affect:? Expectations for mother-infant relationship?? Interpretation of infant’s behaviour?? Ability to benefit from intervention?23Assessing Mothers’ Perceptions of Infant EmotionsCarey Anne DeOliveira, Ph.D., C.Psych24Mothers’ Perception of Infant Emotions Experience of emotions in early relationshipsPerception of own andothers’ emotionsLack of understanding of emotionsExpectations ofothers’ responsesProjection of ownfeelingsPerception of their infant’s emotionsResponse to their infant25IFEEL Pictures (Emde, Osofsky, & Butterfield, 1993)26Perceived EmotionsUnresolved Mothers perceived LESS:  ContentUnresolved Mothers perceived MORE:   SurpriseShame/GuiltPassivity27Perceived Emotions: Atypical Responses• Used by <5% of the reference sample (Emde et al., 1993)Unresolved Mothers reported MORE:  AtypicalResponses28Perception of Emotions: Implications for Intervention• Unresolved mothers:? perceive different emotions (more passive, shame, surprise)? have atypical perceptions of infant emotions • How will this affect:? behaviour toward infant?? awareness of distortions? 29Summary:Implications for Intervention• Assess relational processes using:? self-report and projective techniques? behavioural observations• Interventions to address:? attributions and expectancies within mothers’ awareness, and? automatic/implicit responses within interactions and to emotion cues

Why Did Mothers with Unresolved Trauma Fail to Benefit from an Attachment Based Intervention? Correlates of Unresolved Status in a High Risk Sample

https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1003&amp;context=psychologypres

Why Did Mothers with Unresolved Trauma Fail to Benefit from an Attachment Based Intervention? Correlates of Unresolved Status in a High Risk Sample

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