RESUMEN
Chronic relational trauma can lead to the formation of pervasively unintegrated attachment representations in adulthood, referred to as Hostile-Helpless (HH) states of mind. Individuals with this type of attachment disorganization evidence conflicting evaluations of caregivers and have difficulty reflecting on their traumatic childhood experiences. This scoping review is the first to systematically integrate the results of all empirical studies on HH states of mind in an effort to highlight the scientific and clinical contributions of the concept and guide future research. Following Arksey and O'Malley's (2005) Methodological Framework, cross-reference keywords were searched in three databases (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). In total, 19 studies met inclusion criteria and were included in the synthesis. Results suggest that prevalence rates of HH states of mind increase as a function of adults' psychosocial risk status. Findings also reveal that the long-term consequences of early trauma are greater in the presence of a HH state of mind, whereas the absence of a HH state of mind acts as a protective factor against the intergenerational transmission of maladaptation. Finally, results support the discriminant validity of the HH classification against other forms of attachment disorganization in adulthood. Research gaps and future research directions are discussed.
El trauma crónico de la relación puede llevar a la formación de representaciones de afectividad profundamente desintegradas en la edad adulta, conocidas como estados mentales Hostiles-Sin Ayuda. Los individuos con este tipo de afectividad desorganizada demuestran evaluaciones conflictivas de quienes les cuidan y tienen dificultades para reflexionar acerca de sus experiencias traumáticas de niñez. Este estudio de alcance comprensivo es el primero en integrar sistemáticamente los resultados de todos los estudios empíricos acerca de los estados mentales Hostiles-Sin Ayuda como un esfuerzo para subrayar las contribuciones científicas y clínicas del concepto y guiar la investigación futura. Siguiendo el Marco de Trabajo Metodológico de Arksey y O'Malley's (2005), se investigaron palabras claves con enlaces de referencia en tres bases de datos (PsycArticles, Colección de Psicología y Ciencias del Comportamiento, ProQuest). En total, 19 estudios reunieron los criterios de inclusión y se les incluyó en la síntesis. Los resultados indican que los puntajes prevalentes de los estados mentales Hostiles-Sin Ayuda aumentan como una función del riesgo sicosocial de los adultos. Los resultados también revelan que las consecuencias a largo plazo del trauma temprano son mayores en presencia de un estado mental Hostil-Sin Ayuda, mientras que la ausencia de un estado mental Hostil-Sin Ayuda actúa como un factor de protección contra la transmisión intergeneracional de mal adaptación. Finalmente, los resultados apoyan la validez discriminante de la clasificación Hostil-Sin Ayuda contra otras formas de desorganización de la afectividad en la edad adulta. Se discuten los vacíos y el futuro de la investigación.
Le trauma relationnel chronique peut mener à la formation de représentations de l'attachement non intégré omniprésent à l'âge adulte, auquel on fait référence en tant qu'états d'esprit Hostile-Impuissant. Les individus avec de type de désorganisation d'attachement font état d'évaluations contradictoires des personnes prenant soin d'eux et ont des difficultés à réfléchir à leurs expériences traumatiques durant l'enfance. Ce passage en revue est le premier à systématiquement intégrer les résultats de toutes les études empiriques sur les états d'esprit Hostile-Impuissant pour essayer de mettre en évidence les contributions scientifiques et cliniques du concept et guider les recherches futures. En suivant la structure méthodologique de Arksey et O'Malley (2005) les mots clés de référence croisée ont fait l'objet d'une recherche dans trois bases de données (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). Au total 19 études ont rempli les critères d'inclusion et ont été inclues dans la synthèse. Les résultats suggèrent que les taux de prévalence d'états d'esprit Hostile-Impuissant augmentent en tant que fonction du statut de risque psychologique des adultes. Les résultats révèlent aussi que les conséquences à long terme du trauma précoce sont plus grandes en présence d'un état d'esprit Hostile-Impuissant, alors que l'absence d'état d'esprit hostile-Impuissance agit en tant que facteur protecteur contre la transmission intergénérationnel de mal-adaptation. Enfin, les résultats soutiennent la validité discriminante de la classification Hostile-Impuissant par rapport à d'autres formes de désorganisation de l'attachement à l'âge adulte. Les écarts dans les recherches et des directions futures de recherches sont discutés.
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Hostilidad , Apego a Objetos , Adulto , Cuidadores , Humanos , Factores de RiesgoRESUMEN
BACKGROUND: Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association. OBJECTIVES: The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention. PARTICIPANTS AND SETTING: The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study. METHODS: Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total. RESULTS: Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (ß = 0.174, p = .02) and depression (ß = 0.37, p = .004). However, both these associations were moderated by higher levels of perceived child resilience factors (ß = -0.29, p = .02, ß = -0.33, p = .008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors. CONCLUSIONS: Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic.
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Experiencias Adversas de la Infancia , Madres , Resiliencia Psicológica , Humanos , Femenino , Niño , Estudios Longitudinales , Experiencias Adversas de la Infancia/estadística & datos numéricos , Experiencias Adversas de la Infancia/psicología , Masculino , Adulto , Madres/psicología , Relaciones Madre-Hijo/psicología , Ansiedad/psicología , Encuestas y Cuestionarios , Depresión/psicología , Trastornos Mentales/psicología , Trastornos Mentales/epidemiologíaRESUMEN
Child maltreatment has many well-documented lasting effects on children. Among its consequences, it affects children's recognition of emotions. More and more studies are recognizing the lasting effect that a history of maltreatment can have on emotion recognition. A systematic literature review was conducted to better understand this relationship. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used and four databases were searched, MEDLINE/PubMed, PsycINFO, EMBASE, and FRANCIS, using three cross-referenced key words: child abuse, emotion recognition, and adults. The search process identified 23 studies that met the inclusion criteria. The review highlights the wide variety of measures used to assess child maltreatment as well as the different protocols used to measure emotion recognition. The results indicate that adults with a history of childhood maltreatment show a differentiated reaction to happiness, anger, and fear. Happiness is less detected, whereas negative emotions are recognized more rapidly and at a lower intensity compared to adults not exposed to such traumatic events. Emotion recognition is also related to greater brain activation for the maltreated group. However, the results are less consistent for adults who also have a diagnosis of mental health problems. The systematic review found that maltreatment affects the perception of emotions expressed on both adult and child faces. However, more research is needed to better understand how a history of maltreatment is related to adults' perception of children's emotions.
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Maltrato a los Niños , Expresión Facial , Niño , Adulto , Humanos , Emociones/fisiología , Maltrato a los Niños/psicología , Miedo , IraRESUMEN
The provision of services that improve the functioning, social participation and quality of life of individuals with behavioral or mental health problems is a common denominator amongst psychosocial professionals in Quebec, including social workers, psychologists and psychoeducators. One intervention that has gained empirical support as an intervention tool is physical activity. In fact, numerous studies have demonstrated the benefits of physical activity for many populations with whom psychosocial professionals work. Objectives Thus, the primary objective of this study was to understand the role physical activity plays in psychosocial intervention, specifically in the field of psychoeducation. The specific objectives of this study are (1) to assess how physical activity spans out in the academic and continuing education of psychoeducators, (2) establish the use of physical activity, and (3) to explore whether certain variables influence the use of physical activity by psychoeducators. Method A total of 150 psychoeducators across Quebec (years of experience: M = 11.2; SD = 9.1) completed an online survey. Descriptive statistics, conditional probability, chi-square, analyses, and logistic regression were performed. Results The results suggest that physical activity is an intervention tool used by psychoeducators, with just over 75% of professionals reporting having used physical activity in their practice. However, very few psychoeducators have received academic or continuing education pertaining to this intervention tool. The use of physical activity was not found to differ across clienteles with whom psychoeducators worked, but was positively and significantly predicted by the number of years of experience of the professionals. Conclusion Considering the numerous benefits associated with physical activity, the results of the present study emphasize the need to reflect on physical activity in psychosocial intervention and on the training offered to professionals in relation to the use of this tool. Taken together, the results of the scientific literature and our study highlight that physical activity can be used as an intervention tool by psychosocial professionals. However, in order to avoid iatrogenic outcomes resulting from inappropriate use of physical activity, further research is needed to ensure that professionals have the necessary training and supervision for safe and effective implementation.
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Calidad de Vida , Trabajadores Sociales , Humanos , Quebec , Educación Continua , Sistemas de Apoyo PsicosocialRESUMEN
BACKGROUND: Individuals who experience chronic relational trauma within the parent-child relationship are at risk of developing disorganized representations of attachment relationships in the form of Hostile-Helpless (HH) states of mind. While this association is well recognized theoretically, few studies to date have empirically tested predictors of HH states of mind. OBJECTIVE: The purpose of this study was to examine whether retrospective self-reports of maltreatment and the quality of mother-child affective communication assessed in childhood predict HH states of mind in young adulthood. METHODS: The sample was composed of 66 young adults from a low-income community sample, who had been taking part in a longitudinal project since they were preschoolers. RESULTS: Results indicate that childhood maltreatment experiences significantly predict HH states of mind and that the quality of mother-child affective communication serves a protective role in the association between childhood maltreatment severity and adult attachment disorganization. CONCLUSION: This study is one of the first to prospectively examine how the quality of mother-child affective communication in childhood relates to attachment disorganization in young adulthood. Our results highlight the importance of providing support to families in which the child is at risk of experiencing relational trauma, with a particular focus on improving the quality of parent-child interactions.
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Maltrato a los Niños , Relaciones Madre-Hijo , Adulto Joven , Humanos , Niño , Adulto , Estudios Retrospectivos , Relaciones Madre-Hijo/psicología , Relaciones Padres-Hijo , Emociones , Maltrato a los Niños/psicología , Apego a ObjetosRESUMEN
OBJECTIVE: The current meta-analytic review provides a comprehensive synthesis of studies examining parent exposure to ACEs and the developmental and mental health outcomes of their children. PARTICIPANTS AND SETTING: Eligible studies up to August 2021 were identified through comprehensive database searches in PsycINFO, MEDLINE, and Embase. Studies that were included examined the intergenerational effects of parent ACEs on child development (i.e., cognitive, language, motor, social difficulties, and early social-emotional development) or mental health (i.e., internalizing problems, externalizing problems) outcomes. METHODS: Data were extracted by two coders using a standardized extraction protocol. A multi-level meta-analytic approach was used to derive pooled effect sizes and test for moderators. RESULTS: A total of 52 studies were included in the meta-analysis. Parent ACEs were positively associated with child mental health problems (r=0.17, 95% CI [0.12, 0.21], p<.001), child externalizing difficulties (r=0.20, 95% CI [0.15, 0.26], p<.001), and child internalizing difficulties (r=0.17, 95% CI [0.11, 0.22], p<.001). There were no significant sociodemographic (i.e., child age, parent age, income level, child sex, or racial/ethnic minority status) or methodological (i.e., study type or quality) moderators of these associations. Preliminary evidence suggests that parent ACEs were not associated with offspring developmental outcomes, such as cognitive or language skills. CONCLUSIONS: Results suggest that parent ACEs are associated with some, but not all child outcomes. Additional research focused on the mechanisms of transmission are needed to inform policies and practices related to the intergenerational transmission of ACEs.
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Introduction: Developmental research has traditionally focused on parenting behaviors such as nurturance and care, due to a focus on mothers' behaviors. Other parenting dimensions such as parental playfulness (i.e., use of creativity, imagination, and humor during parent-child interactions) have comparatively received little attention. Although some measures tap into parents' and children's playfulness, these measures are limited. Indeed, they do not assess multiple domains of playfulness (i.e., both parents' and the child's playfulness) or focus on one specific setting such as children's play with peers. Additionally, existing measures do not consider parents' reactions to their partners' playfulness. To address this gap, we created the Playful Parenting Style Questionnaire (PPSQ), which assesses three domains of playfulness: (a) parental domain, (b) child domain, and (c) partner domain. The current study is part of a validation effort of the PPSQ using a quantitative design. We aimed to explore the structure of the PPSQ by conducting an exploratory factor analysis (EFA) for each domain of playfulness; and assess the construct validity of the PPSQ factors by examining the association between factors and existing measures of playful parenting, child playfulness, and co-parenting. Method: The sample includes 347 parents (294 mothers and 53 fathers) of preschool/school-age children (M = 5.10 years; 182 girls, 127 boys). Parents were mostly White (76%) and from a low socioeconomic risk background. Parents completed a series of online questionnaires including the PPSQ, 3 existing measures of parent playfulness (Parental Playfulness Questionnaire; Adult Playfulness Scale; Challenging Parenting Behavior Scale), 2 existing measures of child playfulness (Child Behavior Inventory; Children's Playfulness Scale), a coparenting instrument (Co-parenting Relationship Scale), and sociodemographic information. Results: The EFA revealed 4 factors for parental playfulness, 1 factor for child playfulness, and 3 factors for partner's playfulness. The construct validity analyses identified multiple associations indicating convergence with existing measures for the parent and partners domain but not the child factor. Discussion: This study allowed for a better understanding of the playful dynamics that occur within a family.
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The aim of this study was to investigate whether the quality of the sibling relationship moderates the association between parental psychological distress and child maladjustment (i.e., internalizing and externalizing problems). We extended previous literature by studying mothers and fathers separately and by including an observational measure of the quality of the sibling relationship. Participants were 52 two-parent families from a community sample who had at least two children living at home. Only one child (aged 6-10 years) was targeted for the study and studied in relation to his/her siblings. Mothers and fathers completed a self-reported questionnaire on their psychological distress and individually assessed their child's social-emotional maladjustment. The targeted child's interactions with his/her siblings were observed by independent judges during a home-visit. Results indicate that both maternal and paternal psychological distress are significant predictors of child social-emotional maladjustment. Moderation analyses reveal that children of distressed fathers are at lower risk of social-emotional maladjustment when they engage in highly positive interactions with their siblings. Post hoc analyses suggest that only sibling empathy (not teaching nor companionship) is a significant moderator of the association between paternal psychological distress and child maladjustment. The results of this study provide further evidence of the influence that fathers have in their child's development and highlight the importance of using a systemic family approach to promote children's social-emotional adaptation in the context of parental distress.
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Objectives The purpose of this study was to examine the unidimensional structure and psychometric qualities of the short version of the Kessler Psychological Distress Scale (K6) in adolescents living in Quebec. Method Data analyzed were obtained from the 2013-2014 Canadian Community Health Survey and included data from 1618 adolescents. The internal structure of the K6 and invariance by gender and age were tested using confirmatory factor analyses. Convergent and divergent validity of the K6 were also assessed. Finally, Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive power of the K6 in predicting the presence of a major depressive episode. Results The analyses suggest the presence of a unidimensional structure in the Quebec adolescent sample, as well as in the studied subgroups. The invariance of the measure is observed for the age subgroups but cannot be established with certainty for the gender analyses. The results support the convergent and divergent validity of the K6 with adolescents, whereas the alpha and omega values of the K6 indicate that its internal consistency ranges from questionable to acceptable for all respondents and subgroups. The results of the ROC curves reveal that the 4/5 cut-off point best predicts the presence of a major depressive episode among all participants and subgroups. Conclusion Although the K6 has several advantages, the internal consistency and invariance by gender results warrant caution regarding its use to identify the level of psychological distress of Quebec adolescents.
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Trastorno Depresivo Mayor , Humanos , Adolescente , Trastorno Depresivo Mayor/epidemiología , Escalas de Valoración Psiquiátrica , Canadá , Reproducibilidad de los Resultados , Encuestas Epidemiológicas , Encuestas y CuestionariosRESUMEN
Several studies have shown that child maltreatment is associated with both positive and negative effects on the recognition of facial emotions. Research has provided little evidence of a relation between maltreatment during childhood and young adults' ability to recognize facial displays of emotion in children, an essential skill for a sensitive parental response. In this study, we examined the consequences of different forms of maltreatment experienced in childhood on emotion recognition during parenthood. Participants included sixty-three mothers of children aged 2 to 5 years. Retrospective self-reports of childhood maltreatment were assessed using the short form of the Childhood Trauma Questionnaire (CTQ). Emotion recognition was measured using a morphed facial emotion identification task of all six basic emotions (anger, disgust, fear, happiness, sadness, and surprise). A Path Analysis via Structural Equation Model revealed that a history of physical abuse is related to a decreased ability to recognize both fear and sadness in children, whereas emotional abuse and sexual abuse are related to a decreased ability to recognize anger in children. In addition, emotional neglect is associated with an increased ability to recognize anger, whereas physical neglect is associated with less accuracy in recognizing happiness in children's facial emotional expressions. These findings have important clinical implications and expand current understanding of the consequences of childhood maltreatment on parents' ability to detect children's needs.
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Experiencias Adversas de la Infancia/psicología , Reconocimiento Facial , Madres/psicología , Adulto , Preescolar , Emociones , Femenino , Humanos , Masculino , Reconocimiento en Psicología , Estudios Retrospectivos , Autoinforme , Adulto JovenRESUMEN
BACKGROUND: Sensitivity is defined as parents ability to perceive, react and respond to children signals. Having a history of childhood maltreatment changes the way adults perceive visual emotions. These perceptual characteristics could have important consequences on how these parents respond to their children. OBJECTIVE: The current study examines how a history of childhood maltreatment moderates the relationship between maternal emotion recognition in child faces and sensitive behaviors toward their child during free-play and a structured task. PARTICIPANTS AND SETTING: Participants included 58 mothers and their children aged between 2 and 5 years. METHODS: Mothers were exposed to a set of photographs of child faces showing morphed images of the six basic emotional expressions. Mother-child interactions were then coded for sensitive behaviors. Mothers' history of childhood maltreatment was assessed using the Childhood Trauma Questionnaire. RESULTS: Maltreatment severity was related to poorer abilities in emotion recognition. However, the association between emotion recognition and sensitive behavior was moderate by history of childhood maltreatment. For mothers exposed to a severe form of childhood maltreatment, a better emotion recognition was related to less sensitive behaviors toward the child, both during free-play and the structured task. CONCLUSION: This relationship is unique to these mothers and is inconsistent with Ainsworth's definition of sensitivity. These results have important implications as they suggest mothers with a history of severe maltreatment would need tailored interventions which take into account their particular reactions to children's emotions.
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Maltrato a los Niños/psicología , Emociones/fisiología , Conducta Materna/psicología , Relaciones Madre-Hijo/psicología , Preescolar , Femenino , Humanos , MasculinoRESUMEN
Advanced cell culture methods for modeling organ-level structure have been demonstrated to replicate in vivo conditions more accurately than traditional in vitro cell culture. Given that the liver is particularly important to human health, several advanced culture methods have been developed to experiment with liver disease states, including infection with Plasmodium parasites, the causative agent of malaria. These models have demonstrated that intrahepatic parasites require functionally stable hepatocytes to thrive and robust characterization of the parasite populations' response to investigational therapies is dependent on high-content and high-resolution imaging (HC/RI). We previously reported abiotic confinement extends the functional longevity of primary hepatocytes in a microfluidic platform and set out to instill confinement in a microtiter plate platform while maintaining optical accessibility for HC/RI; with an end-goal of producing an improved P. vivax liver stage culture model. We developed a novel fabrication process in which a PDMS soft mold embosses hepatocyte-confining microfeatures into polystyrene, resulting in microfeature-based hepatocyte confinement (µHEP) slides and plates. Our process was optimized to form both microfeatures and culture wells in a single embossing step, resulting in a 100 µm-thick bottom ideal for HC/RI, and was found inexpensively amendable to microfeature design changes. Microfeatures improved intrahepatic parasite infection rates and µHEP systems were used to reconfirm the activity of reference antimalarials in phenotypic dose-response assays. RNAseq of hepatocytes in µHEP systems demonstrated microfeatures sustain hepatic differentiation and function, suggesting broader utility for preclinical hepatic assays; while our tailorable embossing process could be repurposed for developing additional organ models.