Showing papers by "Carlo Schuengel published in 2016"

Narrowing the Transmission Gap: A Synthesis of Three Decades of Research on Intergenerational Transmission of Attachment

Abstract: Twenty years ago, meta-analytic results (k = 19) confirmed the association between caregiver attachment representations and child-caregiver attachment (Van IJzendoorn, 1995). A test of caregiver sensitivity as the mechanism behind this intergenerational transmission showed an intriguing "transmission gap." Since then, the intergenerational transmission of attachment and the transmission gap have been studied extensively, and now extend to diverse populations from all over the globe. Two decades later, the current review revisited the effect sizes of intergenerational transmission, the heterogeneity of the transmission effects, and the size of the transmission gap. Analyses were carried out with a total of 95 samples (total N = 4,819). All analyses confirmed intergenerational transmission of attachment, with larger effect sizes for secure-autonomous transmission (r = .31) than for unresolved transmission (r = .21), albeit with significantly smaller effect sizes than 2 decades earlier (r = .47 and r = .31, respectively). Effect sizes were moderated by risk status of the sample, biological relatedness of child-caregiver dyads, and age of the children. Multivariate moderator analyses showed that unpublished and more recent studies had smaller effect sizes than published and older studies. Path analyses showed that the transmission could not be fully explained by caregiver sensitivity, with more recent studies narrowing but not bridging the "transmission gap." Implications for attachment theory as well as future directions for research are discussed.

Family Functioning and Children's Post-Traumatic Stress Symptoms in a Referred Sample Exposed to Interparental Violence.

Abstract: This study examined the association between interparental violence (IPV), child abuse and neglect, other traumatic experiences, and children’s post-traumatic stress (PTS) symptoms and explored the moderating role of family functioning in the aftermath of IPV. One hundred and twenty IPV-exposed children (53.3 % male, M age = 9.85) and parents who were referred to community mental health centers participated in the study. Combined, IPV, child abuse and neglect, and other traumatic experiences were associated with PTS symptoms. For family functioning, higher levels of parenting stress were associated with higher levels of PTS symptoms. No moderating effects were found. To understand the variability in PTS symptoms among children exposed to IPV, other traumatic and stressful experiences need to be taken into account.

Self-Reporting Tool On Pain in People with Intellectual Disabilities (STOP-ID!): A Usability Study

Abstract: The use of the Self-reporting Tool On Pain in people with Intellectual Disabilities (STOP-ID!), an online application developed by the authors to aid in the self-reporting of pain, was evaluated in 40 adults with Down syndrome. Comprehension of the use of the tool (the ability to recognize representations for vocabulary and pain, and to navigate the tool interface), and the use of the tool to self-report pain experience, were investigated. The use of the online tool was investigated with both a laptop and a tablet computer in a crossover design. The results provide evidence that more participants recognized representations of pain location and pain affect than representations of pain intensity and pain quality. A small percentage of participants demonstrated the ability to recognize all of the representations of vocabulary items and to navigate the tool without assistance (18% laptop, 18% tablet). Half of the participants were able to report at least one pain component of a current or remembered pain experience without assistance (50% laptop, 53% tablet). Ways to improve the design of tools for reporting pain and to improve performance are suggested.

Self-Reported Presence and Experience of Pain in Adults with Down Syndrome.

Abstract: Objective. The aim was to examine whether the presence of pain (based on physical conditions and participants’ report) and self-reported pain experience in adults with Down syndrome (DS) differ from general population controls. Design. Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) and 142 age-matched controls (median age = 40.5 years, mean estimated IQ = 105.7) in the Netherlands. Methods. File-based medical information was evaluated. Self-reported presence and experience of pain were assessed in rest and after movement during a test session (affect with facial affective scale (FAS: 0.04–0.97), intensity assessed with numeric rating scale (NRS: 0–10). Results. Compared with controls, more DS participants had physical conditions that may cause pain and/or discomfort ( p = .004, 50% vs 35%), but fewer DS participants reported pain during the test session ( p = .003, 58% vs 73%). Of the participants who indicated pain and comprehended self-reporting scales ( n = 198 FAS, n = 161 NRS), the DS group reported a higher pain affect and intensity than the controls ( p < .001, FAS: 0.75–0.85 vs 0.50–0.59, NRS: 6.00–7.94 vs 2.00–3.73). Conclusions. Not all adults with DS and painful/discomforting physical conditions reported pain. Those who did indicated a higher pain experience than adults from the general population. Research into spontaneous self-report of pain, repeated pain assessment, and acute pain is needed in people with DS for more insight into pain experience and mismatches between self-report and medical information.

Weakened Resilience in Parenting Self-Efficacy in Pregnant Women Who Were Abused in Childhood: An Experimental Test

Abstract: This study tested experimentally whether the combination of a history of childhood abuse and confrontation with difficult infant temperament is associated with negative changes in parenting self-efficacy. First-time pregnant women (N = 243) participated in the Adult Attachment Interview, which was used to assess the occurrence of abuse by parents in childhood and unresolved representations, and completed a task asking them to respond to infant cries. Sixty of the 243 participants (25%) experienced childhood abuse, mostly physical or sexual. The task simulated infant temperamental difficulty by manipulating soothing success in order to reflect an easy-to-soothe (80% soothing success) and a difficult-to-soothe infant (20% soothing success). Both after baseline and after each of the two stimulus series women assessed their parenting self-efficacy. Women who reported childhood abuse did not differ from women who reported no childhood abuse in parenting self-efficacy at baseline or in response to the easy-to-soothe infant (relative to baseline), but decreased more in parenting self-efficacy following the difficult-to-soothe infant. Effects did not vary according to resolution of trauma. These findings suggest that in response to infant temperamental difficulty, women who experienced childhood abuse may more easily lose confidence in their parenting abilities, which underlines the importance of preparing at-risk women for the possible challenges that come along with parenthood.

Parenting self-efficacy moderates linkage between partner relationship dissatisfaction and avoidant infant-mother attachment: A Dutch study.

Abstract: The early infant-mother attachment relationship is part of a network of close relationships in which the relationship between parents is especially relevant. Evidence for linkages between maternal satisfaction with the partner relationship and infant-mother attachment is equivocal. The current study tested whether associations between partner relationship dissatisfaction and infant-mother attachment quality might be conditional on mothers' parenting self-efficacy. The bivariate effect of partner relationship dissatisfaction on infant-mother attachment as well as moderation of this effect by parenting self-efficacy was tested in a sample of 260 infant-mother dyads 1 year after birth. There was no direct effect of partner dissatisfaction on attachment. Unexpectedly, for high parenting self-efficacy, greater partner dissatisfaction increased the odds of an avoidant infant attachment (compared with a disorganized) whereas, for low parenting self-efficacy, greater partner dissatisfaction decreased the odds of an avoidant infant attachment (compared with secure and disorganized). Findings underline the importance of parenting cognitions for understanding contextual factors of infant-mother attachment quality. (PsycINFO Database Record

Inhibited attachment behaviour and disinhibited social engagement behaviour as relevant concepts in referred home reared children.

Abstract: Background Disorders of attachment and social engagement have mainly been studied in children, reared in institutions and foster care. There are few studies amongst home reared children living with biological parents. The aim of this study was to test the clinical significance of inhibited attachment behaviour and disinhibited social engagement behaviour in young home reared children, referred for treatment of emotional and behavioural problems, compared with young children in treatment foster care. Methods The Disturbances of Attachment Interview, Maltreatment Classification System, the Child Behaviour Checklist and Parenting Stress Index were used in 141 referred home reared children and 59 referred foster children, aged 2.0–7.9 years (M = 4.7, SE = 1.3), 71% boys. Results Inhibited attachment behaviour was less prevalent in the referred home reared group (9%) than in the foster care group (27%). Disinhibited social engagement behaviour was found in 42% of the home reared group, similar to the foster care group. Inhibited attachment behaviour and disinhibited social engagement behaviour were not associated with child maltreatment. More inhibited attachment behaviour was associated with clinical levels of child internalizing and externalizing behaviour in the home reared group, not in the foster care group. In both groups, more disinhibited social engagement behaviour was associated with clinical levels of externalizing behaviour and with more parenting stress. Conclusions Even without evident links to maltreatment, results of this study suggest clinical significance of inhibited attachment behaviour and disinhibited social engagement behaviour in young home reared children referred for treatment of emotional and behavioural problems.

Adaptive behaviour, comorbid psychiatric symptoms, and attachment disorders

Abstract: Purpose – The purpose of this paper is to describe the mental and intellectual developmental status of children with combined intellectual disabilities, reactive attachment disorder (RAD), and/or disinhibited social engagement disorder (DSED), and to describe the presence of comorbid diagnoses. Design/methodology/approach – The study included 55 children that were referred for psychiatric consultation due to low intellectual functioning (borderline or mild; IQ 50-84). Attachment diagnoses were based on the Clinical Observation of Attachment (COA) procedure. Development was measured with the Dutch version of the Vineland Adaptive Behaviour Scales. Psychopathology was measured with the DISC-IV and AUTI-R. Emotional and behavioural problems were measured with the Dutch version of the Developmental Behaviour Checklist. Findings – Children with and without attachment diagnoses had similar IQs. However, children with disturbed attachment, RAD, and/or DSED had lower levels of adaptive behaviour than those withou...

Comprehension of pictograms for pain quality and pain affect in adults with Down syndrome

Abstract: Background Adults with Down syndrome (DS) are at risk for age-related painful physical conditions, but also for under-reporting pain. Pictograms may facilitate self-report of pain, because they seem suitable for the global visual processing in DS and for iconic representation of abstract concepts.Method Participants (N = 39, M age = 41.2) assigned pain qualities to pictograms, rated pain affect levels in facial scales (pictograms vs. drawn faces), and performed cognitive tests.Results Recognition of all intended pain qualities was above chance level. Pain affect levels of both facial scales were ordered equally well. Both facial scales were preferred equally well. Comprehension of the 3 scales was positively associated with mental age, receptive language ability, and verbal memory. Most participants (74%) had pictograms in their direct environment, mainly to communicate activities or objects.Conclusion Using pictograms may optimise communication about pain for a subgroup of cognitively higher func...

Pain and Cognitive Functioning in Adults with Down Syndrome.

Abstract: Objective: The aim of the present study was to examine whether cognitive functioning (i.e., memory and executive functioning) is related to self-reported presence of pain (i.e., affirmative answer to the question whether the individual feels pain) and experience of pain (i.e., intensity and affect) in adults with Down syndrome (DS). Design, Setting, and Subjects: Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) in the Netherlands. Methods: File-based medical information was evaluated. Self-reported presence and experience of pain were assessed during a test session, both in rest and after movement (affect with the facial affective scale [FAS], intensity with the numeric rating scale [NRS]). Neuropsychological tests for memory and executive functioning were used. Results: Participants with lower memory scores were more likely to report the presence of pain, while controlling for age, gender, physical conditions that may cause pain, language comprehension, and vocabulary ( p = .030, 58.4% classification rate, N = 154). No statistically significant associations were found between executive functioning and self-reported presence of pain or between cognitive functioning and self-reported pain experience. Conclusions: Memory seems to be related to the self-reported presence of pain in adults with DS after explicit inquiry, although the clinical use of this model is yet limited. Therefore, further research is needed for insight into the role of cognitive processes in self-report (e.g., involving aspects such as acquiescence and repeated measurements) to evaluate whether neuropsychological examination could contribute to pain assessment in DS.

Attachment relationships of preschool-aged children of mothers with HIV and HIV-related psychosis.

Abstract: Children from mothers with HIV-related psychosis are frequently raised in challenging contexts, yet the extent to which these children grow up in insecure or disordered attachment relationships is unknown. Using the Strange Situation Procedure the distribution of attachment relationships of children from mothers with HIV and psychosis (n = 45) was compared with children from mothers with HIV without psychosis (n = 41). No significant differences in the distributions were found between the two groups and attachment was not associated with specific psychotic symptomatology. Security of attachment was associated with more people providing the mother with emotional support, but only in the psychosis group. Disordered attachment (24%) was more often found in the total sample than in studies with other normal and high risk populations. Recommendations were made for future research about factors facilitating resilience in the children and on interventions increasing emotional support for affected mothers.

Een schoolleergemeenschap met leerkrachten en ouders: Samenwerken aan het verbeteren van educatief partnerschap

Abstract: A school learning community formed by teachers and parents: Towards improving educational partnership A partnership in which parents and teachers attune their support can be beneficial for children’s development. However, in practice parents and teachers encounter difficulties in establishing such partnerships. A school learning community (SLC) in which parents and teachers cooperate and reflect on their views and practices could be beneficial for the improvement of such a partnership. In the current study parents and teachers were supervised during their cooperation in a SLC towards an improved educational partnership. This research examined how equality and diversity were expressed in the SLC and to what extent participants were able to reflect on their opinions and practices. Also, it was investigated whether participants were able to convert the insights gained through reflection into practical partnership returns for the school. Four schools formed SLC’s consisting of kindergarten teachers and parents, which met five times. Transcripts of the meetings were analysed using a Thematic Coding Approach. Results show that equality and diversity were expressed in several ways. Equality in communication and attention to individual experiences and differences became important topics in the improvement of educational partnership. Depending on the school context, parents and teachers were able to reflect more or less thorough on their opinions and practices, especially regarding ‘communication’. At each school new insights into equality and diversity were translated into applications in the school. Differences between schools are discussed. Further research should determine whether these events lead to an improved long-term educational partnership that is anchored in school policy.

Exploring the role, needs and challenges of relatives of mothers with HIV or HIV and psychosis: A qualitative study

Abstract: This study explored types and nature of supports by relatives of mothers living with HIV and psychosis in comparison to mothers with HIV only. Interview data on their experiences of their roles, needs and challenges were collected from 33 relatives on mothers with HIV and psychosis (n=12, females=10, blacks =12, age ranges 21 to 62) and those with HIV only (n=21, females=16, blacks =21, age ranges 18 to 63). The data were thematically analysed utilizing Atlas.ti. The results showed that relatives in both groups provided a variety of supporting roles. Important challenges were experiencing the negative consequences of especially HIV in combination with psychosis in their lives and dealing with the caregiving responsibilities without having enough information. Important strengths included utilizing support networks and remaining hopeful. Support needs for carers of mothers living with HIV related psychosis or HIV only, can be enhanced with increasing social and material resources at the community level. Sup...