Attachment representations among substance-abusing women in transition to motherhood: implications for prenatal emotions and mother-infant interaction
TL;DR: It is proposed that obstetric risk among comparisons and adverse relational experiences among almost all SA mothers might override the protective role of mother’s autonomous representations for dyadic interaction, and concludes that prenatal emotional turbulence and high interaction risk of allSA mothers calls for holistic treatment for the dyad.
Abstract: We studied how attachment representations contribute to central components of transition to motherhood, prenatal emotion processing (EP) and emotional availability (EA) of mother-infant interaction, and whether there are group specific differences. Participants were 51 treatment-enrolled substance-abusing (SA) mothers and their infants and 50 non-using comparison dyads with obstetric risk. Mother's attachment representations (AAI) and EP were assessed prenatally and EA when infants were four months. Results showed that autonomous attachment only had a buffering effect on prenatal EP among comparisons. All SA mothers showed more dysfunctional EP than comparisons and, contrary to comparisons, autonomous SA mothers reported more negative cognitive appraisals and less meta-evaluation of emotions than dismissing SA mothers. Preoccupied SA mothers showed high negative cognitive appraisals, suggesting under-regulation of emotions. Attachment representations were not associated with EA in either group; rather, SA status contributed to global risk in the relationship. Surprisingly, autonomous SA mothers showed a tendency towards intrusiveness. We propose that obstetric risk among comparisons and adverse relational experiences among almost all SA mothers might override the protective role of mother's autonomous representations for dyadic interaction. We conclude that prenatal emotional turbulence and high interaction risk of all SA mothers calls for holistic treatment for the dyad.
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TL;DR: The transition to parenthood is one of the literary work in this world in suitable to be reading material and this book will show you the amazing benefits of reading a book.
Abstract: Now, we come to offer you the right catalogues of book to open. transition to parenthood is one of the literary work in this world in suitable to be reading material. That's not only this book gives reference, but also it will show you the amazing benefits of reading a book. Developing your countless minds is needed; moreover you are kind of people with great curiosity. So, the book is very appropriate for you.
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TL;DR: The goal of the present review is to evaluate the value of neurobiological and psychodynamic perspectives to inform the understanding of addiction, particularly substance-use disorders.
Abstract: Although substance use and abuse may impact brain and behavior, it is still unclear why some people become addicted while others do not. Neuroscientific theories explain addiction as a series of between- and within-system neuroadaptations that lead to an increasingly dysregulating cycle, affecting reward, motivation, and executive control systems. In contrast, psychoanalysis understands addiction through a relational perspective wherein there is an underlying failure in affect regulation, a capacity shaped early developmentally. Considering recent findings suggesting the neurobiological overlap of addiction and attachment, it may be possible to integrate both perspectives into a developmental model through the lens of attachment. The goal of the present review is to evaluate the value of neurobiological and psychodynamic perspectives to inform our understanding of addiction, particularly substance-use disorders.
37 citations
Cites background from "Attachment representations among su..."
...Likewise, numerous studies have found that unresolved and insecure attachment representations are more common in mothers with SUDs than in those without SUDs (Espinosa et al., 2001; Isosävi et al., 2016; Medrano et al., 2002; Sokolowsky Sokolowski, Hans, Bernstein, & Cox, 2007; Suchman et al., 2012)....
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...own histories of abuse and neglect (Freeman, Collier, & Parillo, 2002; Isosävi et al., 2016; Medrano, Hatch, Zule, & Desmond, 2002; Suchman et al., 2012)....
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...…mechanisms of change in improving maternal caregiving behaviors and thus reducing the risk for addictive processes in the offspring (Alvarez-Monjaras et al., 2017; Isosävi et al., 2016; Rutherford, Booth, Crowley, & Mayes, 2016; Rutherford, Wallace, Laurent, & Mayes, 2015; Suchman et al., 2012)....
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...motivational, and executive skills (Crittenden, 2015; Fonagy, Gergely, Jurist, & Target, 2004; Isosävi et al., 2016; Lyden & Suchman, 2013; Wiseman, Hashmonay, & Harel, 2006)....
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...For instance, reduced activity in the PFC, particularly in the ventromedial (vmPFC) and orbitofrontal (OFC) areas (Elliott, Dolan, & Frith, 2000), has been associated with compromised executive control and decision-making in SUDs....
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TL;DR: In a recent study, this article found that 90% of the reviewers agreed with, supported by, or acclaimed by _________% of reviewers, usually greater than 90%, which is not a rigorous review process, but a social media approach to scientific oversight.
Abstract: agreed with, supported by, or acclaimed by _________% of reviewers, usually greater than 90%. Translated, this means that when the paper was posted, 90% of readers said they “liked” the paper. This is not a rigorous review process, but a social media approach to scientific oversight. As to the impact factor, many of these new journals are not even listed by the agency that compiles this metric of citation frequency. Let the buyer beware. Some of these journals have offered to become “The Official Journal of _______ Society” and are willing to share that designation with established journal relationships. That would be a blessing for that new company’s reputation. In fact, they may be willing to pay for that ordination. I have firsthand knowledge of this kind of offer. JDBP is not for sale. Given what we are beginning to find out about this new breed of journal, you might think that such an entry on a CV would be less an asset than a blemish. If not now, soon. And that is fine for established researchers who have set reputations and long lists of publications. A few weak entries may not even be noticed. However, junior investigators might be encouraged to submit their work to such a venue. I don’t think that is the path to career advancement and would be an embarrassment in a promotion package. Furthermore, that cheats the next generation of learning from strong reviews, carefully revising their work, and seeing it shine in a first-tier publication. Shortcuts to publication should not be promoted. Open access has the potential to change the face of science and scientific publishing. Much of that is on the upside: wider dissemination of knowledge, a world open and free to all who wish to reach out. But there are dangers lurking inside that tidal wave as well. I suggest that we all get not only surfboards to ride this wave but also snorkels to see what is below the surface.
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TL;DR: A review of evidence on the challenges of parenthood, particularly when affected by addiction, is presented in this article, where the authors explore the centrality of object relations in personality development and parenting practices.
Abstract: Motherhood has been deemed a normal crisis, given the significant psychological, biological, and neural changes surrounding pregnancy and the postpartum period. These challenges can become more complex as they are closely related to the parent’s own selfdevelopment and sense of self-efficacy grounded in their personality prior to parenthood. The normal crisis of motherhood may be further complicated by addiction. Considering the evidence of the negative impact and poor developmental outcomes of children born to mothers with substance use disorders, special attention must be paid to addiction in this context. This paper is a review of evidence on the challenges of parenthood, particularly when affected by addiction. We explore the centrality of object relations in personality development and parenting practices and discuss the problem of maternal addiction from multiple perspectives, particularly Blatt’s (1991a) two-polarities model of personality development. Key words: motherhood, addiction, psychoanalysis, object relations, personality. PERSONALITY AND MATERNAL ADDICTION 3 Introduction Mothers are the first environment their offspring encounter in their process of development; therefore, it is essential to understand how maternal behavior, sensitivity, and personality interplay with the developing psyche of the child. Motherhood can be a very challenging task given the significant psychological, biological, and neural changes surrounding pregnancy and the postpartum period. The transition to parenthood is also characterized by changes in interpersonal interactions, social demands and expectations of being a parent, conscious and unconscious wishes and fantasies related to their child and the parental experience, and sometimes disappointments from not meeting the individual parenthood ideals (Priel & Besser, 2001; Von Mohr, Mayes, & Rutherford, 2017). These challenges –typical of parenthood– can become more complex as they are closely related to the parent’s own self-development and sense of self-efficacy, grounded in their personality prior to parenthood. Therefore, maternity could be thought of as a particularly vulnerable period for women already struggling with self-control and emotion dysregulation and this may be particularly true in mothers with substance use disorders (SUDs). Considering the growing evidence underscoring the negative impact and poor developmental outcomes of children born to mothers with SUDs (e.g. Salo & Flykt, 2013), special attention must be paid to addiction in the context of maternity in order to minimize risk and prevent the perpetuation of SUDs across generations. The structural-developmental psychodynamic –or “two polarities”– model of personality development (Blatt, 1991a) offers a valuable framework to consider addiction in the context of motherhood. Grounded on cognitive, humanistic, and psychodynamic theories of development, the model was initially developed to empirically study depression (Shahar & Mayes, 2017). Blatt PERSONALITY AND MATERNAL ADDICTION 4 (1991a) proposed that as human beings develop, they are faced with the dialectic transaction between fostering and tending to relationships and attachment bonds (i.e., interpersonal relatedness or anaclitic processes), and developing an independent and fully differentiated sense of self (i.e., self-definition or introjective process). Extreme reliance on one process over the other may lead to psychopathology or severe distortions of experiences and result in extremely dependent or self-critical strategies in interpersonal interactions (Berman, 2017; Blatt, 1991a; Blatt & Luyten, 2009). However, under favorable circumstances, humans are able to integrate both polarities into a mature, integrated, and socially embedded sense of self. While the two polarities model was originally focused on individual personality development and initially focused on the first 11 years of life, it was later expanded to consider development across the lifespan (Blatt & Luyten, 2009). Further, it has been argued that the model might facilitate understanding of the intergenerational transmission of attachment styles and psychopathology, including SUDs (Beebe & Lachman, 2017; Priel & Besser, 2001; Blatt and Luyten, 2013; Liden & Suchman, 2013; Luyten, 2017; Soenens, Vansteenkiste, & Luyten, 2010). This paper is a review of evidence on the challenges of motherhood, specifically in relation to substance abuse. The paper will explore the centrality of object relations in personality development and parenting practices. Next, in line with recommendations by Blatt and Luyten (2009) inviting research efforts to be oriented towards the examination of the impact of neurobiological and genetic dimensions on psychological development, we discuss the problem of addictions from multiple perspectives, incorporating object relations, Blatt’s (1991a) personality organizations, and a recently proposed developmental model of addiction (AlvarezMonjaras, Mayes, Potenza, Rutherford, 2018). Motherhood: A normal crisis PERSONALITY AND MATERNAL ADDICTION 5 Motherhood has been considered a “normal crisis” (Pines, 1972). Although highly rewarding and meaningful under ideal circumstances, becoming a parent may also be stressful and overwhelming. The complexity of the emotional experiences surrounding motherhood reflects both the hormonal, neurobiological, social, and intrapsychic processes that take place during the transition to motherhood, as well as this being a period of time where mothers revisit their own memories and representations of being parented to (1) internalize the newborn, (2) resolve early conflict, and (3) identify available resources to apply in the new caregiving tasks (Pines, 1972; Priel & Besser, 2001; Von Mohr et al., 2017) In line with Blatt’s (1991a) model, the internal world of mothers and their children –both during and after pregnancy– are essential to understand motherhood (Blum, 2017). Object relations are dynamic systems or “internal working models” that guide behaviors, attitudes, and expectations, and help an individual make sense of themselves, others, and relationships (Auerbach & Diamond, 2017). Even before birth, an expectant mother may hold a mental representation of the newborn, with a series of conscious and unconscious fantasies associated with them. Some mothers, for instance, may have idealized phantasies of their unborn child (e.g., “perfect in every way”, “a fulfilment of my life”, Sorenson & Schuelke, 1999), others may talk about fantasies of symbiosis or fusion (e.g., envisioning themselves encompassing the fetus, Blum, 2017), or be more anxious and concerned by persecutory fantasies (e.g., parasitic fetus or depletion, Raphael-Leff, 1996). Considering that these representations guide behaviors and attitudes, some mothers might feel better prepared than others to take on the caregiving task. In line with this, studies have shown that the content of internal representations can have a considerable impact on mother-child interactions. For instance, fantasies around childbirth can impact the decision of primiparous mothers regarding whether or not to request cesarean section PERSONALITY AND MATERNAL ADDICTION 6 –this was especially true for mothers that were more inclined to project negative or unwanted thoughts, feelings, fantasies, and motives (Handelzalts, Fisher, Sadan & Goldzweig, 2017). Likewise, other studies have reported that mental representations of breastfeeding and the feeding interaction (e.g., comfort, rejection, crying, etc.) may also impact how mothers approach breastfeeding, and even the decision to switch to bottle-feeding (Kronborg et al., 2015; Sayre et al., 2001). Mental representations impacting parenting behavior extend beyond infancy, including during play interactions and in relation to parental control practices (Crawford & Benoit, 2009; Soenens et al., 2010). The quality (i.e., coherence, flexibility, and richness) of internal representations may also affect a mother’s capacity to make sense and adapt their own behavior to sensitively and appropriately respond to their child’s preverbal demands and mental states (Alvarez-Monjaras, McMahon & Suchman, 2017; Fonagy, Gergely & Target, 2007; Fonagy, Steele, Steele, Moran, & Higgitt, 1991). For instance, mothers with disengaged representations in the Adult Attachment Interview (George, Kaplan, & Main, 1985) tend to be less sensitive, more passive, and less encouraging, while those with more coherent representations engage in less negative (e.g., aggressive or intrusive) and more positive (e.g., warm or soothing) parenting practices (Slade, Belsky, Aber & Phelps, 1999; Sokolowsky, Hans, Bernstein, & Cox, 2007). Thus, the overall quality of mental representations allows for mothers to engage more sensitively with their child. Maternal object relations and the internal world of the child Recent studies have argued that not only do these object representations influence maternal behaviors but they might also be passed on across generations via the mother’s capacity to think about and interpret their own and their infant’s behavior in terms of mental states and intentions (termed reflective functioning; Fonagy et al., 2007). A caregiver’s reflective PERSONALITY AND MATERNAL ADDICTION 7 functioning –inherently associated with mental representations (Alvarez-Monjaras et al., 2017)– has been considered the missing link in the well-known intergenerational transmission of attachment patterns and relational knowledge (Fonagy & Allison, 2014). Through these marked, ostensive, and contingent feedback reactions towards the infant’s automatic behavioral expressions (i.e., parental sensitivity), the caregiver slowly sensitizes the child to primary and secondary mental states and intentions in oneself and others (Fonagy & Bateman, 2008; Fonagy et al., 2007). This “natural pedagogy” (Csibra & Gergely, 2009) fosters self-awareness and selfregulation capabilities by allowing
4 citations
Cites background from "Attachment representations among su..."
...…2011; Fonagy et al., 2002, 2008). inconsistency, and fragmentation (Speranza, Nicolais, Vergano, & Dazzi, 2017)– are indeed more common in mothers with SUDs than in those without SUDs (Bean et al., 1981; Isosävi et al., 2016; Sokolowsky et al., 2007; Suchman, DeCoste, Rosenberger, & McMahon, 2012)....
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TL;DR: In this article , the authors examined the associations between mothers' prenatal AAI-RF and pre-and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes.
Abstract: Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.
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12,519 citations
"Attachment representations among su..." refers background in this paper
...Feeling states Circumplex model of emotions (Larsen & Diener, 1992; Russell, 1980) Negative 18 “I feel sad / self-blaming / ashamed / angry” Positive 27 “I feel happy / hopeful / trusting / relaxed” Cognitive appraisals Multifocal theory of emotions (Frijda et al....
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TL;DR: The AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.
Abstract: The Alcohol Use Disorders Identification Test (AUDIT) has been developed from a six-country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10-item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol-related problems. Questions were selected from a 150-item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non-hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.
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09 Aug 2008
TL;DR: SPSS for Windows Step by Step: A Simple Guide and Reference, 18.0Update is a comprehensive guide to using SPSS that takes students step-by-step through all S PSS procedures.
Abstract: "SPSS for Windows Step by Step: A Simple Guide and Reference, 160 Update" makes data analysis and SPSS procedures clear and accessible Presents straightforward "step by step" instructions in each analysis chapter to clarify procedures Hundreds of screen shots and "Step by Step" boxes guide the student through the program All of the datasets used in the book are available for download on the text website Exercises at the end of each chapter and selected answers on the website give students an opportunity to practice using SPSS Updated to reflect SPSS Version 160
8,750 citations
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...…and comparison groups: negative feeling states and negative behavioral urges; in the within-SA analysis: negative feeling states, negative behavioral urges, positive behavioral urges, and metaevaluation of emotions) were transformed to meet acceptable symmetry and kurtosis (George & Mallery, 2010)....
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TL;DR: Five studies tested two general hypotheses: Individuals differ in their use of emotion regulation strategies such as reappraisal and suppression, and these individual differences have implications for affect, well-being, and social relationships.
Abstract: Five studies tested two general hypotheses: Individuals differ in their use of emotion regulation strategies such as reappraisal and suppression, and these individual differences have implications for affect, well-being, and social relationships. Study 1 presents new measures of the habitual use of reappraisal and suppression. Study 2 examines convergent and discriminant validity. Study 3 shows that reappraisers experience and express greater positive emotion and lesser negative emotion, whereas suppressors experience and express lesser positive emotion, yet experience greater negative emotion. Study 4 indicates that using reappraisal is associated with better interpersonal functioning, whereas using suppression is associated with worse interpersonal functioning. Study 5 shows that using reappraisal is related positively to well-being, whereas using suppression is related negatively.
8,261 citations
"Attachment representations among su..." refers background in this paper
...Processing these diverse emotions provides information of the changing situation, and is thus inherently regulating (Gross & John, 2003)....
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Abstract: We are grateful to the Institute of Human Development, Berkeley, and to the Society for Research in Child Development for funding that made the study of our sample at 6 years possible. In its earlier phases, the Social Development Project was supported by the William T. Grant Foundation, by the Alvin Nye Main Foundation, and by Bio-Medical Support Grants 1-444036-32024 and 1-444036-32025 for studies in the behavioral sciences. The Child Study Center at the University of California was invaluable in its provision of subjects and in the training provided for our observers and examiners. The National Center for Clinical Infancy Programs provided support and assistance to Nancy Kaplan. This project would not have been possible without the direction and assistance provided by Donna Weston and by Bonnie Powers, Jackie Stadtman, and Stewart Wakeling in its first phases. For the initial identification of infants who should be left unclassified-an identification critical to the present study-we gratefully acknowledge both Judith Solomon and Donna Weston. Carol George participated in the designing of the sixth-year project; Ruth Goldwyn served as adult interviewer; and Ellen Richardson served as the child's examiner. The videotapes and transcripts of the sixth-year study were analyzed by Jude Cassidy, Anitra DeMoss, Ruth Goldwyn, Nancy Kaplan, Todd Hirsch, Lorraine Littlejohn, Amy Strage, and Reggie Tiedemann. Mary Ainsworth, John Bowlby, Harriet Oster, and Amy Strage provided useful criticism of earlier versions of this chapter. The overall conceptualization was substantially enriched by suggestions made by Erik Hesse.
4,213 citations