Latin American Attachment studies: A narrative review.

Attachment theory´s core hypotheses (universality, normativity, sensitivity, and competence) are assumed to be applicable worldwide. However, the majority of studies on attachment theory have been conducted in Western countries, and the extent to which these core hypotheses are supported by research conducted in Latin America has never been systematically addressed. The purpose of this systematic narrative literature review is to provide an integrative discussion of the current body of empirical studies concerning attachment theory conducted in Latin American countries. For that purpose, a search was conducted in four electronic databases (Web of Science, PsycInfo, SciELO, and Redalyc) and 82 publications on attachment and/or sensitivity met inclusion criteria. None of the studies reported cases in which an attachment relationship was absent, and a predominance of secure attachment patterns was found, mainly for non-risk samples (NRS). Sensitivity levels were generally deemed adequate in NRS, and related to attachment quality. Attachment security and caregivers' sensitivity were positively associated with child outcomes. Attachment-based intervention studies mostly showed efficacy. In conclusion, Latin American research supports the key theoretical assumptions of attachment theory, mainly in samples of urban middle-class NRS. However, the field of attachment-related research would be enriched by also investing in Latin American studies on caregiving rooted in local concepts and theories.

Hostile-helpless states of mind: A scoping review of risk factors, correlates, and consequences.

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.

Effectiveness of an attachment-based intervention for the assessment of parenting capacities in maltreating families: A randomized controlled trial.

Even though Parenting Capacity Assessments (PCAs) are essential for child protection services to support placement decisions for maltreating families, presently no evidence-based PCA protocols are available. In this randomized controlled trial, we tested the quality of an attachment-based PCA protocol based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We recruited 56 parent-child dyads (Mage children = 3.48 years) in Dutch family residential clinics that conduct PCAs to support placement decisions. After pretest, families were randomized to receive the Regular Assessment Procedure (RAP) (n = 28), or an additional assessment based on VIPP-SD (n = 28). An immediate post-test and a 10-month follow-up were conducted. Multilevel models showed that therapists felt equally confident about their recommendations regarding child placement for both groups and that they equally often modified their initial placement recommendations. Moreover, children in the VIPP-SD group did not show fewer behavior problems and did not experience recurring child maltreatment less often than children in the RAP group. Thus, we found no evidence that PCAs incorporating the VIPP-SD protocol outperformed PCAs as usual. We discuss possible explanations why in the current study VIPP-SD did not seem to add to the quality of the RAP.

A pesar de que las Evaluaciones de Capacidad de Crianza (PCA) son esenciales para los servicios de protección al niño para apoyar las decisiones de dónde colocarlo por razones de familias maltratadoras, en el presente no se encuentran disponibles ningún protocolo PCA basado en la evidencia. En este ensayo controlado al azar, pusimos a prueba la calidad de un protocolo PCA basado en la afectividad para lo cual nos basamos en la Intervención de Video Informativo para promover una Crianza Positiva y Disciplina Sensible (VIPP-SD). Reclutamos 56 díadas de progenitor-niño (edad promedio de los niños = 3.48 años) en clínicas residenciales de familias holandesas que utilizan las PCA para apoyar las decisiones de dónde colocar. Después del pre-examen, las familias fueron asignadas al azar para recibir el Procedimiento de Evaluación Regular (RAP) (n = 28), o una evaluación adicional basada en VIPP-SD (n = 28). Se llevaron a cabo un examen posterior inmediato y un seguimiento a los 10 meses. Los modelos de niveles múltiples mostraron que los terapeutas se sintieron igualmente confiados acerca de sus recomendaciones con respecto a dónde colocar al niño en ambos grupos y que ellos igualmente modificaron a menudo su recomendación inicial de dónde colocarlo. Es más, los niños en el grupo VIPP-SD no mostraron menos problemas de conducta y no experimentaron maltrato infantil recurrente menos a menudo que los niños en el grupo RAP. Por tanto, no encontramos evidencia de que las PCA que incorporan el protocolo VIPP-SD tuvieran mejores resultados que las PCA en su forma usual. Discutimos posibles explicaciones de por qué en el presente estudio los VIPP-SD no parecieron agregar nada a la calidad de RAP.

Contexte: Des interventions favorables et ciblées pour les familles sont nécessaires afin d'optimiser l'ajustement parental et la relation parent-bébé conformément à un diagnostic précédant de risque neurodéveloppemental pour les bébés. Buts: Le but de cette revue systématique était de déterminer l'efficacité des interventions pour l'amélioration de l'ajustement psychologique et le bien-être pour les parents ayant un bébé ayant été diagnostiqué comme ayant ou étant à risque d'avoir un trouble neurodéveloppemental. Méthodes: La stratégie de recherche du Cochrane Review Group a été suivie avec une recherche des essais contrôlés du Registre Cochrane Central, de PubMed, CINAHL, PsycINFO, et Embase entre juillet et décembre 2017. La qualité méthodologique des articles inclus a été évaluée au moyen de l'échelle de la base de données de preuve de physiothérapie (PEDro Physiotherapy Evidence Database) par deux évaluateurs indépendants. Résultats: Douze études ont rempli les critères d'inclusion. Un petit nombre d'essais de grande qualité ont révélé une efficacité modérée à importante de la réduction chez les parents de symptômes psychologiques indésirables de trauma et de stress des parents. Des améliorations importantes dans les symptômes de dépression et d'anxiété ont émergé lors de follow up post intervention à plus long terme (6 mois-8 ans). Conclusions: On constate un soutien prometteur pour l'efficacité de certaines interventions à réduire les symptômes psychologiques de mésadaptation chez les parents avec des bébés diagnostiqués comme étant à risque d'un trouble neurodéveloppemental. D'autres ECR de qualité d'intervention psychologiques portant sur les conditions plus grandes de risque neurodéveloppemental sont nécessaires.

Attachment & Child Health (ATTACH) pilot trials: Effect of parental reflective function intervention for families affected by toxic stress.

Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function-parents' capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child-may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.

Los factores tóxicos de estrés (v.g. violencia de los padres, depresión, bajos recursos económicos) colocan a los niños bajo riesgo de una insegura afectividad. La función de reflexión de los padres, o sea, lacapacidad de los padres de comprender su propio estado mental y el de sus niños y por tanto regular sus propios sentimientos y conductas hacia su niño, pudiera amortiguar los efectos negativos del estrés tóxico sobre la afectividad. Nuestro objetivo fue probar la eficacia de la intervención Afectividad y Salud del Niño (ATTACH), enfocándonos en mejorar la función de reflexión y la seguridad de la afectividad de los niños, para madres y niños de <36 meses de edad bajo riesgos. Se llevaron a cabo tres estudios pilotos con mujeres y niños de una agencia del centro de la ciudad que les sirve a familias vulnerables de bajos recursos económicos y un albergue para casos de violencia familiar. Un ensayo controlado al azar (n = 20, n = 10 al momento de inscribirse) y métodos cuasi-experimentales (n = 10 al momento de inscribirse) pusieron a prueba el efecto de ATTACH sobre el resultado primario de los puntajes de la función de reflexión, a partir de las transcritas Entrevistas del Desarrollo del Progenitor. Nuestro secundario resultado fueron los patrones de afectividad de los niños con base en el Procedimiento de la Situación Extraña de Ainsworth. A pesar de algunas bajas (n = 2 casos), los análisis de co-variantes con métodos combinados y las pruebas-t revelaron significativas diferencias en la función de reflexión materna, del niño, y en términos generales, con niveles de efectos moderados. Aunque más niños cuyas madres recibieron el programa ATTACH presentaron seguridad en su afectividad después del tratamiento, comparados con el grupo de control, no se observaron diferencias significativas, lo cual pudiera ser consecuencia de observaciones ausentes (n = 5 casos). Comprender la eficacia de programas como ATTACH contribuye a programas y servicios mejorados con el fin de promover un saludable desarrollo de los niños afectados por el estrés tóxico.

Les stresseurs toxiques (par exemple la violence parentale, la dépression, la pauvreté) placement les enfants à risque d'attachement insécure. La fonction parentale de réflexion, c'est-à-dire la capacité des parents à comprendre leurs propres états mentaux et celui de leur enfant et donc de réguler leurs propres sentiments et comportement envers leur enfant, peut servir de tampon aux effets négatifs du stress toxique sur l'attachement. Notre objectif était de tester l'efficacité de l'intervention Attachement et Santé de l'Enfant (en anglais, Attachment and Child Health, soit, ATTACH), en s'attachant à améliorer la fonction de réflexion et la sécurité de l'attachement des enfants, pour des mères à risques et leurs enfants <36 mois d'âge. Trois études pilotes ont été faites avec des femmes et des enfants d'une agence de quartiers défavorisés servant des familles vulnérables, de milieu défavorisé, ainsi qu'un refuge familial pour les victimes de violence. Un essai contrôlé randomisé (n = 20, n = 10 à l'inscription) et des méthodes quasi-expérimentales (n = 10 à l'inscription) ont testé l'effet de ATTACH sur le résultat principal de scores de fonction de réflexion, à partir d'Entretiens du Développement du Parent transcrits. Notre deuxième résultat était les patterns d'attachement des enfants à partir de la Procédure de Situation Etrange d'Ainsworth. En dépit d'une attrition (n = 2 cas), une analyse mixte de la covariance et les tests-t ont révélé des différences importantes dans la fonction de réflexion générale, maternelle, et de l'enfant, avec une ampleur modérée. Alors que plus d'enfants dont les mères ont reçu le programme ATTACH étaient attachés de manière sécure après le traitement, comparés aux contrôles, aucune différence importante n'a été observée, ce qui pourrait s'expliquer par des observations manquantes (n = 5 cas). La compréhension de l'efficacité de programmes comme ATTACH contribue à améliorer des programmes et des services promouvant un développement sain des enfants affectés par le stress toxique.

Does knowing translate to doing? Practitioners' experiences of Circle of Security-Parenting (COS-P) training and implementation.

This study sought to understand how practitioners perceive and experience the Circle of Security-Parenting (COS-P) training, and further, how they integrate and implement it into practice, and how these experiences influence their use and understanding of the program and its underlying model. A thematic analysis of semistructured interviews at two time points (shortly after training and 3-6 months after training) was used to explore 12 practitioners' experiences of COS-P training and subsequent implementation. Three main themes were identified; clinical salience, personal salience, and partial use of the program. The findings reflected participants' common perception that the model is relevant and generalizable to a wide variety of contexts. It also highlighted potential barriers to implementation, particularly practitioners' experiences using only components of the COS-P program in isolation. The results suggest practitioners' assumptions about client complexities, vulnerabilities, and/or incapacities, can prompt practitioners to withhold the use of COS-P (in part or whole), thereby potentially neglecting key components required for client change. The only participants who implemented the COS-P training in full had additional training in Circle of Security.

Este estudio buscaba comprender cómo los profesionales de la práctica perciben y experimentan el entrenamiento Círculo de Seguridad-Crianza (COS-P), y aún más, cómo ellos lo integran e implementan en la práctica y cómo estas experiencias influyen en su uso y comprensión del programa y el modelo que el mismo enfatiza. Se usó un análisis temático de entrevistas semiestructuradas en dos momentos temporales (poco después del entrenamiento y 3-6 meses después del entrenamiento) para explorar doce experiencias de profesionales de la práctica en cuanto al entrenamiento de COS-P y la subsecuente implementación. Se identificaron tres temas principales; relevancia clínica, relevancia personal y el uso parcial del programa. Los resultados reflejan la percepción común de los participantes de que el modelo es relevante y se puede generalizar a una variedad amplia de contextos. También destacó barreras potenciales para la implementación, particularmente las experiencias de los profesionales de la práctica usando sólo componentes aislados del COS-P. Los resultados sugieren que las suposiciones de los profesionales de la práctica acerca de las complejidades, vulnerabilidades y/o incapacidades del cliente pueden dar pie para que tales profesionales no revelen el uso de COS-P (en parte o totalmente), de modo que potencialmente desatiendan componentes claves requeridos para el cambio en el cliente. Los únicos participantes que implementaron el entrenamiento de COS-P en su totalidad recibieron entrenamiento adicional en cuanto a Círculo de Seguridad.

Cette étude s'est donné pour but de comprendre comment les praticiens perçoivent et font l'expérience de la formation du Cercle de Sécurité-Parentage (COS-P en anglais), et ensuite comment ils l'intègrent et la mettent en place dans leur pratique, ainsi que la manière dont ces expériences influencent leur utilisation et compréhension du programme, tout comme son modèle sous-jacent. Une analyse thématique d'entretiens semi-structurés en deux temps (pas longtemps du Cercle de Sécurité-Parentage (COS-P) après la formation et 3 à 6 mois après la formation) a été utilisée afin d'explorer à la fois les expériences du COS-P faites par douze praticiens et leur mise en place subséquente. Trois thèmes principaux ont été identifiés, la saillance clinique, la saillance personnelle et l'utilisation partielle du programme. Les résultats ont reflété la perception commune des participants selon laquelle le modèle est pertinent et généralisable à une grande variété de contextes. L'étude a aussi mis en lumière les barrières potentielles pour la mise en place, en particulier les expériences des praticiens utilisant uniquement des composantes du programme COS-P en isolation. Les résultats suggèrent que les suppositions des praticiens sur les complexités des clients, leurs vulnérabilités et / ou leurs incapacités, peuvent pousser les praticiens à ne pas utiliser le COS-P (en partie ou totalement), négligeant ainsi potentiellement des composantes clés exigées pour que le client change. Les seuls participants qui ont mis en place la formation COS-P en totalité avaient la formation supplémentaire de Cercle de Sécurité.

Afetividade e a politização da dor em territórios de vulnerabilidade social: micropolítica e a produção do cuidado / Affectivity and the politicization of pain in territories of social vulnerability: micropolitics and the production of care / La afectividad y politización del dolor en los territorios de vulnerabilidad social: micropolítica y la producción de cuidados

Esta pesquisa buscou compreender a qualidade das relações intersubjetivas que balizam os encontros entre os sujeitos que compõem o campo micropolítico da produção de cuidado à saúde mental em território marcado pela violência, miséria e exclusão. A escolha metodológica a partir da hermenêutica de profundidade possibilitou a reinterpretação das formas simbólicas a partir de três perspectivas: o reflexo da sociedade de mercado na organização dos processos de trabalho em saúde, o sofrimento psíquico à luz do sofrimento ético-político e dos bons encontros e a potência de ação, orientando as práticas em saúde mental. Dessa forma, a amizade e a solidariedade destacaram-se como afetos importantes no processo de politização da dor, do sofrimento psíquico e ético-político experimentado pelos sujeitos em territórios de vulnerabilidade social.

This research sought to understand the quality of interpersonal relations that guide the meetings among the subjects that make up the micro-political field of care production to mental health in the territory marked by violence, poverty, and exclusion. The methodological choice from the depth of hermeneutics enabled the reinterpretation of symbolic forms from three perspectives: the reflection of the market society in the organization of health work processes, mental suffering in the light of the ethical-political suffering and the good meetings and the power of action guiding the mental health practices. In this way, the friendship and solidarity stood out as important affections in pain politicization process, the psychological and ethical-political suffering experienced by the subjects in socially vulnerable territories.

Esta investigación trató de entender la calidad de las relaciones interpersonales que guían las reuniones entre los sujetos que conforman el campo de micropolítica de la producción de la atención a la salud mental en un territorio marcado por la violencia, la pobreza y la exclusión. La elección metodológica de la hermenéutica profunda permitió la reinterpretación de las formas simbólicas desde tres perspectivas: el reflejo de la sociedad de mercado en la organización de los procesos de trabajo de salud, sufrimiento mental a la luz del sufrimiento ético-política y las buenas reuniones y el poder de acción, guiando las prácticas de salud mental. De esta manera, la amistad y la solidaridad se destacaron como efectos importantes en el proceso de politización del dolor, el sufrimiento psicológico y ético-político experimentado por los sujetos en territorios socialmente vulnerables.

Infant mental health home visiting in the context of an infant-toddler court team: Changes in parental responsiveness and reflective functioning.

This article describes an infant-toddler court team in Michigan, the community-based participatory research approach to the implementation evaluation, and the resulting changes in parenting. Like other court teams, Michigan's Baby Court is led by a science-informed jurist, and all service providers are knowledgeable about the developmental needs of young children and engage in collaborative communication throughout the case. Relationship-based treatment in the form of infant mental health home-visiting was provided to families. Sixteen parents participated in pre- and posttest evaluation visits to assess changes in parents' reflective functioning and interactions with their child. Findings suggest improvements in parents' responsiveness, positive affect, and reflective functioning, with moderate effects. Higher risk parents demonstrated significant changes in reflective functioning, as compared to those at lower risk. These findings add to and support the limited literature on the effectiveness of infant-toddler court teams, which include relationship-based and trauma-informed services.

Este artículo describe un equipo judicial para casos de infantes y niños pequeños en Michigan, el acercamiento de investigación participativo basado en la comunidad para la evaluación de la implementación, así como los resultantes cambios en la crianza. Como otros equipos judiciales, El Tribunal de Michigan para los Bebés está encabezado por un jurista versado en la ciencia y todos los servidores tienen conocimiento acerca de las necesidades de desarrollo de los niños pequeños y participan en la comunicación colaborativa a lo largo del caso. Las familias recibieron un tratamiento con base en la relación, en forma de Visitas de Salud Mental Infantil a Casa. Dieciséis progenitores participaron en la evaluación anterior y posterior a la examinación con el fin de evaluar los cambios en el funcionamiento reflexivo de los padres y las interacciones con su niño. Los resultados sugieren mejoramientos en la sensibilidad de los progenitores, el afecto positivo y el funcionamiento reflexivo, con efectos moderados. Los progenitores de más alto riesgo demostraron cambios significativos en el funcionamiento reflexivo comparados con aquellos de más bajo riesgo. Estos resultados contribuyen y apoyan los estudios impresos acerca de la efectividad de los equipos judiciales para casos de infantes y niños pequeños, los cuales incluyen servicios basados en la relación y fundados en la comprensión del trauma.

Cet article décrit une équipe au tribunal des bébés-jeunes enfants dans l'état américain du Michigan, une approche de recherche participatoire basée sur la communauté au sujet de l'évaluation de la mise en œuvre et les changements résultants dans le parentage. Comme les autres tribunaux le Tribunal pour Bébés du Michigan est dirigé par un juriste qui s'informe à partir de données scientifiques. Tous les prestataires de service sont au fait des besoins en matière de développement des jeunes enfants, et ils procèdent à une communication collaborative tout au long du cas. Un traitement basé sur la relation sous la forme de Visites à Domiciles de Santé Mentale du Nourrisson a été offert aux familles. Seize parents ont participé à des visites d'évaluation pré- et post-test afin d'évaluer les changements dans le fonctionnement de réflexion des parents et dans les interactions avec leur enfant. Les résultats suggèrent des améliorations dans la réaction des parents, l'affect positif et le fonctionnement de réflexion, avec des effets modérés. Les parents au risque le plus élevé ont fait preuve de changements importants dans le fonctionnement de réflexion par rapport à ceux qui étaient à moindre risque. Ces résultats s'ajoutent aux recherches limitées sur l'efficacité des équipes de tribunal pour nourrisson-jeune enfant (qui comportent les services basés sur la relation et les services basés sur le trauma) et les soutiennent.

"What support would you find helpful?" The relationship between treatment expectations, therapeutic engagement, and clinical outcomes in parent-infant psychotherapy.

The aim of this study was to investigate the impact of pretreatment expectations on clinical outcomes and engagement in Parent-Infant Psychotherapy (PIP). Sixty-one mothers who were experiencing mental health difficulties and who were receiving PIP with their young infants participated in the study. A mixed-methodology was used to examine participants' expectations through transformation content analysis of pretreatment interviews; recurring themes were classified and quantified. Further statistical analyses explored relationships between the quantified themes of parental expectations and clinical outcomes and engagement in treatment. No significant correlation was found between expectations and engagement. One of the six clinical outcomes significantly correlated with parental expectations. Improved reflective functioning (RF) was predicted by participants describing expectations of wanting to improve their parent-infant relationship through the treatment, and expressing concerns about discussing their past experiences. These two expectations predicted improvements in RF independently and when combined. These results indicate that PIP may be more effective for some mothers than others and that assessing future clients' expectations before beginning PIP may be beneficial.

El propósito de este estudio fue investigar el impacto de las expectativas anteriores al tratamiento acerca de los resultados clínicos y la participación en la Sicoterapia Progenitor-Infante (PIP). Sesenta y una madres que experimentaban dificultades de salud mental y que estaban recibiendo PIP con sus pequeños infantes participaron en el estudio. Se utilizó una metodología mixta para examinar las expectativas de las participantes a través de análisis de contenido de transformación de las entrevistas anteriores al tratamiento; los temas recurrentes fueron clasificados y cuantificados. Análisis estadísticos adicionales exploraron las relaciones entre los temas cuantificados de expectativas de las madres y los resultados clínicos y participación en el tratamiento. No se encontró una correlación significativa entre las expectativas y la participación. Uno de los seis resultados clínicos se correlacionó significativamente con las expectativas de las madres. Las participantes predijeron el funcionamiento reflexivo mejorado (RF) al describir sus expectativas de querer mejorar su relación progenitor-infante por medio del tratamiento, así como al expresar preocupación sobre discutir sus experiencias pasadas. Estas dos expectativas predijeron las mejoras en RF independientemente y cuando estaban combinadas. Estos resultados indican que PIP pudiera ser más eficaz para ciertas madres que para otras y que evaluar las expectativas de futuros clientes antes de comenzar PIP pudiera ser beneficioso.

Le but de cette étude était de se pencher sur l'impact des attentes pré-traitement sur les résultats cliniques et l'engagement clinique dans une Psychothérapie Parent-Nourrisson (abrégée ici PPN)/ Soixante et une mères qui faisaient l'expérience de difficultés de santé mentale et qui recevaient une PPN avec leur jeune bébé ont participé à cette étude. Une méthodologie mixte a été utilisée afin d'examiner les attentes des participantes à travers une analyse de contenu de transformation des entretiens pré-traitement. Les thèmes qui revenaient ont été ont été classifiés et quantifiés. Des analyses statistiques supplémentaires ont exploré les relations entre les thèmes quantifiés des attentes des parents et les résultats cliniques ainsi que l'engagement clinique dans le traitement. Aucune corrélation n'a été trouvée avec les attentes parentales. Un fonctionnement réfléchi (abrégé RF en français) amélioré a été prédit par les participantes, décrivant des attentes, attentes selon lesquelles elles voulaient améliorer leur relation parent-nourrisson à travers le traitement, et exprimant leurs soucis concernant la discussion de leurs expériences passées. Ces deux attentes ont prédit des améliorations dans le RF indépendamment et lors combinées. Ces résultats indiquent que la PPN peut être plus efficaces pour certaines mères que d'autre et que le fait d'évaluer les attentes des clients avant de commencer la PPN peut s'avérer être une bénéfice.

DOES TRAINING IN THE CIRCLE OF SECURITY FRAMEWORK INCREASE RELATIONAL UNDERSTANDING IN INFANT/CHILD AND FAMILY WORKERS?

This article evaluated whether attendance at Circle of Security training workshops resulted in attendees showing greater empathy and attachment-related knowledge and understanding, and fewer judgmental responses to viewing a stressful parent-child interaction. Participants were 202 practitioners who attended and completed a 2-day (n = 70), 4-day (n = 105), or 10-day (n = 27) COS training workshop in Australia or New Zealand in 2015. In a pre/post design, participant reactions to a video clip of a challenging parent-child interaction were coded for empathic, judgmental, or attachment-focused language. Attachment understanding was coded in response to questions about the greatest challenge that the dyad faced. In all training conditions, participants provided significantly more attachment-focused descriptors and showed significantly greater attachment understanding after training, but significantly fewer empathic descriptors. While participants at the longer workshops provided significantly fewer judgmental/critical descriptors, there was no change for those attending the 2-day workshop. Irrespective of workshop duration or professional background, participants took a more relational perspective on the vignette after the training workshops. More detailed research is required to establish the extent to which this increased knowledge and understanding is retained and integrated into infant mental health practice with parents and young children.

IMPLEMENTING AN ATTACHMENT-BASED PARENTING INTERVENTION WITHIN HOME-BASED EARLY HEAD START: HOME-VISITORS' PERCEPTIONS AND EXPERIENCES.

Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations.

OBSERVING THE INFLUENCE OF MINDFULNESS AND ATTACHMENT STYLES THROUGH MOTHER AND INFANT INTERACTION: A LONGITUDINAL STUDY.

The cross-generational influence of attachment security or insecurity on caregiving is well-established. Recently, research has focused on mindfulness as a potential variable to interrupt the transmission of insecure attachment and disrupt its effect across generations. Thirty-six pregnant female participants completed the Five Facets Mindfulness Questionnaire and Relationship Questionnaire-Clinical Version at 30 weeks' gestation. Following the infant's birth, mothers and their babies participated in a video-recorded feeding session at 7 to 10 weeks' postpartum. It was predicted that a secure attachment style and higher levels of mindfulness measured prenatally would be associated with greater maternal responsiveness postpartum. The hypothesis was supported for both the secure and insecure (fearful and profoundly distrustful) attachment styles. Mindfulness did not mediate the relationship between attachment and maternal distress. The mindfulness subscale Non-Reacting was significantly associated with maternal response to distress. These findings support the role of prenatal mindfulness skills and attachment security for later postnatal maternal sensitivity to baby.

BEYOND THE DYAD: THE RELATIONSHIP BETWEEN PRESCHOOLERS' ATTACHMENT REPRESENTATIONS AND FAMILY TRIADIC INTERACTIONS.

This study examines the relationship between triadic family interactions and preschoolers' attachment representations, or internal working models (IWMs), from a qualitative and dimensional perspective. Individual, relational, and sociocultural variables were evaluated using two different samples. The results showed that triadic family interactions were linked to preschoolers' attachment security levels in both groups, indicating the reliability of the proposed model.

ANTENATAL DETERMINANTS OF PARENTAL ATTACHMENT AND PARENTING ALLIANCE: HOW DO MOTHERS AND FATHERS DIFFER?

Parental (parent-to-infant) attachment and parenting alliance are defined as two important components of psychoaffective adjustment to the parental role. This study aimed to build a predictive model of parental attachment and parenting alliance for mothers and fathers using partial least squares-structural equation modeling. Specifically, we were interested in assessing how adult romantic attachment, marital quality, and psychological distress influenced parental attachment (parent-to-infant) and parenting alliance. Forty heterosexual couples completed questionnaires during the third trimester of pregnancy and 2 months after childbirth. Results showed that adult romantic attachment, marital quality, and psychological distress were important antenatal determinants of parental attachment and parenting alliance, although they behaved differently for mothers and fathers. Hence, different predictive models were therefore proposed for mothers and fathers. Mothers' attachment to the child was influenced by internal factors as adult attachment dimensions; for fathers, it also depended on mothers' antenatal attachment to the child and on marital quality. Concerning parenting alliance, both mothers and fathers depended on own and partner's variables. Antenatal variables are important for what occurs during the transition to parenthood in terms of parenting adjustment and act differently for mothers and fathers. It thus is important to assess the psychological functioning of both mothers and fathers.

OBSERVING TODDLERS' INDIVIDUAL EXPERIENCES IN CLASSROOMS: INITIAL USE OF THE PARENTING INTERACTIONS WITH CHILDREN: CHECKLIST OF OBSERVATIONS LINKED TO OUTCOMES.

This study investigated using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO; Roggman, Cook, Innocenti, Norman, & Christiansen, 2013a) measure to assess teacher-child interactions experienced by individual toddlers within their childcare classrooms. Forty toddlers were observed, each during three 10-min cycles, and all their interactions with adults in the classroom were coded using the PICCOLO. Results, in terms of psychometric properties, indicate promise for using this measure to observe toddlers' individual experiences of teacher-child interactions in group settings. Furthermore, certain individual teacher-toddler interactions were associated with toddlers' problem behavior. Implications for use of the PICCOLO in early childhood classroom research and particular findings related to toddlers' behavior are discussed.

FIRST-GENERATION LATINA MOTHERS' EXPERIENCES OF SUPPLEMENTING HOME-BASED EARLY HEAD START WITH THE ATTACHMENT AND BIOBEHAVIORAL CATCH-UP PROGRAM.

This qualitative pilot study examined first-generation Latina mothers' experiences of supplementing home-based Early Head Start (EHS) services with the evidence-based Attachment and Biobehavioral Catch-up (ABC; M. Dozier, O. Lindheim, & J. Ackerman, 2005) program. Ten low-income, first-generation Latina mothers with infants and toddlers enrolled in home-based EHS were provided 10 ABC home visits by a supplemental parent coach. Following delivery of ABC, mothers participated in in-depth, semistructured, qualitative interviews about their experiences. Interview themes included positive experiences of both EHS and the ABC, a high value placed on receiving both programs, and cultural relevance of the ABC program for Latino families. Participants offered several suggestions for improved program delivery. Study findings suggest that a model of EHS supplemented by ABC delivered to the Latino community is feasible, valuable to participants, and culturally relevant. Considerations for sustainability of this supplemental model are discussed.

RANDOMIZED CONTROLLED TRIAL OF PARENT-INFANT PSYCHOTHERAPY FOR PARENTS WITH MENTAL HEALTH PROBLEMS AND YOUNG INFANTS.

There is a dearth of good-quality research investigating the outcomes of psychoanalytic parent-infant psychotherapy (PIP). This randomized controlled trial investigated the outcomes of PIP for parents with mental health problems who also were experiencing high levels of social adversity and their young infants (<12 months). Dyads were clinically referred and randomly allocated to PIP or a control condition of standard secondary and specialist primary care treatment (n = 38 in each group). Outcomes were assessed at baseline and at 6-month and 12-month follow-ups. The primary outcome was infant development. Secondary outcomes included parent-infant interaction, maternal psychopathology, maternal representations, maternal reflective functioning, and infant attachment. There were no differential effects over time between the groups on measures of infant development, parent-infant interaction, or maternal reflective functioning. Infant attachment classifications, measured only at the 12-month follow-up, did not differ between the groups. There were favorable outcomes over time for the PIP-treated dyads relative to the control group on several measures of maternal mental health, parenting stress, and parental representations of the baby and their relationship. The findings indicate potential benefits of parent-infant psychotherapy for improving mothers' psychological well-being and their representations of their baby and the parent-infant relationship.

MATERNAL REPRESENTATIONS AND INFANT ATTACHMENT: AN EXAMINATION OF THE PROTOTYPE HYPOTHESIS.

The prototype hypothesis suggests that attachment representations derived in infancy continue to influence subsequent relationships over the life span, including those formed with one's own children. In the current study, we test the prototype hypothesis by exploring (a) whether child-specific representations following actual experience in interaction with a specific child impacts caregiver-child attachment over and above the prenatal forecast of that representation and (b) whether maternal attachment representations exert their influence on infant attachment via the more child-specific representation of that relationship. In a longitudinal study of 84 mother-infant dyads, mothers' representations of their attachment history were obtained prenatally with the Adult Attachment Interview (AAI; M. Main, R. Goldwyn, & E. Hesse, 2002), representations of relationship with a specific child were assessed with the Working Model of the Child Interview (WMCI; C.H. Zeanah, D. Benoit, & L. Barton, 1986), collected both prenatally and again at infant age 11 months, and infant attachment was assessed in the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Walters, & S. Wall, 1978) when infants were 11 months of age. Consistent with the prototype hypothesis, considerable correspondence was found between mothers' AAI and WMCI classifications. A mediation analysis showed that WMCI fully accounted for the association between AAI and infant attachment. Postnatal WMCI measured at 11 months' postpartum did not add to the prediction of infant attachment, over and above that explained by the prenatal WMCI. Implications for these findings are discussed.

Sofrimento ético-político: uma análise do estado da arte / Sufrimiento ético-político: un análisis del estado del arte / Ethical-political suffering: an analysis of the state of the art

Este artigo analisa o uso do conceito do sofrimento ético-político, criado por Sawaia, a partir das reflexões fomentadas em seu núcleo de pesquisa. Neste estudo, optou-se pela análise do uso do conceito em artigos publicados entre 2000 a 2011, usando a base de dados SciELO e Capes, e posteriormente o Google Acadêmico, os quais foram incluídos ou excluídos da análise, de acordo com os critérios do período pesquisado e do uso do conceito pelo autor em sua análise. A publicação inicial do conceito data do ano de 1999 e justifica-se o período pesquisado pela abrangência, que alcançou tanto na Psicologia Social como em outras áreas do conhecimento. O resultado da pesquisa evidencia que o sofrimento ético-político já constitui um conceito-chave nas Ciências Humanas, para a compreensão da dimensão psicossocial do processo de exclusão/inclusão em contextos sócio-históricos de desigualdade social.(AU)

Este artículo examina el uso del concepto de sufrimiento ético-político, creado por Sawaia, de las reflexiones impulsadas en su central de investigación. En este estudio, se optó por analizar el uso del concepto en los artículos publicados desde 2000 hasta 2011, el uso de la SciELO Capes y los datos, y luego Google Scholar, los cuales no son incluidos o excluidos del análisis, de acuerdo con los criterios del período de investigación y el uso del concepto por el autor en su análisis. El concepto inicial de la fecha de publicación de 1999 y justificó el período relevado por la amplitud, que alcanzó tanto en la psicología social y en otros campos del conocimiento. El resultado de la investigación muestra que el sufrimiento ético-político ya es un concepto clave en las Humanidades, para la comprensión de la dimensión psicosocial de la exclusión / inclusión en contextos socio-históricos del proceso de la desigualdad social.(AU)

This article analyzes the use of the concept of ethical-political suffering, created by Prof. Dr. Bader Sawaia, from the reflections fostered in its core research. In this study, we chose to analyze the use of the concept in articles published from 2000 to 2011, using the SciELO database and Capes, and later Google Scholar, which were included or excluded from the analysis according to the criteria of the period researched and the use of the concept by the author in his analysis. The concept of the initial publication date of 1999 and is justified by the scope of the survey period who achieved so much in social psychology and in other fields of knowledge. The research result shows that the ethical-political suffering is already a key concept in the Humanities for understanding the psychosocial dimension of the process of exclusion / inclusion in socio-historical contexts of social inequality.(AU)

Sofrimento ético-político: uma análise do estado da arte / Sufrimiento ético-político: un análisis del estado del arte / Ethical-political suffering: an analysis of the state of the art

Este artigo analisa o uso do conceito do sofrimento ético-político, criado por Sawaia, a partir das reflexões fomentadas em seu núcleo de pesquisa. Neste estudo, optou-se pela análise do uso do conceito em artigos publicados entre 2000 a 2011, usando a base de dados SciELO e Capes, e posteriormente o Google Acadêmico, os quais foram incluídos ou excluídos da análise, de acordo com os critérios do período pesquisado e do uso do conceito pelo autor em sua análise. A publicação inicial do conceito data do ano de 1999 e justifica-se o período pesquisado pela abrangência, que alcançou tanto na Psicologia Social como em outras áreas do conhecimento. O resultado da pesquisa evidencia que o sofrimento ético-político já constitui um conceito-chave nas Ciências Humanas, para a compreensão da dimensão psicossocial do processo de exclusão/inclusão em contextos sócio-históricos de desigualdade social...

Este artículo examina el uso del concepto de sufrimiento ético-político, creado por Sawaia, de las reflexiones impulsadas en su central de investigación. En este estudio, se optó por analizar el uso del concepto en los artículos publicados desde 2000 hasta 2011, el uso de la SciELO Capes y los datos, y luego Google Scholar, los cuales no son incluidos o excluidos del análisis, de acuerdo con los criterios del período de investigación y el uso del concepto por el autor en su análisis. El concepto inicial de la fecha de publicación de 1999 y justificó el período relevado por la amplitud, que alcanzó tanto en la psicología social y en otros campos del conocimiento. El resultado de la investigación muestra que el sufrimiento ético-político ya es un concepto clave en las Humanidades, para la comprensión de la dimensión psicosocial de la exclusión / inclusión en contextos socio-históricos del proceso de la desigualdad social...

This article analyzes the use of the concept of ethical-political suffering, created by Prof. Dr. Bader Sawaia, from the reflections fostered in its core research. In this study, we chose to analyze the use of the concept in articles published from 2000 to 2011, using the SciELO database and Capes, and later Google Scholar, which were included or excluded from the analysis according to the criteria of the period researched and the use of the concept by the author in his analysis. The concept of the initial publication date of 1999 and is justified by the scope of the survey period who achieved so much in social psychology and in other fields of knowledge. The research result shows that the ethical-political suffering is already a key concept in the Humanities for understanding the psychosocial dimension of the process of exclusion / inclusion in socio-historical contexts of social inequality...

Merleau-Ponty e a psicanálise: da fenomenologia da afetividade à figurabilidade do afeto / Merleau-Ponty and psychoanalysis: from affectivity's phenomenology to affection's figurability

Como entender a afirmação de Merleau-Ponty que "a fenomenologia está em consonância com a psicanálise", e que ambas apontam "em direção da mesma latência"? Este artigo pretende problematizar as dificuldades de aproximação entre fenomenologia e psicanálise, para examiná-las mais precisamente na perspectiva de Merleau-Ponty. Após ter analisado o conceito de inconsciente na obra do filósofo, a leitura merleau-pontyana da psicanálise é confrontada às críticas de vários psicanalistas. Este diálogo permite ressaltar duas concepções do inconsciente, opostas no que diz respeito às ideias (Vorstellungen), mas próximas quanto aos afetos. A noção de "busca em figurabilidade do afeto" oferece, então, uma nova solução para esta tentativa de aproximação entre fenomenologia e psicanálise, e introduz uma nova leitura da metapsicologia do afeto.(AU)

What did Merleau-Ponty mean when he wrote that "phenomenology is in agreement with psychoanalysis", and that both aim towards "the same latency"? This article aims to problematize the difficult comparison between phenomenology and psychoanalysis and examine it in Merleau-Ponty's work. After his understanding of the concept of the unconscious is analyzed, Merleau-Ponty's reading of psychoanalysis is confronted to various psychoanalysts' criticisms. This dialogue conjures up two conceptions of the unconscious, opposed when it comes to ideas (Vorstellungen) but close as far as afects are concerned. The notion of "affect search for figurability" is a new way to bridge the gap between phenomenology and psychoanalysis, and brings in a new reading of the metapsychology of affect.(AU)

¿Cómo entender la afirmación de Merleau-Ponty que dice "la fenomenología está en consonancia con el psicoanálisis" y que ambas apuntan "hacia la misma latencia"? Este artículo pretende problematizar las dificultades de aproximación entre fenomenología y psicoanálisis, para examinarlas más precisamente desde la perspectiva de Merleau-Ponty. Después de analizar el concepto de inconsciente en la obra del filósofo, la lectura merleau-pontyana del psicoanálisis es confrontada con las críticas de varios psicoanalistas. Este diálogo permite resaltar dos concepciones del inconsciente, opuestas con respecto a las ideas (Vorstellungen) pero próximas en cuanto a los afectos. La noción de "búsqueda de figurabilidad del afecto" ofrece una nueva solución para este intento de aproximación entre fenomenologia y psicoanalisis, e introduce una nueva lectura de la metapsicología del afecto.(AU)