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Maternal self-efficacy (MSE) is associated with healthy functioning in mothers and children globally. Maternal exposure to adverse childhood experiences (ACEs) and intimate partner violence (IPV) is known to negatively impact MSE in high-income countries; however, the association has not been examined in low-and-middle-income countries, such as India, which face socioeconomic risks including poverty, illiteracy, and discrimination based on caste membership. The present study examines the mediating role of IPV in the association between ACEs (specifically-emotional, physical, and sexual abuse, neglect, household dysfunction, and discrimination) and MSE and tests caste membership as a moderator. A community-based, cross-sectional survey was performed with 316 mothers with at least one child between 0 and 24 months in a rural area in the North Indian state of Uttar Pradesh. A structural equation framework was used to test the moderated-mediation model. Results from the moderated-mediation model indicate that greater ACEs exposure was associated with lower MSE and this association was mediated by IPV exposure for low-caste but not high-caste mothers, even after controlling for wealth and literacy. These findings add to existing evidence on ACEs exposure as a significant burden for rural Indian mothers, negatively impacting parenting outcomes such as MSE. The critical role of caste membership is also highlighted, providing implications for future research.La autoeficacia materna (MSE) se asocia con el saludable funcionamiento en las madres y niños globalmente. Se conoce que el hecho de que la madre haya estado expuesta a experiencias adversas en la niñez (ACE) y a la violencia de la pareja íntima (IPV) tiene un negativo impacto en MSE en países de altas entradas económicas; sin embargo, esta asociación no se ha examinado en países donde las entradas económicas son bajas o medias, como India, que enfrenta riesgos socioeconómicos entre los que se incluyen la pobreza, el analfabetismo, así como la discriminación basada en la pertenencia a una casta. El presente estudio examina el papel mediador de IPV en la asociación entre ACE (específicamente - el abuso emocional, físico y sexual, negligencia, disfuncionalidad en el hogar y discriminación) y MSE, y pone a prueba la pertenencia a una casta como aspecto moderador. Se llevó a cabo una encuesta de base comunitaria e inter-seccional con 316 madres con por lo menos un niño entre 0 y 24 meses de edad en un área rural en el estado de Uttar Pradesh en el norte de India. Se usó un marco de trabajo de ecuación estructural para examinar el modelo de moderación y mediación. Los resultados del modelo de moderación y mediación indican que una mayor exposición a ACE estaba asociada con una más baja MSE y que la exposición a IPV mediaba esa asociación para madres de castas bajas, pero no para madres de castas altas, aun después del factor control de recursos económicos y alfabetismo. Estos resultados contribuyen a la existente evidencia de que el haber estado expuesta a ACE es una carga significativa para las madres en la India rural, la cual tiene un impacto negativo en los resultados de crianza tales como MSE. También se subraya el papel esencial de la pertenencia a una casta, lo cual aporta implicaciones para la investigación futura.L'auto-efficacité maternelle (MSE en anglais) est globalement liée à un fonctionnement sain chez les mères et les enfants. L'exposition maternelle à des expériences de l'enfance adverses (ACE en anglais) et à la violence intime ou conjugale (IPV) est connue comme impactant de manière négative l'auto-efficacité maternelle dans les pays à revenus élevés. Cependant ce lien n'a pas toujours été examiné dans les pays à faibles ou moyens revenus, tels que l'Inde qui fait face à des risques socioéconomiques qui comportent la pauvreté, l'illettrisme, la discrimination en fonction de l'appartenance à une caste. Cette étude examine le rôle médiateur de la violence conjugale (ou violence entre partenaires intimes) dans le lien entre les ACE (plus spécifiquement l'abus émotionnel, physiques, sexuel, la négligence, la dysfonction au sein du foyer et la discrimination) et l'auto-efficacité maternelle et les tests d'appartenance à une caste en tant que modérateurs. Un questionnaire communautaire, en coupe transversale, a été présenté à 116 mères ayant au moins un enfant entre l’âge de 0-24 mois dans une région rurale de l’état du nord de l'Inde, Uttar Pradesh. Un cadre d’équation structurelle a été utilisé pour tester le modèle de modération-médiation. Les résultats de ce modèle de modération-médiation indiquent que plus l'exposition aux ACE est grande, plus l'auto-efficacité maternelle est basse et cette association est affectée par l'exposition à la violence conjugale pour les castes moins élevées mais pas pour les mères des castes plus élevées, même en effectuant un contrôle pour la richesse et l'alphabétisation. Ces résultats s'ajoutent aux preuves existantes sur l'exposition aux ACE en tant que poids important pour les mères indienne de milieux ruraux, ce qui impacte de manière négative les résultats de parentage telles que l'auto-efficacité maternelle. Le rôle critique de l'appartenance à une caste est également mis en lumière, offrant des implications pour les recherches à venir.Nachteilige Kindheitserfahrungen und mütterliche Selbstwirksamkeit: Eine Untersuchung der mediierenden Rolle von Gewalt in der Partnerschaft und der moderierenden Rolle der Kastenzugehörigkeit im ländlichen Indien Mütterliche Selbstwirksamkeit (Maternal Self-Efficacy, MSE) ist weltweit mit einem gesunden Funktionsniveau von Müttern und Kindern assoziiert. Es ist bekannt, dass sich nachteilige Kindheitserfahrungen der Mutter (adverse childhood experiences; ACEs) und Gewalt in der Partnerschaft (intimate partner violence; IPV) in Ländern mit hohem Einkommen negativ auf die MSE auswirken. Dieser Zusammenhang wurde jedoch in Ländern mit niedrigem und mittlerem Einkommen wie Indien, die mit sozioökonomischen Risiken wie Armut, Analphabetismus und Diskriminierung aufgrund der Kastenzugehörigkeit konfrontiert sind, nicht untersucht. In der vorliegenden Studie wird die mediierende Rolle von IPV im Zusammenhang zwischen ACEs (insbesondere emotionaler, körperlicher und sexueller Missbrauch, Vernachlässigung, dysfunktionaler Haushalt und Diskriminierung) und MSE untersucht. Zusätzlich wurde die Kastenzugehörigkeit als Moderator getestet. Dazu wurde eine gemeindebasierte Querschnittserhebung bei 316 Müttern mit mindestens einem Kind im Alter von 0-24 Monaten in einem ländlichen Gebiet im nordindischen Bundesstaat Uttar Pradesh durchgeführt. Ein Strukturgleichungsmodell wurde verwendet, um das Modell der moderierten Mediation zu testen. Die Ergebnisse des Modells der moderierten Mediation zeigen, dass eine höhere ACE-Exposition mit einer niedrigeren MSE assoziiert war und dass dieser Zusammenhang bei Müttern niedriger Kaste, aber nicht bei denen einer hoher Kaste, durch IPV-Exposition mediiert wurde, selbst nach Kontrolle von Wohlstand und Bildung. Diese Ergebnisse ergänzen die vorhandenen Belege dafür, dass die ACE-Exposition eine erhebliche Belastung für indische Mütter in ländlichen Gebieten darstellt und sich negativ auf elterliche Outcomes wie die MSE auswirkt. Die kritische Rolle der Kastenzugehörigkeit wird ebenfalls hervorgehoben, was Implikationen für die zukünftige Forschung nach sich zieht.子ども時代の逆境体験と母親の自己効力感:インド農村部における親密なパートナーからの暴力の仲介的役割とカーストへの帰属による緩和作用の検討 要旨 母親の自己効力感 (MSE) は、世界的にも健康的な母子機能と関連が見られる。高所得国では、母親が幼児期の逆境体験 (ACE) や親密なパートナーからの暴力 (IPV) にさらされると、MSEに負の影響を与えることが知られているが、貧困、非識字、カーストによる差別などの社会経済的リスクに直面するインドなどの低・中所得国での関連は検討されていない。本研究では、ACEs (具体的には、感情的・身体的・性的虐待、ネグレクト、家庭機能不全、差別) とMSEの関連におけるIPVの仲介的役割を検証し、緩和因子としてカーストへの帰属を検証する。北インドのウッタル・プラデーシュ州の農村地域で、0-24ヶ月の子どもを1人以上持つ母親316人を対象に、地域密着型の横断調査を実施した。構造方程式の枠組みを用いて、条件付き間接効果モデルを検証した。その結果、ACEsへの曝露の大きさはMSEの低さと関連し、この関連は富と識字率を制御した後でも、低カーストの母親ではIPVへの曝露によって媒介されたが高カーストの母親では媒介されないことが明らかにされた。これらの知見は、ACEsへの曝露がインドの農村部の母親にとって大きな負担であり、MSEなどの育児アウトカムに負の影響を与えるという既存のエビデンスに追加されるものである。また、カーストへの所属が重要な役割を果たすことも明らかになり、今後の研究への示唆を与えている。.在全球范围内, 母亲自我效能 (MSE) 与母亲和儿童的健康功能相关。众所周知, 在高收入国家, 母亲遭受不良童年经历 (ACEs) 和亲密伴侣暴力 (IPV) 会对MSE产生负面影响;然而, 该关联尚未在印度等中低收入国家得到验证, 这些国家面临着包括贫困、文盲和种姓身份歧视在内的社会经济风险。本研究检验了IPV在ACEs (具体而言是情感、身体和性虐待, 忽视, 家庭机能不全以及歧视) 和MSE关联中的介导作用, 并测试了种姓身份的调节作用。在印度北部北方邦的一个农村地区, 对316名至少有一个0-24个月大孩子的母亲进行了一项基于社区的横断面调查。使用结构方程框架来测试调节中介模型。调节中介模型的结果表明, ACEs遭受程度越高, MSE越低, 并且这种联系是由低种姓母亲而非高种姓母亲的IPV遭受程度介导的, 即使在控制了财富和识字率之后也是如此。这些发现补充了现有证据, 表明遭受ACEs对印度农村母亲来说是一个重大负担, 对MSE等育儿结果产生了负面影响。本研究还强调了种姓身份的关键作用, 为未来的研究提供了启示。.التجارب السلبية في الطفولة والكفاية الذاتية للأمهات: دراسة الدور الوسيط لعنف الشريك الحميم والدور المعتدل لعضوية الطائفة في ريف الهند ترتبط الكفاية الذاتية للأم(MSE) بالأداء الصحي للأمهات والأطفال بشكل عام. ومن المعروف أن تعرض الأمهات لتجارب الطفولة السلبية(ACEs) وعنف الشريك الحميم(IPV) يؤثر سلبًا على الكفاية الذاتية للأمهات ((MSE في البلدان ذات الدخل المرتفع ؛ ومع ذلك ، لم يتم دراسة هذه الارتباطات في البلدان ذات الدخل المتوسط والمنخفض ، مثل الهند ، التي تواجه مخاطر اجتماعية واقتصادية بما في ذلك الفقر والأمية والتمييز على أساس العضوية الطائفية. تبحث الدراسة الحالية في الدور الوسيط لعنف الشريك في الارتباط بين تجارب الطفولة السلبية (على وجه التحديد - الاعتداء العاطفي والجسدي والجنسي والإهمال والارتباك الأسري المنزلي والتمييز) و الكفاية الذاتية للأم واختبارات عضوية الطائفة كمتغير وسيط. تم إجراء استبيان مجتمعي مع 316 أم لديها طفل واحد على الأقل بين صفر - 24 شهرًا في منطقة ريفية في ولاية أوتار براديش شمال الهند. وتم استخدام إطار المعادلة الهيكلية لاختبار نموذج الوسيط المعتدل. تشير النتائج من هذا النموذج إلى أن التعرض الأكبر لتجارب الطفولة السلبية كان مرتبطًا بانخفاض الكفاية الذاتية للأمهات وتوسط هذا الارتباط تعرض الأمهات (من الطائفة الدنيا وليس العليا) لعنف الشريك، حتى بعد التحكم في متغيرات الفقر ومحو الأمية. تضيف هذه النتائج إلى الأدلة الموجودة على التعرض للتجارب السلبية في الطفولة كعبء كبير على الأمهات الهنود الريفيات ، مما يؤثر سلبًا على نتائج التربية الوالدية مثل الكفاية الذاتية كما تم تسليط الضوء على الدور الهام لعضوية الطائفة ، مما يقدم تطبيقات للبحث في المستقبل.

This comment on the Special Issue contributions regarding the attachment network addresses the clinical implications of the findings from three perspectives: (1) the need to look beyond maternal influences on child developmental outcomes; (2) to be open to every seemingly peripheral influence on the child as this may have a central impact on the child, for example, grandmothers, the parental couple relationship, and others not living in the child's home but nonetheless influential; and (3) identify and cultivate security spreading effects that help change not only the child, but the child's relationships with others in and outside the family-to the benefit of all. Some evidence-based attachment-based interventions are highlighted.

A growing body of literature has consistently shown how adopted children often have previous history of trauma and neglect, and in turn develop negative representations of the self and others. This study assesses the internal representations of three groups of children, as measured by the Story Stem Assessment Profile (SSAP). These were: (1) a maltreated, late-adopted (MLA) sample (n = 63); (2) a non-maltreated, early-adopted (EA) sample (n = 48); and (3) a non-maltreated community sample (COMM) (n = 80). In addition, it examined whether MLA and EA adopted children’s attachment and internal representations changed over time. Results showed that children in the MLA sample significantly displayed more disorganised, avoidant and negative representations and fewer representations characteristic of ‘secure’ attachment when compared with EA and, especially, COMM children. Longitudinal follow-up of both MLA and EA samples demonstrated significant changes over a two-year period in SSAP representation; secure representations increased while the avoidant and disorganised ones diminished. These findings are discussed and the limitations and implications of the study presented.

Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child’s need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments o attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration. info:eu-repo/semantics/publishedVersion

“Fa'a'amu” is a type of adoption commonly found in French Polynesia involving open, informal adoption arrangements, in which the child maintains ties to the family of origin. Although the function ...

In an attempt to go beyond the analysis of children's outcomes in adoption research, the central goal of this study was the analysis of parents' reflective functioning (PRF)—understood as the parents' capacity to reflect upon their own experience as parents, upon their child's experience, and upon the relationships between them— and its connection with parent-child interactions (PCI)—referring to the behavioral patterns observed in verbal and non-verbal interactions between parents and children around a task. To measure PRF, the Parent Development Interview (PDI) was administered to 40 internationally adoptive and 58 non-adoptive parents. To measure PCI, the parent-child dyads were observed while interacting in a co-construction task. The results show reliable psychometric characteristics of PDI instrument for its use with a Spanish sample. Compared to non-adoptive mothers, adoptive PRF was found more articulate and positive, with non-adoptive mothers scoring higher in less positive or openly negative contents. Furthermore, some characteristics of the children (age and gender) and the parents (educational level) were significantly related to PDI factors. For the adoptive dyads, the relationship between PRF and PCI was particularly significant regarding the PDI contents related to the positive perception of the child in the relationship. Moreover, the behaviors in the PCI task were influenced by the child's gender and age at placement. The way parents behave with their children is influenced by their thoughts and feelings about them, and the promotion of parental mind-mindedness may facilitate more constructive interactions.

In the service of children's best interests, we argue for a sharpening of the evidentiary standards used in family court decision making, from preponderance of (occasionally substandard) evidence to "beyond a reasonable doubt." Second, we call for a move in child protection cases from static diagnoses (e.g., attachment classifications) to assessments of the potential for enhanced parenting. Finally, informed by the implications of the replication crisis in the biomedical and psychological sciences, we applaud the move of the attachment field forward to large-scale, collective research agendas and goals.

Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function-parents' capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child-may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.Los factores tóxicos de estrés (v.g. violencia de los padres, depresión, bajos recursos económicos) colocan a los niños bajo riesgo de una insegura afectividad. La función de reflexión de los padres, o sea, lacapacidad de los padres de comprender su propio estado mental y el de sus niños y por tanto regular sus propios sentimientos y conductas hacia su niño, pudiera amortiguar los efectos negativos del estrés tóxico sobre la afectividad. Nuestro objetivo fue probar la eficacia de la intervención Afectividad y Salud del Niño (ATTACH), enfocándonos en mejorar la función de reflexión y la seguridad de la afectividad de los niños, para madres y niños de36 meses de edad bajo riesgos. Se llevaron a cabo tres estudios pilotos con mujeres y niños de una agencia del centro de la ciudad que les sirve a familias vulnerables de bajos recursos económicos y un albergue para casos de violencia familiar. Un ensayo controlado al azar (n = 20, n = 10 al momento de inscribirse) y métodos cuasi-experimentales (n = 10 al momento de inscribirse) pusieron a prueba el efecto de ATTACH sobre el resultado primario de los puntajes de la función de reflexión, a partir de las transcritas Entrevistas del Desarrollo del Progenitor. Nuestro secundario resultado fueron los patrones de afectividad de los niños con base en el Procedimiento de la Situación Extraña de Ainsworth. A pesar de algunas bajas (n = 2 casos), los análisis de co-variantes con métodos combinados y las pruebas-t revelaron significativas diferencias en la función de reflexión materna, del niño, y en términos generales, con niveles de efectos moderados. Aunque más niños cuyas madres recibieron el programa ATTACH presentaron seguridad en su afectividad después del tratamiento, comparados con el grupo de control, no se observaron diferencias significativas, lo cual pudiera ser consecuencia de observaciones ausentes (n = 5 casos). Comprender la eficacia de programas como ATTACH contribuye a programas y servicios mejorados con el fin de promover un saludable desarrollo de los niños afectados por el estrés tóxico.Les stresseurs toxiques (par exemple la violence parentale, la dépression, la pauvreté) placement les enfants à risque d'attachement insécure. La fonction parentale de réflexion, c'est-à-dire la capacité des parents à comprendre leurs propres états mentaux et celui de leur enfant et donc de réguler leurs propres sentiments et comportement envers leur enfant, peut servir de tampon aux effets négatifs du stress toxique sur l'attachement. Notre objectif était de tester l'efficacité de l'intervention Attachement et Santé de l'Enfant (en anglais, Attachment and Child Health, soit, ATTACH), en s'attachant à améliorer la fonction de réflexion et la sécurité de l'attachement des enfants, pour des mères à risques et leurs enfants36 mois d’âge. Trois études pilotes ont été faites avec des femmes et des enfants d'une agence de quartiers défavorisés servant des familles vulnérables, de milieu défavorisé, ainsi qu'un refuge familial pour les victimes de violence. Un essai contrôlé randomisé (n = 20, n = 10 à l'inscription) et des méthodes quasi-expérimentales (n = 10 à l'inscription) ont testé l'effet de ATTACH sur le résultat principal de scores de fonction de réflexion, à partir d'Entretiens du Développement du Parent transcrits. Notre deuxième résultat était les patterns d'attachement des enfants à partir de la Procédure de Situation Etrange d'Ainsworth. En dépit d'une attrition (n = 2 cas), une analyse mixte de la covariance et les tests-t ont révélé des différences importantes dans la fonction de réflexion générale, maternelle, et de l'enfant, avec une ampleur modérée. Alors que plus d'enfants dont les mères ont reçu le programme ATTACH étaient attachés de manière sécure après le traitement, comparés aux contrôles, aucune différence importante n'a été observée, ce qui pourrait s'expliquer par des observations manquantes (n = 5 cas). La compréhension de l'efficacité de programmes comme ATTACH contribue à améliorer des programmes et des services promouvant un développement sain des enfants affectés par le stress toxique.Pilotversuche von ATTACH (AttachmentChild Health; BindungKindesgesundheit): Effekt einer Intervention zur elterlichen Reflexionsfähigkeit für Familien, die von toxischem Stress betroffen sind Toxische Stressoren (z. B. elterliche Gewalt, Depressionen, geringes Einkommen) stellen ein Risiko dafür dar, dass Kinder eine unsichere Bindung aufbauen. Die Reflexionsfähigkeit der Eltern, d. h. ihre Fähigkeit die eigenen mentalen Zustände und die ihres Kindes zu verstehen und so Gefühle und Verhaltensweisen gegenüber dem Kind regulieren zu können, könnte die negativen Effekte toxischen Stresses auf die Bindung abfedern. Unser Ziel war es, die Wirksamkeit der ATTACH-Intervention für gefährdete Mütter und Kinder unter 36 Monaten zu testen, wobei der Schwerpunkt auf der Verbesserung der Reflexionsfähigkeit und der kindlichen Bindungssicherheit lag. Mit den Frauen und Kindern, rekrutiert in einer innerstädtischen Behörde für vulnerable Familien mit niedrigem Einkommen und einem Frauenhaus, wurden 3 Pilotstudien durchgeführt. Die Wirkung von ATTACH auf das Primärergebnis, die Reflexionsfähigkeits-Scores aus transkribierten Elternentwicklungsinterviews, wurde durch randomisierte, kontrollierte (n = 20, n = 10 bei der Aufnahme) und quasi-experimentelle (n = 10 bei der Aufnahme) Methoden getestet. Unser sekundäres Ergebnis waren die von den Kindern gezeigten Bindungsmuster aus Ainsworths Fremde-Situations-Test. Trotz einiger Dropouts (n = 2 Fälle) ergaben eine Kovarianz-Analyse und T-Tests signifikante Unterschiede in der mütterlichen, der kindlichen und der gesamten Reflexionsfähigkeit bei moderaten Effektstärken. Im Vergleich zur Kontrollgruppe waren zwar mehr Kinder, deren Mütter die ATTACH-Intervention erhalten hatten, sicher gebunden, allerdings wurden keine signifikanten Unterschiede beobachtet, was möglicherweise auf fehlende Beobachtungen zurückzuführen ist (n = 5 Fälle). Das Wissen um die Wirksamkeit von Programmen wie ATTACH trägt zu verbesserten Programmen und Angeboten bei, die eine gesunde Entwicklung von Kindern fördern sollen, die von toxischem Stress betroffen sind.“アタッチメントと乳幼児の健康” (ATTACH) のパイロット研究:過剰なストレスに晒されている家族に対する親の内省機能介入の効果 過剰なストレス要因 (例:親の暴力、抑鬱、低収入) は、乳幼児を不安定なアタッチメントの状況におくリスクがある。親の内省機能−例えば、親の、自分自身や子どもの心の状態を理解し、それ故に子どもに対して、その感情や行動を制御する能力―は、アタッチメントにおける過剰なストレスのマイナス効果を緩和させるかもしれない。我々の研究目的は、リスクのある母親と生後36か月以下の乳幼児における、内省機能と乳幼児のアタッチメント安定性の改善に焦点を当た“アタッチメントと子どもの健康”(ATTACH)介入の効果を分析することであった。3つのパイロット研究を、脆弱な低収入家族へ支援をしている市内の機関と家庭内暴力のシェルターにいる母子に実施した。無作為化対照試験(n = 20, n = 10 登録時) と疑似実験(n = 10 登録時) の方法でペアレント・デベロップメント・インタビューを筆記したものから、内省機能スコアの最初の結果を分析した。我々の2つめの結果は、エインズワースの ストレインジ・シチュエーション法における乳幼児のアタッチメント・パターンである。多少の擦れ(n = 2 cases)があるにもかかわらず、共分散とt検定の混合法分析では、母親、乳幼児及び全体的な内省機能において、中程度の効果量で有意差があった。ATTACHプログラムを受けた母親の乳幼児はコントロール群に比較して、治療後より安定的にアタッチメントを示す一方、有意差は見られなかった。それは恐らく欠測値(n = 5 cases)によるものと思われる。ATTACHのようなプログラムの効果性を理解することは、過剰なストレスに晒された乳幼児の健康的な発達を促進するためにプログラムやサービスを改善することに寄与する。.摘 要:毒性压力源 (如父母暴力、抑郁、低收入) 会使儿童处于不安全依恋的风险中。育儿反思功能, 即父母认知自己和孩子的心理状态, 进而调节自己对孩子的感觉和行为的能力。它可以缓冲毒性压力对依恋的负面影响。我们的目标是测试依恋与儿童健康 (ATTACH) 干预措施的有效性, 重点是为了改善处于风险中的母亲的反思功能和36月龄以下儿童的依恋安全。我们对一个贫民区代理机构中的妇女和儿童进行了三项试点研究, 这个机构为弱势低收入家庭和家庭暴力庇护所提供服务。研究使用了随机对照试验 (n = 20, 入组时n = 10) 和准实验 (入组时n = 10) 两种方法, 通过录制的“父母发展访谈”测试了ATTACH对反思功能得分主要结果的影响。我们的次要结果是来自安斯沃思“陌生情境法”的儿童依恋模式。尽管有一些损耗 (n = 2例) , 协方差和t检验的混合方法分析显示, 母亲、儿童和整体反思功能存在显著差异, 均为中度影响。虽然有更多的其母亲接受ATTACH计划的儿童, 在治疗后表现为安全型依恋, 但与对照组相比, 未观察到显著的差异, 这可能是由于缺少观察结果 (n = 5例) 。了解诸如ATTACH计划的有效性有助于改进计划及其服务, 以促进受毒性压力影响的儿童的健康成长。.تجارب التعلق وصحة الطفل (ATTACH): تأثير تدخل الأداء التأملي الوالدي مع العائلات المتضررة من الضغوط السامة ملخص الضغوط السامة (مثل عنف الوالدين، والاكتئاب، والدخل المنخفض) تعرض الأطفال لخطر التعلق غير الآمن. والأداء التأملي الوالدي، أي قدرة الوالدين على فهم حالاتهم الخاصة وحالة أطفالهم النفسية، وبالتالي تنظيم مشاعرهم الخاصة وسلوكهم تجاه أطفالهم، قد يحجب الآثار السلبية للضغوط على التعلق. كان هدفنا هو اختبار فعالية التدخل في التعلق وصحة الطفل (ATTACH) ، مع التركيز على تحسين الأداء التأملي وأمن تعلق الأطفال ، للأمهات المعرضين للخطر والأطفال الأصغر من 36 شهرا من العمر. وأجريت ثلاث دراسات تجريبية مع نساء وأطفال من وكالة داخل المدينة تخدم الأسر الضعيفة المنخفضة الدخل وملجأ للعنف العائلي. وتم اختبار تأثير ATTACH)) على النتيجة الأولية لدرجات الأداء التأملي من خلال إجراءات تجريبية وشبه تجريبية (N = 10) وذلك من واقع تفريغ مقابلات تطوير الوالدين. وكانت النتائج الثانوية هي أنماط تعلق الأطفال من خلال إجراء الموقف الغريب (آيسنوورث). بالرغم من تراجع الاشتراك في الدراسة (2 حالة) ، فقد كشف تحليل التباين المشترك واختبارات الفروق الإحصائية عن اختلافات كبيرة في الأداء التأملي للأم والطفل وبشكل عام ، مع أحجام تأثير معتدل. في حين أن المزيد من الأطفال الذين تلقت أمهاتهم برنامج ATTACH كانوا متعلقين بشكل آمن بعد العلاج ، مقارنة بالمجموعة الضابطة ، ولم يتم ملاحظة اختلافات ذات دلالة إحصائية، مما قد يكون بسبب الملاحظات المفقودة (5 حالات) .إن فهم فعالية برامج مثل ATTACH يساهم في تحسين البرامج والخدمات لتعزيز النمو الصحي للأطفال المتضررين من الضغوط السامة.

This paper describes the treatment of a mother and child who demonstrated disorganized attachment behaviors in their interactions with one another. The mother, who was diagnosed with Borderline Personality Disorder, felt incapable of managing her aggressive toddler and his emotional needs. The dyad was referred for therapy due to concerns about his developmental progress, evident delays having been mainly attributed to the problems observed within the parent-child relationship. The primary intervention applied to working with the dyad was the Group Attachment-Based Intervention (GABI©), developed by Anne Murphy in collaboration with Miriam Steele and Howard Steele. The mother also received individual psychotherapy as a supplement to the dyadic and group work of GABI©. The process and outcome of this comprehensive approach to treating a vulnerable dyad is explored in this case study.

This study aimed to investigate the multidimensional nature of maternal mental state talk with respect to children’s social-behavioral functioning in a low-income urban preschool sample. Maternal s...

Exposure to childhood adversity has been linked to accelerated telomere shortening, a marker of cellular aging and an indicator of physical health risk. In the current study, we examined whether adult attachment representation moderated the association between childhood adversity and telomere length. Participants included 78 young adults (M age = 20.46, SD = 1.57), who reported on their exposure to adverse childhood experiences (ACE) and were administered the Adult Attachment Interview, which was coded for attachment state of mind. Relative telomere length was assayed from buccal cells. Multiple regression analyses revealed a significant interaction between attachment state of mind and ACE in predicting telomere length. Whereas the association between number of ACE and telomere length was nonsignificant for secure–autonomous, r (50) = –.15, p = .31, and insecure–preoccupied young adults, r (9) = –.15, p = .71, there was a strong negative association between number of ACE and telomere length for insecure–dismissing young adults, r (19) = –.59, p = .007. This study is novel in demonstrating that attachment may affect biological resilience following childhood adversity, contributing to the growing literature about the role of the quality of early caregiving experiences and their representations in shaping biological processes and physical health.

Fotopoulou and Tsakiris in their target paper offer a theoretical and methodological corrective in their argument for the need to reclaim the physical body of the individual for a fuller understanding of the origins and maintenance of the sense of a unified, regulated, relational self. While we share their injunctive to mindfully not throw out the baby (or body of the baby) with the ‘cognitive/ symbolic/ representational’ bath water, nevertheless we also argue for the inclusion of all that has been gained from the study of representational processes in the parent’s mind, including mentalization or reflective functioning, and the intergenerational data this work has spawned. We also argue for the relevance of careful microanaltyic observations of young infants and their caregivers, and attention to what has been gained from decades of research on this interactive process which is crucial to the development of the self and the emergence of infant-caregiver attachment patterns. In brief, three topics occupy ...

The potential effects of maternal trauma on mother-infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother-infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4-6 months. Split-screen videotaped interaction was coded on a one-second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self-contingency and interactive contingency of behavior by time-series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper-contingent, high-arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.

This paper reports on a randomized control trial involving children less than 3 years old and their mothers who were regarded at risk of maltreating their children by referral agencies. Mothers’ risk status derived from a heavy trauma burden (average exposure over the first 18 years of their lives to 10 possible adverse childhood experiences [ACEs] was >5), mental health challenges (15%–28% had experienced a prior psychiatric hospitalization), and prior removal of a child to foster care (20%). Mothers were randomly assigned to either a widely used parenting class known as Systematic Training for Effective Parenting (STEP) or the Group Attachment-Based Intervention (GABI), a multifamily 26-week treatment. The resulting mother–child pairs available for consideration in this baseline versus end-of-treatment report were 35 families in the STEP arm and 43 families in the GABI arm. The focus of this paper is the outcome measure of observed parent–child relationship assessed with the Coding of Interactive Behavior (Feldman, 1998) collected at baseline and end of treatment. In comparison to STEP, results indicated that GABI was linked to significant improvements in maternal supportive presence and dyadic reciprocity, and significant declines in maternal hostility and dyadic constriction (proxies for risk of child maltreatment). These medium-to large-sized effects remained significant even after controlling for mothers’ prior ACEs in analysis of covariance procedures. In addition, two small interaction effects of ACEs by treatment type were found, underlining the need for, and value of, treatments that are sensitive to parents’ traumatic histories.

This study interviewed adolescents conceived using sperm donation to examine their experiences of contacting and meeting 'same-donor offspring' (i.e. donor-conceived offspring raised in different families who share the same donor), their motivations for this contact, and how they make meaning of these relationships. This in-depth qualitative study involved semi-structured interviews with 23 young people aged 12-19 years (mean = 14 years). Interviewees were motivated by curiosity about their biological relations and by wanting to extend their family. Contact with same-donor offspring was described as being either normal/neutral or as a unique experience that was integrated into their identity. This study highlights the importance of contact between same donor offspring, particularly during adolescence, a developmental stage associated with identity formation. The findings have important policy implications as they suggest that donor-conceived individuals may benefit from contact with others conceived using the same donor prior to the age of 18 years.

Adverse childhood experiences (ACEs) are associated with physical and mental health problems in adulthood, as well as unresolved or discordant states of mind regarding attachments that have implications for problematic parenting. Currently, there are no studies on the association between ACEs and adults' subjective experiences of stress in the parenting role, where socioeconomic status (SES)−related poverty effects have been controlled for--the central question behind the current study. We examined exposure to ACEs among 118 mothers (n = 33 low SES/impoverished and n = 85 middle/high SES) and parenting distress. Participants completed an ACE questionnaire that assessed exposure to 10 adverse experiences from childhood (e.g., abuse, neglect, household dysfunction), and the Parenting Stress Index−Short Form. Parenting distress and ACEs were significantly higher in the low SES group; yet, even after controlling for SES, higher ACE scores added significant explained variance in parental distress in a linear regression model. DISCUSSION focuses on the need to administer ACE screening in prenatal and pediatric settings to identify and to offer trauma- and attachment-informed treatment, so to reduce the intergenerational transmission of risk associated with problematic parenting. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Underlying persistent psychological difficulties have been found to moderate potential adverse effects of maternal postpartum depression (PPD) on parenting and infant development. The authors examined whether mothers presenting postpartum depressive symptoms showed higher levels of personality pathology and more insecure state of mind regarding attachment compared to nondepressed mothers. Participants (N = 85) were assessed with the Edinburgh Postnatal Depression Scale (EPDS), the Present State Examination, the Adult Attachment Interview, and the Structured Clinical Interview for DSM-IV Axis II. Mothers with high EPDS scores were more likely to have a preoccupied insecure state of mind and to have personality disorder compared with mothers scoring below clinical cutoff. Furthermore, multiple regression analysis showed that personality disorder and AAI classification were independently related to EPDS score, and that these two factors together accounted for 48% of the variance in EPDS score. Findings are discussed in terms of heterogeneity in PPD populations and underline the importance of examining potential coexisting psychological difficulties when studying PPD.

People's work often brings them into contact with children whose parents were unable to care for them, leaving others to assume this duty. They have often endured multiple separations and losses. Bowlby postulated that humans are bio-psychologically motivated by the need for attachment and that our survival is inextricably linked to and dependent upon the capacity to establish and maintain emotional ties to others. Operational from birth and evident across the life span, especially at times of crisis, the "instincts" of crying, reaching out, and holding are the functional expressions of a biological imperative with evolutionary origins. Bowlby was emphatic that we need to account for the actual experiences that infants and children endure and to try as much as possible to keep in focus what has probably happened to them. The Adult Attachment Interview outlines individual differences in how parents represent their childhood history.

Miriam Steele begins by reviewing the increasing roles of attachment, microanalytic, and neuroscience research in clinical practice, with particular attention to Beatrice Beebe’s original microanalytic studies and Safran’s creative use of Tronick’s rupture and repair findings, which inspired a new way of looking at therapeutic alliance. She then turns our attention to Julie, a traumatized nine-year-old who underwent multiple foster care placements early in her life and was eventually adopted at age seven. Steele suggests that the therapeutic context offered a consistent and empathic presence where the terrifying images permeating Julie’s internal world could find expression, thereby opening up the possibility of a more flexible internal working model – the hallmark of secure attachment. Steele reflects on ways in which developmental research guided and found extension in her work with Julie, including helping her to utilize the “mid-range” forms of engagement necessary in interactions with traumatized children.

This article aims to illustrate the central underpinning role that observation has had in the development of attachment theory and research, and in clinical work informed by attachment theory. Also, the paper aims to highlight reflective functioning in clinical practice and how it can be shown to ignite positive change processes, with illustrations provided from our ongoing trauma-informed clinical work with our Group Attachment Based Intervention or GABI in our work with vulnerable parents and their infants and toddlers. In pointing to how reflective functioning informs clinical practice in GABI, the paper aims to highlight what is proposed as fundamental to therapeutic action with infants, toddlers, children, adolescents, adults/parents and that is a strikingly new relationship with a benign, supportive other, who helps one practice novel ways of thinking, feeling and acting that may later become habitual across contexts.

The first distribution of Chinese infant–mother ( n = 61) attachment classifications categorised by trained and reliability-tested coders is reported with statistical comparisons to US norms and previous Chinese distributions. Three-way distribution was 15% insecure-avoidant, 62% secure, 13% insecure-resistant, and 4-way distribution was 13% insecure-avoidant, 58% secure, 16% insecure-resistant,13% disorganised. These findings support the hypotheses that: (1) consistent with global norms the majority of infants will show secure attachments to mother; (2) insecure-resistant attachments will be greater than insecure-avoidant attachments in this interdependent cultural setting; and (3) disorganised attachments will be comparable to Western norms. Pooled samples from previously reported Chinese samples demonstrate deviations from US norms on all categories including relatively low proportions of avoidant and disorganised classifications, especially among samples from the South. Culture-specific childrearing practices and the role of training and reliability-testing for coders are suggested as possible contributors to these differences.

Risk factors during preschool years, such as poverty and unattended social/emotional problems, are known to have a strong negative influence on children’s later functioning. This study aimed to investigate the effectiveness of an on-site integrated school-based mental health services and consultation program for preschool children and their families. The sample consisted of 47 children and parents in 3 childcare centers who came from low-socioeconomic, urban backgrounds. Parents provided questionnaire data on children’s social-emotional functioning at 2 assessment times. Children’s ages ranged between 2 and 4 years at Time 1. Approximately half of the sample consisted of children who were selected for and received twice-weekly peer play psychotherapy (PPP) and, at-times, other mental health services from clinicians (playgroup [PG] children). The other half of the sample consisted of better functioning non-playgroup (NPG) children from the same centers. When PG and NPG were compared at Time1, the PG children were significantly behind the NPG children justifying their assignment to PG. However, at Time 2, the difference between PG and NPG was no longer significant on vital measures of adaptation, revealing the ways in which Relationships for Growth & Learning (RfGL) Program arguably led to ‘catch up’. PG children’s behavioral problems and total symptomatology decreased significantly from Time 1 to Time 2. Higher dosage of PPP was linked with higher social competence and decreased behavioral problems. Areas of gain differed between internalizing and externalizing children, indicating that intervention was helpful to different types of children. Clinical and research implications were discussed. Philip and Lynn Straus Foundation ; Irving Harris Foundation

In this Introduction to the Special Issue The Use of Video in Attachment-Based Interventions, we describe how film and video made their entry in attachment theory and research and ultimately in att...

This paper provides an account of multiple potential benefits of using video in clinical interventions designed to promote change in parent-child attachment relationships. The power of video to provide a unique perspective on parents' ways of thinking and feeling about their own behavior and that of their child will be discussed in terms of current attachment-based interventions using video either as the main component of the treatment or in addition to a more comprehensive treatment protocol. Interventions also range from those that use micro-analytic as compared to more global units of analyses, and there are potential bridges to be made with neuro-scientific research findings. In addition, this paper provides a clinical illustration of the utility of showing parents vignettes of video-filmed observations of parent-child interactions from the Group Attachment Based Intervention (GABI) for vulnerable families. Emphasis is placed on the motivational force arising from seeing (and hearing) oneself in interaction with one's child on video, thus serving as a powerful catalyst for reflective functioning and updating one's frame of reference for how to think, feel and behave with one's child.

Microanalysis research on 4-month infant-mother face-to-face communication operates like a "social microscope" and identifies aspects of maternal sensitivity and the origins of attachment with a more detailed lens. We hope to enhance a dialogue between these two paradigms, microanalysis of mother-infant communication and maternal sensitivity and emerging working models of attachment. The prediction of infant attachment from microanalytic approaches and their contribution to concepts of maternal sensitivity are described. We summarize aspects of one microanalytic study by Beebe and colleagues published in 2010 that documents new communication patterns between mothers and infants at 4 months that predict future disorganized (vs. secure) attachment. The microanalysis approach opens up a new window on the details of the micro-processes of face-to-face communication. It provides a new, rich set of behaviors with which to extend our understanding of the origins of infant attachment and of maternal sensitivity.

The present paper looks at the potential of the Adult Attachment Interview (AAI) and its underlying basis in attachment theory for use in psychotherapeutic work. We summarize the basic tenets of attachment theory, detail the content and structure of the AAI, provide instructions for conducting the AAI, and introduce the Main et al. (2002) coding system. We then report on associations between AAI-Attachment groups and psychosomatic diseases and, finally, demonstrate applications of the AAI in clinical work and research.

In this paper we test the hypothesis that beliefs about the ideal mother are convergent across cultures and that these beliefs overlap considerably with attachment theory’s notion of the sensitive mother. In a sample including 26 cultural groups from 15 countries around the globe, 751 mothers sorted the Maternal Behavior Q-Set to reflect their ideas about the ideal mother. The results show strong convergence between maternal beliefs about the ideal mother and attachment theory’s description of the sensitive mother across groups. Cultural group membership significantly predicted variations in maternal sensitivity belief scores, but this effect was substantially accounted for by group variations in socio-demographic factors. Mothers living in rural versus urban areas, with a low family income, and with more children were less likely to describe the ideal mother as highly sensitive. Cultural group membership did remain a significant predictor of variations in maternal sensitivity belief scores above and beyond socio-demographic predictors. The findings are discussed in terms of the universal and culture-specific aspects of the sensitivity construct., info:eu-repo/semantics/publishedVersion

Within primary care pediatrics, there is an optimal and essential opportunity to educate parents on how the pernicious effects of toxic stress have impacted their lives and how they can prevent and/or buffer the effects of stress in their child’s life. The recommendation from the 2012 American Academy of Pediatrics policy statement is to infuse a trauma-informed perspective into pediatrics, and this may be accomplished by introducing providers to the Adverse Childhood Experiences (ACEs) Study and the essential role of two-generational ACE screening. The seminal ACEs studies provided a paradigm shift in our understanding of the impact of childhood trauma on both physical and mental health throughout the life span. At the same time, the intergenerational link between childhood experiences and quality of parenting has been well established in attachment research. Integrating these two bodies of work has led to new ways of understanding the links between parental experiences in their own childhood and the quality of the parent–child relationship with their offspring. The link between trauma and attachment research provides a solid rationale for including the ACE measures into comprehensive screening and treatment with vulnerable families, many of whom regularly present to primary care pediatrics.

Objective To study the processes by which donor-conceived children incorporate donor conception into their subjective sense of identity. Design Cross-sectional. Setting Family homes. Patient(s) Nineteen donor-conceived adolescents. Intervention(s) Administration of an interview and questionnaire. Main Outcome Measure(s) The mother-child relationship was assessed through the Friends and Family Interview, a semistructured interview designed to assess adolescents' security of attachment in terms of secure-autonomous, insecure-dismissive, insecure-preoccupied, and insecure-disorganized attachment patterns. The Donor Conception Identity Questionnaire assessed adolescents' thoughts and feelings about donor conception, yielding two factors: [1] curiosity about donor conception and [2] avoidance of donor conception. Result(s) Statistically significant associations were found between the Curiosity scale and the secure-autonomous and insecure-dismissing attachment ratings. Adolescents with secure-autonomous attachment patterns were more interested in exploring donor conception whereas those with insecure-dismissing patterns were less likely to express curiosity. Insecure-disorganized attachment ratings were statistically significantly correlated with the Avoidance scale, indicating higher levels of negative feelings about donor conception. Conclusion(s) The results of this study of the influence of parent-child relationships on thoughts and feelings about donor conception in adolescence suggest that the valence of the parent-child relationship influences adolescents' appraisal of their donor conception within the context of their growing sense of identity.

Attachment has been assessed in the extreme environment of orphanages, but an important issue to be addressed in this chapter is whether in addition to standard assessment procedures, such as the Strange Situation, the lack of a specific attachment in some institutionalized children should be taken into account given the limits to the development of stable relationships in institutionalized care. In addition, this chapter discusses disinhibited or indiscriminately friendly behavior that is often seen in institutionalized children. Enhanced caregiving quality alone appears to be insufficient to diminish indiscriminate behavior, at least in some children, as evidenced by the persistence of indiscriminate behavior in children adopted out of institutions into adoptive families. We suggest that the etiology and function of indiscriminate friendly behavior may be different for institutionalized versus not-institutionalized children. In the first case it may reflect a distortion or disruption of early attachment relationships, in the latter case it is likely to result from the lack of expected input in the form of contingent interactions with a stable caregiver in early life. We try to delineate infant and caregiver characteristics that are associated with secure attachment in institutional settings, given the inevitable fact that large numbers of infants worldwide are being raised, and will be raised, in contexts of institutional care. We conclude that much further study is needed of the development of children's attachments following adoption out of an institutional setting.