Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse, neglect and psychosocial risk.

BACKGROUND: Parental mentalising difficulties are robustly linked to caregiving problems. Mothers with intellectual disability are at risk for caregiving problems, but knowledge on their parental mentalising abilities is lacking. The present study aimed to fill this gap. METHOD: Thirty mothers with mild intellectual disability, and 61 comparison mothers with ADHD, were assessed for parental mentalising using the Parental Reflective Functioning Questionnaire. Contributions of intellectual disability, maternal exposure to childhood abuse/neglect and psychosocial risk to parental mentalising were examined through hierarchical regression analysis. RESULTS: Mothers with intellectual disability had a heightened risk for parental mentalising difficulties, in the form of elevated prementalising. Intellectual disability and cumulative childhood abuse/neglect uniquely predicted prementalising among the mothers, whereas cumulative psychosocial risk added to the risk for prementalising specifically among mothers with intellectual disability. CONCLUSIONS: Our findings support contextual models of caregiving, and suggest a need for mentalisation-based support for parents with mild intellectual disability.

Experiences of Interpersonal Trauma Among Parents With Intellectual Disabilities: A Systematic Review.

Research has suggested highly elevated levels of interpersonal trauma (IPT) among parents with intellectual disabilities (ID), and that such experiences may contribute to the caregiving and child developmental problems often seen in this population. Conflicting results have however been reported, and there is no systematic review on this matter. This study therefore systematically reviewed the empirical evidence concerning (a) prevalence of IPT among parents with ID, and links with (b) caregiving-relevant and (c) child developmental outcomes, in accordance with the PRISMA 2020 guidelines. Searches were conducted in MEDLINE, CINAHL, PsycINFO, and PTSDpubs. Peer-reviewed empirical articles reporting exposure to any form of systematically assessed IPT (unspecified IPT, physical, sexual, and emotional abuse, neglect, prolonged childhood separations from caregivers, witnessing abuse in the family) among parents with ID were included, yielding a final selection of 20 studies. Findings consistently indicated markedly elevated levels of IPT among parents with ID, with a majority (>50%) having experienced some form of IPT. Estimates for both unspecified and specific forms were typically higher than corresponding estimates in other groups at elevated risk, and than meta-analytical general population estimates in comparable countries. Findings regarding caregiving-relevant outcomes were mixed but indicated links with adverse outcomes, particularly regarding parental mental health. Reports pertaining to child developmental outcomes were scant and inconsistent. We highlight important limitations in the extant literature and provide directions for future research and clinical practice.

Concepts travel faster than thought: an empirical study of the use of attachment classifications in child protection investigations.

Scholarly discussion suggests prevalent, overconfident use of attachment classifications in child protection (CP) investigations but no systematic research has examined actual prevalence, the methods used to derive such classifications, or their interpretations. We aimed to cover this gap using survey data from a nationally representative sample of Swedish CP workers (N = 191). Three key findings emerged. First, the vast majority formed an opinion about young children's attachment quality in all or most investigations. Second, most did not employ systematic assessments, and none employed well-validated attachment methods. Third, there was overconfidence in the perceived implications of attachment classifications. For example, many believed that insecure attachment is a valid indicator of insufficient care. Our findings illustrate a wide researcher-practitioner gap. This gap is presumably due to inherent difficulties translating group-based research to the level of the individual, poor dissemination of attachment theory and research, and infrastructural pressures adversely influencing the quality of CP investigations.

Attachment goes to court: child protection and custody issues.

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

Attachment in the time of COVID-19: Insecure attachment orientations are associated with defiance of authorities' guidelines during the pandemic.

Previous research has linked people's relational attachment orientations to emotional reactions and coping during crises, and to social trust and trust in societal institutions. The COVID-19 pandemic is a global crisis for which collective efforts, such as social distancing, are necessary to stop the spread of the virus. During previous pandemics, people high in trust have typically adhered to such efforts. In the present study, we investigated whether attachment orientations were related to people's adherence to authorities' guidelines to stop the spread of COVID-19. We also tested whether previous mediational findings-linking attachment-related avoidance to welfare state trust via social trust-would replicate. We used a web-based survey of 620 participants. Our findings showed that attachment-related anxiety was linked to low adherence to social distancing regulations. This finding was especially noteworthy because high attachment-anxious participants also experienced more negative emotions, yet negative emotions were generally linked to high adherence. Thus, people higher in attachment anxiety seem to have more difficulties in avoiding social situations despite heightened risk of catching and spreading the virus. In addition, attachment-related avoidance was negatively related to adherence and to welfare state trust, and its effects on welfare state trust were statistically mediated by low social trust.

Admissibility of attachment theory, research and assessments in child custody decision-making? Yes and No!

Attachment theory, research, and assessments have become increasingly applied to settle child custody cases. We discuss such applications in relation to admissibility criteria for scientific evidence and testimony proposed by Faigman et al. (2014). We argue that attachment theory and research can provide valid "framework evidence"; group-based attachment research has yielded general principles suitable as a frame of reference for pertinent court decisions. In particular, child custody decision-making should generally be guided by research indicating that children benefit from attachment networks. In contrast, assessments of attachment quality fall short of providing valid "diagnostic evidence"; information that a specific individual/dyad is a "true" instance of a general group-level principle. In particular, such assessments do not yield valid information about whether a particular caregiver has better caregiving skills than another caregiver and will better support child development. We conclude that attachment theory and research should be admissible for framework but not for diagnostic testimony.

Depression and mentalizing: A psychodynamic therapy process study.

The present study aimed to explore the relationship between changes in depressive symptoms and the capacity to mentalize over the course of a 3-month inpatient psychodynamic therapy in a sample of 56 patients with depression. Depressive symptoms and mentalizing were assessed weekly during treatment and at 1-year follow-up with the Beck Depression Inventory and the Reflective Functioning Questionnaire (RFQ). Data were analyzed using Latent Growth Curve (LGC) modeling with structured residuals. In the total sample, depressive symptoms improved on average from baseline to the end of treatment, while mentalizing skills did not. However, individual variations were observed in mentalizing skills, with some patients improving while others did not. Within-patient residual changes in mentalizing skills did not predict residual changes in depressive symptoms. Accordingly, the results did not support mentalizing as a mechanism of change at this level. Nonetheless, between-patient effects were found, showing that patients with higher levels of mentalizing at baseline and patients whose mentalizing skills improved over the course of therapy also had greater reductions in depressive symptoms. We suggest that the presence of relatively higher mentalizing skills might be a factor contributing to moderately depressed individuals' ability to benefit from treatment, while relatively poor or absent mentalizing capacity might be part of the dynamics underlying treatment resistance in individuals with severe depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mothers With Mild Levels of Intellectual Disability: Emotion-Interpretation, Traumatization, and Child Attachment Representations.

Prior research indicates links between parents' experiences of interpersonal trauma and emotion-interpretation difficulties, and between such difficulties and child attachment insecurity and disorganization. Although mothers with mild levels of intellectual disability (ID) are at heightened risk for trauma and emotion-interpretation difficulties, and their children for attachment insecurity, corresponding links in this population have not been examined. We therefore investigated emotional interpretations among mothers with mild levels of ID (n = 23) and matched comparison mothers without ID (n = 25), in relation to mothers' experiences of trauma and their children's attachment representations. Mothers with mild levels of ID were not less accurate than comparison mothers with regard to general positive and negative emotion-interpretation accuracy, but they were significantly more likely to misinterpret shame and anger. Among mothers with mild levels of ID, misinterpretations of shame were positively related to maternal experiences of trauma, and to child attachment insecurity and disorganization.

The God, the blood, and the fuzzy: reflections on Cornerstones and two target articles.

In response to Cornerstones of attachment research and the target articles, I reflect on three questions. First, what is "attachment"? Although a natural kind, I argue against an essentialist understanding (i.e. in terms of necessary/sufficient conditions for class membership). Instead, the attachment concept must be allowed to have fuzzy boundaries, partly because of how attachments transform in both phylogeny and ontogeny. Second, how to think about the normative (species-typical) features of the theory vis-à-vis dyadic/individual differences in attachment? Whereas the former are foundational, I argue that the latter largely reflect surface variation. Despite this, the lion's share of attachment research has horned in on variation and its measurement, to some detriment to the theory's potential and applications. Finally, what is encouraging and discouraging about recent developments? While applauding large-scale cooperative endeavors (e.g. individual participant meta-analyses, consensus statements) I caution the field not to lose sight of the value of smaller-scale, creative explorations of uncharted territories.

Attachment, culture, and gene-culture co-evolution: expanding the evolutionary toolbox of attachment theory.

I argue that attachment relationships, and particularly secure ones, are important contexts for social learning and cultural transmission. Bowlby originally treated the attachment-behavioral system as serving only one evolutionary function: protection, via physical proximity. Yet the time is ripe to consider learning, especially social learning, as an additional functional consequence of attachment. Updated accordingly, attachment theory has the potential to serve as a much-needed developmental anchor for models of cultural evolution and gene-culture co-evolution. To support my arguments, I review progress in evolutionary science since Bowlby's lifetime, highlighting the growing recognition of ecological flexibility and the cultural embeddedness of animal behavior. I also review research pointing to a facilitating role of secure attachment relationships for social learning from caregivers among humans. For illustrational purposes, I show how one important aspect of human culture - religion - is culturally transmitted within attachment relationships, and of how the generalization of attachment-related working models biases the cultural transmission of religion from parents to offspring. I end the paper with a call for empirical research to test the role of attachment in cultural transmission beyond religion.

Attachment theory and religion.

Attachment theory deals with the development and dynamics of interpersonal affectional bonds. It also provides a framework for understanding individuals' relationship with God, which is central to religion. We review basic concepts of attachment theory and survey research that has examined religion both in terms of normative attachment processes and individual differences in attachment. We cite evidence from cross-sectional, experimental, and longitudinal studies showing that many religious individuals experience God as a source of resilience (e.g. a safe haven and secure base). We also summarize proposed attachment-related developmental pathways to religion. Finally, we review research on religion and mental health undertaken from an attachment viewpoint and discuss future directions.

The scent of security: Odor of romantic partner alters subjective discomfort and autonomic stress responses in an adult attachment-dependent manner.

When in a stressful situation, access to adult attachment figures (e.g., romantic partners) is an important means by which adults regulate stress responses. The practice of smelling a partner's worn garment is reported as a self-treatment against stress. Here, we experimentally determined whether exposure to a partner's body odor attenuates adults' subjective discomfort and psychophysiological responses, and whether such effects are qualified by adult attachment security. In a blocked design, participants (N = 34) were presented with their partner's body odor, their own body odor, the odor of a clean t-shirt and rose odor, while exposed to weak electric shocks to induce discomfort and stress responses. Results showed that partner body odor reduces subjective discomfort during a stressful event, as compared with the odor of oneself. Also, highly secure participants had attenuated skin conductance when exposed to partner odor. We conclude that partner odor is a scent of security, especially for attachment-secure adults.

Faith in the wake of disaster: A longitudinal qualitative study of religious attachment following a catastrophic flood.

OBJECTIVE: This longitudinal qualitative study explores the impact of natural disasters on religious attachment (perceived relationship with God). We sought to validate and conceptually extend the religion-as-attachment model in a postdisaster context. METHOD: At 4 weeks (T1; n = 36) and 6 months postdisaster (T2; n = 29), survivors of the 2016 Louisiana flood completed a disaster-adapted version of the Religious Attachment Interview (Granqvist & Main, 2017). RESULTS: At T1 and T2, survivors emphasized God being a safe haven (source of protection, comfort, or nurturance). This emphasis was especially pronounced for survivors who were directly affected (their home or business flooded) or had previous disaster exposure to Hurricane Katrina. Overall, survivors consistently emphasized God serving as a stronger and wiser attachment figure, and it was rare for them to report experiencing perceived separation or loss of intimacy from God. At T1 and T2, around 85% of survivors described their current religious attachment as either having a positive affective quality (e.g., closer, stronger) or as no different from before the disaster; around 15% said it had a negative affective quality (e.g., disappointed, strained). In describing their postdisaster religion/spirituality, survivors highlighted (a) God being a source of love, comfort, strength, and hope; (b) actively putting trust/faith in God; and (c) experiencing God through family/community. CONCLUSION: Results support and conceptually extend the religion-as-attachment model in a postdisaster context. Findings suggest disasters activate the attachment system, and survivors commonly view and relate with God as an attachment figure, especially one who serves as a safe haven. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

ON EXACTITUDE IN SCIENCE: A MAP OF THE EMPIRE THE SIZE OF THE EMPIRE.

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

DIAGNOSTIC USE OF CRITTENDEN'S ATTACHMENT MEASURES IN FAMILY COURT IS NOT BEYOND A REASONABLE DOUBT.

We express serious doubt and cautioning regarding Spieker and Crittenden's (2010) claim that attachment measures associated with the dynamic-maturational model of attachment and adaptation (DMM; Crittenden, 2016) can be used for court decision-making. We demonstrate, using Crittenden's and coworkers' (e.g., Spieker & Crittenden, 2010) own data, that such measures have (a) insufficient reliability for use in individual diagnosis and (b) cannot retrodict maltreatment with sufficient sensitivity or specificity for court use. Just as atypical forms of attachment are sometimes observed among children reared adequately, typical (secure or mildly insecure) forms of attachment are sometimes observed among maltreated children and among children of caregivers struggling with psychopathology or socioeconomic adversity. The stakes are high, so it is imperative that court decisions accord with the rule of law. Certainty beyond a reasonable doubt is required, and DMM measures do not meet that requirement.

Mixed support for a causal link between single dose intranasal oxytocin and spiritual experiences: opposing effects depending on individual proclivities for absorption.

Intranasal oxytocin (OT) has previously been found to increase spirituality, an effect moderated by OT-related genotypes. This pre-registered study sought to conceptually replicate and extend those findings. Using a single dose of intranasal OT vs placebo (PL), we investigated experimental treatment effects, and moderation by OT-related genotypes on spirituality, mystical experiences, and the sensed presence of a sentient being. A more exploratory aim was to test for interactions between treatment and the personality disposition absorption on these spirituality-related outcomes. A priming plus sensory deprivation procedure that has facilitated spiritual experiences in previous studies was used. The sample (N = 116) contained both sexes and was drawn from a relatively secular context. Results failed to conceptually replicate both the main effects of treatment and the treatment by genotype interactions on spirituality. Similarly, there were no such effects on mystical experiences or sensed presence. However, the data suggested an interaction between treatment and absorption. Relative to PL, OT seemed to enhance spiritual experiences in participants scoring low in absorption and dampen spirituality in participants scoring high in absorption.

Disorganized attachment in infancy: a review of the phenomenon and its implications for clinicians and policy-makers.

Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static "trait" of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.

Religious and spiritual development are determined 100% by nature, and 100% by nurture: A playful response to Boyatzis.

In this response, we respond to Boyatzis' commentary to our paper 'Nature meets nurture in religious and spiritual development'. We also provide additional elaborations on how nurture might co-sculpt nature in the context of religious and spiritual development.

Nature meets nurture in religious and spiritual development.

We consider nurture's (including culture's) sculpting influences on the evolved psychological predispositions that are expressed in religious and spiritual (R&S) development. An integrated understanding of R&S development requires a move away from the largely one-sided (nature-or-nurture) and additive (nature + nurture) accounts provided in the extant literature. R&S development has been understood as an expression of evolved cognitive modules (nature) on the one hand, and of socialization and social learning (nurture) on the other, or in similar albeit additive terms (e.g., nature produces the brain/mind, culture fills in the details). We argue that humans' evolved psychological predispositions are substantially co-shaped by environmental/cultural input, such as relational experiences and modelling at the microlevel through belief and value systems at the macrolevel. Nurture's sculpting of nature is, then, expressed in R&S development. Finally, for heuristic purposes, we illustrate a fully integrated nature-nurture model with attachment theory and its application to R&S development. Statement of contribution What is already known on this subject? Development unfolds as a function of nature-nurture interaction. R&S development has mostly been understood from the point of view of separate nature or nurture models. What does this study add? A collected consideration of the intricate interactions between nature and nurture in development. A sketch, examples, and a conceptual toolbox of how nature and nurture interact in R&S development.