Aggression and the psychic self

In this paper we explore the idea of aggression as a defence against threats to the psychological self. This aspect of the self allows reflection about people in psychological terms and develops, in the first three years of life, through appreciation of mental states in the other. When the object is unpredictable or hostile, recognition of this is painful to the child, and his reflective function will not be adequately established. The defences of aggression or avoidance will be invoked very frequently. In time, aggression may become an organising influence in the construction of the self; pathological destructiveness then takes the place of emotional relatedness and concern for the other. Psychoanalytic treatment no longer works primarily by addressing conflict. Instead, particularly through interpretations of transference and countertransference, the analyst recreates an intersubjective process which enhances the patient's reflective self, this time in the safety of a benign relationship.     

Attachment and reflective function: their role in self-organization

The paper traces the relationship between attachment processes and the development of the capacity to envision mental states in self and others. We suggest that the ability to mentalize, to represent behavior in terms of mental states, or to have "a theory of mind" is a key determinant of self-organization which is acquired in the context of the child's early social relationships. Evidence for an association between the quality of attachment relationship and reflective function in the parent and the child is reviewed and interpreted in the context of current models of theory of mind development. A model of the development of self-organization is proposed which has at its core the caregiver's ability to communicate understanding of the child's intentional stance. The implications of the model for pathological self-development are explored, with specific reference to the consequences of maltreatment.     

Mentalization in adult attachment narratives: Reflective functioning, mental states, and affect elaboration compared.

Relationships between three measures of mentalization (reflective function, mental states, and verbal elaboration of affect), attachment status, and the severity of axis I and axis II pathology were examined. Seventy-three adults, both ex-psychiatric patients and nonclinical volunteers were administered the Adult Attachment Interview (AAI). Comparisons between the three measures indicate that they share some aspect of a core mentalization process and that each illuminates a specific component. Reflective function was the only predictor of attachment status. The number of axis I diagnoses is partly explained by attachment insecurity, but the capacity to generate high-level defensive mental states as well as increments in verbal affect elaboration further contribute to the model. Finally, increments in affect elaboration, as well as augmentations in high-level defensive activity and reflective function are all associated with decreases in the number of axis II diagnoses, over and above the contribution of attachment status and axis I pathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The risk-taking and self-harm inventory for adolescents: Development and psychometric evaluation.

In this study, we report on the development and psychometric evaluation of the Risk-Taking (RT) and Self-Harm (SH) Inventory for Adolescents (RTSHIA), a self-report measure designed to assess adolescent RT and SH in community and clinical settings. 651 young people from secondary schools in England ranging in age from 11.6 years to 18.7 years and 71 young people referred to mental health services for SH behavior in London between the ages of 11.9 years and 17.5 years completed the RTSHIA along with standardized measures of adolescent psychopathology. Two factors emerged from the principal axis factoring, and RT and SH were further validated by a confirmatory factor analysis as related, but different, constructs, rather than elements of a single continuum. Inter-item and test–retest reliabilities were high for both components (Cronbach's α = .85, ru = .90; Cronbach's α .93, ru = .87), and considerable evidence emerged in support of the measure's convergent, concurrent, and divergent validity. The findings are discussed with regard to potential usefulness of the RTSHIA for research and clinical purposes with adolescents. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Associations among attachment classifications of mothers, fathers, and their infants

Associations are reported among classifications of Adult Attachment Interviews (AAIs) obtained from expectant parents and subsequent classifications of their infants in the Strange Situation Procedure (SSP). Mothers' AAIs predicted infant-mother SSPs (chi 2 = 41.87, N = 96, df = 9, p < or = .0001), and fathers' AAIs predicted infant-father SSPs (chi 2 = 18.94, N = 90, df = 6, p < or = .005). Associations between parents' AAIs and infant-parent SSPs were lessened by the failure to predict the insecure-resistant pattern with mother and the absence of this pattern with father. Counter to expectation, infant-father SSPs were associated with infant-mother SSPs (chi 2 = 3.78, N = 90, df = 1, p < or = .05), which could not be accounted for in terms of an overlap between parental AAIs. A secondary analysis of the data suggested that this dependency effect of SSPs may be explained by the influence of maternal AAIs upon child-father SSPs. Results are discussed in terms of intergenerational and relationship-specific influences upon attachment during infancy, the possible influence of infant temperament, and the relative influence of mother and father upon the child's evolving representations of attachments within the family.     

In search of shared and nonshared environmental factors in security of attachment: A behavior-genetic study of the association between sensitivity and attachment security.

The current article presents results from a twin study of genetic and environmental components of maternal sensitivity and infant attachment and their association. The sample consisted of 136 twin pairs from 2 sites: Leiden, the Netherlands, and London, UK. Maternal sensitivity was assessed in the home at 9-10 months, and infant attachment security was observed in the laboratory at 12 months. The study yielded little evidence that genetic factors are involved in variations between twins in maternal sensitivity ratings but did find that shared variance in maternal sensitivity was able to account for some of the similarity between twins in attachment security. Weak nonshared associations between sensitivity and attachment appeared to suppress the magnitude of the correlation between attachment and sensitivity in twin children. The results could indicate that the attachment security of one twin may depend on the relationship the parent has with the other twin. The results are brought to bear on the validity of attachment theory as a theory of primarily shared environmental effects in children's development and the continuing challenge posed to attachment theory by within-family differences in socioemotional processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Studies on the efficacy of child psychoanalysis.

This article summarizes 3 studies that evaluated the psychoanalytic psychotherapeutic treatment of diabetic children and adolescents with grossly abnormal blood glucose profiles necessitating repeated admissions to hospital. Study 1 used time series analysis to demonstrate that improvements in control were predicted by unconscious themes emerging in the analytic material. Study 2 compared the effect of psychotherapeutic treatment with that of minimal psychological intervention in 2 well-matched groups (n?=?11). Patients in the treatment group were offered psychoanalytic psychotherapy 3–4 times per week on the hospital ward. The intervention was highly effective in improving the diabetic control of the children, and this improvement was maintained at 1-yr follow-up. Study 3 used single-case experimental design to demonstrate the marked effect of psychotherapeutic help on growth in diabetic children with short stature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Child Attachment Interview: A psychometric study of reliability and discriminant validity.

While well-established attachment measures have been developed for infancy, early childhood, and adulthood, a "measurement gap" has been identified in middle childhood, where behavioral or representational measures are not yet sufficiently robust. This article documents the development of a new measure--the Child Attachment Interview (CAI)--which seeks to bridge this gap. The CAI is a semistructured interview, in which children are invited to describe their relationships with their primary caregivers. The coding system is informed by the Adult Attachment Interview and the Strange Situation Procedure, and produces 4 attachment categories along with a continuous measure of attachment security based on ratings of attachment-related dimensions. The main psychometric properties are presented, including interrater reliability, test-retest reliability, and concurrent and discriminant validities, both for normally developing children and for those referred for mental health treatment. The CAI correlates as expected with other attachment measures and predicts independently collected ratings of social functioning. The findings suggest that the CAI is a reliable, valid, and promising measure of child-parent attachment in middle childhood. Directions for improvements to the coding system are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)