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Psychological and Physiological Trauma Research
Seize Your Journeys
_______________________ Traumatic stress is found in many competent, healthy, strong, good people. No one can completely protect themselves from traumatic experiences. Many people have long-lasting problems following exposure to trauma. Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy. What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences. Having symptoms after a traumatic event is NOT a sign of personal weakness. Given exposure to a trauma that is bad enough, probably all people would develop PTSD. By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment. _______________________
FUNCTIONAL NEUROANATOMY In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.
The Deep Limbic System
Functions
Problems
The Basal Ganglia System
Functions
Problems
The Prefrontal Cortex
Functions
Problems
The Cingulate Gyrus
Problems
The Temporal Lobes
Functions
Problems
Non-dominant Side (usually the right)
Secure Attachments as a Defense Against Trauma “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses. Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses. The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal. Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984). In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).” van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York and London: Guilford Press. .p. 185 _______________________
Sleep Disorders
“The sleep disorders are organized into four major sections according to presumed etiology. Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible. Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors. Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions). Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention. Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system. Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications). That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance. Five distinct sleep stages can be measured by polysomnography: rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4). Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults. Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep. Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time. REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep. These sleep stages have a characteristic temporal organization across the night. NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation. REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes. REM sleep periods increase in duration toward the morning. Human sleep also varies characteristically across the life span. After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range. This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep. Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual. Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity. Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea. Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep. Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night. However, daytime polysomnographic studies also are used to quantify daytime sleepiness. The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day. Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness. The converse of the MSLT is also used: In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day. Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness. Standard terminology for polysomnographic measures is used throughout the test in this section. Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep. “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness. Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity). Sleep architecture refers to the amount and distribution of specific sleep stages. Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency). The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders: (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association. _________________
Substance Dependence “Features The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine. The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence). Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence. Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period. Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance. The degree to which tolerance develops varies greatly across substances. Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects. For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates. Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser. Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine. Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking. Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals). Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances. In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely). Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances. For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination. Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance. After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening. Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes. Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics. Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis. No significant withdrawal is seen even after repeated use of hallucinogens. Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals). Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence. However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems). Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal. Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use. The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal. The following items describe the pattern of compulsive substance use that is characteristic of Dependence. The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3). The individual may express a persistent desire to cut down or regulate substance use. Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4). The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5). In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance. Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6). The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends. Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7). The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.
Specifiers Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate. Specifiers are provided to note their presence or absence: With Physiological Dependence. This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). Without Physiological Dependence. This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.
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PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com __________________ Major Depressive Disorder “Diagnostic Features The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B). The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission). The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission. If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369 “Course Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder). Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state. Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder. It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
________________ Major Depressive Disorder “Diagnostic Features The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B). The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission). The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission. If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369 “Course Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder). Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state. Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder. It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373 Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. ________________ DID-PTSD-EMDR Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com
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NeuroBiology of Trauma
Affect Regulation and Attachment I
Title: Stages of decompensation in combat-related posttraumatic stress disorder: A new conceptual model. Author(s)/Editor(s): Wang, Sheila; Wilson, John P.; Mason, John W. Source/Citation: Integrative Physiological & Behavioral Science; Vol 31(3) Jul-Sep 1996, US: Transaction Periodicals Consortium; 1996, 237-253 Abstract/Review/Citation: This conceptual article presents a model of severe, chronic combat-related posttraumatic stress disorder (PTSD) based on several years of longitudinal clinical observations of Vietnam veterans. The model describes a repeating cycle of decompensation that profoundly disrupts the veteran's life. There appear to be "stages" of decompensation that can be described clinically and may be distinct physiologically. The stages describe a wide range of functioning, from adaptive to totally dysfunctional. PTSD core symptoms, as well as several other dimensions of clinical functioning, such as affect regulation, defenses, ego states, interactions with the environment, capacity for self-destruction/suicide and capacity for attachment and insight are described for each stage. Clinical and research implications are discussed. ========================================
Title: Dimensions of adult attachment, affect regulation, and romantic relationship functioning. Author(s)/Editor(s): Brennan, Kelly A.; Shaver, Phillip R. Source/Citation: Personality & Social Psychology Bulletin; Vol 21(3) Mar 1995, US: Sage Publications, Inc.; 1995, 267-283 Abstract/Review/Citation: Explored attachment-style differences in affect-regulation strategies; investigated attachment-related couple dynamics, such as partner-matching and satisfaction, in a sample of dating couples; and validated a multi-item measure of attachment developed by K. A. Brennan et al (1989) and compared it with another measure developed by C. Hazan and P. R. Shaver (1990). Brief categorical and rating measures of attachment style, 7 multi-item attachment scales, and 3 affect-regulation measures were administered to 242 students (15-47 yrs old). Results indicate substantial associations between attachment dimensions and relationship satisfaction, nonintimate sexuality, eating disorders, and motives for drinking. ========================================
Title: Separation anxiety and adjustment to college: An attachment-theoretical perspective. Author(s)/Editor(s): Lease, Cynthia Ann Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 56(2-B) Aug 1995, US: Univ. Microfilms International; 1995, 1112 Abstract/Review/Citation: The relationships between working models of attachment and adjustment to college among first-year college students was examined in a longitudinal study. The results of this study indicated that when college students were classified as secure, dismissing, or preoccupied by the Adult Attachment Interview, significant differences emerged in their experience of separation anxiety, self-perceived competence, perceptions of relationships, and attachment-related behaviors. Over half of the secure group reported clinical levels of separation anxiety at the beginning of the academic year, however, they showed a significant decline in symptomatology over time indicating adaptive resolution of the distress associated with the developmental task of emancipating from home. All but one member of the preoccupied group had clinical levels of separation anxiety at the beginning of the year, and although they reported some decline in symptomatology over time, decrease in the number of symptoms did not reach statistical significance. The preoccupied group reported having the most people upon whom they could rely for support, and they went home more often than the other two groups. However, they were the least satisfied with the support they received. As predicted, separation anxiety was not prevalent in the dismissing group at any point in time. This group also reported the least number of people upon whom they could rely for support, but they perceived themselves as more socially competent than the secure or preoccupied groups. Finally, the dismissing group showed a significant increase in utilization of university health services across time. These findings lend support to the idea that working models of attachment are associated with differing approaches to affect regulation in situational and developmental contexts that elicit distress. Overall, the results of the present study provide evidence that attachment is associated with social-emotional adjustment during the course of the transition to college. ========================================
Title: The relationship between attachment classification and emotion regulation in the strange situation. Author(s)/Editor(s): Voran, Miriam Judith Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 56(5-B) Nov 1995, US: Univ. Microfilms International; 1995, 2907 Abstract/Review/Citation: Attachment and emotion regulation are overlapping constructs. Attachment classifications are considered to vary by the child's emotion regulation strategies used to maintain proximity and 'felt security' in relation to the attachment figure. The present study tests hypotheses implicit in attachment theory about emotion regulation strategies in the Strange Situation. Two related constructs, emotion expression and emotion regulation strategies, were coded in a sample of 80 12-month-old infant Strange Situations with equal numbers of four attachment groups (avoidant, resistant, secure B1/B2, and secure B3/B4). These constructs were coded from the initial episode and four episodes of stranger entry and maternal separation. To increase the independence of these emotion measures from attachment classification, reunions were not coded. As expected, negative affect, and two regulatory strategies (self-contained and mother-directed) increased as episodes became more stressful. B3/B4s and Cs showed more negative emotion, more mother-directed, and fewer environment-directed strategies than As and B1/B2s. In most cases, the secure subgroup (B1/B2 or B3/B4) could not be distinguished from the adjacent insecure group. Attachment differences in emotionality and regulatory strategies became most pronounced in episode 6 (child alone). Results are interpreted as consistent with attachment theory, but also highlighting the orthogonal nature of emotionality to attachment. The methodological difficulties in studying emotion regulation and the usefulness of analyzing these data from a more ethological perspective are also discussed. ========================================
Title: Maternal scaffolding and the development of self-regulatory processes: A longitudinal study. Author(s)/Editor(s): Asmussen, Kirsten Adele Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 56(6-B) Dec 1995, US: Univ. Microfilms International; 1995, 3472 Abstract/Review/Citation: This dissertation is part of an ongoing longitudinal study examining the way in which maternal and child variables contribute to the development of self-regulation. The population consists of mothers and their preschool children who come from a primarily Caucasian, urban, upper middle class background and the majority of the mothers are married. In this study, three separate assessments were conducted. The first assessment took place when the child was between 12 and 24 months, measuring the security of the child's attachment (n = 188), as well as the mother's sensitivity and unresponsiveness (n = 162). The second assessment took place when the children were between 27 and 36 months while they worked on a difficult problem with their mothers. At this time, the self-regulatory skills (positive affect, motivation and compliance) of the children (n = 200), as well as the emotional and instructional scaffolding skills of the mother (n = 204) were independently coded. After this, a third assessment took place considering the delay skills of the children during the fifth year (n = 100, the sample size being smaller because of the two year time lag in collecting the data. This dissertation focuses on the ways in which maternal scaffolding skills contribute to the development of the child's self-regulation. I reasoned that while child's security of attachment may be related to the development of the motivational and delay skills measured during the third and fifth years, this relationship will be strengthened by the instructional and mastery oriented scaffolding support the mother provides during the third year. The results of this study indicate that maternal scaffolding skills are significantly related to child persistence, compliance and positive affect during the third year. Furthermore, maternal scaffolding predicts all three of the child self-regulatory skills over and above anything predicted by child attachment and maternal sensitivity and unresponsiveness. ========================================
Title: Treating attachment abuse: A compassionate approach. Author(s)/Editor(s): Stosny, Steven Source/Citation: New York, NY, US: Springer Publishing Co, Inc; 1995, (xiv, 290) Abstract/Review/Citation: Attachment abuse can involve both physical and emotional violence between people in close relationships, which includes couples, parents and their children, and adult children and their aging parents, among others. Attachment abusers blame their victims for their own feelings of shame, inadequacy, or inability to love. Dr. Stosny's innovative and integrative approach to the treatment of attachment abuse emphasizes the importance of compassion for both the abused and the abuser. This hands-on manual provides a series of treatment modules designed to teach the perpetrators and the victims how to cope with their feelings and to end attachment abuse. This volume will be of interest to psychotherapists, group therapists, social workers, and counselors working with abusive clients and their victims. Notes/Comments: Introduction Part I: The role of attachment in abuse Beginnings: Self-building, abuse, and treatment The experience of attachment Attachment abuse: Why we hurt the ones we love Pathways to abuse: Deficits in attachment skills and affect regulation A new response for clinicians in the prevention of emotional abuse and violence Compassion and therapeutic morality Part II: Treating attachment abuse The Compassion Workshop, module one: Healing The Compassion Workshop, module two: Dramatic compassion The Compassion Workshop, module three: Self-empowerment; module four: Empowerment of loved ones The Compassion Workshop, module five: Negotiating attachment relationships; module six: Moving toward the future Epilogue References Appendix A. Pilot evaluation of the Compassion Workshop Appendix B. The Attachment Compassion Scale Index Compassion Workshop treatment modules, victims & perpetrators of attachment abuse, manual ========================================
Title: An expansion of motivational theory: Lichtenberg's motivational systems model. Author(s)/Editor(s): Fosshage, James L. Source/Citation: Psychoanalytic Inquiry; Vol 15(4) 1995, US: Analytic Press; 1995, 421-436 Abstract/Review/Citation: Contends that J. Lichtenberg (1989) has provided the most complex and comprehensive motivational theory extant in psychology today. Lichtenberg proposed 5 motivational systems: the need for physiological regulation, for attachment and affiliation, for assertion and exploration, aversive reaction, and for sensual and sexual pleasure. Each of these emerges in, is shaped by, and becomes established through life experience within a relational context. Priorities shift depending on changing intensities of needs and external input. All systems aim to develop and maintain a vitalized cohesive sense of self. The functional success or failures of the motivational systems affect the sense of self. The analyst, recognizing the need for regulation of any of these systems, can shape interpretive interventions to aid the analysand in taking the steps toward regulation. ========================================
Title: Contemporary attachment theory: An introduction with implications for counseling psychology. Author(s)/Editor(s): Lopez, Frederick G. Source/Citation: Counseling Psychologist; Vol 23(3) Jul 1995, US: Sage Publications Inc; 1995, 395-415 Abstract/Review/Citation: Attachment theory is principally concerned with the role that enduring affectional bonds, or attachments, play in shaping the life course. The theory assumes that the developing infant's early attachment-related experiences are in time represented cognitively in the form of internal working models of self and other. Patterns of attachment are exemplified by the secure infant, anxious-ambivalent infant, and avoiding infant. Contemporary extensions of attachment theory to adulthood are reflected in measures of adult attachment styles and a 4-group taxonomy of adult attachment. Findings linking adult attachment styles and working models to variations in affect regulation and interpersonal behavior underscore the theory's integrative potential for guiding practice in counseling psychology. ========================================
Title: Attachment style and perceived social support: Effects on affect regulation. Author(s)/Editor(s): Priel, Beatriz; Shamai, Dalit Source/Citation: Personality & Individual Differences; Vol 19(2) Aug 1995, England: Elsevier Science Ltd.; 1995, 235-241. Abstract/Review/Citation: Explored the contribution of attachment styles and perceived social support (SCS) to levels of anxiety and depression in 328 psychology students, 59% of whom rated themselves as securely attached, 31% as avoidant, and 10% as ambivalent. Securely attached Ss were significantly less anxious and depressed, perceived more SCS in their environment, and were more satisfied with it. SCS scores were significantly related to anxiety and depression levels and were affected by attachment styles. The exploration of the relative contributions of attachment classification and perceived SCS to the explanation of affect regulation suggests that subjective satisfaction with SCS contributes to the prediction of felt distress beyond attachment styles. ========================================
Title: Adult attachment and emotional control. Author(s)/Editor(s): Feeney, Judith A. Source/Citation: Personal Relationships; Vol 2(2) Jun 1995, US: Cambridge University Press; 1995, 143-159 Abstract/Review/Citation: Explored the connection between attachment style and affect regulation in the context of long-term dating relationships. 72 couples completed questionnaire measures of attachment (using a 4-group forced-choice item, together with scales tapping Comfort with closeness, and Anxiety over relationships) and emotional control (in which Ss rated own and partner's control of anger, sadness, and anxiety, and the extent to which partners wanted them to control these emotions). Couples in which both partners endorsed insecure attachment styles (using the forced-choice measure) reported greater emotional control than did couples with two secure partners. Data from the attachment scales also supported the link between insecure attachment and emotional control: Comfort with closeness was negatively related both to one's own emotional control and to perceptions that partners wanted Ss to control their sadness; Anxiety over relationships was associated with perceptions that partners controlled sadness and wanted subjects to control their anger and sadness. The Courtauld Emotional Control Scale (Revised) is appended. ========================================
Title: Attachment style in married couples: Relation to current marital functioning, stability over time, and method of assessment. Author(s)/Editor(s): Fuller, Tamara L.; Fincham, Frank D. Source/Citation: Personal Relationships; Vol 2(1) Mar 1995, US: Cambridge University Press; 1995, 17-34 Abstract/Review/Citation: Examined several aspects of attachment in marriage, including the association among attachment style, mental models of the spouse, satisfaction, affect regulation within the marriage, the stability of attachment style, and its operationalization. 53 married couples (all Ss aged 19-57 yrs) completed initial assessments, and 44 participated in a 24-mo follow-up. Attachment style was related to positive and negative affect immediately preceding a potentially stressful event and to the mental model of the spouse. Approximately 35% of the Ss changed their attachment style rating over a 2-yr period; later attachment style was related to changes in mental models of the spouse. Categorical and dimensional measures of attachment style did not yield equivalent results. ========================================
Title: Attachment security, affect regulation, and defensive responses to mood induction. Author(s)/Editor(s): Lay, Keng-Ling; Waters, Everett; Posada, German; Ridgeway, Doreen Source/Citation: Monographs of the Society for Research in Child Development; Vol 60(2-3) 1995, US: Univ. of Chicago Press; 1995, 179-196 Abstract/Review/Citation: Examined the relation between the attachment security and representational/defensive processes in childhood. 48 children (aged 4.2-4.9 yrs) were ranked on the basis of E. Waters's (1987) Attachment Q-Set security scores. 16 most secure and 16 least secure children (11 females and 5 males in each group) were selected. Ss viewed vignettes for positive and negative moods containing both "mother-involved" and "mother-not-involved" situations. A modified version of a nonverbal paired-comparison procedure assessed emotional response to each mood-induction vignette. Results show secure Ss were no more responsive to positive mood inductions, and no less responsive to negative mood inductions, than insecure Ss. Although secure and insecure Ss were equally likely to respond defensively to negative mood inductions, their responses to mother-agent and other-agent vignettes were different. ========================================
Title: Attachment style and affect regulation: Relationships with health behavior and family experiences of illness in a student sample. Author(s)/Editor(s): Feeney, Judith A.; Ryan, Susan M. Source/Citation: Health Psychology; Vol 13(4) Jul 1994, US: American Psychological Assn; 1994, 334-345 Abstract/Review/Citation: Questionnaire measures of attachment style and health behavior were completed by 287 university students on 2 occasions, 10 wks apart. At Time 1, Ss also provided reports of emotionality and early family experiences of illness. Reports of early family illness showed theoretically meaningful relationships with attachment style. Symptom reporting was predicted most strongly by anxious/ambivalent attachment and negative emotionality, with the link between anxious/ambivalent attachment and symptom reporting partially mediated by negative emotionality. Visits to health professionals at Time 2 were directly related to reports of chronic illness in the family but inversely related to paternal illness and avoidant attachment, controlling for symptom reporting. The results are discussed in terms of theories of attachment and affect regulation. ========================================
Title: Affect and attachment in the family: A family-based treatment of major psychiatric disorder. Author(s)/Editor(s): Doane, Jeri A.; Diamond, Diana Source/Citation: New York, NY, US: Basic Books, Inc; 1994, (xiii, 224) Description/Edition Info.: Authored Book; 120 Abstract/Review/Citation: Based on empirical findings from the Yale Psychiatric Institute Family Study, a longitudinal research project, the book describes a family typology . . . that reflects intergenerational patterns of attachment bonds and styles of expressing affect in the family. In order to work effectively with families who have a member with a major psychiatric disorder, it is crucial to understand how the history of each family member's attachments and primary relationships becomes reprojected and reenacted in the next generation. [Using] clinical case studies, the authors detail a family therapy model in which attachment dysfunction is addressed as the first critical step in treatment. . . . The authors' approach is aimed not only at relapse prevention but at improving the quality of relating among family members beyond periods of acute stress. Although the research study focused on severely disturbed patients, this treatment approach can be helpful for clinicians treating a wide range of family dysfunction. Notes/Comments: Acknowledgments Introduction: Attachment and family emotional climate--An epigenetic approach to studying the family A review of previous studies on expressed emotion, affective style, and attachment The Yale Psychiatric Institute Family Study: Research design and methods The Yale Psychiatric Institute Family Study: Research findings Family typology Treatment of the disconnected family Treatment of the high-intensity family: A model of teaching affect regulation Treatment of the low-intensity family Intergenerational interviewing and parent-child rapprochement: General principles References Index family therapy & intergenerational attachment bonds & expression of affect, families with one member with psychiatric disorder, longitudinal study ========================================
Title: Affect regulation and the origin of the self: The neurobiology of emotional development. Author(s)/Editor(s): Schore, Allan N. Source/Citation: Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc; 1994, (xxxiv, 670) Abstract/Review/Citation: The purpose of this book is to integrate two rapidly converging streams of developmental research: psychological studies of the critical interactive experiences that influence the development of socioemotional functions and neurobiological studies of the ontogeny of postnatally maturing brain structures that come to regulate these same functions. This volume addresses the fundamental problems of how and why early events permanently affect the development of the self. Drawing upon current findings in infant research and neurobiology, a central hypothesis is proposed--that the infant's affective interactions with the early human social environment directly and indelibly influence the postnatal maturation of brain structures that will regulate all future socioemotional functioning. This principle of the experience-dependent development of self-regulatory structures and functions is supported by multidisciplinary evidence from a spectrum of developmental sciences. The studies cited in this work are used as a multidisciplinary source pool of experimental data, theoretical concepts, and clinical observations that form the base and scaffolding of an overarching heuristic model of socioemotional development that is grounded in contemporary neuroscience. . . . My intention in writing this volume is to demonstrate that a deeper understanding of affect regulation and dysregulation can offer penetrating insights into a number of affect-driven phenomena--from the motive force that underlies human attachment to the proximal causes of psychiatric disturbances and psychosomatic disorders, and indeed to the origin of the self. Notes/Comments: List of illustrations Foreword [by] James S. Grotstein Preface Acknowledgments Part I: Background and overview General principles of growth of the developing brain Recent advances in the multidisciplinary study of emotional development Structure-function relationships of orbitofrontal cortex Overview Part II: Early infancy Visual experiences and socioemotional development The practicing period The psychobiology of affective reunions Early imprinting Imprinting neuroendocrinology Socioaffective influences on orbitofrontal morphological development The emotionally expressive face The neurochemical circuitry of imprinted interactive representations The regulatory function of early internal working models Part III: Late infancy The onset of socialization procedures and the emergence of shame Late orbitofrontal development Orbitofrontal versus dorsolateral prefrontal ontogeny The dyadic origin of internal shame regulation Socialization and experience-dependent parcellation The origins of infantile sexuality and psychological gender The onset of dual component orbitofrontal mature structure and adaptive function Part IV: Applications to affect regulatory phenomena A psychoneurobiological model of the dual circuit processing of socioemotional information Cross-modal transfer and abstract representations The development of increasingly complex interactive representations Orbitofrontal influences on the autonomic nervous system The regulation of infantile rage reactions Affect regulation and early moral development The emergence of self-regulation Part V: Clinical issues The neurobiology of insecure attachments The clinical psychiatry of affect dysregulation The developmental psychopathology of personality disorders Vulnerability to psychosomatic disease Psychotherapy of developmental disorders Part VI: Integrations Right hemsipheric language and self-regulation The dialogical self and the emergence of consciousness Further directions of multidisciplinary study A proposed rapprochement between psychoanalysis and neurobiology References Subject index multidisciplinary approach to neurobiology of emotional development & regulation & role in origin of self, infants & children ========================================
Title: Disorders and dysfunctions of the self. Author(s)/Editor(s): Cicchetti, Dante; Toth, Sheree L. Source/Citation: Rochester, NY, US: University of Rochester Press; 1994, (xix, 409) Rochester Symposium on Developmental Psychopathology, Vol. 5. Abstract/Review/Citation: The papers in this volume illustrate advances that have been made in understanding the developmental mechanisms that contribute to anomalies and perturbations in the self systems of high risk and disordered populations. Their work demonstrates that the utilization of a developmental psychopathological approach can ensure that the renascence of the study of the self will continue to flourish. "Disorders and Dysfunctions of the Self" is an invaluable resource for the libraries of academics interested in theory and research on normal and abnormal self processes, clinicians who work with children and adults with self dysfunctions and disorders, and students in psychology, psychiatry, social work, and related fields. Notes/Comments: List of contributors Preface Intersubjectivity, joint attention, and autistic developmental pathology Peter Mundy and Anne Hogan Self-regulation in normal and atypical development Claire B. Kopp and Natalie Wyer The development of the will: A neuropsychological analysis of Gilles de la Tourette syndrome Simon Baron-Cohen, Mary M. Robertson and John Moriarty Peering into the black box? An exploratory treatise on the development of self in young children Patricia M. Crittenden Affective splitting and dissociation in normal and maltreated children: Developmental pathways for self in relationships Kurt W. Fisher and Catherine Ayoub The impact of sexual abuse on self structure Drew Westen Dissociation and disturbances of self Frank W. Putnam Attachment and meta-monitoring: Implications for adolescent autonomy and psychopathology Roger Kobak and Holland Cole Clinical-developmental psychology in developmental psychopathology: Theory and research of an emerging perspective Gil. G. Noam and Gayle Valiant The directionality of the link between self-esteem and affect: Beyond causal modeling Susan Harter and Donna B. Marold Adolescent suicide and the loss of personal continuity Michael Chandler Index of authors Index of subjects developmental mechanisms contributing to anomalies & perturbations in self systems, high risk & disordered populations Conference ========================================
Title: Marital conflict and child adjustment: An emotional security hypothesis. Author(s)/Editor(s): Davies, Patrick T.; Cummings, E. Mark Source/Citation: Psychological Bulletin; Vol 116(3) Nov 1994, US: American Psychological Assn.; 1994, 387-411 Abstract/Review/Citation: An emotional security hypothesis that builds on attachment theory is proposed to account for recent empirical findings on the impact of marital conflict on children and to provide directions for future research. Children's concerns about emotional security play a role in their regulation of emotional arousal and organization and in their motivation to respond in the face of marital conflict. Over time these response processes and internalized representations of parental relations that develop have implications for children's long-term adjustment. Emotional security is seen as a product of past experiences with marital conflict and as a primary influence on future responding. The impact and interaction of other experiential histories within the family that affect children's emotional security are also examined, with a focus on parent-child relations. ========================================
Title: Caring behavior in children of clinically depressed and well mothers. Author(s)/Editor(s): Radke-Yarrow, Marian; Zahn-Waxler, Carolyn; Richardson, Dorothy T.; Susman, Amy Source/Citation: Child Development; Vol 65(5) Oct 1994, US: Blackwell Publishers Inc; 1994, 1405-1414 Abstract/Review/Citation: Investigated 90 preschool-age children's (aged 24-48 mo) sensitivity and responsiveness to mothers' needs under conditions of high and low parenting risk (depressed and nondepressed mothers, respectively). Child characteristics of gender, affect, and impulse control problems and the mother-child attachment relationship were examined as they related to children's caring actions. Children's caring behavior was observed in an experimental situation in which their mothers simulated sadness and in a naturalistic setting. Girls were significantly more caring than boys. Severe maternal depression was necessary to bring out high levels of responding in boys. Highest frequencies of caring were from children with severely depressed mothers, problems of affect regulation, and secure attachment. The importance of recognizing interacting influences and diverse underlying processes in the development of children's caring behavior is discussed. ========================================
Title: Avoidant attachment as a risk factor for health. Author(s)/Editor(s): Kotler, Tamara; Buzwell, Simone; Romeo, Yolanda; Bowland, Jocelyn Source/Citation: British Journal of Medical Psychology; Vol 67(3) Sep 1994, England: British Psychological Society; 1994, 237-245 Abstract/Review/Citation: Describes a style of coping with stress that has been observed in cancer patients and in highly dependent, insecurely attached individuals. This coping style includes the suppression of negative emotions and avoidance of support seeking. It is suggested that this pattern of responses is potentially dysfunctional as it tends to perpetuate distress and may increase vulnerability to a broad range of illnesses. These considerations provide the basis for a provisional conceptual model, which links avoidant attachment style to the regulation of negative affect and to symptoms of psychological and physical ill health. ========================================
Title: Utilizing parenting as a clinical focus in the treatment of dissociative disorders. Author(s)/Editor(s): Benjamin, Lynn R.; Benjamin, Robert Source/Citation: Dissociation: Progress in the Dissociative Disorders; Vol 7(4) Dec 1994, US: Ridgeview Inst; 1994, 239-245 Abstract/Review/Citation: Parenting is a potent resource in both the individual and family treatment of dissociative disorders. A focus on parenting subtly shifts the client's attention to childhood experiences and the parenting that he or she experienced. The therapist's empathy and crediting of the client is echoed in the relationship between the dissociative parent and his or her child. The therapist promotes bonding and attachment, sensitizes the parent to the child's needs, and increases the parent's sense of self-efficacy. Through involving the parenting partner, the therapist promotes cooperation and reduces conflict. Therapy teaches affect regulation, decreases negative affect, and increases positive affect among family members. Utilization of extrafamilial support is also encouraged. A focus on parenting can stimulate progress in individual therapy and correct dysfunctional transgenerational patterns. ========================================
Title: The role of adult attachment in the experience and regulation of affect. Author(s)/Editor(s): Schaffer, Carrie Ellen Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 54(7-B) 1994, US: Univ. Microfilms International; 1994, 3891 ========================================
Title: Affect in psychoanalysis: A clinical synthesis. Author(s)/Editor(s): Spezzano, Charles Source/Citation: Hillsdale, US: Analytic Press, Inc; 1993, (xiv, 250) Relational perspectives book series, Vol. 2. Abstract/Review/Citation: In the first half of "Affect in Psychoanalysis," Spezzano, drawing on the writings of Freud, Fairbairn, Klein, Sullivan, and Winnicott, retells the story of psychoanalysis as the evolution of a theory of affects. Spezzano concludes that every affect reaching consciousness can be understood psychoanalytically as the most relevant possible assessment of the state of the self in its unconscious relational world. . . . Drawing on both classical and relational accounts of the unconscious mind, Spezzano synthesizes the major polarities of psychoanalysis--security/risk, sex/aggression, attachment/separation, self creation/affiliation--into a clinically useful conceptualization of the unconscious as a shifting dialectic of affective states. Spezzano proceeds to a radical redefinition of the analytic process as the intersubjective elaboration and regulation of affect. Notes/Comments: Acknowledgments Preface I. Knowing and talking about affect The place of psychoanalysis in the conversation about human affective life How psychoanalysts talk about affects now II. The evolution of psychoanalytic thinking about affects Freud's alleged missing theory of affects revisited Affect and its regulation in post-Freudian theory III. The dialectics of affect Patients and their discontents: Who or what is responsible? Excitement, certainty, relational coordination, and competence IV. The technical implications of affect theory Affects, resistance, and character The struggle to imagine References Index presents a psychoanalytic theory of emotions ========================================
Title: Nursing care of the self-mutilating patient. Author(s)/Editor(s): Pawlicki, Catherine M.; Gaumer, Carol Source/Citation: Bulletin of the Menninger Clinic; Vol 57(3) Sum 1993, US: Menninger Foundation; 1993, 380-389 Abstract/Review/Citation: Self-mutilative behavior (SMB) is common among patients with multiple personality and other dissociative disorders. Nursing staff members face particular challenges in managing these patients because 1 act of SMB can disrupt the entire inpatient milieu. The authors present an approach to nursing care that focuses on working with patients to understand and develop a specific plan to curtail the SMB. The nursing care focuses on (1) modulation of attachment in the nurse-patient relationship, (2) affect regulation, (3) interruption of arousal state, (4) contracting, (5) wound care, (6) distinguishing between suicide and SMB, and (7) milieu management. The essence of fostering the personality development of a self-mutilating patient requires the patient to realize that he/she is ultimately responsible for the behavior. ========================================
Title: Thoughts on the constructions of maternal representations. Author(s)/Editor(s): Schwartz, Adria E. Source/Citation: Psychoanalytic Psychology: Special Issue: Women, psychoanalysis, and gender; Vol 10(3) Sum 1993, US: Educational Publishing Foundation; 1993, 331-344 Abstract/Review/Citation: Discusses the deconstructive shift in the conception of mothers and mothering from a unitary category of women in a biological relationship with their offspring to a more fluid constellation of active maternal relations. The author suggests a new parenting subject that transcends gender, constructed through the work of intersubjective dyads. Two questions are addressed: (1) How might the representation of such maternal relationships and their internalization be envisioned? (2) How might a changing conception of internalized maternal representations affect psychoanalytic practice? With reference to J. Bowlby's (1980) concept of internal working models of attachment, and to more recent infant research, the concept of maternal functions (specifically, functions of security, regulation, and recognition) is introduced as central to the mothering relation. ========================================
Title: The infant's relationship experience: Developmental and affective aspects. Author(s)/Editor(s): Emde, Robert N. Source/Citation: Relationship disturbances in early childhood: A developmental approach., New York, NY, US: Basic Books, Inc; 1992, (x, 267), 33-51 Source editor(s): Sameroff, Arnold J. (Ed) Abstract/Review/Citation: early caregiving relationship in biological perspective / functional aspects of the parent-child relationship / attachment and bonding / vigilance and protection / physiological regulation / play and learning/teaching / self-control and discipline / biological preparedness for social interaction / developmental transformations and affect / first-year shifts / second-year shifts / role of affect in organizing experience / implications for the child's future relationships ========================================
Title: Quality of attachment in the preschool years. Author(s)/Editor(s): Crittenden, Patricia M. Source/Citation: Development & Psychopathology; Vol 4(2) 1992, US: Cambridge Univ; 1992, 209-241 Abstract/Review/Citation: Discusses differences in quality of attachment in preschool-aged children with emphasis on the development of the goal-corrected partnership. The notion of quality of attachment is expanded to include strategy, regulation of affect, negotiation, secure base behavior, and response to maternal behavior. The classificatory system is expanded by adding 2 defended patterns (compulsive caregiving and compulsive compliance) to the infant avoidant pattern. At the preschool age, the infant ambivalent pattern is identified as having a coercive strategy. Also, the disorganized infant category is reconceptualized in terms of complex organization, reorganization, and disorganization. Finally, the process of generating theories and hypotheses through a participant-observer methodology is considered from the perspective of developmental psychopathology. ========================================
Title: Adult romantic attachment: Measurement, affect-regulation, and relationship functioning in dating couples. Author(s)/Editor(s): Brennan, Kelly A. Source/Citation: Dissertation Abstracts International; Vol 53(2-B) Aug 1992, US: Univ. Microfilms International; 1992, 1097 ========================================
Title: Developmental perspectives on depression. Author(s)/Editor(s): Cicchetti, Dante; Toth, Sheree L. Source/Citation: Rochester, NY, US: University of Rochester Press; 1992, (xix, 396) Rochester symposium on developmental psychopathology, Vol. 4. Abstract/Review/Citation: This volume is noteworthy in its focus on one of the most prevalent and devastating psychiatric disorders, depression. The contributors to this volume apply a developmental analysis to the etiology, course, and sequelae of depression across the lifespan. The effects of depression on multiple domains of functioning, including socio-emotional, social cognitive, and psycho-biological, are explored. In addition to the impact of the disorder on the depressed individual, its role on the developmental process in offspring of depressed parents and for families having a depressed member are examined and reviewed. In accord with the developmental psychopathology perspective, "Developmental Perspectives on Depression" illustrates the mutually enriching interchanges that can occur among theory, research, and intervention with clinical and at risk populations. It will be an invaluable addition to the libraries of practicing clinicians, scholars interested in conducting research on developmental aspects of the affective disorders, and students of psychology, psychiatry, and related fields of mental health. Notes/Comments: Acknowledgements List of contributors Preface The evolution and validity of the diagnosis of major depression in childhood and adolescence Barry Nurcombe A neurobehavioral systems approach to developmental psychopathology: Implications for disorders of affect Paul F. Collins and Richard A. Depue Influence of maternal depression on infant affect regulation Jeffrey F. Cohn and Susan B. Campbell Maternal depressive symptoms, disorganized infant-mother attachment relationships and hostile-aggressive behavior in the preschool classroom: A prospective longitudinal view from infancy to age five Karlen Lyons-Ruth Emotional dysregulation in disruptive behavior disorders Pamela M. Cole and Carolyn Zahn-Waxler Depression in families: A systems perspective James C. Coyne, Geraldine Downey and Julie Boergers The family-environmental context of depression: A perspective on children's risk Constance Hammen Parental depression, family functioning and child adjustment: Risk factors, processes, and pathways E. Mark Cummings and Patrick T. Davies Developmental predictors of depressive cognitive style: Research and theory Donna T. Rose and Lyn Y. Abramson Childhood maltreatment and adult depression: A review of research Jules R. Bemporad and Steven J. Romano Index of authors Index of subjects applies a developmental analysis to the etiology, course, & sequelae of depression across the lifespan Conference Proceedings/Symposia ========================================
Title: Family interactions in mood-disordered youth. Author(s)/Editor(s): McCauley, Elizabeth; Myers, Kathleen Source/Citation: Child & Adolescent Psychiatric Clinics of North America; Vol 1(1) Jul 1992, US: WB Saunders Co; 1992, 111-127. Abstract/Review/Citation: Reviews the literature on family interactions and depression in children and adolescents, with a focus on identifying those variables most salient for future investigations. The review reveals that family interactions appear to play a significant role in the timing, intensity, and persistence of depressive disorders in adults. How family environment affects the presentation and course of depression in young people is not yet as clear. Most progress has been made in the study of the offspring of depressed mothers; there is an association between parental mental illness and increased behavioral dysfunction of offspring but many questions remain as to this association. The study of families of depressed youth is just beginning; many areas are open for productive research. Most promising are parent-child attachment or support and conflict resolution, especially as it reflects the regulation of negative affect. ========================================
Title: Nothingness, meaninglessness, chaos, and the "black hole": III. Self- and interactional regulation and the background presence of primary identification. Author(s)/Editor(s): Grotstein, James S. Source/Citation: Contemporary Psychoanalysis; Vol 27(1) Jan 1991, US: W. A. White Institute; 1991, 1-33 Abstract/Review/Citation: As proposed by J. S. Grotstein, the concepts of nothingness, meaninglessness, and chaos are informed by deficit theory (a theory of both primary and secondary absence), as well as by conflict theory. The author argues that conflicts are to be solved through dialectic resolution and that deficits are to be solved through self- and interactional regulation. Regulation relates to the physiological aspects of the internal milieu and of behavior with others and is the "language" of primary narcissism and symbiosis. Self- and interactional disorders (e.g., affect and attachment/bonding disorders, respectively) are contrasted with the symbolic functioning disorders, which presuppose that the self-regulatory capacity is intact. ========================================
Title: Implications of research on infant development for psychodynamic theory and practice. Author(s)/Editor(s): Zeanah, Charles H.; Anders, Thomas F.; Seifer, Ronald; Stern, Daniel N. Source/Citation: Annual progress in child psychiatry and child development, 1990., Philadelphia, PA, US: Brunner/Mazel, Inc; 1991, (vii, 603), 5-33 Source editor(s): Chess, Stella (Ed) Abstract/Review/Citation: to address the question of the importance of early experiences for development, research on continuities and discontinuities in development, temperament, motivational systems in infancy, affect development and regulation, development of the sense of self, and infant-caregiver attachment are reviewed / two major implications emerge, both emphasizing the need for more complexities in our conceptualizations / first, research in infant development underscores the importance of context in development and cautions about the limits of reductionistic thinking and theories / second, a major paradigmatic shift away from the fixation-regression model of psychopathology and development is indicated / a new model that better fits available data is proposed instead / implications for psychodynamic treatment are also described ========================================
Title: Contributions from the study of high-risk populations to understanding the development of emotion regulation. Author(s)/Editor(s): Cicchetti, Dante; Ganiban, Jody; Barnett, Douglas Source/Citation: The development of emotion regulation and dysregulation., New York, NY, US: Cambridge University Press; 1991, (xii, 338), 15-48 Cambridge studies in social and emotional development. Source editor(s): Garber, Judy (Ed) Abstract/Review/Citation: examine the process of emotion regulation first in normal infants and toddlers and then in . . . high-risk conditions across four of the stage-salient issues of the early years of life: (1) homeostatic regulation, (2) the differentiation of affect and the management of cognitive and physiological "tension," (3) the development of a secure attachment relationship, and (4) self-awareness and further self-other differentiation / review empirical work conducted with children in each of the four risk groups [children with Down syndrome, offspring of mothers with unipolar depression, offspring of mothers with bipolar depression, maltreated children] ========================================
Title: Regulation of negative reactivity during the strange situation: Temperament and attachment in 12-month-old infants. Author(s)/Editor(s): Braungart, Julia M.; Stifter, Cynthia A. Source/Citation: Infant Behavior & Development; Vol 14(3) Jul-Sep 1991, US: Ablex Publishing Corp.; 1991, 349-364 Abstract/Review/Citation: Examined regulatory behaviors (RBs) displayed during a strange situation and the extent to which those behaviors were related to infants' negative reactivity and attachment classification in 80 12-mo-olds and their mothers. Negative affect (NA) and regulatory categories were measured during the strange situation. Infants who were overtly upset oriented less toward people, more toward objects, and engaged in less toy exploration. An analysis of variance (ANOVA) yielded significant differences for attachment groups: insecure avoidant (IA), secure (SC), and insecure-resistant (IR) in reactivity and regulation. One SC subgroup showed low levels of distress and low levels of regulation, and another SC subgroup displayed high levels of NA and high levels of RBs during separation and reunion episodes. IAs displayed moderate amounts of distress and exhibited self-directed types of regulation, and IRs expressed intense levels of negative reactivity, exhibited some RBs during separation, but little regulation during reunion. ========================================
Title: Family patterns of relationship in normative and dysfunctional families. Author(s)/Editor(s): Crittenden, Patricia M.; Partridge, Mary F.; Claussen, Angelika H. Source/Citation: Development & Psychopathology: Special Issue: Attachment and developmental psychopathology; Vol 3(4) 1991, US: Cambridge Univ; 1991, 491-512 Abstract/Review/Citation: Explored the relation among family relationships for couple pairings and parent-child dyads. In 53 maltreating and adequate poverty-level families, mothers' and male partners' quality of attachment (QOA) was compared with each other and with the QOA of their 1-4 yr old child. The parents were interviewed, and the children were assessed with M. D. Ainsworth's (1978) Strange Situation. Both concordance and discordance were found; in particular, a hypothesis of meshed adult relationships and parent-child transformations was supported. Results suggest the need for greater incorporation of regulation of affect in assessment procedures, greater theory development, and precision in validation and application of assessment procedures. ========================================
Title: Attachment styles and fear of personal death: A case study of affect regulation. Author(s)/Editor(s): Mikulincer, Mario; Florian, Victor; Tolmacz, Rami Source/Citation: Journal of Personality & Social Psychology; Vol 58(2) Feb 1990, US: American Psychological Assn.; 1990, 273-280 Abstract/Review/Citation: The relation between attachment styles and fear of personal death was assessed. We classified a sample of Israeli undergraduate students into secure, ambivalent, and avoidant attachment groups and assessed the extent of, and the meaning attached to, overt fear of personal death as well as the extent of fear at a low level of awareness. Ambivalent subjects exhibited stronger overt fear of death than did secure and avoidant subjects, and both ambivalent and avoidant subjects showed stronger fear of death at a low level of awareness than secure subjects. Ambivalent subjects were also more likely to fear the loss of their social identity in death, and avoidant subjects were more likely to fear the unknown nature of their death. Results are discussed in terms of the effects of attachment styles on affect regulation. ========================================
Title: Implications of research on infant development for psychodynamic theory and practice. Author(s)/Editor(s): Zeanah, Charles H.; Anders, Thomas F.; Seifer, Ronald; Stern, Daniel N. Source/Citation: Annual Progress in Child Psychiatry & Child Development, US: Brunner/Mazel Inc; 1990, 5-33 Abstract/Review/Citation: (This reprinted article originally appeared in the Journal of the American Academy of Child and Adolescent Psychiatry, 1989, Vol 28[5], 657-668. The following abstract of the original article appeared in PA, Vol 77:7136.) Research on continuities and discontinuities in development, temperament, motivational systems in infancy, affect development and regulation, development of the sense of self, and infant-caregiver attachment are reviewed to examine the importance of early experiences for later development. Research on infant development underscores the importance of context in development and cautions about the limits of reductionistic thinking and theories. Also, a major paradigmatic shift away from the fixation-regression model of psychopathology and development is indicated. A new model that better fits available data is a continuous construction model in which there is no need for regression, and ontogenetic origins of psychopathology are no longer necessarily tied to specific critical or sensitive periods in development. ========================================
Title: Implications of research on infant development for psychodynamic theory and practice. Author(s)/Editor(s): Zeanah, Charles H.; Anders, Thomas F.; Seifer, Ronald; Stern, Daniel N. Source/Citation: Journal of the American Academy of Child & Adolescent Psychiatry; Vol 28(5) Sep 1989, US: Williams & Wilkins Co.; 1989, 657-668 Abstract/Review/Citation: Research on continuities and discontinuities in development, temperament, motivational systems in infancy, affect development and regulation, development of the sense of self, and infant-caregiver attachment are reviewed to examine the importance of early experiences for later development. Research on infant development underscores the importance of context in development and cautions about the limits of reductionistic thinking and theories. Also, a major paradigmatic shift away from the fixation-regression model of psychopathology and development is indicated. A new model that better fits available data is a continuous construction model in which there is no need for regression, and ontogenetic origins of psychopathology are no longer necessarily tied to specific critical or sensitive periods in development. ========================================
Title: Attachment in late adolescence: Working models, affect regulation, and representations of self and others. Author(s)/Editor(s): Kobak, R. Rogers; Sceery, Amy Source/Citation: Child Development; Vol 59(1) Feb 1988, US: Blackwell Publishers Inc; 1988, 135-146 Abstract/Review/Citation: In 53 1st-yr college students, 3 kinds of working models of attachment were assessed: Dismissing of Attachment, Secure, and Preoccupied with Attachment. Affect regulation was evaluated with peer Q-sort ratings, and representations of self and others were assessed with self-report measures. The Secure group was rated as more ego-resilient, less anxious, and less hostile by peers and reported little distress and high levels of social support. The Dismissing group was rated low on ego-resilience and higher on hostility by peers and reported more distant relationships in terms of more loneliness and low levels of social support from family. The Preoccupied group was viewed as less ego-resilient and more anxious by peers and reported high levels of personal distress, while viewing their family as more supportive than the Dismissing group. ========================================
Title: Transference and information processing. Author(s)/Editor(s): Westen, Drew Source/Citation: Clinical Psychology Review; Vol 8(2) 1988, US: Elsevier Science Inc/Pergamon; 1988, 161-179 Abstract/Review/Citation: Examines transference phenomena from an information processing perspective, delineates aspects of transference experience, and shows how experimental research documents processes involved in transference. It distinguishes between transference as person schemas/object representations, attachment, schema-triggered affect, interpersonal expectancies, scripts, and defenses, and argues for the importance of making such distinctions. The clinical utility of examining and working with transference phenomena in the alteration of dysfunctional schemas and maladaptive mechanisms of affect regulation is demonstrated. ========================================
Title: Stage-salient issues: A transactional model of intervention. Author(s)/Editor(s): Cicchetti, Dante; Toth, Sheree L.; Bush, Marcy A.; Gillespie, Janet F. Source/Citation: Developmental psychopathology and its treatment., San Francisco, CA, US: Jossey-Bass Inc, Publishers; 1988, (173), 123-145 New directions for child development, No. 39. Source editor(s): Nannis, Ellen D. (Ed) Abstract/Review/Citation: examine development within pathological or high-risk conditions / transactional model / illustrative conditions involving disorders of development / Down syndrome / nonorganic failure to thrive / offspring of depressed parents / child maltreatment / homeostatic regulation and the development of a reliable signaling system / management of tension (cognitively produced arousal) and the differentiation of affect / development of a secure attachment / development of an autonomous self / implications for intervention ========================================
Title: Social and personality development: An evolutionary synthesis. Author(s)/Editor(s): MacDonald, Kevin B. Source/Citation: New York, NY, US: Plenum Press; 1988, (xiii, 349) Perspectives in developmental psychology. Abstract/Review/Citation: This volume is an attempt to integrate the theory and data of social and personality development within a modern evolutionary framework. Chapter 1 deals with the theoretical foundations of this enterprise, and the focus is on the compatibility of mainstream approaches within the field to a modern evolutionary approach. Chapters 2-4 concern what I view to be the fundamental proximal mechanisms underlying social and personality development. Chapter 2, on temperament and personality development, is particularly central to the rest of the volume because these processes are repeatedly invoked as explanatory concepts at later points in the volume. If the theory of temperament is one central pillar of the volume, Chapter 5, on family processes, is the other. The perspective developed there on the evolution of the family is central to much of the discussion in Chapter 6 on aggression and sex differences as well as the discussion of the development of altruism in Chapter 8. Chapter 5 is the first chapter to emphasize modern evolutionary theory and the remaining chapters continue and expand this perspective in several of the central areas of social development, including moral reasoning (Chapter 7) and the wider context of human development (Chapter 9). This work culminates a long process of attempting to develop a unified account of social and personality development based on evolutionary theory. Notes/Comments: Theoretical considerations Introduction Philosophical issues and world views General theoretical issues Evolutionary theory and the theoretical traditions of social development Theoretical fragmentation or integration? Temperament and personality development Theories of temperament Self-regulation as sensitivity to rewards, with an emphasis on the positive social reward system: Evidence for a third personality dimension Biological and environmental influences on temperament The stability of temperament The development of the emotions Theories of emotional development Parent-child interaction as an example of emotional processes in development The development of the emotions Social and biological events in infancy and their relevance for later behavior Attachment in evolutionary perspective Aberrations in attachment and later behavior Parent-child relationships and the transmission of culture Global parenting styles The family and the socialization of children in evolutionary and historical perspective Centrifugal tendencies within families and their effects on children Affective relationships within the family and the transmission of culture General effects of decrements in parental investment and an evolutionary analysis of parental control Topics in the development of aggression, peer relations, and sex differences Issues in the development of aggression Issues in the development of peer relations Sex differences in development Moral and altruistic development I: The roles of cognition and context The cognitive-developmental approach to moral reasoning Rest's component model of moral behavior A review of the literature on moral reasoning from the perspective of sociobiological theory Research on norms related to altruism and morality Reasoning about altruistic events Moral and altruistic development II: The importance of socialization and affect Descriptive studies of emotions and their role in motivating altruism Three sociobiological hypotheses Development in a wider context: Evolutionary considerations Evolution and ideology Socialization beyond the family and peer systems Resource availability as a contextual variable: Empirical data References Index ========================================
Title: Infants' affective responses in the strange situation: Effects of prematurity and of quality of attachment. Author(s)/Editor(s): Frodi, AnnThompson, Ross Source/Citation: Child Development; Vol 56(5) Oct 1985, US: Blackwell Publishers Inc; 1985, 1280-1290 Abstract/Review/Citation: Videotaped 20 full-term (aged 38-42 wks) and 20 preterm (aged 30-36 wks) infants and their mothers in the Strange Situation procedure and determined the security of their attachment relationships. Each episode was divided into consecutive 15-sec intervals, during each of which ratings of facial expressions were performed. From these ratings several summary dimensions of affect were derived (e.g., affective peak and range during all episodes, latency and rise time for onset of distress during separation episodes, recovery time during reunions). Term and preterm Ss did not differ from one another in either the security of attachment or their affective expression and regulation. When groups were combined, patterns of affective expression were significantly different for Ss classified as insecure-avoidant, insecure-ambivalent, and securely attached (Group B), as well as for Subgroups B1 and B2 Ss compared to Subgroups B3 and B4. Findings indicate that attachment-related affect may reflect an affect continuum that underlies certain mother- and stranger-directed behaviors in the Strange Situation but that not all aspects of reunion behavior can be predicted by prior separation reactions. (26 ref) ========================================
Title: Research strategies to identify developmental vulnerabilities for drug abuse. Author(s)/Editor(s): Greenspan, Stanley I. Source/Citation: National Institute on Drug Abuse: Research Monograph Series; No 56 1985, US: US Department of Health & Human Services; 1985, 136-154 Abstract/Review/Citation: Discusses the theoretical perspectives of the development of psychopathology and preventive intervention in infancy with regard to predisposing risk factors for drug abuse. A developmental structuralist approach to etiologic and intervention research is presented, and the links between infancy and subsequent behaviors associated with drug use are illustrated. Case vignettes are presented to show how early intersensory integration, self-regulatory mechanisms, and affective development relate to subsequent processes and affective relationships that appear to be impaired in individuals prone to acting out, behaving antisocially, or using "feel good" substances, whether from a somatic, affective, or interpersonal stance. It is hypothesized that intersensory integration, self-regulatory mechanisms, affect regulation, attachment patterns, and eventually the symbolization of affect leading to interpersonal relations and the capacity to relate to both persons and social conventions provide the keys to predisposing risk factors associated with risk for or avoidance of drug use. (9 ref) ========================================
Title: Affect development and its assessment in infancy. Author(s)/Editor(s): Solyom, Antal E. Source/Citation: Infant Mental Health Journal; Vol 3(4) Win 1982, US: John Wiley & Sons Inc; 1982, 276-292 Abstract/Review/Citation: Approaches the complex issue of affect from a primarily clinical perspective that focuses on the infant as an individual and reviews 2 quantitative methods for assessing discrete affects in clinical settings: the Gaensbauer Scales and the Michigan Infant Affect Scales. Each consists of 2 components: (1) a systematically used procedure designed to elicit affective responses and (2) rating scales for quantitative measurement of the intensity of discrete affects. Affects are defined as both biobehavioral states and signals of social and intrapsychic communication. Discrete affects can reliably be identified, and their intensities scored, from at least 3 mo of age on. Affects are thought to play a central role in organizing, regulating, and motivating the infant's behaviors and social object relationships. A concept of "affective system" is proposed that integrates the modalities of affect expression and the mechanisms of affect regulation. Attachment behaviors are seen as part of the expression and/or regulation of affect states during social interactions. (55 ref) Title: Infant-mother and infant-father synchrony: The coregulation of positive arousal. Author(s)/Editor(s): Feldamn, Ruth Source/Citation: Infant Mental Health Journal; Vol 24(1) Jan-Feb 2003, US: John Wiley & Sons; 2003, 1-23 Abstract/Review/Citation: To examine the coregulation of positive affect during mother-infant and father-infant interactions, 100 couples and their first-born child (aged 5 mos) were videotaped in face-to-face interactions. Parents' and infant's affective states were coded in one-second frames, and synchrony was measured with time-series analysis. The orientation, intensity, and temporal pattern of infant positive arousal were assessed. Synchrony between same-gender parent-infant dyads was more optimal in terms of stronger tagged associations between parent and infant affect, more frequent mutual synchrony, and shorter lags to responsiveness. Infants' arousal during mother-infant interaction cycled between medium and low levels, and high positive affect appeared gradually and was embedded within a social episode. During father-child play, positive arousal was high, sudden, and organized in multiple peaks that appeared more frequently as play progressed. Mother-infant synchrony was linked to the partners' social orientation. Father-child synchrony was related to the intensity of positive arousal and to father attachment security. Results contribute to research on the regulation of positive emotions and describe the unique modes of affective sharing that infants coconstruct with mother and father. ========================================
Title: Anger regulation in disadvantaged preschool boys: Strategies, antecedents, and the development of self-control. Author(s)/Editor(s): Gilliom, Miles; Shaw, Daniel S.; Beck, Joy E.; Schonberg, Michael A.; Lukon, JoElla L. Author Affiliation: U Pittsburgh, Pittsburgh, PA, US U Pittsburgh, Pittsburgh, PA, US U Pittsburgh, Pittsburgh, PA, US U Pittsburgh, Pittsburgh, PA, US Paper Number: 20020227 Source/Citation: Developmental Psychology; Vol 38(2) Mar 2002, US: American Psychological Assn; 2002, 222-235 Abstract/Review/Citation: Emotion regulation strategies observed during an age 3 1/2 frustration task were examined in relation to (a) angry affect during the frustration task, (b) child and maternal characteristics at age 1 1/2, and (c) indices of self-control at age 6 in a sample of low-income boys (Ns varied between 189 and 310, depending on the assessment). Shifting attention away from sources of frustration and seeking information about situational constraints were associated with decreased anger. Secure attachment and positive maternal control correlated positively with effective regulatory strategy use. Individual differences in strategy use predicted self-control at school entry, but in specific rather than general ways: Reliance on attention-shifting strategies corresponded with low externalizing problems and high cooperation; reliance on information gathering corresponded with high assertiveness. ========================================
Title: Infants' behavioral strategies for emotion regulation with fathers and mothers: Associations with emotional expressions and attachment quality. Author(s)/Editor(s): Diener, Marissa L.; Mengelsdorf, Sarah C.; McHale, Jean L.; Frosch, Cynthia A. Author Affiliation: U Illinois, Dept of Psychology, IL, US U Arizona, Dept of Family & Consumer Services, AZ, US Source/Citation: Infancy; Vol 3(2) May 2002, US: Lawrence Erlbaum; 2002, 153-174 Abstract/Review/Citation: This study examined 12- and 13-mo-old infants' behavioral strategies for emotion regulation, emotional expressions, regulatory styles, and attachment quality with fathers and mothers. 85 infants participated in the Strange Situation procedure to assess attachment quality with mothers and fathers. Infants' behavioral strategies for emotion regulation were examined with each parent during a competing demands task. Emotion regulation styles were meaningfully related to infant-father attachment quality. Although expressions of distress and positive affect were not consistent across mothers and fathers, there was consistency in infant strategy use, emotion regulation style, and attachment quality with mothers and fathers. Furthermore, infants who were securely attached to both parents showed greater consistency in parent-oriented strategies than infants who were insecurely attached to one or both parents. Limitations of this study include the constrained laboratory setting, potential carryover effects, and a homogeneous, middle-class sample ========================================
Title: An attachment theory conceptualization of adults who have witnessed domestic violence as children: Adult attachment styles and implications for treatment. Author(s)/Editor(s): Patton, Kimberly Anne Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 62(9-B) Apr 2002, US: Univ Microfilms International; 2002, 4231 Abstract/Review/Citation: This study indirectly examined the population of adults who have witnessed domestic violence as children within the context of attachment theory. Implications were drawn for treatment approaches, utilizing Bartholomew's and Horowitz's (1991) four adult attachment styles: secure, preoccupied, dismissing, and fearful. Up to the present time, there has been little research on adults who have witnessed domestic violence as children. The study expanded the research to include this population as well as derive unique treatment measures for these individuals. Treatment recommendations were formulated from synthesizing the literature on witnessing domestic violence and attachment theory. These recommendations were delineated for the four attachment styles, including general treatment considerations and trauma-focused treatment. The interventions included several treatment parameters for each attachment style, such as goals of treatment, psychopathology, the therapeutic relationship, affect regulation, and internal working models. Additionally, qualitative research was conducted exploring clinicians' treatment approaches with a domestic violence population. A nonrandom, national sample of 32 clinicians was recruited from domestic violence agencies. Participants completed a questionnaire requesting demographic information, perceptions of therapeutic issues with adults who have witnessed childhood domestic violence, treatment approaches with such clients, and the application of attachment concepts in therapy. Several areas were identified by clinicians as attachment-based clinical issues and treatment interventions for adult witnesses of childhood domestic violence. Addressing issues with self-esteem, affect, trauma, interpersonal relationships, and the therapeutic relationship were seen as important for all attachment styles. Group therapy, couples therapy, psychodynamic psychotherapy, and psychoeducation were seen as useful interventions for each of the attachment styles. In addition, cognitive-behavioral therapy was recommended for clients with insecure attachment styles. Recommendations for specific attachment styles were as follows: for individuals with a secure attachment style, treatment focused on accessing these clients' strengths to help them cope with past trauma. Preoccupied clients' poorly regulated affect, low self-esteem, rejecting interpersonal relationships, and inadequate defenses were a focus. With dismissing clients, interpersonal relationships, particularly the therapeutic relationship, behavioral problems, cognitive distortions, and emotional constriction were emphasized. For individuals with a fearful attachment style, trauma resolution, safety, coping, dysregulated affect, and chaotic relationships were seen as important clinical issues. ========================================
Title: Affect regulation, mentalization, and the development of the self. Author(s)/Editor(s): Fonagy, Peter; Gergely, Gyoergy; Jurist, Elliot L.; Target, Mary Author Affiliation: Hungarian Academy of Sciences, Psychology Inst, Developmental Psychology Lab, Hungary Hofstra U, Dept of Philosophy, Hempstead, NY, US U Coll London, London, England Source/Citation: New York, NY, US: Other Press; 2002, (xiii, 577) Abstract/Review/Citation: Aimed at addressing multiple audiences: research psychologists, clinical psychologists, and psychotherapists, as well as developmentalists from across other disciplines, this book highlights the crucial importance of developmental work to psychotherapy and psychopathology. Notes/Comments: About the authors Acknowledgements Introduction Part I: Theoretical perspectives Attachment and reflective function: Their role in self-organization Historical and interdisciplinary perspectives on affects and affect regulation The behavior geneticist's challenge to a psychosocial model of the development of mentalization Part II: Developmental perspectives The social biofeedback theory of affect-mirroring: The development of emotional self-awareness and self-control in infancy The development of an understanding of self and agency "Playing with reality': Developmental research and a psychoanalytic model for the development of subjectivity Marked affect-mirroring and the development of affect-regulative use of pretend play Developmental issues in normal adolescence and adolescent breakdown Part III: Clinical perspectives The roots of borderline personality disorder in disorganized attachment Psychic reality in borderline states Mentalized affectivity in the clinical setting Epilogue References Index psychotherapy; psychopathology; regulation; self; mentalization; development ========================================
Title: Self- and interactive regulation: Treating a patient with AD/HD. Author(s)/Editor(s): Carney, Jean K. Source/Citation: Psychoanalytic Inquiry: Special Issue: Self-regulation: Issues of attention and attachment.; Vol 22(3) 2002, US: Analytic Press; 2002, 355-371 Abstract/Review/Citation: Presents the psychoanalytic treatment of an adult attention deficit/hyperactivity disorder (AD/HD) patient, taking account of the development of self-regulation in terms of interactive social exchanges, as well as neurobiologically based factors. The patient's gains in cognition and affect management opened the way for development of empathic capacity after the therapist began integrating ideas and methods from the AD/HD theoretical literature with B. Beebe and F. M. Lachmann's (1994, 1998) model of self- and mutual regulation. The author notes that Ritalin treatment seemed to treat temporarily the neurobiological deficit well enough to have allowed the patient, over time, to use the self- and interactive regulation in psychoanalytic treatment to develop a capacity for empathy. The author explores a key idea from the AD/HD research--that the disorder is at root a deficit in the capacity to inhibit response to internal and external stimuli long enough to allow time for reflection, affect management, planning, and other executive functions that neuroscience links with the prefrontal cortex and other areas of the brain. ========================================
Title: The impact of premature birth on fear of personal death and attachment styles in adolescence. Author(s)/Editor(s): Lubetzky, Ofra; Gilat, Itzhak Author Affiliation: Levinsky Coll of Education, Israel Source/Citation: Death Studies; Vol 26(7) Aug 2002, United Kingdom: Taylor & Francis; 2002, 523-543 Abstract/Review/Citation: The differences between adolescents born pre-term (n=50; aged 14-16 yrs) and a matched sample of adolescents born full-term were examined in relation to fear of personal death, attachment styles, and the relation between the 2 variables. Findings revealed that adolescents born pre-term showed a higher level of fear of personal death and a lower frequency of secure attachment style than adolescents born full-term. In addition, secure full-term born adolescents exhibited a lower level of fear of personal death compared with insecure adolescents; whereas among those born pre-term, attachment styles did not affect the level of fear of personal death. Results are discussed in terms of the long-term impact of premature birth on affect regulation in adolescence. ========================================
Title: Attachment and emotional experiences: Regulatory strategies used with negative and positive emotions in response to daily life events and social interaction feedback. Author(s)/Editor(s): Gentzler, Amy Lynn Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 62(12-B) 2002, US: Univ Microfilms International; 2002, 6023 Abstract/Review/Citation: Associations between attachment and emotional experiences were examined in two studies. In the first study, participants (119 undergraduates) reported on their emotional reactions to positive and negative events from their own lives three times a day for four days. After one week, for participants' most positive and negative event which occurred during the four days of daily reporting, they estimated their earlier emotional reactions, reported coping strategies used and current feelings toward the events. In the second study, emotion regulation strategies were examined in a laboratory setting to control for the variability of events in the first study. Participants (133 undergraduates) were informed the study was about first impressions. They engaged in a five minute conversation with a confederate and were randomly assigned to receive positive or negative feedback about their personality. To assess regulatory strategies, after viewing the feedback participants completed a measure of emotional reactions, a stream-of-consciousness thought task, and measures of inward and outward directed strategies. Across both studies, attachment showed some relation to emotion regulation. Specifically, secure attachment was related to a greater likelihood to be accurate or overestimate positive affect, and more processing of positive experiences. Preoccupied attachment was associated with more intense negative emotions, and more negative thought processes even after receiving positive feedback. Hypotheses for dismissing attachment were not supported in that dismissing individuals did not underestimate initial negative affect intensity, rely on avoidant coping or blame the confederate for the negative feedback. Fearful attachment was linked to a tendency to focus on negative experiences (i.e. receiving negative feedback), but not positive events or emotions. ========================================
Title: Attachment and coping with chronic disease. Author(s)/Editor(s): Schmidt, Silke; Nachtigall, Christof; Wuethrich-Martone, Olivia; Strauss, Bernhard Author Affiliation: U Jena, Inst of Psychology, Dept of Methodology, Jena, Germany U Jena, Inst of Psychology, Dept of Methodology, Jena, Germany U Hosp Jena, Inst of Medical Psychology, Jena, Germany Source/Citation: Journal of Psychosomatic Research; Vol 53(3) Sep 2002, US: Elsevier Science; 2002, 763-773 Abstract/Review/Citation: Tested the hypothesis that attachment patterns have an influence on coping strategies (CSs) in patients with chronic disease, and that APs may predict the subjective emotional and physical health status during medical treatment. 150 patients (suffering from breast cancer, chronic leg ulcers, or alopecia) were investigated with an adult attachment interview and a coping interview. Self-reported CSs, social support, subjective health status, and quality of life were also assessed by self-report measures at 2 or more sampling points. Findings indicate a moderate effect of attachment patterns on CSs when controlling the influence of confounding variables. Insecure attachment was related to less flexible coping. CSs differed between the different types of insecure attachment; however, there were differences depending on the perspective of the coping behavior (self vs observer ratings) as well. It is concluded that 2 levels of coping should be differentiated--1 level corresponding with affect regulation, in particular the regulation of attachment-related emotions and concerns, while the other level shows a stronger tendency to outwardly oriented coping. A more secure attachment might be considered to be an important inner resource in the emotional adaptation to chronic diseases. ========================================
Title: Ein neuer Zugang zu Margaret Mahler: normaler Autismus, Symbiose, Spaltung und libidinoese Objektkonstanz aus der Perspektive der kognitiven Entwicklungstheorie./ Reapproaching Mahler: New perspectives on normal autism, symbiosis, splitting and libidinal object constancy from cognitive developmental theory. Author(s)/Editor(s): Gergely, Gyoergy Source/Citation: Psyche: Zeitschrift fuer Psychoanalyse und ihre Anwendungen; Vol 56(9-10) Sep-Oct 2002, Germany: J G Cotta sche Buchhandlung Nachfolger GmbH; 2002, 809-838 Abstract/Review/Citation: This article is a reprint of an article originally appearing in the Journal of the American Psychoanalytical Association 48(4), 2000. Reformulates insights of M. Mahler's theory on the psychological birth of the infant using conceptual tools that cognitive developmental theory provides. Mahler's stage of normal autism is reconsidered in the light of contingency detection theory as an initial phase of primary preoccupation with self-generated, perfectly response-contingent stimulation. Her concept of normal symbiosis is recast with the help of attachment theory's views on homeostatic regulation and the social biofeedback model of affect-reflective mirroring interactions with parents. Finally, her ideas about the development of splitting and libidinal object constancy are reconsidered according to recent theories of early representational development and mentalization. ========================================
Title: Neubewertung der Entwicklung der Affektregulation vor dem Hintergrund von Winnicotts Konzept des "falschen Selbst"./ Reevaluation of the development of affect regulation against the background of Winnicott's concept of the "false self." Author(s)/Editor(s): Fonagy, Peter; Target, Mary Author Affiliation: University College London, Psychoanalysis Unit, London, England Source/Citation: Psyche: Zeitschrift fuer Psychoanalyse und ihre Anwendungen; Vol 56(9-10) Sep-Oct 2002, Germany: J G Cotta sche Buchhandlung Nachfolger GmbH; 2002, 839-862 Abstract/Review/Citation: Presents central theories on the role of affect in the development of the self. Based on the theory of social biofeedback the authors conceptualize emotion with regard to the development of intentionality and mentalization. Early attachment experiences and specific mirroring processes encourage affect regulation, mentalization, the development of the self, the perception of others, and interactive compentencies. The authors provide empirical findings to prove how congruent or inconguent mirroring in early childhood contribute to the success or failures in constituting the self. A "new" perspective developed based on D. W. Winnicott's concept of the "false self" is presented. ========================================
Title: The experience and regulation of emotional states in avoidant attachment: An examination of affect and defensive operations in fearful-avoidant and dismissing-avoidant adults. Author(s)/Editor(s): Strasser, Tracey Joy Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 63(4-B) Oct 2002, US: Univ Microfilms International; 2002, 2077 Abstract/Review/Citation: Attachment theory (Bowlby, 1969, 1973, 1980) suggests affective self-regulation is influenced by attachment styles that develop out of early care-taking experiences. While much research has demonstrated group differences among three primary attachment styles-Secure, Anxious, and Avoidant -Bartholomew (1990) noted that the Avoidant group was comprised of two distinct subgroups that she termed Fearful-avoidant ('Fearful') and Dismissing-avoidant ('Dismissing'). The current investigation sought to examine how these two subgroups differ in the experience and defensive regulation of their emotional states. Dismissing individuals were expected to evidence more repression, suppression, and denial than Fearful individuals, whereas Fearful individuals were expected to show greater emotional distress and unsuccessful attempts at defense use. Repression was operationalized as poorer processing of emotional memories from childhood, as demonstrated by greater latency to retrieve memories, greater recency and decreased emotional intensity of memories recalled, 'emotional isolation' (decreased spreading from 'dominant' to 'non-dominant' emotions), and low proportions of memories associated with attachment/loss themes. A Stroop task assessed repression in current cognitive processing. Other defenses were assessed by self-report. Seventy-eight college students provided descriptions of emotional memories from childhood, engaged in an emotional analogue to the Stroop (1935) task, and completed questionnaires including the Bartholomew & Horowitz (1991) Relationship Questionnaire, Weinberger (1990) Adjustment Inventory, and the Defense Style Questionnaire (Andrews, et al., 1993). As predicted, Dismissing individuals reported less intense emotional experiences currently and in their emotional memories (suggesting greater emotional isolation), recalled fewer early childhood memories, took longer to retrieve these memories, and recalled fewer attachment/loss memories than Fearful individuals, suggesting more successful repressive strategies. The two groups showed differential use of other defenses; while total defense use was equivalent, the Fearful group reported greater somatization, autistic withdrawal, and inhibition of aggression, and the Dismissing group reporting greater denial, acting out, and suppression. These defense patterns, combined with patterns of emotional experience, suggest that the Fearful group is less effective using defense to mitigate negative affect. Limitations to the current investigation and clinical implications of the findings are discussed. ========================================
Title: Trauma recovery in female survivors: Age, affect regulation and safe attachment. Author(s)/Editor(s): Bolduc-Hicks, Lynda Lee Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 63(5-B) Dec 2002, US: Univ Microfilms International; 2002, 2573 Abstract/Review/Citation: The purpose of this retrospective study was to examine the relationship between age, Affect Regulation and Safe Attachment in adult female survivors of interpersonal trauma and identify differences between survivor groups differing in onset of trauma and recovery status. Clinicians working with trauma survivors in outpatient mental health settings completed assessments of resilience and recovery using the Multidimensional Trauma Recovery and Resiliency Scale (MTRR) designed to assess the ways in which survivors of trauma respond to their experiences. Pearson correlations were conducted using MTRR data for 125 female survivors of trauma to identify the relationship between age, Affect Regulation, and Safe Attachment with all survivors and the differences between survivors based on these areas of psychological functioning. Several hypotheses were explored in this study. First, it was hypothesized that there would be a positive relationship between age, Affect Regulation, and Safe Attachment within each of these three groups as a result of the interrelationship between affect and interpersonal relationships. Findings demonstrated that both domain scores for each group of survivors showed clear trends suggesting that Safe Attachment and Affect Regulation were positively related. Differences were postulated between the three groups of survivors on onset of trauma, recovery status and by the MTRR domains of Safe Attachment and Affect Regulation according to mean MTRR domain scores. A MANOVA was conducted to identify differences in variation in MTRR scores across recovery status and for onset of trauma. No distinctions between groups were found as a result of onset of trauma however a significant main effect was found for recovery status as it demonstrated the ability to distinguish stages of recovery based on mean scores. Significant interaction effects were revealed from mean scores on Safe Attachment concerning an expected trajectory of recovery for all survivors. Lastly, it was also hypothesized that mean scores would increase as a result of adult development or chronological age where older survivors of interpersonal violence would obtain higher MTRR mean scores independent of onset of exposure to interpersonal violence. Various findings for the Pearson Correlations and multivariate analysis of variance are discussed following clinical implications of the results. ========================================
Title: Adult attachment, developmental personality styles and interpersonal affect regulation. Author(s)/Editor(s): Sherry, Alissa Rene' Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 63(5-B) Dec 2002, US: Univ Microfilms International; 2002, 2625 Abstract/Review/Citation: This study explores the relationships between developmental personality styles and (a) adult attachment and (b) affect regulation. These variables were examined among a sample of participants (N = 273) using Bartholomew's (Griffin & Bartholomew, 1994) Relationship Scales Questionnaire (RSQ), the Millon Clinical Multiaxial Inventory-III (MCMI-III), and an Interpersonal Affect Regulation Scale based on a method developed by Mikulincer, Orbach and Iavnieli (1998). In the first part of the study, adult attachment dimensions (secure, dismissing, preoccupied and fearful) were correlated using canonical correlation analysis (CCA) with the ten personality disorder scales on the MCMI-III (Avoidant, Paranoid, Schizotypal, Schizoid, Compulsive, Borderline, Antisocial, Narcissistic, Histrionic and Dependent). Findings indicated that the adult attachment dimensions were able to predict seven of the ten personality styles. These were Avoidant, Paranoid, Schizoid, Schizotypal, Histrionic, Dependent, and Borderline. In addition, secure attachment was negatively correlated with all of these personality styles except for Histrionic. In the second part of the study, a second CCA was conducted between the MCMI-III personality disorder scales and the interpersonal affect regulation scores. Interpersonal affect regulation was assessed by first having participants generate 10 traits that describe themselves and freely recall four scenarios of previous relationships. These scenarios varied in terms of whether the relationship had a positive or negative impact on the participant and whether a positive or negative event occurred during the relationship. The participants were then instructed to generate 10 traits that described each of the people in each of these scenarios. Finally, the participants rated the extent to which they possessed each of the generated traits on a scale ranging from 1 (a little) to 4 (extremely). Results indicated that positive relationship, regardless of the valence of the event, were able to predict five of the personality styles: Avoidant, Dependent, Histrionic, Narcissitic and Obsessive Compulsive. Results suggested that adult attachment theory may be a viable model in which to conceptualize developmental personality styles, with only moderate support for the concept of interpersonal affect regulation and its relation to personality styles. The specific relationships between the attachment dimensions and the personality styles are discussed. ========================================
Title: Berceuses et chansonnettes: Considerations theoriques pour une intervention musicotherapie precoce de l'attachment par le chant parental aupres de nourrissons au developpment a risques./ Lullabies and little songs: Theoretical considerations for an early music therapy intervention with parental singing for the attachment of newborns with developmental risks. Author(s)/Editor(s): Bargiel, Marianne Source/Citation: Canadian Journal of Music Therapy; Vol 9(1) Fal 2002, Canada: Canadian Assn for Music Therapy; 2002, 30-49 Abstract/Review/Citation: Following an overview of the literature on the musical predispositions of the newborn and on the development of attachment, this article elaborates a theoretical rationale on which is proposed a model of early intervention with parental singing. The author first looks at the links between regulation of affect and attachment, also taking a look at the attachment pathologies and how they inform us about healthy attachment. Then, the functions of infant-directed speech, and also by extension, infant-directed singing, are looked at in terms of their developmental impacts over the baby's regulation of affect. The suggested music therapy program is presented as a clinical articulation of a usually natural behaviour within the parent-child dyad. Considering the importance of early intervention in order to prevent the crystallisation of dysfunction or its contamination over the whole development of the young child, this intervention model aims at recreating, preferentially with the parent's participation, the favorable relational conditions for a resumption or a continuation of the developmental sequence for the baby whose attachment is at risk because of endogenous or environmental reasons. ========================================
Title: Addiction as an attachment disorder: Implications for group therapy. Author(s)/Editor(s): Flores, Philip J. Source/Citation: International Journal of Group Psychotherapy; Vol 51(1) Jan 2001, US: Guilford Publications; 2001, 63-81. Abstract/Review/Citation: Presents a perspective on addiction that the author notes not only substantiates why group therapy is the treatment of choice for addiction, but also integrates diverse perspectives from 12-step abstinence-based models, self-psychology, and attachment theory into a complementary integrative formula. Attachment theory, self-psychology, and affect regulation theory characterize addiction as an attachment disorder induced by a person's misguided attempt at self-repair because of deficits in psychic structure. Vulnerability of the self is the consequence of developmental failures and early environmental deprivation leading to ineffective attachment styles. Substance abuse, as a reparative attempt, only exacerbates that condition because of physical dependence and further deterioration of existing physiological and psychological structures. Prolonged stress on existing structures leads to exaggerated difficulty in the regulation of affect, which leads to inadequate modulation of appropriate behavior and increased character pathology. ========================================
Title: The dyadic regulation of affect. Author(s)/Editor(s): Fosha, Diana Source/Citation: Journal of Clinical Psychology: Special Issue: Treating emotion regulation problems in psychotherapy.; Vol 57(2) Feb 2001, US: John Wiley & Sons Inc; 2001, 227-242 Abstract/Review/Citation: Accelerated experiential-dynamic psychotherapy integrates experiential, relational, and psychodynamic elements. Deep authentic affective experience and its regulation through coordinated emotional interchanges between patient and therapist are viewed as key transformational agents. When maintaining attachment with caregivers necessitates excluding particular affects, a patient's capacity to regulate emotion becomes compromised. Being in an emotionally alive therapeutic relationship enables patients to better tolerate and communicate affective states: doing so, in turn, fosters security, openness, and intimacy in their other relationships. A clinical vignette illustrates how using the therapist's affect, and focusing on the patient's experience of it, contributes to the repair of affect regulatory difficulties. ========================================
Title: Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Author(s)/Editor(s): Schore, Allan N. Paper Number: 20010314 Source/Citation: Infant Mental Health Journal: Special Issue: Contributions from the decade of the brain to infant mental health. Vol 22(1-2) Jan-Apr 2001, US: John Wiley & Sons Inc; 2001, 7-66 Abstract/Review/Citation: Integrates current interdisciplinary data from attachment studies on dyadic affective communications, neuroscience on the early developing right brain, psychophysiology on stress systems, and psychiatry on psychopathogenesis to provide a deeper understanding of the psychoneurobiological mechanisms that underlie infant mental health. This 1st part of a 2-part work (see record 2001-16734-007 for the 2nd part) details the neurobiology of a secure attachment, an exemplar of adaptive infant mental health, and focuses on the primary caregiver's psychobiological regulation of the infant's maturing limbic system, the brain areas specialized for adapting to a rapidly changing environment. The infant's early developing right hemisphere has deep connections into the limbic and autonomic nervous systems and is dominant for the human stress response, and in this manner the attachment relationship facilitates the expansion of the child's coping capacities. This model suggests that adaptive infant mental health can be fundamentally defined as the earliest expression of flexible strategies for coping with the novelty and stress that is inherent in human interactions. This efficient right brain function is a resilience factor for optimal development over the later stages of the life cycle. ========================================
Title: The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Author(s)/Editor(s): Schore, Allan N. Source/Citation: Infant Mental Health Journal: Special Issue: Contributions from the decade of the brain to infant mental health. ; Vol 22(1-2) Jan-Apr 2001, US: John Wiley & Sons Inc; 2001, 201-269 Abstract/Review/Citation: A primary interest of the field of infant mental health is in the early conditions that place infants at risk for less than optimal development. The fundamental problem of what constitutes normal and abnormal development is now a focus of developmental psychology, infant psychiatry, and developmental neuroscience. In the 2nd part of this sequential work, the author presents interdisciplinary data to more deeply forge the theoretical links between severe attachment failures, impairments of the early development of the right brain's stress coping systems, and maladaptive infant mental health. He comments on topics such as the negative impact of traumatic attachments on brain development and infant mental health, the neurobiology of infant trauma, the neuropsychology of a disorganized/disoriented attachment pattern associated with abuse and neglect, the etiology of dissociation and body-mind psychopathology, the effects of early relational trauma on enduring right hemispheric function, and some implications for models of early intervention. These findings suggest direct connections between traumatic attachment, inefficient right brain regulatory functions, and both maladaptive infant and adult mental health. ========================================
Title: Parental sensitivity, infant affect, and affect regulation: Predictors of later attachment. Author(s)/Editor(s): Braungart-Rieker, Julia M.; Garwood, Molly M.; Powers, Bruce P.; Wang, Xiaoyu Source/Citation: Child Development: Special Issue: Vol 72(1) Jan-Feb 2001, US: Blackwell Publishers Inc; 2001, 252-270. Abstract/Review/Citation: This longitudinal study on 94 families examined the extent to which parent sensitivity, infant affect, and affect regulation at 4 months predicted mother-infant and father-infant attachment classifications at 1 yr. Parent sensitivity was rated from face-to-face interaction episodes; infant affect and regulatory behaviors were rated from mother-infant and father-infant still-face episodes at 4 months. Infants' attachment to mothers and fathers was rated from the Strange Situation at 12 and 13 mo. MANOVAs indicated that 4-mo parent and infant factors were associated with infant-mother but not infant-father attachment groups. Discriminant Function Analysis further indicated that 2 functions, "Affect Regulation" and "Maternal Sensitivity," discriminated infant-mother attachment groups; As and B1-B2s showed more affect regulation toward mothers and fathers than B3-B4s and Cs at 4 mo, and mothers of both secure groups were more sensitive than mothers of Cs. Finally, the association between maternal sensitivity and infant-mother attachment was partially mediated by infant affect regulation. ========================================
Title: Bridging the gap between attachment and object relations theories: A study of the transition to motherhood. Author(s)/Editor(s): Priel, Beatriz; Besser, Avi Source/Citation: British Journal of Medical Psychology: Special Issue: Vol 74(Pt1) Mar 2001, England: British Psychological Society; 2001, 85-100 Description/Edition Info.: Journal Article; 250 Abstract/Review/Citation: An empirical study of the relations between assessments of adult attachment styles and object representations was performed in the context of first-time mothers' emotional ties to their unborn babies. It was assumed that, while conceptualizations of attachment behavior and internal working models grasp the early basic patterns of interpersonal relationships and affect regulation, object representations indicate current transformations of these patterns in an individual's internal world. Ss were a sample of 120 women (mean age 25.21 yrs) in their first pregnancy. Ss' representations of their own mothers were found to fully mediate the association between internal working models and antenatal ties to their babies. Similarities and differences between theoretical conceptualizations and empirical operationalizations of attachment and object relations theories are discussed. ========================================
Title: Sexuality and attachment: A passionate relationship or a marriage of convenience? Author(s)/Editor(s): Silverman, Doris K. Source/Citation: Psychoanalytic Quarterly; Vol 70(2) Apr 2001, US: Psychoanalytic Quarterly Inc; 2001, 325-358. Abstract/Review/Citation: The ubiquitous and persistent bodily urges of sexuality and their vicissitudes are explored in this paper, focusing on the complex relationship between libidinal desire and the attachment system, especially the latter's affect-regulating function. This interrelationship is highlighted with clinical vignettes, and implications for transference and countertransference are explored in the discussion of affect regulation and its possible sexual entwining. Clinical data is also presented to highlight the plasticity of sexuality. Sexuality's protean nature allows for a reassessment of the case of Little Hans, with emphasis on the unique interconnections between sexuality and the vital need for an attachment relationship. In conclusion, the author states that stressing such interconnections raises important questions about the traditional concept of psychosexual stages. ========================================
Title: The developmental psychopathology of anxiety. Author(s)/Editor(s): Vasey, Michael W.; Dadds, Mark R. Source/Citation: New York, NY, US: Oxford University Press; 2001, (xvi, 510) Abstract/Review/Citation: This book brings together some of the foremost experts to review and integrate the current research and theory on the major factors that shape anxiety disorders in childhood and throughout the life span. The book is divided into three parts: Part I provides a framework for conceptualizing the developmental psychopathology of anxiety and introduces foundational issues, including developmental variations in the prevalence and manifestation of anxiety. Part II covers a diverse array of factors that precede, precipitate, maintain, intensify, protect against, and ameliorate anxiety, as well as some of the processes by which they may operate. Part III offers integrative discussions of these varied factors and processes in the context of specific anxiety disorders that affect children. Researchers and clinicians alike will find this collection of chapters of interest. Notes/Comments: Print (Paper) Contributors Part I: Preliminary issues An introduction to the developmental psychopathology of anxiety Michael W. Vasey and Mark R. Dadds Developmental variations in the prevalence and manifestations of anxiety disorders Danielle D. Weiss and Cynthia G. Last Part II: Predisposing, protective, maintaining, and ameliorating influences Contributions of behavioral genetics research: Quantifying genetic, shared environmental and nonshared environmental influences Thalia C. Eley Temperamental influences on the development of anxiety disorders Christopher J. Lonigan and Beth M. Phillips Anxiety sensitivity Steven Reiss, Wendy K. Silverman, and Carl F. Weems Control and the development of negative emotion Bruce F. Chorpita The role of glucocorticoids in anxiety disorders: A critical analysis Megan R. Gunnar Childhood anxiety disorders from the perspective of emotion regulation and attachment Ross A. Thomspson Nonassociative factors in the development of phobias Ross G. Menzies and Lynne M. Harris Developmental aspects of conditioning processes in anxiety disorders Mark R. Dadds, Graham C. L. Davey, and Andy P. Field Operant conditioning influences in childhood anxiety Thomas H. Ollendick, Michael W. Vasey, and Neville J. King Information-processing factors in childhood anxiety: A review and developmental perspective Michael W. Vassey and Colin McLeod Family processes in the development of anxiety problems Mark R. Dadds and Janet H. Roth Current issues in the treatment of childhood anxiety Paula Barrett Prevention strategies Susan H. Spence Part III: Integrative examples The etiology of childhood specific phobia: A multifactorial model Peter Muris and Harald Merckelbach Posttraumatic stress disorder: A developmental perspective Eric M. Vernberg and R. Enrique Varela Social withdrawal and anxiety Kenneth H. Rubin and Kim B. Burgess Social phobia Tracy L. Morris Early separation anxiety and its relationship to adult anxiety disorders Derrick Silove and Vijaya Manicavasagar The development of generalized anxiety Ronald M. Rapee Index issues in developmental psychopathology of anxiety disorders ========================================
Title: Shame reduction, affect regulation, and sexual boundary development: Essential building blocks of sexual addiction treatment. . Author(s)/Editor(s): Adams, Kenneth M.; Robinson, Donald W. Source/Citation: Sexual Addiction & Compulsivity: Special Issue: Vol 8(1) 2001, England: Taylor & Francis Ltd; 2001, 23-44 Abstract/Review/Citation: Sexual addiction is a compulsive cycle that attempts to compensate, soothe, and regulate the internal struggle. The cycle, in turn, creates more shame and dysregulation of affect. Sexual addiction treatment presents clinicians with unique challenges. This disorder has multiple facets to its etiology and requires multiple interventions at critical points in the process. Facing and reducing shame, developing affect regulation strategies to cope with feelings, impulses, and urges, and developing and maintaining sexual boundaries are key and necessary elements to successful treatment of sexual addiction. Intervention of both the addictive behavior and its causes is more likely to assure success than treatment of one area over the other. In treating both the behavior and its cause, the ability to form successfulattachments and assimilate feelings and life experiences through a filter of hope, love, and worthiness is greatly increased. ========================================
Title: Family structure and interparental conflict: Effects on adolescent drinking. Author(s)/Editor(s): Gilbreth, Joan Gettert Source/Citation: Dissertation Abstracts International Section A: Humanities & Social Sciences; Vol 61(7-A) Feb 2001, US: Univ Microfilms International; 2001, 2936 Abstract/Review/Citation: This study investigated how parents' relationships with each other affect their relationship with their children and how these relationships affect adolescent drinking. A developmental perspective was taken to consider how the effects of family relationships differ by age of the adolescent. Social control theory and Emery's (1982) interparental conflict perspective provided the theoretical orientation. The sample came from a midwestern state and included cross-sectional responses from 715 parent/guardian and adolescent pairs. Interparental relationships were assessed by measures of family structure and interparental conflict. Social controls of family attachment, parental monitoring, and normative regulation are the measures of child-parent relationships. The dependent variable had four categories: no alcohol use ever, occasional use, one to three problems resulting from alcohol use, and four or more problems reported from alcohol use. Because adolescent drinking was measured in four categories, ordinal regression techniques were used to assess the model. Results revealed that interparental conflict does disrupt the social control processes. Conflict is related to lower levels of family attachment, parental monitoring, and normative regulation. Adolescents living in single-parent families and stepfamilies reported lower levels of family attachment, but family structure was not significantly related to the other two social control variables. Lower levels of attachment and monitoring were significant predictors of adolescent drinking when measured both with and without the parental relationship variables. The effects of family structure on adolescent drinking can be explained by levels of interparental conflict, and the effects of interparental conflict appear to work through decreased levels of attachment and monitoring. Implications of this study emphasized the need for parents to reduce levels of conflict between each other and to work at strengthening attachment bonds and monitoring. These efforts will serve to not only delay or prevent the initiation of adolescent drinking but also limit their child's movement through the stages of drinking behaviors. These results are consistent across the age range. ========================================
Title: Communicating feelings: An examination of the processes linking mothers' representations of their 7-month-old infant to early emotional development. Author(s)/Editor(s): Rosenblum, Katherine Lisa Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 61(7-B) Feb 2001, US: Univ Microfilms International; 2001, 3882 Abstract/Review/Citation: The present investigation was aimed towards elucidating the processes that linked maternal representations of their 7-month-old infant with individual differences in infant emotion regulation. Participants were 100 mother-infant dyads recruited from local pediatric clinics, and comprised a range of socio-economic and demographic circumstances. Mothers' representations of their infant were assessed via a semi-structured, attachment-based interview, and maternal behavior was observed in a variety of contexts, including a free play, teaching task, and the Still Face procedure. Infant emotion regulation was assessed along a number of behavioral and affective display dimensions upon resuming interaction with his or her parent following the Still Face procedure (i.e., the reengagement episode). Results indicated that mothers' representations were indeed related to differences in maternal behavior and infant emotion regulation. In general, mothers with balanced and positive/coherent representations were more sensitive, less rejecting, less intrusive and expressed more positive affect during interaction with their infant. Patterns of association between mothers' representations and behavior varied according to the nature of the interactive task, with a greater number of associations obtained for the more challenging, stress-inducing, tasks (i.e., the teaching task and Still Face procedure). In addition, the specific type of maternal behaviors associated with differences in mothers' representations varied according to the interactive task. Furthermore, mothers with balanced and positive/coherent representations had infants who demonstrated more positive affect and more attention seeking/contact maintenance upon resuming interaction following the still face, even when controlling for the amount of distress the infant displayed while his or her mother held a still face. Finally, results provided support for the hypothesis that some aspects of maternal behavior mediate the association between her representation of the infant and individual differences in infant emotion regulation. While maternal representation classifications were related to self-reported depressive symptomatology, in the present investigation, maternal depression was unrelated to infant behavior during the Still Face. Results are discussed emphasizing the important role that may be played by maternal representations in shaping mothers' behavioral and emotional responsivity and sensitivity to the infant, thus promoting intergenerational continuity in attachment representations and affect regulation style. ========================================
Title: Attachment status, affect regulation, and behavioral control in young adults. Author(s)/Editor(s): Allen, Sarah Turrentine Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 61(8-B) Mar 2001, US: Univ Microfilms International; 2001, 4386 Abstract/Review/Citation: The present study evaluates predictions based on the model of development of behavioral self-control proposed by Schore (1994), which suggests that children develop the abilities to regulate affect and control self-destructive behaviors in the context of primary attachment relationships. The model proposes that insecurely attached children do not fully develop the experience-dependent neuronal control pathways necessary for behavioral inhibition, which leaves them vulnerable to potentially lifelong difficulties with impulse control. To test these predictions, 198 college students were administered measures of sensory regulation, attachment status, and child abuse and trauma, as well as measures of hypothesized outcomes related to poor impulse control, including substance use, risky sexual behavior, bulimia, verbal aggressiveness, and Attention Deficit Hyperactivity Disorder (ADHD) symptoms, as well as a measure of general psychological distress. Multiple regression was used to predict each hypothesized outcome as a function of sensory regulation and attachment status. The combination of attachment status and sensory regulation was significantly predictive of cigarette, alcohol, and marijuana use, bulimic symptomatology, and ADHD symptoms, but not other drug use, risky sexual behavior, or verbal aggressiveness. Sensory regulation was a more significant contributor to prediction than was attachment status, possibly due to psychometric limitations of the measure of attachment. Additionally, attachment status and sensory regulation appear to be equally predictive of general psychopathology, rather than specific to problems of poor impulse control. The second phase of the study compared the normative sample with a clinical sample of college students (n = 21) in treatment for substance abuse disorders. The clinical substance-abusing group did not differ from the normative sample in rate of insecure attachment classification or sensory regulatory capacity. The results suggest a more general model for the role of insecure attachment and poor sensory regulation in the development of general psychological symptoms, rather than being specific to the development of impulse control problems, and a direct impact of poor regulatory capacity as well as an indirect contribution mediated by attachment status is proposed. ========================================
Title: Experimental protocols for investigating relationships among mother-infant interaction, affect regulation, physiological markers of stress responsiveness, and attachment. Author(s)/Editor(s): Nichols, Kathie; Gergely, Gyoergy; Fonagy, Peter Source/Citation: Bulletin of the Menninger Clinic: Special Issue: Cognitive and interactional foundations of attachment. Vol 65(3) Sum 2001, US: Menninger Foundation; 2001, 371-379 Abstract/Review/Citation: G. Gergely and J. S. Watson's (1996) social biofeedback theory of parental affect mirroring applies the conditional probability model of contingency perception to parent-child interactions. Infants are first evaluated at birth on neurological and temperament measures. Infants are also evaluated at 6 and 12 mo on tasks that study social interactional determinants, infant attachment, and physiological reactions. The Strange Situation is completed at 12-15 mo of age. The authors describe how the combination of these experimental and observational procedures allows specific developmental hypotheses to be investigated about the quality of contingent parental affect regulation, sensitivity to internal states, and security of attachment. ========================================
Title: Maternal distress regulation and dyadic repair: Contributions to infant socio-emotional functioning. Author(s)/Editor(s): Spitzer, Sally Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 61(9-B) Apr 2001, US: Univ Microfilms International; 2001, 5007 Abstract/Review/Citation: Although mothers' responsiveness is often thought to play an important role in relation to infant socio-emotional functioning, the exact nature of this role has remained unclear. Furthermore, few studies have empirically measured maternal responsiveness in the context of an episode of dysregulation and interactive stress. Towards these ends, the present study sought to address these issues by developing a set of maternal emotion regulation strategies and dyadic repair measures, for the purpose of examining the responses mothers use to negotiate a process of 'disruption and repair' (Tronick & Gianino, 1986) and to regulate infant affect and attention. Thirty-five primiparous mothers participated in the study. Data was drawn from videotapes of mothers and their 10-month old infants during a laboratory still-face procedure (Tronick, Als, Adamson, Wise, & Brazelton, 1978). This was an older age group than had previously been reported in the literature. Based on analyses of reunion behavior following the still face, levels of infant negative affect and maternal emotion regulation strategies were assessed, and dyads were classified according to repair outcome. Additional data was drawn four months later from videotapes of these dyads during the Strange Situation (Ainsworth & Wittig, 1969). Based on findings, infants were classified according to security of attachment. The study found that 10-month old infants, like their younger counterparts, displayed a carry-over of negative affect following the still face. Maternal responses to infant distress differentiated into attention- andaffect-regulating strategies. Attention-regulating strategies include responses like distraction; affect-regulating strategies included responses like comfort and affect-labeling. Affect-labeling responses were further characterized by negative or positive valence. Analyses showed that in response to infant state, mothers used both attention-regulating and affect-regulating strategies. However, only affectregulating strategies were related to repair. Specifically, comfort and negative affect-labeling responses were linked to continued dysregulation and distress, while, positive affect-labeling responses were associated with regulation and repair. In this regard, a re-evaluation of the construct of maternal sensitivity was provided, contextualized by developmental and situational factors. While maternal strategies did not directly predict infant attachment, a substantive trend emerged between dyadic repair and attachment security. The data suggest that maternal positivity and capacity to sensitively and effectively repair dyadic disruptions impact favorably upon development. Implications of these findings in terms of clinical interventions were examined. ========================================
Title: Affect regulation and attachment strategies of adjudicated and non-adjudicated adolescents and their parents. Author(s)/Editor(s): Keiley, Margaret K.; Seery, Brenda L. Source/Citation: Contemporary Family Therapy: An International Journal; Vol 23(3) Sep 2001, US: Kluwer Academic/Plenum Publishers; 2001, 343-366 Abstract/Review/Citation: This exploratory qualitative study used semi-structured interviews with adjudicated and non-adjudicated adolescents (aged 12-18 yrs) and their parents (aged 37-57 yrs) to identify: (1) different behavioral manifestations of affect regulation and attachment interactions as described by respondents; and (2) interactional patterns that we might wish to target in a therapeutic intervention. Parents used more functional internal affect regulation strategies, while adolescents relied on less functional ones. Most respondents used functional external affect regulation strategies, such as direct communication. Approximately half of them used more dysfunctional strategies, such as yelling and aggression. Most of the adolescents used at least one secure attachment strategy in their relationships with their parents, but the majority also used avoidant or ambivalent strategies. Almost half of the parents described secure strategies in their relationships with their adolescents, while the remainder indicated using insecure. ========================================
Title: The use of the term Multiple Complex Developmental Disorder in a diagnostic clinic serving young children with developmental disabilities: A report of 15 cases. Author(s)/Editor(s): Demb, Howard B.; Noskin, Olga Author Affiliation: Albert Einstein Coll of Medicine, Bronx, NY, US. Source/Citation: Mental Health Aspects of Developmental Disabilities; Vol 4(2) Apr-Jun 2001, US: Psych Media; 2001, 4960 Abstract/Review/Citation: Multiplex Complex (Multiplex) Developmental Disorder (MCDD) is a proposed developmental disorder (or syndrome) designed to encompass preschool and early school age children who have consistent and enduring deficits in affect regulation, relatedness, and thought. Such children are thought to represent another variant in the spectrum of pervasive developmental disorders (PDDs). This paper presents clinical data on 15 preschool children with developmental disorders diagnosed as having a MCDD. The developmental disorders were a language disorder and/or mental retardation. Each of the children was diagnosed using criteria reported on by K. E. Towbin et al in 1993. The most common symptoms of a MCDD in this population were: disturbed attachments (82%); idiosyncratic anxiety reactions (64%); episodes of behavioral disorganization (64%); and, wide emotional variability (54%). Although the proposed syndrome of a MCDD appears to be a useful concept in diagnosing preschool children with developmental disabilities and comorbid emotional/behavioral disorders, there appears to be at least two distinct clusters of behaviors seen in such children. One cluster approximates a borderline syndrome, while the other is more clearly in the PDD spectrum. ========================================
Title: Continued attachment to parents: Its relationship to affect regulation and perceived stress among college students. Author(s)/Editor(s): McCarthy, Christopher J.; Moller, Naomi P.; Fouladi, Rachel T. Author Affiliation: U Texas, Austin, TX, US U Texas, M. D. Anderson Cancer Ctr, Dept of Behavioral Science, Houston, TX, US Source/Citation: Measurement & Evaluation in Counseling & Development; Vol 33(4) Jan 2001, US: American Counseling Assn; 2001, 198-213 Abstract/Review/Citation: The authors factor analyzed 4 self-report parental attachment (PA) inventories (the PBI, IPPA, PAQ, and CAS) designed for use with young adults to examine the construct validity of scores from these instruments and the overall factor structure of the attachment scales. The aim was to replicate the G. E. Heiss et al (1996) findings with a more specific focus on PA as opposed to general attachment style. The authors also evaluated whether factors derived from the 4 attachment measures were related to measures of emotional functioning, specifically, measures of confidence in coping with negative mood, awareness of one's own mood regulation strategies, and levels of perceived stress. Data were collected from 200 undergraduates (mean age 21.6 yrs; 60% female). The exploration of the relationships among the attachment measures showed several dimensions of attachment in young adults, including maternal attachment, paternal attachment, and parental overprotection. Preoccupation with one's parents was also assessed by 1 of the attachment measures and was reflected as a distinct dimension of attachment. The findings that these dimensions of PA were related to emotional functioning and levels of perceived stress provide evidence of the role of attachment in the well-being of young adults. ========================================
Title: Substance abuse and childhood maltreatment: Conceptualizing the recovery process. Author(s)/Editor(s): Millar, Golden M.; Stermac, Lana Source/Citation: Journal of Substance Abuse Treatment; Vol 19(2) Sep 2000, US: Elsevier Science Inc.; 2000, 175-182 Abstract/Review/Citation: Research exploring the dual, yet related, issues of adulthood substance abuse and childhood maltreatment remains limited to the effects of such experiences on the individual. To date, clinical literature has failed to explore the ways in which individuals, particularly women, cope with and recover from these experiences. The current study applied a qualitative methodology to a sample of six women. Respondents had completed a minimum of 3 years of chemical-free living and self-identified as survivors of prolonged childhood sexual abuse. Women participated in a semi-structured interview to detail their recovery process. Results show support for a multifactorial process of recovery; specifically, strategies aimed at affect regulation, development of a new self-concept, and the forging of more adaptive attachment styles. The implications of these results are discussed in the context of improving clinical intervention strategies and encouraging additional research endeavors to understand this complex process. ========================================
Title: Affect regulation and the development of psychopathology. Author(s)/Editor(s): Bradley, Susan J. Source/Citation: New York, NY, US: The Guilford Press; 2000, (xii, 324) Abstract/Review/Citation: The volume presents current findings on such risk factors as loss, trauma, and abuse; temperamental or stress reactivity; brain insult; attachment difficulties; and sensitivity to expressed emotion or familial conflict. Showing that these traits and experiences have all been linked to psychological problems, the author demonstrates that they also share a tendency to disrupt the regulation of affect. She details the development of affect regulation, with special attention to the influence of learning and experience on the physiology, chemistry, and structure of the brain. The book shows how disruptions in this aspect of development make some individuals more likely than others to experience heightened states of distress or emotional arousal. Chapters then address links to behavioral disorders, affective spectrum disorders, and the psychoses. The book will be a resource for practitioners, students, and researchers in clinical psychology, psychiatry, and related mental health disciplines; and as a text in graduate-level courses. Notes/Comments: Part I: Overview The model and its rationale Part II: The evidence An introduction to affect regulation and its development Constitutional and genetic factors The caregiving environment Stress, trauma, and abuse Coping: Learning and experience The neurobiology of affect regulation Therapeutic considerations Part III: Clinical syndromes Internalizing disorders: Anxiety, mood, and relational disorders Externalizing disorders: The disruptive behavior disorders Psychotic disorders Part IV: Final remarks Future directions References Index risk factors for psychological disturbance & affect development dysregulation, development of psychopathology ========================================
Title: Religiosity, adult attachment, and why "singles" are more religious. Author(s)/Editor(s): Granqvist, Pehr; Hagekull, Berit Source/Citation: International Journal for the Psychology of Religion; Vol 10(2) 2000, US: Lawrence Erlbaum Assoc; 2000, 111-123 Abstract/Review/Citation: Investigated the links of adult attachment style and relationship status to various indexes of religiosity. Ss were 156 university students (aged 18-51 yrs). Results showed a modest positive association between adult attachment security and those religiosity variables that tapped features of the individual's relationship with God. In support of a compensation hypothesis, singles, as compared to lovers, were found to be more religiously active, perceive a personal relationship with God, have experienced changes implying increased importance of religious beliefs, and have experienced a religiosity that is based on affect regulation to a larger extent. ========================================
Title: Rorschach interaction patterns, alexithymia, and closeness to parents in psychotic and psychosomatic patients. Author(s)/Editor(s): Solano, Luigi; Toriello, A.; Barnaba, L.; Ara, R.; Taylor, G. J. Source/Citation: Journal of the American Academy of Psychoanalysis; Vol 28(1) Spr 2000, US: Guilford Publications; 2000, 101-116 Abstract/Review/Citation: Explores the similarities and differences between 20 mentally ill patients (mean age 32.25 yrs) and 20 psychosomatically ill patients (32.40 yrs) on measures of alexithymia, perceived closeness to parents, and mental representations of interrelationships. The authors expected to find high but similar degrees of alexithymia in both groups, and low closeness to parents in both groups with possible differences with respect to relationships with mother and father. Additionally, they expected to find a prevalence of an avoidant relational style among psychosomatic Ss, and a prevalence of an ambivalent relational style among psychotic Ss. All Ss were given the Twenty-Item Toronto Alexithymia Scale, the Family Attitude Questionnaire, and the Rorschach Interaction Scale. Both the psychotic and psychosomatic Ss showed a lack of general closeness to parents and a high degree of alexithymia. In addition, the two groups showed a predominance of maladaptive Rorschach interaction patterns suggestive of internal working models associated with insecure attachment styles, poor affect regulation, and a defective "inner container". However, while the majority of the psychosomatic Ss showed an Avoidant interaction pattern, the majority of psychotic Ss were Ambivalent (55%) and Flexible (25%). ========================================
Title: Mental representations in stressful situations: The calming effect of significant others. Author(s)/Editor(s): Mcgowan, Stephanie Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(8-B) Mar 2000, US: Univ Microfilms International; 2000, 4305 Abstract/Review/Citation: The relationship between mental representations of others and attachment style was investigated in order to explain affect regulation and self-esteem maintenance in stressful situations. Participants were asked to think about and describe either a significant other or acquaintance while waiting to take part in a potentially stressful event. In terms of anxiety, mood, and state self-esteem, no overall differences were found between individuals who thought of an acquaintance and individuals who thought of an important person in their life; however, an interaction between attachment style and other-condition was found. In the significant other condition, secure individuals had significantly lower levels of anxiety and negative affect than insecure individuals, but in the acquaintance condition, insecure individuals had slightly lower levels of anxiety and negative affect than secure individuals. Additional analyses suggested that, in particular, the self-model aspect of adult attachment seems to explain these differences. ========================================
Title: Attachment disorders in children: An integrated treatment approach. Author(s)/Editor(s): Kelly, Victoria Jackson Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(8-B) Mar 2000, US: Univ Microfilms International; 2000, 4228 Abstract/Review/Citation: This dissertation focuses on the severe manifestations of the disorganized/disoriented attachment pattern that constitute attachment disorders in children. Attachment disorders derive from early experiences of severe maltreatment, compounded by often multiple losses of attachment relationships. Attachment disorders are evidenced by serious disturbances in both behavior and relationships. These disturbances appear intractable as the child replicates his or her dysfunctional patterns in all subsequent relationships. This dissertation utilizes the concept of internal working models to explain how these patterns evolve and are maintained. Attachment disorders are viewed from the perspective of cumulative trauma with significant insult to the developing systems of affect, cognitive and neurophysiological regulation. As the trauma precludes the effective regulation of these systems, subsequent impingement is seen on the child's developing self-system and interpersonal functioning. This dissertation seeks to explain the interrelated and mutually iterative process in the development and regulation of these systems. This perspective then enables a broader understanding of the cumulative effects of unresolved attachment-related trauma. Recommendations for an integrated treatment approach are provided. ========================================
Title: Attachment style, representations of self and others, and affect regulation: Implications for the experience of depression. Author(s)/Editor(s): Levy, Kenneth Neil Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(9-B) Apr 2000, US: Univ Microfilms International; 2000, 4895 Abstract/Review/Citation: The capacity for affect regulation is essential for healthy adaptation, and impairments in the ability to regulate affect increases an individual's vulnerability to a variety of psychological difficulties. An increasing number of studies have documented that both impaired mental representations and insecure attachment are related to increased risk for problems in affect regulation such as depression. However, there is a dearth of empirical data linking mental representations and insecure attachment to affect regulation and depression. The present study examined the hypothesis that differences in adult attachment styles are associated with differences in the content and structure of mental representations and with qualitatively different ways of modulating affects. One hundred twenty-eight undergraduates were classified into one of four attachment groups using the Relationship Questionnaire (Bartholomew & Horowitz, 1993). Mental representations were assessed using procedures developed by Blatt, Diamond, and their colleagues (Blatt et al., 1992; Diamond et al., 1995). Affect regulation was assessed using the Affect Regulation Scale (Levy, 1994), the Affect Regulation Questionnaire (Schaffer, 1992), and the Depressive Experiences Questionnaire (Blatt et al., 1979). Correlational, multivariate analyses of variance, and regression analyses revealed significant relationships among attachment patterns, mental representations, affect regulation, and depression. Secure and fearful individuals evidenced significantly more complex, differentiated, and integrated representations of self and others. While there were no differences in the self-report of adaptive affect regulation strategies, preoccupied and dismissive subjects reported using significantly more maladaptive affect regulation strategies. Preoccupied individuals tended toward oral-somatic and self-injurious behaviors to regulate affect, whereas dismissing individuals were more likely to employ sex, drugs, and violent fantasy and behaviors to regulate negative internal states. In contrast, secure and fearful individuals' narrative descriptions of feeling states evidenced higher developmental levels of affective organization than preoccupied and dismissing subjects. Finally, secure attachment was negatively related to depression, fearful attachment was related to an interpersonally-based depression, while anxious-ambivalent attachment was related to a more anaclitic needy depression. Findings are consistent with previous research and further contribute to our understanding by elaborating the relationship between adult attachment style, mental representations, and affect regulation. The developmental and clinical implications of these findings are discussed. ========================================
Title: Parental bonding, adult attachment, and differences in affect regulation. Author(s)/Editor(s): Schreiber, Roxanne Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(9-B) Apr 2000, US: Univ Microfilms International; 2000, 4968 Abstract/Review/Citation: In this study differences in affects organized along four dimensions of contrast (positive affect, negative affect, affect directed toward self-enhancement, and affect directed toward contact and union with others) were examined among a sample of participants (N = 100) as a function of either dominant parental bonding category (optimal, affectionate constraint, affectionless control, and absent/weak) or dominant attachment style (secure, preoccupied, dismissing, and fearful). Findings from this study were similar to those from previous research on emotion and attachment. Participants in the optimal bonding group and the secure attachment group reported the most positive affective experiences across all four dimensions of contrast, while participants in the affectionless control bonding group and the fearful attachment group reported the least positive experiences across all four dimensions of contrast. Participants in the dismissing attachment group reported significantly high levels of affect directed toward self-enhancement, and significantly low levels of affect directed toward contact and union with others, while participants in the preoccupied attachment group reported significantly high levels of affect directed toward contact and union with others. It is important to note that affective experiences also differed by caregiver gender (i.e., absent/weak paternal bonding was associated with significantly low levels of positive affect while absent/weak maternal bonding was associated with significantly high levels of affect directed toward self-enhancement). Unexpectedly, participants in the preoccupied attachment group did not report significantly high levels of negative affect and also did not differ from participants in the secure and dismissing attachment groups in affect directed toward self-enhancement. Possible reasons for these discrepancies are explored in the context of differing cognitive and affective working models, as well as differing manifestations of this style's parental care scores (high maternal care versus low paternal care) across gendered contexts. Differences were also noted in levels of paternal and maternal bonding across attachment styles. More specifically, (a) participants in the fearful attachment group reported significantly high levels of parental (maternal and paternal) overprotection, (b) participants in the dismissing attachment group reported significantly low levels of maternal overprotection, and (c) participants in the preoccupied attachment group reported significantly high levels of maternal care and significantly low levels of paternal care. The potential role these parental dimensions may play in the development of self and other working models is discussed. ========================================
Title: Reapproaching Mahler: New perspectives on normal autism, symbiosis, splitting and libidinal object constancy from cognitive developmental theory. Author(s)/Editor(s): Gergely, Gyoergy Source/Citation: Journal of the American Psychoanalytic Association; Vol 48(4) 2000, US: The AnaIytic Press Inc; 2000, 1197-1228 Abstract/Review/Citation: Reformulates insights of M. Mahler's theory on the psychological birth of the infant using conceptual tools that cognitive developmental theory provides. Mahler's stage of normal autism is reconsidered in the light of contingency detection theory as an initial phase of primary preoccupation with self-generated perfectly response-contingent stimulation. Her concept of normal symbiosis is recast with the help of attachment theory's views on homeostatic regulation and the social biofeedback model of affect-reflective mirroring interactions with parents. Finally, her ideas about the development of splitting and libidinal object constancy are reconsidered according to recent theories of early representational development and mentalization. ========================================
Title: Adult attachment style and cognitive reactions to positive affect: A test of mental categorization and creative problem solving. Author(s)/Editor(s): Mikulincer, Mario; Sheffi, Elka Source/Citation: Motivation & Emotion; Vol 24(3) Sep 2000, US: Kluwer Academic/Plenum Publishers; 2000, 149-174 Abstract/Review/Citation: Examined the moderating effect of attachment style on cognitive reactions to positive affect inductions in 3 studies. Ss were university students (aged 19-32 yrs) in Israel. Attachment styles assessed included secure, anxious-ambivalent, and avoidant. In Study 1, 110 Ss completed attachment style scales, were asked to retrieve a happy or a neutral memory, and performed a categorization task. Study 2 used the same affect induction while examining creative problem solving in 120 Ss using Remote Associates Test. Study 3 replicated Study 2 while using another affect induction (watching a comedy film) and controlling for trait anxiety scores in 120 Ss. The results suggest that securely attached persons react to positive affect with broader categorization and better performance in creative problem-solving tasks. Anxious-ambivalent persons show an opposite pattern of cognitive reactions to positive affect. Further, avoidant persons show no difference in their cognitive reactions to positive and neutral affect inductions. These findings emphasize the role that attachment-related strategies of affect regulation may play in episodes of positive affect. ========================================
Title: Predictors of coping styles in response to infidelity among college students. Author(s)/Editor(s): Vocaturo, Loran Catherine Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(11-B) Jun 2000, US: Univ Microfilms International; 2000, 5796 Abstract/Review/Citation: This study considers the role of relationship factors in determining individual coping styles in response to a partner's infidelity. This research is designed to be consistent with attachment theory in determining affect regulation and appraisals of threat within romantic relationships. Additionally, this study examined the relationship between attachment styles as defined by Bartholomew and Horowitz's (1991) four-category model of attachment with other relationship variables, namely, the caregiving system and commitment levels. Finally, this research explored gender differences in defining infidelity. Subjects were 227 students (108 undergraduate, 19 graduate) enrolled in research subject pools and introductory psychology courses. Subject's attachment style was determined via The Adult Attachment Scale (Bartholomew & Horowitz, 1991). Caregiving styles were determined by Kunce and Shaver's (1994) Caregiving Questionnaire. Commitment levels were measured with the Commitment Inventory developed by Adams and Jones (1997). Subjects were presented with a scenario depicting the discovery of their partner's sexual or emotional infidelity. Subjects were then asked to rate how much the scenario reflected infidelity and the level of distress they would feel in response to this event, and they then responded to the Ways of Coping Scale developed by Folkman and Lazarus (1988). The analysis revealed that individuals with secure attachment reported higher levels of secure caregiving and commitment to their partners. Additionally, securely attached persons tended to report more problem-focused coping while individual's with insecure attachment styles reported more emotion-focused coping strategies. The results imply, therefore, that attachment styles are related to how relationship stressors are appraised and responded to. Caregiving and commitment levels were not found to have a significant impact on the coping process. The analysis also revealed that men and women define infidelity differently, with men defining infidelity by sexual behaviors while women include emotional factors. Although men and women may define infidelity differently, the results indicate that infidelity, regardless of the type, produces a moderate degree of distress among men and women. Finally, the results suggest that attachment style is related more to coping styles in response to emotional infidelity than sexual infidelity. ========================================
Title: Attachment, stress, and coping in college students. Author(s)/Editor(s): Kemp, Martha Allison Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(12-B) 2000, US: Univ Microfilms International; 2000, 6368 Abstract/Review/Citation: This study explored the relationship between adult attachment style and responses to self-reported stress events in college students. The study was designed to test hypotheses about the buffering effects of secure attachment and specific affect regulation strategies used by people with the preoccupied, fearful, and dismissing attachment styles. Introductory psychology students (N = 1157) were prescreened using the Bartholomew and Horowitz four-category self-report measure of adult attachment. Scores on this measure were used to select 193 participants (101 women, and 92 men) in the four attachment categories. Participants wrote a narrative account of a recent stressful experience and completed the Impact of Event Scale (IES) and the Ways of Coping (Revised) (WOC) in relation to the stress event. Participants also described current levels of psychiatric symptoms on the Brief Symptom Inventory (BSI). Results generally supported hypotheses about the buffering effects of secure attachment with respect to significantly lower levels of distress on the IES intrusion scale and the BSI Global Severity Index (GSI) but not in relation to increased social support seeking on the WOC. As hypothesized, the preoccupied attachment group reported increased distress, as evidenced by significantly higher mean scores on the EES intrusion scale and the GSI of the BSI as well as elevated levels of escape avoidance responses on the WOC. As predicted, the fearful attachment group had elevated scores on the Depression scale of the BSI (significantly higher than the secure and dismissing groups, although not different from the preoccupied group). Results failed to support predictions that the dismissing group would have elevated scores on scales of avoidance (EES), distancing (WOC), or Hostility and Somatization (BSI). The relation between attachment style and measures of distress and coping was the same within each gender, but for 9 of the 20 measures, there was a significant gender effect, with women scoring higher than men in each case. Recommendations for future research included the use of alternatives to self-report to increase internal validity, particularly with regard to testing hypotheses about the dismissing attachment group. Results are discussed as supporting the utility of attachment theory in conceptualizing mental health issues, and planning interventions. ========================================
Title: Promoting the emotional development of preschoolers. Author(s)/Editor(s): Ashiabi, Godwin S. Source/Citation: Early Childhood Education Journal; Vol 28(2) Win 2000, US: Kluwer Academic/Plenum Publishers; 2000, 79-84. Abstract/Review/Citation: Examines evidence pertaining to the emotional development of preschoolers. The issues discussed include a synopsis of emotional expression, emotional understanding, the regulation of emotions, and their developmental significance. Furthermore, the role of the caregiver-child relationship as indicated by the security of attachment is provided. It is argued that caregivers influence the emotional development of children as they model, coach, and contingently respond to children. The implications of emotional development and the quality of the caregiver-child relationship for teachers as they pertain to affective displays, negotiation skills, affect regulation, and expectancies of children are discussed. Finally, some strategies for enhancing emotional development are suggested. ========================================
Title: Manifestations of damaged development of the human affectional systems and developmentally based psychotherapies. Author(s)/Editor(s): Schwartz, Mark F.; Southern, Stephen Source/Citation: Sexual Addiction & Compulsivity; Vol 6(3) 1999, US: Brunner/Mazel; 1999, 163-175 Abstract/Review/Citation: Sexual compulsion is the end point of a series of developmental events that begin in early attachment difficulties with caretakers, subsequent overwhelming experiences the child is unable to assimilate, affect dysregulation, and impaired self-development and gender-related behavior, all which is then activated. This article reviews the developmental psychopathology of sexual compulsive behavior, with suggestions for psychotherapeutic amelioration. The development of human affectional systems and affective regulation are discussed. ========================================
Title: Affect, imagery, and attachment: Working models of interpersonal affect and the socialization of emotion. Author(s)/Editor(s): Magai, Carol Source/Citation: Handbook of attachment: Theory, research, and clinical applications., New York, NY, US: The Guilford Press; 1999, (xvii, 925), 787-802 Source editor(s): Cassidy, Jude (Ed) Abstract/Review/Citation: The author considers attachment research in conjunction with contemporary theories and research on human emotion. Topics include: comparison of attachment and affect theory constructs; modern developmental and personality psychology: the emotion-attachment interface (affect regulation, internal working models and interpretative biases). ========================================
Title: Adult attachment, emotional control, and marital satisfaction. Author(s)/Editor(s): Feeney, Judith A. Source/Citation: Personal Relationships; Vol 6(2) Jun 1999, US: Cambridge University Press; 1999, 169-185 Abstract/Review/Citation: This study extends previous research into the relations among attachment style, emotional experience, and emotional control. Questionnaire measures of these variables were completed by a broad sample of 238 married couples. Continuous measures of attachment showed that insecure attachment (low Comfort with closeness; high Anxiety over relationships) was related to greater control of emotion, regardless of whether the emotion was partner-related or not. Insecure attachment was also associated with less frequent and intense positive emotion and with more frequent and intense negative emotion, although these links depended on context (partner-related or not), attachment dimension, and gender. Emotional control added to the prediction of marital satisfaction, after controlling for attachment dimensions; the most robust links with satisfaction were inverse relations with own control of positive emotion and with partner's control of negative emotion. The results are discussed in terms of attachment theory, affect regulation, and communication in marriage. ========================================
Title: Attachment and marital functioning: Comparison of spouses with continuous-secure, earned-secure, dismissing, and preoccupied attachment stances. Author(s)/Editor(s): Paley, Blair; Cox, Martha J.; Burchinal, Margaret R.; Payne, C. Chris Source/Citation: Journal of Family Psychology; Vol 13(4) Dec 1999, US: American Psychological Assn; 1999, 580-597 Abstract/Review/Citation: In a sample of 138 couples, the present study examined whether individuals' marital functioning related to both their own and their partner's attachment stance. Earned-secure wives managed their affect as well as continuous-secure wives during problem-solving discussions and better than preoccupied or dismissing wives. However, preoccupied and dismissing wives did not exhibit markedly different patterns of affect regulation in their marriages. Regarding individuals' marital functioning and partners' attachment stance, neither husbands' behavior nor perceptions related to their wives' attachment stance. However, wives of continuous-secure husbands exhibited more positive marital behavior than wives of dismissing and earned-secure husbands. Findings are discussed in terms of how attachment working models may account for both continuities and discontinuities between earlier caregiving experiences and functioning in adult relationships. ========================================
Title: Conflict management with friends and romantic partners: The role of attachment and negative mood regulation expectancies. Author(s)/Editor(s): Creasey, Gary; Kershaw, Kathy; Boston, Ada Source/Citation: Journal of Youth & Adolescence; Vol 28(5) Oct 1999, US: Kluwer Academic Publishers; 1999, 523-543 Abstract/Review/Citation: The degree to which attachment orientations are related to negative mood regulation expectancies and conflict management strategies with best friends and romantic partners was examined for a sample of 140 late adolescent, female college students. Participants were administered a questionnaire packet, including the Relationship Styles Questionnaire, the negative mood regulation scale, and the Managing Affect and Differences Scale. Correlational and multiple regression analyses yielded results that were generally consistent with theoretical expectations. Adolescents with more insecure attachment orientations were likely to report having difficulties managing conflict with attachment figures and had less confidence regulating negative mood than individuals who endorsed more secure orientations. In addition, more avoidant and ambivalent attachment orientations often predicted specific conflict management difficulties, and confidence in negative mood partially mediated these associations. The results are discussed in relation to previous research on attachment theory, and implications for interventions are offered. ========================================
Title: Depressive styles in adolescence: Investigating psychosocial adjustment and daily mood regulation. Author(s)/Editor(s): Fichman, Laura Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(8-B) Feb 1999, US: Univ. Microfilms International; 1999, 4522 Abstract/Review/Citation: The increasing incidence of adolescent depression calls for the study of individual difference factors that may impinge on psychosocial adjustment. Researchers have identified depressive personality styles, namely dependency and self-criticism, that represent distinct vulnerability orientations. A series of four studies was conducted to (1) examine the relation of the depressive styles to adolescent dysphoria and interpersonal functioning; (2) assess the Personality-Event Congruence Model of Depressive Vulnerability in youngsters; and (3) explore how dependency and self-criticism relate to the regulation of negative affect using an experience sampling methodology. Findings provide evidence for heightened vulnerability of adolescent self-criticism in terms of increased dysphoria and interpersonal problems, demonstrate the vulnerability of dependency during attachment-related transitions, and reveal the relation of depressive styles to distinctive patterns of poor mood management. Together, these studies highlight the need to help youngsters adopt strategies that may be effective in forestalling dysphoria, enabling healthy adaptation to developmental challenges. ========================================
Title: The effects of parental bonding, adult attachment, and levels of psychological distress on the ability to discriminate facial expressions of emotion. Author(s)/Editor(s): Purvis, Donna Marie Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(8-B) Feb 1999, US: Univ. Microfilms International; 1999, 4541 Abstract/Review/Citation: Previous research in the area of attachment and affect regulation has provided support for the notion that attachment is related to the ability to regulate affect and the ability to regulate affect is related to the ability to accurately perceive facial expressions of emotion. The present study investigated the direct and indirect role that attachment plays in discrimination of facial expressions of emotion. There was no support found for the hypothesis that participants with secure attachment styles were better at discriminating facial expressions of emotion. There was also no support found for the hypothesis that individuals with high levels of psychological distress (poor regulators of affect) would perform worse on a facial discrimination task. Finally, there was no support found for the hypothesis that attachment and current levels of psychological distress exhibit interactive effects on the ability to discriminate facial expressions of emotion. Pertinent methodological and statistical issues, however, cast doubt on the reliability of these findings. ========================================
Title: Revisiting the alcoholic personality: Object relations, affect regulation, and defense styles in alcoholic sibling pairs. Author(s)/Editor(s): Vieten, Cassandra Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(11-B) Jun 1999, US: Univ. Microfilms International; 1999, 6108 Abstract/Review/Citation: Psychodynamic theories suggest that impaired object relations, poor affect regulation, and immature defense styles might contribute to the development of alcoholism and other addictions. Adoption and twin studies show that there is a heritable component to alcoholism as well. By studying families with alcoholic members, this study looked at how object relations, affect regulation, and defense styles might be related to alcoholism and influenced by genetics or family environment. Sibling pairs concordant and discordant for alcoholism responded to the Bell Object Relations and Reality Testing Inventory, the 40-item version of the Defense Styles Questionnaire, and the Affect Regulation Scale. Difference scores were constructed by subtracting the scores of one member of a pair from the other member. Using these difference scores, sibling pairs concordant for alcoholism with sibling pairs discordant for alcoholism were compared. If these variables were related to alcoholism, the discordant sibling pairs should have had higher difference scores than the concordant sibling pairs. The only significant difference observed between pairs was on the individual defense style of Displacement. However, when alcoholics were compared with non-alcoholics across the whole sample, alcoholics had significantly higher scores on the Reality Distortion scale of the Bell Inventory and were more likely to exceed the clinical cutoff score (>60) on the Alienation and Insecure Attachment scales. It may be that these variables are not associated with alcoholism to the degree that was theorized. However, the difference observed in the full sample suggests that there may be a relationship. False sibling pairs were constructed by matching unrelated individuals and maintaining the proportion of pairs concordant and discordant for gender and alcoholism diagnosis. These false sibling pairs were compared to the real sibling pairs, and there were no differences between pairs. The real sibling pairs were no more similar than the false sibling pairs, suggesting that these variables may be more influenced by nonshared environment than by shared environment. Intercorrelations between measures were high, suggesting that these measures tap into a similar dimension of personality, or capture different aspects of personality that are highly correlated with one another. ========================================
Title: Paternal contributions to the etiology of Gender Identity Disorder: A study of attachment, affect regulation, and gender conflict. Author(s)/Editor(s): Cook, Cassandra Graham Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(1-B) Jul 1999, US: Univ. Microfilms International; 1999, 0361 Abstract/Review/Citation: The goal of this study was to formulate hypotheses concerning the contribution of paternal dynamics to the etiology of Childhood Gender Identity Disorder (GID) in boys. Six fathers of sons diagnosed with GID were interviewed using the Adult Attachment Interview (AAI), the Early Memories Test, and the Fatherhood Interview, a semi-structured interview designed for this project to assess the fathers' experience of their sons' cross-gender symptoms. AAI transcripts were scored using both Main & Goldwyn's (1998) scoring system and Fonagy et al's (1998) Reflective Functioning Manual. According to Main's system, every father in this sample evidenced clinically significant levels of Unresolved Trauma, and no subject was classified as Secure. The dramatic over-representation of Insecure and Unresolved Trauma classifications in this sample was understood as suggesting that these fathers' are very likely to have formed insecure attachment relationships with their sons, as well as to have manifested, when stressed, the kinds of frightened and frightening behaviors that may lead a sensitive and highly reactive child to feel anxious and unsafe in establishing a masculine identification. The low levels of reflective functioning obtained on this sample were seen as suggestive of these fathers' difficulties in forming accurate and detailed inner representations of their children. Significantly, however, this sample also provided clear clinical evidence that overall reflective functioning scores may not capture certain key capacities which interact to determine the quality of parents' internal representations of their children. It was proposed that the capacity to take responsibility for one's own role in relationships is critical to the constructive use of reflective capacities, and also that the absence of well-developed reflective capacities in the specific domain of the relationship with the child may render the more general capacity for reflective functioning relatively useless in the process of preventing the intergenerational transmission of trauma. Finally, traumatic attachment-related experiences in these fathers' histories were found to be intimately related to past and present experiences of gender. The identification of two distinct attitudes toward the child's cross-gender symptoms led to the formation of hypotheses concerning two distinct dynamic pathways for paternal reinforcement of cross-gender symptomatology. ========================================
Title: Adult attachment and affect regulation: A test of a stylistic model. Author(s)/Editor(s): Fuendeling, James Mervyn Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(3-B) Sep 1999, US: Univ. Microfilms International; 1999, 1341 Abstract/Review/Citation: This project pursues the idea that consistent differences in the emotional experiences of individuals with different attachment styles are accompanied by systematic differences in the ways they regulate their affect. A broad range of findings, when reorganized according to a process level explanation of affect regulation, supports this idea. In order to further explore this model of affect regulation styles, a study was conducted in which 135 undergraduate participants responded to standard self report measures of attachment styles. Affect regulation was assessed using both a free response method developed for the study, and a revised version of the Ways of Coping Checklist (Folkman & Lazarus, 1980; Vitaliano, Russo, Carr, Maiuro & Becker, 1985). Results were mixed in terms of their support for specific hypotheses, but clearly support the larger idea that attachment styles include distinct styles of affect regulation. Differences were found in attributions and appraisal, where secures tended to see a situation as less threatening than did fearful avoidants, and blamed themselves for situations less than avoidants in general. Differences were also found in expression of both positive and negative emotions. Secures were more likely to be expressive of positive emotions, and avoidants were more likely to be expressive of negative emotions. These findings for expression were complex, and included interactions of attachment style with situation. Effects were also observed for rumination, introduction of new goals, and scales of Ways of Coping. Implications of results on the validity of the self report measure are discussed, as well as theoretical implications of the findings. ========================================
Title: Cognitive development, temperament, attachment, and maternal sensitivity as factors in emotion regulation. Author(s)/Editor(s): Powers v Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(5-B) Dec 1999, US: Univ Microfilms International; 1999, 2390 Abstract/Review/Citation: Cognitive development, temperament, attachment, and maternal sensitivity often are cited as factors influencing a child's ability to regulate his or her emotional reactivity. In order to assess the impact of these factors, four measures of emotion regulation were employed: frequency of behaviors, effectiveness of behaviors, change in frequency of behaviors over baseline, and regulation style, a categorical variable based on the combination of regulatory behaviors exhibited. Twelve-month-old infants and their mothers (N = 83) were observed during structured interactions and the Strange Situation. Results indicated that infants in varying attachment categories displayed consistent differences in terms of emotion regulation behavior use, and the regulation style measure was significantly related to attachment classification. Cognitive development, temperament, and maternal sensitivity were found to influence the effectiveness with which infants reduced negative affect through multiple interactions. It appears that attachment security may play a role in determining the behaviors infants select for emotion regulation purposes and the frequency with which they employ those behaviors. However, cognitive development, temperament, and maternal sensitivity seem to help determine the effectiveness of the behaviors in reducing negative reactivity, although their effects are rarely direct. Implications for methodology and future study are discussed. ========================================
Title: Emotion regulation and its relation to internal working models of attachment in adults. (adult attachment, facial display, maternal response). Author(s)/Editor(s): Halpern, Beth Jonina Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 60(6-B) Jan 1999, US: Univ. Microfilms International; 1999, 3001 Abstract/Review/Citation: Emotion regulation was studied within the framework of attachment theory. Specifically, three aspects of emotion regulation: communication of emotion, facial display and attributions of emotion to the facial displays of others were explored in relation to attachment. Participants were 44 adult females (mean age 25 years) who completed a self-report measure of emotion socialization, a self-report measure of attachment style, and a measure of emotion attribution. Participants were also interviewed about their memories of emotion socialization. The interview was videotaped and the facial affect of participants was coded. It was predicted that attachment security would be associated with recall of rewarding maternal responses to emotion expression and recall of emotional expressiveness in childhood. These hypotheses were confirmed. It was also predicted that fearful avoidance would be associated with recall of a punitive maternal response to emotion expression and recall of hiding expressions of emotion in childhood. These hypothesis were also confirmed. Hypotheses regarding preoccupied and dismissing attachment styles and emotion socialization were not confirmed. It was also predicted that attachment style would be significantly related to both emotion attribution and facial display of emotion. These hypotheses were not confirmed. ========================================
Title: The familiar and the strange: Hopfield network models for prototype-entrained attachment-mediated neurophysiology. Author(s)/Editor(s): Smith, Thomas S.; Stevens, Gregory T.; Caldwell, Sarah Source/Citation: Mind, brain, and society: Toward a neurosociology of emotion, Vol. 5., Stamford, CT, US: JAI Press, Inc; 1999, (viii, 358), 213-245 Social perspectives on emotion. Source editor(s): Franks, David D. (Ed) Abstract/Review/Citation: By showing how cognitive, normative, and cultural phenomena are linked to the neurophysiology underlying attachment and social interaction, the authors point in the direction of further modeling the deep biological foundations of social behavior. Hopfield networks provide useful computational frameworks for studying cognitive prototypes. The authors show that Hopfield networks can be useful in studying how behavior and cognition work in tandem, within the context of social interaction, to regulate activity in core brain systems--in effect, controlling comfort and modulating arousal. Topics discussed are: affect regulation; behavioral mechanisms of opioid and arousal regulation; social mechanisms of opioid and arousal regulation; cognitive mechanisms of opioid and arousal regulation; Hopfield networks; a Hopfield network model of arousal modulation; transference and the generalization of attachment; resistance of working models to change later in life; inconsistent, incoherent, or fragmented working models; cognitive dissonance and balance theory; dependency, prototype building and interaction pressures; joint reconstruction of cognitive structures; interaction ritual and normativity; intimacy, talk, transitional objects, and symbolism; and culture and comfort. ========================================
Title: Made to measure: Adapting emotionally focused couple therapy to partners' attachment styles. Author(s)/Editor(s): Johnson, Susan M.; Whiffen, Valerie E. Source/Citation: Clinical Psychology: Science & Practice; Vol 6(4) Win 1999, England: Oxford Univ Press; 1999, 366-381 Abstract/Review/Citation: This article summarizes the theory, practice, and empirical findings on emotionally focused couple therapy (EFT), now one of the best documented and validated approaches to repairing close relationships. EFT is based on an attachment perspective of adult intimacy. The article considers how individual differences in attachment style have an impact on affect regulation, information processing, and communication in close relationships and how the practice of EFT is influenced by these differences. ========================================
Title: How attachment theory can contribute to the understanding of affective functioning in psychoanalysis. Author(s)/Editor(s): Ammaniti, Massimo Source/Citation: Psychoanalytic Inquiry: Special Issue: Attachment research and psychoanalysis: 2. Clinical implications.; Vol 19(5) 1999, US: Analytic Press; 1999, 784-796 Abstract/Review/Citation: Focuses on the implications of attachment theory for psychoanalysis, particularly in understanding affect regulation, experience, and representation within the therapeutic context. A vignette is presented about clinical observations of a 24-yr-old male who suffers from substance dependence and mood disorder. In particular, considering the narrative structure of the patient's communication, the attachment strategies are investigated. It is suggested that mental representations of attachment could be conceived of as a network whose different attachment strategies could be activated by the interaction with others. In the clinical context, the interaction between patient and psychoanalyst can activate the more secure strategies if the patient had in his personal history secure attachment experience and also if it is not the dominant strategy. ========================================
Title: Representation, symbolization, and affect regulation in the concomitant treatment of a mother and child: Attachment theory and child psychotherapy. Author(s)/Editor(s): Slade, Arietta Source/Citation: Psychoanalytic Inquiry: Special Issue: Attachment research and psychoanalysis: 2. Clinical implications.; Vol 19(5) 1999, US: Analytic Press; 1999, 797-830 Abstract/Review/Citation: Considers the role of representation, particularly shifts in metacognitive monitoring, reflective functioning, and mentalization in the intensive treatment of a young child and his mother. Topics discussed include representational processes in attachment theory and research; parental representations of the child; metacognition, mentalization, and the mother-child relationship; representation, symbolization, and psychotherapy; dyadic treatment phase; and concomitant treatment phase. ========================================
Title: Attachment theory and close relationships. Author(s)/Editor(s): Simpson, Jeffry A.; Rholes, William Steven Source/Citation: New York, NY, US: The Guilford Press; 1998, (x, 438) Abstract/Review/Citation: "Attachment Theory and Close Relationships" discusses the application of attachment theory to adult relationships. This book integrates the important theoretical and empirical advances in this growing area of study and suggests new and promising directions for future investigation. Its balanced coverage of measurement issues, affect regulation, and clinical applications makes this a valuable sourcebook for scholars, students, and clinicians. It also serves as a supplemental text in advanced undergraduate or graduate-level courses. Notes/Comments: Part I: Introduction Attachment in adulthood. Jeffry A. Simpson and W. Steven Rholes Part II: Measurement issues Methods of assessing adult attachment: Do they converge? Kim Bartholomew and Phillip R. Shaver Self-report measurement of adult attachment: An integrative overview. Kelly A. Brennan, Catherine L. Clark and Phillip R. Shaver Adult attachment patterns: A test of the typological model. R. Chris Fraley and Niels G. Waller Working models of attachment: A theory-based prototype approach. Eva C. Klohnen and Oliver P. John Part III: Affect regulation The relationship between adult attachment styles and emotional and cognitive reactions to stressful events. Mario Mikulincer and Victor Florian Attachment orientations, social support, and conflict resolution in close relationships. W. Steven Rholes, Jeffry A. Simpson and Jami Grich Stevens Adult attachment and relationship-centered anxiety: Responses to physical and emotional distancing. Judith A. Feeney Part IV: Clinical applications The role of attachment in therapeutic relationships. Mary Dozier and Christine Tyrrell Dismissing-avoidance and the defensive organization of emotion, cognition, and behavior. R. Chris Fraley, Keith E. Davis and Phillip R. Shaver Childhood revisited: The intimate relationships of individuals from divorced and conflict-ridden families. Kate Henry and John G. Holmes The associations between adult attachment and couple violence: The role of communication patterns and relationship satisfaction. Nigel Roberts and Patricia Noller Part V: Conceptual and empirical extensions Evolution, pair-bonding, and reproductive strategies: A reconceptualization of adult attachment. Lee A. Kirkpatrick Adult romantic attachment and individual differences in attitudes toward physical contact in the context of adult romantic relationships. Kelly A. Brennan, Shey Wu and Jennifer Loev Index measurement issues & affect regulation & clinical applications of attachment theory to close relationships, adults ========================================
Title: Attachment representations and representations of the self in relation to others: A study of preschool children in inner-city London. Author(s)/Editor(s): McCarthy, Gerald Source/Citation: British Journal of Medical Psychology; Vol 71(1) Mar 1998, England: British Psychological Society; 1998, 57-72 Abstract/Review/Citation: Examined the relationship between attachment representations (ATRs) and representations of the self in relation to others in a sample of 42 children (aged 4-5.9 yrs). The relationship between children's ATRs and parents' style of regulating negative affect was also explored. The quality of ATRs was assessed using a modified version of the Separation Anxiety Test. Assessments of the representation of the self in relation to others consisted of (1) assessment of the child's view of self within the relationship with the attachment figure, using an incomplete doll story procedure; and (2) assessment of the child's perceptions of the way others view them using a puppet interview. Significant connections between ATRs, representations of self in relation to others, and parents' negative affect regulation were found. Children with secure ATRs had a significantly more positive view of the self in the relationship with the attachment figure than children with disorganized ATRs, and a significantly more positive perception of the way others view them than children with avoidant ATRs. Children with secure ATRs had parents with more adaptive ways of regulating their own negative affect than children with ambivalent or disorganized ATRs. ========================================
Title: The tie that binds: Affect regulation, attachment, and psychoanalysis. Author(s)/Editor(s): Silverman, Doris K. Source/Citation: Psychoanalytic Psychology; Vol 15(2) Spr 1998, US: Educational Publishing Foundation; 1998, 187-212 Abstract/Review/Citation: Psychoanalytic theory has both expanded and altered its constructs in response to clinical work. The attachment system is a construct in need of integration, and it requires its own motivational status in psychoanalytic theory. The author regards affect regulation (mutual and self-regulation) as a key aspect of the attachment system and as an addendum to Bowlby's ideas, one that is consistent with contemporary findings in infant research. A published case and 2 clinical cases are used to demonstrate the usefulness of the concepts of mutual and self-regulation in clinical work. Illustrated as well are the benefits of an integration of affect regulation and traditional motives for optimizing clinical work. The inclusion of these motivational constructs provides for a more comprehensive psychoanalytic theory that offers enriched explanations of complex psychic and behavioral phenomena. ========================================
Title: Attachment working models and the sense of trust: An exploration of interaction goals and affect regulation. Author(s)/Editor(s): Mikulincer, Mario Source/Citation: Journal of Personality & Social Psychology; Vol 74(5) May 1998, US: American Psychological Assn.; 1998, 1209-1224 Abstract/Review/Citation: Five studies examined the association between adult attachment style and the sense of trust in close relationships. Study 1 focused on the accessibility of trust-related memories. Studies 2-5 focused on trust-related goals and coping strategies, while using different data collection techniques (open-ended probes, diary methodology, lexical decision task). Findings showed that secure persons felt more trust toward partners, showed higher accessibility of positive trust-related memories, reported more positive trust episodes over a 3-week period, and adopted more constructive strategies in coping with the violation of trust than insecure persons. In addition, whereas intimacy attainment was the main trust-related goal for all the attachment groups, security attainment was an additional goal of anxious-ambivalent persons, and control attainment was an additional goal of avoidant persons. Findings are discussed in terms of attachment working models. ========================================
Title: Interpersonal schemata in child psychotherapy: A cognitive-interpersonal perspective. Author(s)/Editor(s): Shirk, Stephen R. Source/Citation: Journal of Clinical Child Psychology; Vol 27(1) Mar 1998, US: Lawrence Erlbaum Assoc; 1998, 4-16 Abstract/Review/Citation: Presents a cognitive-interpersonal framework for child psychotherapy derived from attachment theory. Interpersonal schema, conceptualized as expectations regarding others' probable responses to the self, are posited as a key mediating mechanism linking past interpersonal experience with current social-emotional functioning, and as an important target for intervention. Three schema-based models of pathogenic process are examined: preemptive information-processing, schema-triggered affect, and schema-primed interpersonal and emotion-regulation strategies. Implications for assessment of and intervention with interpersonal schema are considered. Preventive, compensatory, and remedial intervention strategies are proposed. ========================================
Title: Negative affectivity as a mediator of the association between adult attachment and marital satisfaction. Author(s)/Editor(s): Davila, Joanne; Bradbury, Thomas N.; Fincham, Frank Source/Citation: Personal Relationships; Vol 5(4) Dec 1998, US: Cambridge University Press; 1998, 467-484 Abstract/Review/Citation: Although the association between adult attachment and marital satisfaction is well documented, research has not examined processes by which attachment affects satisfaction. Drawing on attachment-oriented conceptualizations of affect regulation, the present study tested the hypothesis that negative affectivity mediates the association between attachment and marital satisfaction. Data from two samples of married couples were used to test the hypothesis. In both samples, negative affectivity mediated the association between some aspects of attachment insecurity and marital dissatisfaction, although attachment also retained a direct association with marital satisfaction in a number of cases. Results are discussed in terms of attachment-oriented conceptualizations of the function of negative emotion in marriage, and the empirical and conceptual overlap between attachment and negative affectivity. ========================================
Title: Defenses, personality structure, and development: Integrating psychodynamic theory into a typological approach to personality. Author(s)/Editor(s): Weinberger, Daniel A. Source/Citation: Journal of Personality: Special Issue: Defense mechanisms in contemporary personality research.; Vol 66(6) Dec 1998, US: Blackwell Publishers; 1998, 1061-1080 Abstract/Review/Citation: Psychodynamic theory does not conceptualize motivated unconscious defenses primarily in terms of individual traits. Rather, a person's mechanisms of defense are understood in terms of his or her personality structure and level of psychological development. This paper outlines the way in which this perspective has been integrated into a configural approach to personality assessment. The six-group typology based on the Weinberger Adjustment Inventory (WAI) identifies higher-order personality organization through the intersection of self-reported high/low distress and high/moderate/low self-restraint. The framework incorporates a developmental perspective by assessing affect regulation in conjunction with the internalization of self-regulatory controls. The primary defenses of prototypic members of each of the six groups are highlighted, and hypothesized links to personality traits, stages of ego development, attachment styles, and proneness to specific personality disorders are discussed. ========================================
Title: Affect regulation as a stylistic process within adult attachment. Author(s)/Editor(s): Fuendeling, James M. Source/Citation: Journal of Social & Personal Relationships; Vol 15(3) Jun 1998, England: Sage Publications, Ltd.; 1998, 291-322 Abstract/Review/Citation: The literature on adult attachment indicates consistent differences in the emotional experiences of individuals according to their attachment styles. With the idea that these differences in experience are accompanied by systematic differences in the ways people with different attachment styles regulate their affect, a broad range of findings are reviewed and reorganized according to a process-level explanation of affect regulation, including specific mechanisms by which affect is regulated. This reexamination of findings does suggest consistent, or stylistic, ways of regulating affect that are particular to each attachment style. Variation is particularly evident in the management of attention, appraisal styles and the ability to interact with others as agents of affect regulation. Implications for future research are discussed. ========================================
Title: Optimal responsiveness and a search for guidelines. Author(s)/Editor(s): Shane, MortonShane, Estelle Source/Citation: Optimal responsiveness: How therapists heal their patients., Northvale, NJ, US: Jason Aronson, Inc; 1998, (xix, 392), 75-96 Self psychology and intersubjectivity. Source editor(s): Bacal, Howard A. (Ed) Abstract/Review/Citation: In this chapter, the authors review the perspectives of a number of significant psychoanalytic thinkers whose ideas, in their view, constitute guidelines for optimal responsiveness in the clinical situation. Thus, they cite the work of J. Bowlby (attachment theory), D. M. Terman (dialogue of construction), J. Lichtenberg (motivational systems), J. A. Lindon (optimal provision), R. Stolorow and colleagues (attunement to affect states), M. Basch (attention to pathological affect states), B. Beebe and F. M. Lachmann (mutual and self regulation), and A. Goldberg (interpretation of H. Kohut's [1977] vertical split) that is relevant to the optimal responsiveness concept. They introduce a concept of their own--optimal restraint--as a substitute for the principle of abstinence ("transference gratification"). This guideline can usefully serve as a reminder of the asymmetry of the therapy situation and draw attention to the ethical and professional responsibility of the therapist in responding optimally to the patient. In their search for the optimal, the authors distill from within the psychoanalytic situation ways of conceptualizing emergent order among the complexities that pertain there by formulating a theory of developmental systems of self psychology. ========================================
Title: The development of marriage: A 9-year perspective. Author(s)/Editor(s): Lindahl, Kristin; Clements, Mari; Markman, Howard Source/Citation: The developmental course of marital dysfunction., New York, NY, US: Cambridge University Press; 1998, (xviii, 473), 205-236 Source editor(s): Bradbury, Thomas N. (Ed) Abstract/Review/Citation: The Denver Family Development Project (DFDP) began in 1981 to study how relationship quality in a group of satisfied and committed premarital couples changed over time during the 1st decade of their marriages. The authors sought to discover what individual or relationship characteristics ultimately lead to distress, divorce, or continued happiness. The authors present some of the results of the 1st 9 yrs of the DFDP and discuss their successes and failures in meeting the challenges of longitudinal work. Data collection across all time periods emphasized the following constructs: negative affect regulation, especially in the context of conflict, conflict management, and communication. Discussion includes changes in satisfaction and communication, marital development over the transition to parenthood, marital and family functioning (attachment, self-concept, parent-child affect regulation), dyadic parent-child interactions, and triadic family interactions (including peer relationships). Longitudinal issues include when to start the study, sample size, sample retention, measure decay, the impact of couples research on the participants, and seeking and keeping funding for longitudinal studies. ========================================
Title: Proneness to distress and ambivalent relationships. Author(s)/Editor(s): Moran, Greg; Pederson, David R. Source/Citation: Infant Behavior & Development; Vol 21(3) Jul-Sep 1998, US: Ablex Publishing Corp.; 1998, 493-503 Abstract/Review/Citation: Mothers of preterm and full term infants completed R. Abidin's (1986) Parenting Stress Index at 8 months, E. Waters' (1995) Attachment Behavior Q-sort at 12 months, and the J. E. Bates et al (1979) Infant Characteristics Questionnaire at 18 months. These instruments provided assessments of fussy and difficult infant behaviors that were moderately stable over the 10 months. On the basis of home observations at 12 months, the infant-mother relationships were classified as secure, avoidant and ambivalent. J. Cassidy (1994) has proposed that infants in ambivalent relationships may have poor affect regulation. Consistent with Cassidy's view, mothers in ambivalent relationships reported more fussy and difficult infant behavior at each age than did mothers in secure or avoidant relationships. Mothers of preterm infants reported higher scores on the Child Domain of the Parenting Stress Index than mothers of full term infants. The birth groups did not differ on the 12- and 18-month assessments. ========================================
Title: Adult attachment style and affect regulation: Strategic variations in self-appraisals. Author(s)/Editor(s): Mikulincer, Mario Source/Citation: Journal of Personality & Social Psychology; Vol 75(2) Aug 1998, US: American Psychological Assn.; 1998, 420-435 Abstract/Review/Citation: Four studies examined the link between adult attachment style and strategic variations in self-appraisals. Whereas secure persons held a stable positive self-view, Studies 1-2 showed that avoidant persons showed a positive self-view and anxious-ambivalent persons a negative self-view, which were strengthened by distress arousal and weakened by factors that inhibit the activation of regulatory mechanisms. Studies 3-4 indicated that insecure persons' self-views varied in accordance with specific attachment-related concerns and needs. Avoidant persons' positive self-view was related to their attempts to validate their sense of self-reliance, and anxious-ambivalent persons' negative self-view was related to their attempts to win others' compassion and affection. Results are discussed in terms of attachment-related strategies of affect regulation. ========================================
Title: Adult attachment style and affect regulation: Strategic variations in subjective self-other similarity. Author(s)/Editor(s): Mikulincer, Mario; Orbach, Israel; Iavnieli, Daria Source/Citation: Journal of Personality & Social Psychology; Vol 75(2) Aug 1998, US: American Psychological Assn.; 1998, 436-448 Abstract/Review/Citation: Six studies examined the link between adult attachment style and subjective self-other similarity. In Studies 1-3, data were collected on representations of self-other similarity in the realms of traits and opinions. Studies 4-5 examined the effects of affective inductions on the link between attachment and self-other similarity. Study 6 examined the cognitive maneuvers people differing in attachment style use for changing self-other similarity upon distress arousal. Whereas avoidant persons underestimated self-other similarity and anxious-ambivalent persons overestimated it, secure persons provided more accurate similarity scores. These differences were exacerbated by negative affect and mitigated by positive affect. Insecure persons' distortions resulted from transformations they made in representations of the self and others. Results are discussed in terms of attachment theory. ========================================
Title: The influence of working models of attachment on emotion regulation. Author(s)/Editor(s): Flack, Amy Marie Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(6-B) Dec 1998, US: Univ. Microfilms International; 1998, 3092 Abstract/Review/Citation: The purpose of this study was to examine how working models of attachment are associated with the ways in which young adults modulate their emotions. In a sample of 64 ethnically diverse community college students between the ages of 18 and 35 years, three kinds of working models of attachment were assessed with the Adult Attachment interview: Dismissing of attachment, Secure, and Preoccupied with attachment. Affect regulation was measured using the 40-item Affect Intensity Measure in addition to three subfactors derived from a factor analysis of this measure: positive affectivity, negative reactivity, and negative intensity. Gender was also examined with regard to overall affect intensity (positive and negative emotions combined), and with respect to the three subfactors that separate positive from negative intensity. The first hypothesis was supported; women reported experiencing greater amounts of affect intensity than males. Women were also found to report more negative reactivity than males in the present study. Given these results, gender was used as a covariate in the remaining analyses. Results partially supported the second hypothesis; participants with Dismissing working models of attachment reported significantly less affect intensity in their daily lives than those with Secure working models of attachment. However, Dismissing individuals did not report experiencing less intense affect than Preoccupied individuals. The third hypothesis was not supported in the present study. Participants with Preoccupied working models of attachment did not report experiencing greater levels of affect intensity than Secure or Dismissing individuals. Rather, those with Preoccupied attachment styles were found to report significantly less affect intensity in their daily lives than Secure individuals, and were not found to be different from Dismissing individuals. No differences existed between attachment styles when affect intensity was divided into positive and negative factors. These findings reflect the notion that individuals with Secure working models of attachment can safely experience intense emotions, while both Dismissing and Preoccupied individuals limit the experience of their emotions. The results are discussed in terms of possible variations in the manifestation of defense mechanisms designed to limit emotional experience that are particular to Dismissing and Preoccupied individuals. ========================================
Title: The client's perspective: Adult attachment style, gender and the self-reported experience of anxiety, anger and depression. Author(s)/Editor(s): Searle, Barbara Schmich Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(6-B) Dec 1998, US: Univ. Microfilms International; 1998, 3075 Abstract/Review/Citation: The purpose of this study was to contribute to the prototypical descriptions of the emotional experience of men and women in each of four adult attachment styles: secure, and three insecure styles, preoccupied, avoidant-fearful, and avoidant-dismissing (Bartholomew & Horrowitz, 1991). The study focused on three emotions, anxiety, anger and depression, which are associated with insecure attachment patterns. In order to investigate the experience of these three emotions, the following aspects of emotionality were addressed in reference to each attachment style and each gender: the extent to which these emotions are trait-like characteristics, the particular aspects of anger and depression which are prominent, and the affect regulation strategies generally used in response to feelings of anxiety, anger and depression. Fifty undergraduate men and 50 undergraduate women were given eight self-report measures: an attachment style questionnaire, standardized measures of the three target emotions, surveys of affect regulation strategies, and a measure of social desirability response set. Data were analyzed by a series of factorial 2 (gender) x 4 (attachment style) MANOVAs and followed up with a series of discriminant analyses. Social desirability was found to have a differential effect within attachment categories, and adjusted scores were created to compensate for this effect. Secure subjects were found to be less anxious than the avoidant-fearful, have less inwardly directed anger than the avoidant-dismissing and to be less depressed than each of the three insecurely attached groups. The insecurely attached groups were found to experience different forms of depression. The depression of the preoccupied is characterized by sad mood and instrumental helplessness, the depression of the avoidant-fearful by guilt and social introversion, the depression of the avoidant-dismissing by low energy and social introversion. Greater gender differences were found in affect regulation strategies than in the experience of the target emotions. Gender differences within attachment categories were non-significant. These results provide information for a descriptive emotional profile of each attachment group, potentially useful in the counseling situation for making appropriate affective interventions and promoting secure emotionality. ========================================
Title: Perceived relatedness and self-regulatory motivations in the adjustment of maltreated children. Author(s)/Editor(s): River, Vincent Bryan Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 59(6-B) Dec 1998, US: Univ. Microfilms International; 1998, 3099 Abstract/Review/Citation: 42 moderately to severely maltreated, inner city children (MCs) were assessed for perceptions of relatedness, self-regulatory motivations and symptomatology. In normal development, middle childhood is seen as a time of increasing internal organization, partly based upon quality of earlier attachment experience, and leading to increased self-regulation and autonomy. Study of MCs permits analysis of the association between relationship disturbance and self-regulatory development. While links from relationship disturbance to dysregulation are hypothesized, little is known about particular developmental pathways MCs may take. Self-reported relatedness feelings and self-regulatory motivations were predicted to yield valid indices of developmental attainments in attachment-like relatedness and self-regulation. Relative immaturity on both was expected for MCs, together with greater emotional dysregulation. Overall, trends in most expected directions were observed, but significant effects were mild. As expected, relatedness disturbance differentiated better and poorer affect regulation. Particular insecure relatedness styles did correspond with styles of affective dysregulation. Few MCs were found capable of forming a secure attachment with another caregiver if their primary attachment to mother was insecure. Those who did were not significantly better adjusted than insecure children. The expected association was found between relatedness and self-regulatory development. However, some insecure children showed greater than expected self-regulation development and more resilient adaptation. Relatedness and self-regulatory development impacted different aspects of functioning. Negative perceptions of relatedness with mother most strongly predicted affective dysregulation. Self-regulatory developmental level most strongly predicted variations in behavioral disturbance and global adjustment. Findings support the ecological-transactional model of abuse effects (Cicchetti & Lynch, 1995) in which internalization of relationship models mediates, but does not determine, self-regulatory development. Secondly, more mature self-regulatory development appears to serve a mild buffering role in adjustment of MCs. By middle childhood, self-regulation style more strongly predicted social adaptation than did quality of attachment/relatedness. However, even better self-regulated MCs did not function resiliently at levels comparable with normal children. This study's mild findings point to the complex interrelations involved in studying abuse impact on the development of relatedness and self-regulation. However, child self-report measures seem sufficiently robust to differentiate resilient MCs from those with self-regulatory disturbance. ========================================
Title: Attachment, detachment and borderline personality disorder. Author(s)/Editor(s): Sable, Pat Source/Citation: Psychotherapy: Theory, Research, Practice, Training; Vol 34(2) Sum 1997, US: Division of Psychotherapy, A.P.A.; 1997, 171-181 Abstract/Review/Citation: In an attempt to expand understanding of more severe pathology, attachment theory, developed by John Bowlby, is applied to borderline personality disorder in adults. Conceptualized as a condition of profound insecure attachment, with extreme vacillations between a desire for proximity and attachment and a dread and avoidance of engagement, borderline pathology reflects traumatic attachment experiences, beginning early in life. Besides the importance of trauma, disturbances in affect regulation and cognitive distortions are emphasized. The secure base of a therapeutic bond provides consistency, reliability, and affirmation while encouraging exploration of separation and loss experiences, both current and past, in order to modify inner working models of oneself and relationships with others. Implications for prevention are discussed. ========================================
Title: Ontogenesis, depressotypic organization, and the depressive spectrum. Author(s)/Editor(s): Cicchetti, Dante; Rogosch, Fred A.; Toth, Sheree L. Source/Citation: Developmental psychopathology: Perspectives on adjustment, risk, and disorder., New York, NY, US: Cambridge University Press; 1997, (xxi, 618), 273-313 Source editor(s): Luthar, Suniya S. (Ed) Abstract/Review/Citation: In this chapter, we examine the emerging insights that a developmental psychopathology perspective provides for understanding the etiology, course, and sequelae of depressive disorders. Additionally, treatment and social policy implications derived from this perspective are discussed. An organizational or organismic orientation to understanding development has been central to E. Zigler's formulations, and this developmental view forms the basis for the ontogenetic perspective on depression espoused in this chapter. Zigler's depiction of premorbid social competence as a developmental attainment achieved through success in adaptive tasks and contributing to individual differences among persons with psychopathological conditions is echoed herein in terms of articulating how incompetent resolutions of stage-salient developmental challenges contribute to the developmentally derived depressotypic organizations. These challenges include the development of homeostatic and physiological regulation; affect differentiation and the modulation of attention and arousal; the development of a secure attachment relationship; and the development of the self-system. Furthermore, Zigler's analysis of symptom presentations in terms of their underlying developmental level is reflected in the need to understand the ontogenetic origins of depressive symptomatology, particularly the thought-dominated negative attributions regarding the self. Finally, the interest of Zigler and his colleagues in resilient functioning in the face of adversity is but one example of his striving to understand diversity in developmental pathways and outcomes. ========================================
Title: Relation between premorbid personality and patterns of emotion expression in mid- to late-stage dementia. Author(s)/Editor(s): Magai, Carol; Cohen, Carl I.; Culver, Clayton; Gomberg, David; Malatesta, Chris Source/Citation: International Journal of Geriatric Psychiatry; Vol 12(11) Nov 1997, US: John Wiley & Sons Inc; 1997, 1092-1099 Abstract/Review/Citation: 27 nursing home patients (mean age 84.8 yrs) with mid- to late-stage dementia participated in a study of the relation between preillness personality, as indexed by attachment and emotion regulation style, and current emotional behavior. Preillness measures were completed by family members and current assessments of emotion were supplied by nursing home aides and family members; in addition, emotion was coded during a family visit using an objective coding system for facial emotion expressions. Attachment style was found to be related to the expression of positive affect, with securely attached individuals displaying more positive affect than avoidantly attached individuals. In addition, high ratings on premorbid hostility were associated with higher rates of negative affect and lower rates of positive affect. These findings indicate that premorbid aspects of personality show continuity over time, even in mid- to late-stage dementia. ========================================
Title: Emotion socialization and affect regulation in children with attention deficit hyperactivity disorder. Author(s)/Editor(s): Siegel, Hillary Ilene Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 57(9-B) Mar 1997, US: Univ. Microfilms International; 1997, 5932 Abstract/Review/Citation: The present study examined the development of emotion regulation and dysregulation in ADHD and non-ADHD mother-child pairs by exploring the quality of their attachment relationships, their affective organization/biases, their modes of emotion socialization and the methods of conflict resolution that are employed with these children. The mean age of the children was 9.4 years and the mean age of the mothers was 37.4 years. Both members of the mother-child dyad were separately administered specific measures that assessed the quality of their attachment relationship and their affect-specific biases. Additionally, dyad-specific modes of emotion socialization and conflict resolution were assessed through child and parental interviews. The results indicated several distinctions between ADHD and non-ADHD mother-child dyads. First, mothers of ADHD children were less likely to use rewarding socialization responses and more likely to use punishing and disregarding responses than were mothers of non-ADHD children. Second, ADHD children tended to make a greater amount of anger and/or shame attributions than non-ADHD children, and thus had a preponderance of negative affect biases that appeared to reflect the extreme emotionality and high-arousal interactions that characterize their socialization experiences. Third, mother's attachment style was differentiated by child's diagnostic status, such that, mothers of ADHD children were significantly more likely to have relationships which were classified as insecure than were mothers of non-ADHD children. Finally, securely attached mothers were found to use significantly more rewarding socialization behaviors than insecurely attached mothers, who demonstrated a tendency to utilize more punishing patterns of socialization. However, the results failed to detect differences in maternal disciplinary styles between ADHD and non-ADHD dyads. Unique patterns of interaction appear to evolve within ADHD mother-child dyads. Although the direction of the causal pathway is unclear, the diagnosis of ADHD seems to have powerful and distinct repercussions for the development of personality. ========================================
Title: Dimensions of emotional intelligence: Attachment, affect regulation, alexithymia and empathy. Author(s)/Editor(s): Bekendam, Carol Corwin Source/Citation: Dissertation Abstracts International: Section B: The Sciences & Engineering; Vol 58(4-B) Oct 1997, US: Univ. Microfilms International; 1997, 2109 Abstract/Review/Citation: Emotional intelligence involves accurate appraisal and regulation of emotions in oneself and the ability to respond empathically to emotions in others (Mayer, Di Paolo, & Salovey, 1990). Despite the importance of empathy to effective interpersonal relations, until recently empathy has been a neglected topic of research. A study was conducted to investigate the relationships of Attachment Patterns (measured by the Adult Attachment Scale), styles of Affect Regulation (measured by the Affect Regulation Scale), Alexithymia (measured by the Toronto Alexithymia Scale--20 Items), and Empathy (measured by the Interpersonal Reactivity Index). Personal characteristics and history of child abuse were measured by a personal information questionnaire. The instruments were administered to 167 male parolees who were in group treatment for impulse disorders. Data analysis strategies included ANOVA, correlation analysis and hierarchical multiple regression analysis. Secure Attachment was hypothesized to be related to adaptive Affect Regulation Styles, Empathic Concern (IRI subscale), Perspective Taking (IRI subscale), low Personal Distress (IRI subscale) and absence of Alexithymia. Insecure Attachment was hypothesized to be related to maladaptive Affect Regulation Styles, Personal Distress, Alexithymia and a deficit in empathy. These hypotheses were supported. Specifically, the Preoccupied attachment pattern demonstrated vulnerability to negative emotions of others as measured by Personal Distress and the Fantasy Scale (IRI subscale), whereas Dismissive/Avoidant attachment pattern used fantasy the least, suggesting denial of negative emotions. The Fearful/Avoidant attachment pattern emerged as the most impaired group with high use of maladaptive Affect Regulation Styles, high Personal Distress, and high Alexithymia, lending support for the designation of the Fearful/Avoidant pattern as the adult version of the Disoriented/Disorganized Pattern of childhood Attachment research. The hypothesis that the Fearful/Avoidant Pattern would represent the most participants who reported a history of childhood abuse was not supported. The study lends supp |
