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INTRODUCTION: This study aimed to clarify the role of mentalizing in pathways from attachment to Post Traumatic Stress Symptoms (PTSS) in survivors of childhood maltreatment (CM). We focused on the transition to parenting, a critical period for reworking parenting representations to reduce intergenerational maltreatment cycles. METHOD: Study participants included 100 pregnant CM survivors. We assessed PTSS with the SCID and attachment and mentalizing with the Adult Attachment Interview (AAI), which was rated for Attachment and Reflective Functioning (RF). RESULTS: Regarding Re-experiencing trauma symptoms, the results of the path analysis were consistent with mediation. CM survivors mentalizing about their early relationships with their parents (RF-Other) directly impacted Re-experiencing trauma symptoms, and attachment had an effect on Re-experiencing trauma symptoms through mentalizing (RF-Other). Regarding Arousal/Reactivity symptoms, the results of the pathways analysis were consistent with partial mediation by mentalizing about early relationships with parents (RF-Other). In addition to the pathway from attachment via mentalizing (RF-Other) to Arousal/Reactivity, the pathway between attachment and Arousal/Reactivity also remained significant. DISCUSSION: This study provides new evidence of a mentalizing and attachment model of PTSS in CM survivors. The findings indicate that increased mentalizing about early relationships with parents is an important process associated with lower PTSS. Finally, we discuss the implications of developing interventions for CM survivors to reduce PTSS. Scaffolding the development of mentalizing regarding attachment relationships in which CM occurred may help CM survivors reduce the intrusion of traumatic memories and decrease trauma-related arousal and reactivity symptoms. Interventions to help CM survivors mentalize regarding parents and attachment relationships in which trauma occurred may be particularly important during the transition to parenting when activation of representations of parenting can trigger PTSS.

The aim of the present study was to examine the hypothesis that attachment and childhood sexual abuse (CSA) interacted such that school aged CSA survivors with insecure attachment to parents would be at an elevated risk of developing post-traumatic stress disorder (PTSD) and trauma symptoms. Participants (n = 111, ages 7-12) comprised two groups, child CSA survivors (n = 43) and a matched comparison group of children (n = 68) recruited from the community. Children completed the Child Attachment Interview (CAI) as well as the Trauma Symptom Checklist for Children (TSCC). There was a significant interaction between sexual abuse history and attachment security, such that sexually abused children with insecure attachment representations had significantly more PTSD and trauma symptoms than sexually abused children with secure attachment to parents. The findings show that using a dual lens of attachment and CSA can facilitate the identification of children most at risk and has important implications for understanding risk and resilience processes.

Despite extensive theorizing regarding the regulatory role of reflective functioning (RF), few studies have explored the links between RF and physiological indices of emotion regulation, and none have examined these associations in children. Further, while scholars contend that RF promotes resilience via enhanced ability to process emotional experiences, including those occurring in attachment relationships, this argument has seldom been tested empirically in children. In the current study, we explore the association between RF and physiological measures of emotion reactivity and regulation, as well as the interaction of RF and attachment insecurity. We test these associations by examining children's (N = 76; 8-12 years old) cardiovascular responses [respiratory sinus arrhythmia (RSA)] to a standardized paradigm designed to evoke reactions regarding the experience and expression of attachment-related needs. Children also completed a semi-structured attachment interview, which was later coded for children's attachment insecurity (operationalized as attachment dismissal and preoccupation) and RF. Our findings were largely consistent with theory and our hypotheses, suggesting that higher RF is associated with lesser cardiovascular reactivity (higher levels of RSA) during the stressor task and better recovery following the task. These links were especially strong for children with greater attachment preoccupation but did not vary as a function of children's levels of attachment dismissal. These findings contribute to developmental theory in suggesting that RF is closely linked to physiological emotion regulation in children.

Building on the notion of epistemic trust as facilitating social learning, in this article we clarify how interventions from mentalization-based treatment (MBT) for borderline personality disorder generate this process. We suggest first that being mentalized is a critical cue in interactions to establish epistemic trust and second that epistemic mistrust may represent a final common pathway through which aversive relational experiences in the past may exert their influence on treatments—both as a disposition of the patient and as a characteristic of the therapist-patient encounter. By charting MBT interventions from the initial assessment and formulation, through individual and group therapy sessions, to re-engaging with the wider social environment, we examine how each of these can establish a "we-mode," an interpersonal experience associated with being mentalized that unlocks the barrier posed by epistemic vigilance. In addition, implications for relational mentalizing and rupture and repair within the therapeutic relationship are discussed. [ABSTRACT FROM AUTHOR]

Objective: Considering the fact that the teaching profession is a highly stressful occupation and that teachers' ineffective coping strategies contribute to higher levels of stress, the objective of the present study was to investigate whether insecure attachment is related to global stress experiences in preservice student teachers. Furthermore, it was examined whether this link is mediated by the preservice teachers' mentalizing--the capacity to perceive and consider one's own and others' behavior based on intentional mental states. Methods: Data of this cross-sectional study came from 202 preservice student teachers using self-report instruments (attachment: Expectation in Close Relationships; mentalizing: Reflective Functioning Questionnaire; stress: Trier Inventory of Chronic Stress). The hypotheses were tested using structural equation modelling. Results: Anxious attachment was positively related to stress and impairments in mentalizing. In addition, the link between attachment-related anxiety and stress was partially mediated by mentalizing. Avoidant attachment was not associated with stress or mentalizing. Discussion: Results indicate that anxious attachment is associated with higher perceived stress in preservice student teachers. Consequently, attachmentrelated anxiety may be a risk factor which, in turn, may foster perceptions of higher global stress experiences. Conclusion: Additional research needs to focus on exploring the link between attachment insecurity and global stress experiences among preservice student teachers. An examination of preservice student teachers' own attachment experiences proves to be useful, for example in the context of mentalizationbased supervision or reflective practice. [ABSTRACT FROM AUTHOR]

Anorexia nervosa-focussed family therapy (FT-AN) is the first-line treatment for adolescent anorexia nervosa (AN), but the predictors of poor treatment response are not well understood. The main aim of this study was to investigate the role of attachment and mentalization in predicting treatment outcome. The secondary aims of the study were to investigate therapeutic alliance at 1 month as a predictor of outcome, and to test the associations between alliance and baseline attachment and mentalization. 192 adolescents with AN and their parents were recruited as they began family therapy in out-patient specialist eating disorder services. Self-report measures of attachment, mentalization, and emotion regulation were completed at the start of treatment by adolescent patients and one of their parents. Self-reported alliance scores were collected at one month. Higher scores on the Certainty Scale of the Reflective Functioning Questionnaire, completed by parents, which indicate over-certainty about mental states, were the strongest predictor of poor outcome (Odds Ratio: 0.42, CI: 0.20–0.87). Similarly, for adolescents, higher Lack of Clarity scores on the Difficulties in Emotion Regulation Scale, representing being unclear about one's feelings, were predictive of positive treatment outcome (OR: 1.10, CI: 1.00–1.21). Higher alliance scores at 1 month predicted positive outcome, and were associated with attachment security and mentalization. These novel findings suggest that, particularly in parents, a tendency towards excessive certainty about mental states in others may predict poor outcome in FT-AN. Further research is warranted to replicate the finding and characterise families at risk of poor outcome. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article reviews the current status of research on the relationship between attachment and trauma in developmental psychopathology. Beginning with a review of the major issues and the state-of-the-art in relation to current thinking in the field of attachment about the impact of trauma and the inter-generational transmission of trauma, the review then considers recent neurobiological work on mentalizing and trauma and suggests areas of new development and implications for clinical practice. [ABSTRACT FROM AUTHOR]

Diagnosis and treatment of congenital heart disease (CHD) can present challenges to the developing parent-child relationship due to periods of infant hospitalization and intensive medical care, parent-infant separations, child neurodevelopmental delay and feeding problems, and significant parent and child distress and trauma. Yet, the ways in which CHD may affect the parent-child relationship are not well-understood. We systematically reviewed the evidence on parental bonding, parent-child interaction, and child attachment following CHD diagnosis, according to a pre-registered protocol (CRD42019135687). Six electronic databases were searched for English-language studies comparing a cardiac sample (i.e., expectant parents or parents and their child aged 0–5 years with CHD) with a healthy comparison group on relational outcomes. Of 22 unique studies, most used parent-report measures (73%) and yielded mixed results for parental bonding and parent-child interaction quality. Observational results also varied, although most studies (4 of 6) found difficulties in parent-child interaction on one or more affective or behavioural domains (e.g., lower maternal sensitivity, lower infant responsiveness). Research on parental-fetal bonding, father-child relationships, and child attachment behaviour was lacking. Stronger evidence is needed to determine the nature, prevalence, and predictors of relational disruptions following CHD diagnosis, and to inform targeted screening, prevention, and early intervention programs for at-risk dyads. [ABSTRACT FROM AUTHOR]

Introduction:Exposure to traumatic stressful events in childhood is an important risk factor for the development of posttraumatic symptomatology. From a mentalization-based developmental perspective, childhood adversity can affect attachment in children and may result in insecure attachment and impaired mentalizing abilities, which increase the lifetime risk for psychopathology. The present cross-sectional study examined the potential mediating role of attachment insecurity and impaired mentalizing on the relationship between childhood trauma and posttraumatic symptomatology. Method: Adults who had experienced childhood neglect and abuse (n = 295, 184 patients with personality disorder and 111 community controls) completed self-report measures of posttraumatic stress disorder (PTSD) symptoms, dissociative experiences, adult attachment insecurity, and mentalizing. Results: Structural equation modelling results revealed that attachment insecurity together with lower mentalizing mediated the link between childhood trauma and PTSD symptoms, and lower mentalizing mediated the link between childhood trauma and dissociative experiences. Conclusion: The findings show that attachment insecurity and lower mentalizing play significant mediating roles in the reporting of posttraumatic symptomatology among survivors of childhood abuse and neglect, with treatment implications for mentalization-based therapy as beneficial for individuals with a history of childhood trauma. [ABSTRACT FROM AUTHOR]

The onset of motherhood is characterized by significant psychological and neurobiological changes. These changes equip the mother to care for her new child. Although rewarding, motherhood is also an inherently stressful period, more so for mothers with unresolved trauma. Past research has looked at how unresolved trauma can hamper a mother's caregiving response toward her infant, which further affects the development of secure attachment in her own infant. The Dynamic Maturational Model of Attachment and Adaptation (DMM) has introduced a unique concept of "attachment reorganization" which can be described as a process whereby individuals with unresolved trauma are transitioning toward attachment security based on their enhanced understanding of past and present experiences. Preliminary results from one of our previous studies have shown that, among mothers with unresolved trauma, mothers who themselves demonstrated "reorganizing attachment" toward security, had infants with secure attachment, thereby indicating the potential to halt the intergenerational transmission of insecure attachment. While this concept is of great clinical relevance, further research is required to assess the benefits of attachment reorganization as a protective factor and its positive implications for child development. Thus, the aim of the current review is to expand on the concept of attachment reorganization in mothers with unresolved trauma from both attachment and neuroscience perspectives. To that effect, we will first review the literature on the transition to motherhood from attachment and neuroscience perspectives. Second, we will use attachment and neuroscience approaches to address deviations from normative experiences during motherhood with a specific focus on the role of a mother's unresolved trauma. Lastly, we will expand on the concept of reorganization and the promise this concept holds in resolving or halting the intergenerational transmission of trauma from mothers to their children. [ABSTRACT FROM AUTHOR]

Abstract Problems related to aggression in young people are traditionally subsumed under the header of conduct problems, which include conduct disorder and oppositional defiant disorder. Such problems in children and adolescents are an important societal and mental health problem. In this paper we present an evolutionarily informed developmental psychopathology view of conduct problems inspired by the NIMH Research Domain Criteria (RDoC) initiative. We assume that while there are many pathways to conduct problems, chronic or temporary impairments in the domain of social cognition or mentalizing are a common denominator. Specifically, we conceptualize conduct problems as reflecting temporary or chronic difficulties with mentalizing, that is, the capacity to understand the self and others in terms of intentional mental states, leading to a failure to inhibit interpersonal violence through a process of perspective-taking and empathy. These difficulties, in turn, stem from impairments in making use of a normally evolutionarily protected social learning system that functions to facilitate intergenerational knowledge transmission and protect social collaborative processes from impulsive and aggressive action. Temperamental, biological, and social risk factors in different combinations may all contribute to this outcome. This adaptation then interacts with impairments in other domains of functioning, such as in negative and positive valence systems and cognitive systems. This view highlights the importance of a complex interplay among biological, psychological, and environmental factors in understanding the origins of conduct problems. We outline the implications of these views for future research and intervention. Highlights • Conduct problems in youth are an important societal and mental health problem. • A developmental psychopathology view inspired by RDoC is presented. • Problems with a social learning system that protects from aggression are central in explaining conduct problems. • Heterogeneity in pathways to conduct problems is described. • Research and clinical implications of this view are discussed. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionThe present study introduces and validates the Epistemic Trust Rating System (ETRS), an observer-based measure designed to assess epistemic trust (ET) within psychotherapy. ET in psychotherapy has gained much theoretical attention as a critical component in the therapeutic context, given its inherent link to social communication. However, its empirical validation remains pending, largely due to the absence of a refined instrument to gauge ET levels within the therapy environment. Therefore, this study aimed to translate ET’s theoretical construct into tangible markers within the therapeutic context.One hundred eighteen patients enrolled in a randomized controlled trial received psychodynamic psychotherapy for depression. Incorporating top-down theoretical considerations with bottom-up empirical observations yielded an overall ETRS score accompanied by three distinct sub-scales, each assessing a singular ET element: one gauges the patient’s propensity to share; another measures the degree to which “we-mode” moments are achieved within the session; and the third evaluates the patient’s receptiveness to learning.The findings demonstrate the psychometric robustness of the ETRS, with good internal consistency, interrater reliability (ICC(1,8) = .86-.90), and convergent (r = .23-.29) and discriminant validity (r = -.10).The current study highlights the ETRS as a promising tool bridging theory and empirical exploration, enhancing our understanding of epistemic trust in psychotherapy. [ABSTRACT FROM AUTHOR]

Background: Young mothers living in low-income urban settings often are exposed to significant and chronic environmental difficulties including poverty, social isolation and poor education and typically also have to cope with personal histories of abuse and depression. Minding the Baby® (MTB) is an interdisciplinary home-visiting programme developed to support first-time young mothers, which integrates primary care and mental health approaches into a single intensive intervention from the last trimester of pregnancy until the child’s second birthday. The primary aim of the intervention is to promote caregiver sensitivity, and, secondarily, to promote both child and maternal socioemotional outcomes. Methods/design: This is a multisite randomised controlled trial (RCT) with a target recruitment of 200 first-time adolescent mothers (under 26 years of age). One hundred participants will be randomised to the MTB group and they will receive the MTB programme in addition to the usual services available in their areas. Those participants not allocated to MTB will receive Treatment as Usual (TAU) only. Researchers will carry out blind assessments at baseline (before the birth of the baby), and outcome assessments around the child’s first and second birthdays. The primary outcome will be the quality of maternal sensitivity and the secondary outcomes will focus on attachment security, child cognitive/language development, behavioural problems, postponed childbearing, maternal mental health and incidents of child protection interventions. Discussion: This study evaluates the Minding the Baby® programme in the UK. In particular, this RCT explores the effectiveness of this integrative approach, which focusses on maternal mental issues as well as parent-infant interaction, parental concerns and developmental outcomes. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adolescent Mentalization-Based Integrative Treatment (AMBIT) is a developing approach to working with “hard-to-reach” youth burdened with multiple co-occurring morbidities. This article reviews the core features of AMBIT, exploring applications of attachment theory to understand what makes young people “hard to reach,” and provide routes toward increased security in their attachment to a worker. Using the theory of the pedagogical stance and epistemic (“pertaining to knowledge”) trust, we show how it is the therapeutic worker’s accurate mentalizing of the adolescent that creates conditions for new learning, including the establishment of alternative (more secure) internal working models of helping relationships. This justifies an individual keyworker model focused on maintaining a mentalizing stance toward the adolescent, but simultaneously emphasizing the critical need for such keyworkers to remain well connected to their wider team, avoiding activation of their own attachment behaviors. We consider the role of AMBIT in developing a shared team culture (shared experiences, shared language, shared meanings), toward creating systemic contexts supportive of such relationships. We describe how team training may enhance the team’s ability to serve as a secure base for keyworkers, and describe an innovative approach to treatment manualization, using a wiki format as one way of supporting this process. [ABSTRACT FROM PUBLISHER]

This study contrasted two forms of mother–infant mirroring: the mother's imitation of the infant's facial, gestural, or vocal behavior (i.e., “direct mirroring”) and the mother's ostensive verbalization of the infant's internal state, marked as distinct from the infant's own experience (i.e., “intention mirroring”). Fifty mothers completed the Adult Attachment Interview (Dynamic Maturational Model) during the third trimester of pregnancy. Mothers returned with their infants 7 months postpartum and completed a modified still-face procedure. While direct mirroring did not distinguish between secure and insecure/dismissing mothers, secure mothers were observed to engage in intention mirroring more than twice as frequently as did insecure/dismissing mothers. Infants of the two mother groups also demonstrated differences, with infants of secure mothers directing their attention toward their mothers at a higher frequency than did infants of insecure/dismissing mothers. The findings underscore marked and ostensive verbalization as a distinguishing feature of secure mothers’ well-attuned, affect-mirroring communication with their infants. [ABSTRACT FROM AUTHOR]

Background Twin studies consistently point to limited genetic influence on attachment security in the infancy period, but no study has examined whether this remains the case in later development. This study presents the findings from a twin study examining the relative importance of genetic and environmental influences on attachment in adolescence. Methods The sample included 551 twin pairs aged 15 years recruited from the larger Twins Early Development Study ( TEDS). Attachment was assessed using a semistructured interview, the Child Attachment Interview. Results We found robust associations between MZ twins' scores for Coherence and their overall security of attachment ( r = .42, p < .001; kappa = .26, p < .001), but substantially lower associations for DZ twins ( r = .20, p = .001; kappa = .09, p = .20), suggesting genetic influence on adolescent attachment (and substantial nonshared environment). Model-fitting analyses confirmed this impression, indicating approximately 40% heritability of attachment and negligible influence of the shared environment. Conclusions The results suggest that genes may play an important role in adolescent attachment and point to the potentially distinct aetiological mechanisms involved in individual differences in attachment beyond early childhood. [ABSTRACT FROM AUTHOR]

While the neurobiology of post-traumatic stress disorder has been extensively researched, much less attention has been paid to the neural mechanisms underlying more covert but pervasive types of trauma (e.g., those involving disrupted relationships and insecure attachment). Here, we report on a neurobiological study documenting that mothers’ attachment-related trauma, when unresolved, undermines her optimal brain response to her infant’s distress. We examined the amygdala blood oxygenation level-dependent response in 42 first-time mothers as they underwent functional magnetic resonance imaging scanning, viewing happy- and sad-face images of their own infant, along with those of a matched unknown infant. Whereas mothers with no trauma demonstrated greater amygdala responses to the sad faces of their own infant as compared to their happy faces, mothers who were classified as having unresolved trauma in the Adult Attachment Interview (Dynamic Maturational Model) displayed blunted amygdala responses when cued by their own infants’ sadness as compared to happiness. Unknown infant faces did not elicit differential amygdala responses between the mother groups. The blunting of the amygdala response in traumatized mothers is discussed as a neural indication of mothers’ possible disengagement from infant distress, which may be part of a process linking maternal unresolved trauma and disrupted maternal caregiving. [ABSTRACT FROM AUTHOR]

Background The NOURISHED study: Nice OUtcomes for Referrals with Impulsivity, Self Harm and Eating Disorders. Eating Disorders (ED) and Borderline Personality Disorder (BPD) are both difficult to treat and the combination presents particular challenges. Both are associated with vulnerability to loss of mentalization (awareness of one's own and others' emotional state) In BPD, Mentalization Based therapy (MBT) has been found effective in reducing symptoms. In this trial we investigate the effectiveness and cost-effectiveness of MBT adapted for Eating disorders (Mentalization Based Therapy for Eating Disorders (MBT-ED))compared to a standard comparison treatment, Specialist Supportive Clinical Management SSCM-ED) in patients with a combination of an Eating Disorder and either a diagnosis of BPD or a history of self-harm and impulsivity in the previous 12 months. Methods/Design We will complete a multi-site single-blind randomized controlled trial of MBT-ED vs SSCM-ED. Participants will be recruited from 3 Eating Disorder Services and 2 Borderline Personality Disorder Services in London. Participants allocated to MBT-ED will receive one year of weekly group and individual therapy and participants allocated to SSCM-ED will receive 20 sessions of individual therapy over 1 year. In addition, participants in both groups will have access to up to 5 hours of dietetic advice. The primary outcome measure is the global score on the Eating Disorders Examination. Secondary outcome measures include total score on the Zanarini BPD scale, the Object Relations Inventory, the Depression Anxiety Stress Scales, quality of life and cost-effectiveness. Measures are taken at recruitment and at 6 month intervals up to 18 months. Discussion This is the first RCT of MBT-ED in patients with eating disorders and symptoms of BPD and will provide evidence to inform therapy decisions in this group of patients. During MBT-ED mentalization is encouraged, while in SSCM-ED it is not overtly addressed. Study of proposed moderating factors will help elucidate mechanisms of change in the two therapies and analysis of therapy and interview transcripts will provide qualitative information about the conduct of therapy and changes in mentalization and object relations. Trial registration ISRCTN51304415 [ABSTRACT FROM AUTHOR]

Mentalizing, in particular the successful attribution of complex mental states to others, is crucial for navigating social interactions. This ability is highly influenced by external factors within one's daily life, such as stress. We investigated the impact of stress on the brain basis of mentalization in adults. Using a novel modification of the Reading the Mind in the Eyes Test (RMET-R) we compared the differential effects of two personalized stress induction procedures: a general stress induction (GSI) and an attachment-related stress induction (ASI). Participants performed the RMET-R at baseline and after each of the two inductions. Baseline results replicated and extended previous findings regarding the neural correlates of the RMET-R. Additionally, we identified brain regions associated with making complex age judgments from the same stimuli. Results after stress exposure showed that the ASI condition resulted in reduced mentalization-related activation in the left posterior superior temporal sulcus (STS), left inferior frontal gyrus and left temporoparietal junction (TPJ). Moreover, the left middle frontal gyrus and left anterior insula showed greater functional connectivity to the left posterior STS after the ASI. Our findings indicate that attachment-related stress has a unique effect on the neural correlates of mentalization. [ABSTRACT FROM AUTHOR]

Patients with functional somatic disorders (FSD) represent a sizeable group in our health care system. FSD are associated with high health care use and considerable personal and economic costs. Evidence-based treatments for FSD are only modestly effective in a large subgroup of patients, particularly in the long run, which emphasizes the need to develop more effective treatments rooted in extant knowledge about the nature of FSD. This paper presents a contemporary psychodynamic perspective on the conceptualization and treatment of patients with FSD rooted in attachment and mentalization theory. First, we review animal and human research demonstrating the close relationships among attachment, stress regulation, and immune and pain-regulating systems. We highlight research findings concerning the high interpersonal and metabolic costs associated with the use of insecure secondary attachment strategies (i.e. attachment deactivating and hyperactivating strategies) leading to increased vulnerability for stress. Next, we review evidence for the role of impairments in (embodied) mentalization in patients with FSD both as cause and consequence of functional somatic complaints, leading to the re-emergence of so-called non-mentalizing modes, i.e. modes of subjectivity that antedate the capacity for full mentalizing. Based on these views, a novel brief psychodynamic intervention for patients with functional somatic complaints is presented. [ABSTRACT FROM AUTHOR]

Studies have demonstrated a strong relation between adult attachment security, using the Adult Attachment Interview (AAI), and infant security, using the Strange Situation Procedure (SSP). This suggests that a mother's representations of attachment may influence the development of her infant's attachment to her . This study both confirms and modifies that finding in a cohort of 47 first-time mothers and their infants. The AAIs were administered during the third trimester of pregnancy and the SSPs were performed when the infant was 14 months of age. The AAIs were classified using Crittenden's Dynamic-Maturational Model (DMM) and the SSPs using both the DMM and also Main and Solomon's ABC+D methods. There was a significant match of patterns for secure mothers and babies, but a tendency for inversion of insecure patterns of attachment, that is Type A mothers often had infants with a Type C pattern and vice versa. No significant relation was seen between the DMM adult and ABC+D infant patterns of attachment. A significant, but modest, association was found between the DMM and ABC+D infant SSP classifications. These findings may help guide treatment of insecure mother--infant dyads by individualizing interventions to include a focus on maternal representations of the infant and maternal responses to infant behavior. [ABSTRACT FROM AUTHOR]

Infant cues, such as smiling or crying facial expressions, are powerful motivators of human maternal behavior, activating dopamine-associated brain reward circuits. Oxytocin, a neurohormone of attachment, promotes maternal care in animals, although its role in human maternal behavior is unclear. We examined 30 first-time new mothers to test whether differences in attachment, based on the Adult Attachment Interview, were related to brain reward and peripheral oxytocin response to infant cues. On viewing their own infant's smiling and crying faces during functional MRI scanning, mothers with secure attachment showed greater activation of brain reward regions, including the ventral striatum, and the oxytocin-associated hypothalamus/pituitary region. Peripheral oxytocin response to infant contact at 7 months was also significantly higher in secure mothers, and was positively correlated with brain activation in both regions. Insecure/dismissing mothers showed greater insular activation in response to their own infant's sad faces. These results suggest that individual differences in maternal attachment may be linked with development of the dopaminergic and oxytocinergic neuroendocrine systems. [ABSTRACT FROM AUTHOR]

Data about the quality of attachment between infants and parents in high-risk populations suggests that early intervention may be advantageous for positive developmental outcomes for the child. Mothers in prison represent a high-risk parenting population in terms of both attachment histories and economic and social risk factors. New Beginnings was constructed as a short term, experience-based programme for mothers and infants in the Mother and Baby Units of two UK women's prisons. It is based on the early intervention model developed at the Anna Freud Centre. The programme was piloted in 2004-5, with 27 participating dyads. This paper presents an overview of the pilot stage. Our aim is to introduce the thinking that went into the programme and to present initial observations concerning the effect of the programme. We describe the development of a framework for the programme and its preliminary evaluation using pre- and post-interview protocols concerning the mothers' thoughts and feelings about their babies. We used the Parent Development Interview, for both a qualitative analysis of the major themes in connection to child rearing and quantitative measures of reflective capacity in relation to the child on the part of mother-participants. [ABSTRACT FROM AUTHOR]

Developmental psychology and psychopathology has in the past been more concerned with the quality of self-representation than with the development of the subjective agency which underpins our experience of feeling, thought and action, a key function of mentalisation. This review begins by contrasting a Cartesian view of pre-wired introspective subjectivity with a constructionist model based on the assumption of an innate contingency detector which orients the infant towards aspects of the social world that react congruently and in a specifically cued informative manner that expresses and facilitates the assimilation of cultural knowledge. Research on the neural mechanisms associated with mentalisation and social influences on its development are reviewed. It is suggested that the infant focuses on the attachment figure as a source of reliable information about the world. The construction of the sense of a subjective self is then an aspect of acquiring knowledge about the world through the caregiver's pedagogical communicative displays which in this context focuses on the child's thoughts and feelings. We argue that a number of possible mechanisms, including complementary activation of attachment and mentalisation, the disruptive effect of maltreatment on parent–child communication, the biobehavioural overlap of cues for learning and cues for attachment, may have a role in ensuring that the quality of relationship with the caregiver influences the development of the child's experience of thoughts and feelings. [ABSTRACT FROM AUTHOR]

The current article presents results from a twin study of genetic and environmental components of maternal sensitivity and infant attachment and their association. The sample consisted of 136 twin pairs from 2 sites: Leiden, the Netherlands, and London, UK. Maternal sensitivity was assessed in the home at 9–10 months, and infant attachment security was observed in the laboratory at 12 months. The study yielded little evidence that genetic factors are involved in variations between twins in maternal sensitivity ratings but did find that shared variance in maternal sensitivity was able to account for some of the similarity between twins in attachment security. Weak nonshared associations between sensitivity and attachment appeared to suppress the magnitude of the correlation between attachment and sensitivity in twin children. The results could indicate that the attachment security of one twin may depend on the relationship the parent has with the other twin. The results are brought to bear on the validity of attachment theory as a theory of primarily shared environmental effects in children's development and the continuing challenge posed to attachment theory by within-family differences in socioemotional processes. [ABSTRACT FROM AUTHOR]

This article considers the development of violence with particular reference to family factors in violence such as the quality of the parent-child relationship. In taking a developmental approach to violence, a link is established between the maltreatment of children in an attachment context and the risk of violence via the child's capacity to envision mental states in the other. Evidence from epidemiology and neuroscience is brought to bear on this link. Finally, some studies of prevention of violence that are likely to enhance attachment and mentalizing are considered. [ABSTRACT FROM AUTHOR]

This paper introduces a new measure of attachment in middle childhood (8 - 13 years), an interview extensively adapted from the AAI and with a new coding system. We report data from a series of studies with clinical and normal populations, in which the psychometric properties of reliability, stability and validity are tested and found to be satisfactory. Although work remains to be done, we see the Child Attachment Interview as a promising new attachment measure. [ABSTRACT FROM AUTHOR]

Background: This study examined the degree of overlap and sources of discrepancies between two alternative models of social cognition in early adolescence, a general model based on 'theory of mind' and a relationship-specific model rooted in attachment theory. Methods: We administered newly developed, age-appropriate measures of advanced theory of mind or 'mentalising' and child-parent attachment, indexed by the coherence of children's narratives about attachment relationships, to a sample of 70 early adolescents (mean age 12.6 years). Results: The central findings were that, as expected, there was significant overlap between the mentalising and attachment indices of social cognition ( r(70)=.35, p < .01). The overlap was not significantly mediated by verbal ability or general measures of parenting. There were also substantial discrepancies in children's performance on these measures that were conceptually interesting and statistically reliable. Specifically, adolescent reports of parenting discriminated between measures of mentalising and attachment coherence. In addition, those children who exhibited a less coherent model of attachment than was predicted from performance on a mentalising task were more likely to be rated as exhibiting a 'Dismissing/Avoidant' style in the attachment interview. Conclusions: Findings support a connection between mentalising and attachment in early adolescence, and further suggest that social cognitive processes may be context and relationship-specific. [ABSTRACT FROM AUTHOR]

Mentalization‐based treatment (MBT) is a spectrum of interventions that share a central focus on improving the capacity for mentalizing. Although MBT was originally developed as a treatment for individuals with borderline personality disorder, its scope and focus have been broadened to become a socioecological approach that stresses the role of broader sociocultural factors in determining the closely related capacities for mentalizing and epistemic trust. This special issue brings together some of the newest developments in MBT that illustrate this shift. These contributions also highlight several current limitations in mentalization‐based approaches, providing important pointers for further research. In this editorial, we first outline the broadening scope of the mentalizing approach, and then provide a discussion of each of the contributions to this special issue in the context of the need for further research concerning some of the key assumptions of mentalization‐based approaches and their implementation in clinical practice. We close this editorial with considerations concerning future research. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify a theoretical framework which may provide a meaningful context for developing practical interventions to build upon the concept of resilience, In so doing 1 shall briefly consider the importance of the concept, what is known about it, and then Focus on a specific facet of the problem: Intergenerational transmission of maladaptive relationship patterns and resilience to such a threat. [ABSTRACT FROM AUTHOR]

Current research on personality disorders strives to identify key behavioural and cognitive facets of patient functioning, to unravel the underlying root causes and maintenance mechanisms. This process often involves the application of social paradigms — however, these often only include momentary affective depictions rather than unfolding interactions. This constitutes a limitation in our capacity to probe core symptoms, and leaves potential findings uncovered which could help those who are in close relationships with affected individuals. Here, we deployed a novel task in which subjects interact with four unknown virtual partners in a turn-taking paradigm akin to a dance, and report on their experience with each. The virtual partners embody four combinations of low/high expressivity of positive/negative mood. Higher scores on our symptomatic measures of attachment anxiety, avoidance, and borderline personality disorder (BPD) were all linked to a general negative appraisal of all the interpersonal experiences. Moreover, the negative appraisal of the partner who displayed a high negative/low positive mood was tied with attachment anxiety and BPD symptoms. The extent to which subjects felt responsible for causing partners' distress was most strongly linked to attachment anxiety. Finally, we provide a fully-fledged exploration of move-by-move action latencies and click distances from partners. This analysis underscored slower movement initiation from anxiously attached individuals throughout all virtual interactions. In summary, we describe a novel paradigm for second-person neuroscience, which allowed both the replication of established results and the capture of new behavioural signatures associated with attachment anxiety, and discuss its limitations. [ABSTRACT FROM AUTHOR]

Background: Young mothers living in low-income urban settings often are exposed to significant and chronic environmental difficulties including poverty, social isolation and poor education and typically also have to cope with personal histories of abuse and depression. Minding the Baby® (MTB) is an interdisciplinary home-visiting programme developed to support first-time young mothers, which integrates primary care and mental health approaches into a single intensive intervention from the last trimester of pregnancy until the child's second birthday. The primary aim of the intervention is to promote caregiver sensitivity, and, secondarily, to promote both child and maternal socioemotional outcomes.Methods/design: This is a multisite randomised controlled trial (RCT) with a target recruitment of 200 first-time adolescent mothers (under 26 years of age). One hundred participants will be randomised to the MTB group and they will receive the MTB programme in addition to the usual services available in their areas. Those participants not allocated to MTB will receive Treatment as Usual (TAU) only. Researchers will carry out blind assessments at baseline (before the birth of the baby), and outcome assessments around the child's first and second birthdays. The primary outcome will be the quality of maternal sensitivity and the secondary outcomes will focus on attachment security, child cognitive/language development, behavioural problems, postponed childbearing, maternal mental health and incidents of child protection interventions.Discussion: This study evaluates the Minding the Baby® programme in the UK. In particular, this RCT explores the effectiveness of this integrative approach, which focusses on maternal mental issues as well as parent-infant interaction, parental concerns and developmental outcomes.Trial Registration: ISRCTN08678682 (date of registration 3 April 2014). [ABSTRACT FROM AUTHOR]

This paper reviews recent theoretical, empirical, and clinical work related to parental reflective functioning (PRF) or parental mentalizing. PRF refers to the capacity of the parent to envision his or her child as being motivated by internal mental states such as feelings, wishes, and desires, and to be able to reflect on his or her own internal mental experiences and how they are shaped and changed by interactions with the child. This paper first briefly discusses the historical and theoretical background of this concept and its purported role in child development, with a focus on the development of child attachment, affect regulation, and mentalizing. It then reviews recent thinking and research in four areas: (1) the neurobiology underlying PRF, (2) the multidimensionality of PRF, (3) the relationship between PRF and trauma, and (4) the broader relevance of attention to internal mental states for the development of epistemic trust as the basis of an evolutionary inbuilt capacity for learning from and within social communication. It closes with a brief review of the background of, and empirical evidence supporting, interventions rooted in theoretical considerations concerning the importance of PRF, as well as suggested directions for future research and clinical practice. [ABSTRACT FROM AUTHOR]

OBJECTIVES. Our goal was to determine how a mother's brain responds to her own infant's facial expressions, comparing happy, neutral, and sad face affect. METHODS. In an event-related functional MRI study, 28 first-time mothers were shown novel face images of their own 5- to 10-month-old infant and a matched unknown infant. Sixty unique stimuli from 6 categories (own-happy, own-neutral, own-sad, unknown-happy unknown-neutral, and unknown-sad) were presented randomly for 2 seconds each, with a variable 2- to 6-second interstimulus interval. RESULTS. Key dopamine-associated reward-processing regions of the brain were activated when mothers viewed their own infant's face compared with an unknown infant's face. These included the ventral tegmental area/substantia nigra regions, the striatum, and frontal lobe regions involved in (1) emotion processing (medial prefrontal, anterior cingulate, and insula cortex), (2) cognition (dorsolateral prefrontal cortex), and (3) motor/behavioral outputs (primary motor area). Happy, but not neutral or sad own-infant faces, activated nigrostriatal brain regions interconnected by dopaminergic neurons, including the substantia nigra and dorsal putamen. A region-of-interest analysis revealed that activation in these regions was related to positive infant affect (happy > neutral > sad) for each own—unknown infant-face contrast. CONCLUSIONS. Where first-time mothers see their own infant's face, an extensive brain network seems to be activated, wherein affective and cognitive information may be integrated and directed toward motor/behavioral outputs. Dopaminergic reward-related brain regions are activated specifically in response to happy, but not sad, infant faces. Understanding how a mother responds uniquely to her own infant, when smiling or crying, may be the first step in understanding the neural basis of mother—infant attachment. [ABSTRACT FROM AUTHOR]