Environmental Influences on Neural Plasticity, the Limbic System, Emotional Development and Attachment: A Review

The effects of early environmental influences on neural plasticity, the limbic system, and social and emotional development are reviewed and an illustrative case study is briefly discussed. Deprived or abnormal rearing conditions induce severe disturbance in all aspects of social and emotional functioning, and effect the growth and survival of dendrites, axons, synapses, interneurons, neurons, and glia. The amygdala, cingulate, and septal nuclei develop at different rates which correlate with the emergence of wariness, fear, selective attachments, play behavior, and the oral and phallic stages of development. These immature limbic nuclei are experience-expectant, and may be differentially injured depending on the age at which they suffer deprivation. The medial amygdala and later the cingulate and septal nuclei are the most vulnerable during the first three years of life. If denied sufficient stimulation these nuclei may atrophy, develop seizure-like activity or maintain or form abnormal synaptic interconnections, resulting in social withdrawal, pathological shyness, explosive and inappropriate emotionality, and an inability to form normal emotional attachments.     

An alternative approach for the analyses and interpretation of attachment sort items

Attachment Q-Sort (AQS) is a tool for quantifying observations about toddler/caregiver relationships. Previous studies have applied factor analysis to the full 90 AQS item set to explore the structure underlying them. Here we explore that structure by applying multidimensional scaling (MDS) to judgements of inter-item similarity. AQS items are arranged in the MDS solution along three easily interpretable axes: a model that is compatible with but more parsimonious than factor analysis solutions. This geometrical approach suggests ways to modify the AQS—primarily a research tool—to make it more practical for clinical applications. Sets of AQS data are represented and interpreted in the three-dimensional model as vectors. Summaries at a finer-grained level are obtained by finding points in the model where variability across datasets is greatest. We report re-analyses of archival (published) data, and also data collected with streamlined procedures more suitable in the field. Although not reported here, collection and analysis can both be performed online via a website. The general methodology is not restricted to the current application of toddler attachment.     

Children of mothers with mental ilness: attachment, emotional and behavioural problems

This study describes the pattern of emotional and behavioural difficulties of children whose mothers have mental illness, and explores the relationship between children's behavioural and emotional difficulties and maternal perceptions of attachment. Thirteen mothers previously admitted to psychiatric hospital for mental illness completed a measure of their own symptoms (Brief Symptom Inventory), their children's emotional and behavioural problems (Strengths and Difficulties Questionnaire (SDQ)), and attachment security (Parent/Child Reunion Inventory) (n = 21). Mean scores for child SDQ profiles were found to be within the 'normal' range, although (on some indices) mothers reported more 'case' scores for their children, than would be expected from standardized norms. It was found that there were significant positive correlations between 'insecurity' scores and all problem scales of the SDQ. Best predictors from the Parent/Child Reunion Inventory factors for each SDQ scale are reported and discussed.     

A complex mixture of forces

Abstract

The paper argues that purely psychoanalytical theory, by itself, is not sufficient to understand many of the complex, mixed states carried by many of the children seen by child psychotherapists. Mixed forms of understanding are needed. Psychoanalytic thinking and ‘hard’ science are not the same as each other but need to be brought into active dialogue. As an instance of this, the paper looks at the relationship between Kleinian thinking and attachment theory and argues that a mixed, inner world and environment sensitive form of thinking, that draws on both Klein and Bowlby, has become characteristic of Kleinian child psychotherapy today. This established way of thinking is now being stretched in order to accommodate neuroscientific findings.     

Reflective functioning: A review

Reflective functioning offers an empirically grounded framework for the assessment of mentalization. This article briefly outlines the theory of mentalization and the development of the Reflective Functioning (RF) scale (Fonagy, Target, Steele, & Steele, 1998). It then offers a review and discussion of empirical studies of parental RF regarding the role of RF in linking adult and child attachment and parental RF in the context of psychopathology. Furthermore, empirical studies on RF in relation to different psychiatric populations and to the role of RF in psychotherapy process and outcome are reviewed and discussed. Although research on RF is still relatively limited, evidence seems to support the relevance of RF as an empirical measure in the fields of attachment, psychopathology and psychotherapy research. However, the RF scale has certain limitations due to the extensiveness of the measure, which future research should take into account.     

Maternal-fetal attachment and its correlates in a sample of Italian women: a study using the Prenatal Attachment Inventory

Background: Maternal–fetal attachment (MFA) is considered to be related to the quality of subsequent maternal care of the infant and maternal health behaviour during pregnancy. Objective: The aims of the present study were to investigate the internal structure of a questionnaire used for assessing MFA, the Prenatal Attachment Inventory (PAI), and to address the role of gestational age, couple adjustment and depressive symptomatology on MFA, on a sample of women from suburban areas. Method: A cross-sectional study using self-report questionnaires was conducted to address these two aims on 130 women attending prenatal care services. Results: A five-factor solution emerged for the PAI questionnaire. MFA levels were comparable to those found in previous studies using PAI, whereas depressive symptoms were higher than those reported in previous studies with normative pregnant women. Couple adjustment and gestational age significantly increased MFA. Among the MFA dimensions, Affect and Interaction were mainly affected by gestational age; Maternal–fetal differentiation was associated with gestational age and couple adjustment. Depressive symptoms were associated with an increase in Fantasy and Sensitivity factor scores. Conclusion: Prenatal attachment increased as gestational age advanced and as mothers perceived greater levels of couple adjustment, which promoted MFA strength, positive affect and MFA interaction and differentiation. The internal structure of PAI and its association with specific correlates are discussed.