Background: This study examined whether levels of parental reflective function (RF), parental expressed emotion (EE) and children’s attachment styles are significantly related in a sample of children with high levels of conduct disorder (CD) symptoms. Method: The sample (n = 143) consisted of children aged 5-7 years at risk of behaviour problems. Participants were recruited from a borough of London and a unitary authority in the south west of England. Data for the three main variables and confounders were collected using semi-structured interview, direct observation and questionnaires from both parents and children. The Parent Development Interview (PDI) was used to assess RF; the Five-Minute Speech Sample to assess EE and the Manchester Child Attachment Story Task (MCAST) to assess child attachment. Results: Global levels of maternal RF did not significantly differ between the securely and insecurely attached groups of children. Mothers of securely attached children, however, had higher RF ratings on the negative interactions and anger subscales of the PDI compared to mothers of insecurely attached children. No significant difference was found in parental EE between secure and insecurely attached children. High EE-warmth was associated with high global RF, but there was no significant relationship between EE-criticism and RF. Multiple logistic regression found no significant relationships between parental RF, parental EE and child attachment. Conclusions: These findings may suggest that attachment classification influences the levels of maternal RF in specific negative situations. Conversely it is possible that high maternal RF in such situations enables mothers to respond more sensitively to their child, leading to more secure attachment. The finding that maternal RF and EE were not associated with child attachment may suggest these variables are not strongly related, the sample is too small to detect any effect or that the specific sample lacks variability in scores. To the author’s knowledge this is the first study to test for these relationships with confounders included in the model, which may explain the null findings.

Background: Attachment literature indicates attachment status is related to trauma with associations between early trauma and insecure attachment. Links between psychosis and trauma have been established within the literature; however the precise nature of this relationship is still not fully understood. A systematic review was carried out to assess the state of the evidence pertaining to psychosis and attachment. Associations between insecure attachment and psychotic symptoms were identified. Other psychological correlates such as perceived parental care, attachment to services and interpersonal problems were found to relate to insecure attachment status. However due to the early stage of this area of research, small clinical sample sizes and heterogeneity of correlates investigated, firm conclusions cannot currently be drawn. Aim: The aim of this study was to investigate the relationship between trauma, attachment, reflective functioning (RF) and distress for people with psychosis with a view to further understanding these links and the clinical implications. Method: Participants with a diagnosis of psychosis were recruited and measures were completed with the principle investigator pertaining to trauma, attachment and distress in psychosis. Results: The majority of the sample reported insecure attachment and low RF and there were high levels of general, and more specifically, interpersonal trauma within the sample. Results indicated that early interpersonal trauma was associated with higher levels of emotional distress. Exploratory mediation analyses implicated anxious attachment in mediating the relationship between interpersonal trauma and distress. Discussion: The results indicate the need to consider early trauma histories and specifically interpersonal trauma and attachment in the context of emotional distress for people experiencing psychosis. Incorporating trauma and attachment based therapeutic approaches for people with psychosis is as relevant as it is for other trauma populations, where these approaches may be more routinely drawn on for formulation and treatment. Limitations of the methodological approach are considered along with suggestions for future research.

Made available in DSpace on 2015-03-05T19:36:36Z (GMT). No. of bitstreams: 0 Previous issue date: 26 / Nenhuma / O foco deste estudo foi a função reflexiva e a capacidade de mentalização de pré-adolescentes, no contexto dos rompimentos de vínculos resultantes da separação conjugal altamente conflitiva, e a possibilidade de desenvolvimento da capacidade de mentalização no processo terapêutico desses jovens. A função reflexiva e a capacidade de mentalização são conceitos que vêm sendo elaborados com base na vertente psicanalítica da teoria do apego, nas contribuições de alguns teóricos das relações objetais, especialmente Bion e Winnicott e na Psicologia Cognitiva. Baseado na abordagem qualitativa de pesquisa, esse estudo foi pautado pelo método clínico. O procedimento adotado foi o Estudo de Casos Múltiplos, que permite a investigação sistemática e tão exaustiva quanto possível de casos individuais. Os participantes foram dois pré-adolescentes de classe média entre 11 e 13 anos de idade, uma do sexo feminino e outro de sexo masculino, e seus pais. Cada pré-adolescente e seus pais foram considerados um caso. Eles foram at

Positive parenting practices and secure attachments are consistently linked to healthy child outcomes (Ainsworth & Bowlby, 1991; Waters et al., 2000). Research on cognitive processes that scaffold parental behaviors which contribute to secure attachment is an essential contribution to the literature, particularly given the potential for early intervention with at-risk families. Parental Reflective Functioning (PRF) is a construct of increasing interest which has been linked to secure attachments and positive child outcomes, with one commonly used self-report measure of PRF being the Parental Reflective Functioning Questionnaire (PRFQ; Camoirano, 2017; Clingensmith, 2021; Luyten et al., 2017). As such, the purpose of this dissertation was to examine the relationship between self-reported PRF via the PRFQ and observed parenting behaviors within a sample of mother-child dyads. Participants were mother-child dyads with high psychosocial risk that were engaged in a 10-week attachment-based parenting program. The sample size for participating dyads who completed some portion of the study battery was n = 77; however, the sample size for mothers who completed all segments of the study battery was n = 26. Study results indicated that higher scores on two of the PRFQ subscales (Interest and Curiosity, Certainty of Mental States) predicted lower levels of observed parental sensitivity. These findings lend some support to literature which suggests the PRFQ may capture more maladaptive dimensions of reflective functioning. The discussion explores the significant findings, offers considerations of the non-significant results, and offers avenues for future research.

Gli esseri umani vengono definiti come membri di un gruppo quando assumono i significati che il gruppo stesso crea ed utilizza per concepire sè stesso, i suoi membri e l'universo in generale. Abbiamo studiato i significati che definiscono un essere umano nella versione dell'"autolesionista utente di un gruppo online". In primo luogo, tramite un'analisi tematica di post condivisi nel forum del gruppo siamo venuti a conoscenza delle teorie sul comportamento, la sofferenza ad esso associata ed altre tematiche che definiscono "l'autolesionista". I risultati ottenuti hanno dimostrato che i significati che descrivevano il dolore associato all'autolesionismo erano più rilevanti rispetto a quelli legati all'atto. In seguito tramite IPA di interviste individuali abbiamo compreso che la qualità dello spazio del forum e della relazione tra le dimensioni online e offline determinavano influenze reciproche tra la partecipazione al forum, gli effetti sul sè e sul comportamento e il tipo di utilizzo del forum. Infine abbiamo condotto quattro incontri online con un gruppo di utenti del forum e lavorando sui significati, abbiamo stimolato la loro capacità di diventare consapevoli del loro stato mentale in relazione al comportamento autolesionista. / Human beings are defined as members of a group when they assume the meanings that such group creates and uses to conceive itself, its members and the world in general. We studied meanings that shape a human being in the version of a “self-injurer member of an online group”. Firstly, through a thematic analysis of posts shared in the forum of the group we became acquainted with theories about the behavior, its associated sufferance and other issues that define “a self-injurer”. We found that the most important meanings related to the sufferance rather than to the practice of self-injurious gestures. Secondly, through IPA of individual interviews we understood that the quality of the space of the forum and the relationship between online and offline dimensions determined influences between the self-injurer's identity and her experience in the forum in terms of participation, effects on self and behavior, and type of use of the forum. Finally, we conducted four online meetings with a group of users of the forum and always focusing on meanings, we stimulated their capacity to be aware about their mental states in relation to self-injury.

Abstract : The diagnostic criteria for Reactive Attachment Disorder (RAD) have remained fairly constant over the last few decades. However, the most recent change in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatry Association; APA, 2013) is fairly significant, as the inhibited and disinhibited types of RAD that were found in the previous versions of the manual have been removed. RAD has been replaced with a definition that resembles in some ways the previous inhibited type. Diagnosed in early childhood, this disorder interferes with the child’s ability to form secure relationships with their attachment figures and others. One of the criteria that remain constant is that deprivation in the quality of early care is a risk factor for developing RAD. Although physical abuse and extreme neglect may be easier to identify, emotional neglect is more challenging as a variable to understand. There has been less research on RAD regarding the subtle interactions between mother and child. The theory of mentalization explores some of the complications that arise in attachment and relationships to others that are aggravated by neglect, abuse, and trauma (Bateman & Fonagy 2004). The infant relies on the sensitive attunement and capacity to mentalize of the primary caregiver to help him understand what he is experiencing. The first article uses mentalization and object relations theory applied to children with RAD, in order to facilitate an understanding of these children psychologically as well as certain aspects of the relationship with their mothers. The second article presents two case studies of mother-child dyads of children who have been diagnosed with RAD. The mother and child were evaluated with instruments that provided information regarding the mother’s capacity to mentalize and the child’s attachment representations. The objective of the case studies were meant to reveal how these instruments could be utilized for the specific scores, but also to illustrate what is transpiring psychologically in the relationship between mother and child. The capacity to mentalize of the mothers was measured with the Addendum to Reflective Functioning Scoring Manual (Fonagy, Steele, Steele, & Target, 1998) applied to the Parent Development Interview-Revised (PDI-R; Slade, Aber, Berger, Bresgi, & Kaplan, 2005). The results of the mother’s scores for mentalization were in the low and questionable range. The attachment representations of the children were evaluated through the use of the Attachment Focused Coding System (AFCS; Reiner & Splaun, 2008) applied to the Attachment Story Completion Task (ASCT; Bretherton, Ridgeway, & Cassidy, 1990). The results of the instrument revealed that the two children with RAD (inhibited and disinhibited type) had lowered scores for Supportive Mother and a tendency for Avoidant Attachment Behaviour and Communication. The notions of mentalization and attachment representations were shown to provide a more profound understanding of the mother and child dyad. These evaluation methods support considering a larger study to explore the link between the mother’s capacity to mentalize and the child’s attachment representations in children diagnosed with RAD. / Résumé : Les critères diagnostiques du trouble réactionnel de l'attachement (TRA) sont demeurés relativement stables au cours des dernières décennies. Toutefois, la cinquième version du Manuel diagnostique et statistique des troubles mentaux (DSM-5; American Psychiatric Association; APA, 2013) propose un seul type de TRA, qui correspond au type inhibé de la quatrième version révisée (DSM-IV-TR; APA, 2000), au lieu de distinguer entre deux types, soit inhibé et désinhibé. Diagnostiqué dans la petite enfance, le TRA interfère avec la capacité de l'enfant à former des relations sécurisantes avec ses principales figures d'attachement qui demeure un des critères diagnostiques et un facteur de risque pour le développement du TRA. Bien que l’abus physique et la négligence extrême soient plus faciles à identifier, la négligence au plan affectif est plus subtile et difficile à comprendre. Peu de recherches portent sur les interactions subtiles entre les mères et les enfants ayant reçu un diagnostic de TRA. La notion de mentalisation explore les complications qui peuvent survenir dans la relation aux principales figures d’attachement et dans les interactions sociales dans un contexte d’abus et de négligence (Bateman & Fonagy 2004). Pour être en mesure de comprendre ce qu’il vit, l'enfant nécessite des figures d’attachement sensibles et capables de mentaliser. Dans le premier article, les théories relatives aux notions de mentalisation et des relations d’objet sont utilisées pour comprendre le fonctionnement psychologique des enfants et la relation qu’ils entretiennent avec leurs mères chez des jeunes présentant un diagnostic de TRA. Dans le second article, deux études de cas de dyades mère-enfant ou l’enfant a reçu un diagnostique de RAD sont présentés. Les études de cas avaient pour objectif d’illustrer que les notions de mentalisation et de représentation d’attachement ainsi que les instruments permettant de les mesurer pourraient être utilisé pour approfondir ce qui passe entre la mère et l’enfant aux plans psychologique et relationnel. La capacité de mentalisation des mères participant à l’étude a été mesurée à l’aide de l'Échelle du fonctionnement réflexif (Addendum to Reflective Functioning Scoring Manual; Fonagy et al., 1998) appliquée à l’Entrevue sur le développement du parent (Parent Development Interview-Revised; PDI-R; Slade et al., 2005). Les résultats de la capacité de mentalisation des mères se situent dans les catégories faible ou questionnable. Les représentations d'attachement des enfants ont été évaluées en utilisant le Système de cotation centré sur l’attachement (Attachment Focused Coding System. (AFCS; Reiner & Splaun, 2008) appliqué aux Histoires d’attachement à compléter (Attachment Story Completion Task, ASCT; Bretherton, Ridgeway, & Cassidy, 1990). Les enfants participant à l’étude, ayant respectivement un TRA de type inhibé et désinhibé, ont obtenus des scores faibles dans les échelles Mère soutenante et Évitement des comportements et des communications relatifs à l’attachement. La théorie et la recherche concernant la notion de mentalisation permettent de mieux comprendre les difficultés rencontrées chez les dyades mère-enfant dont les jeunes présentent un diagnostic de TRA. Les notions de mentalisation et de représentations d’attachement ont permis d’approfondir la compréhension des dyades mère-enfant. Les méthodes d’évaluation utilisées dans la présente étude pourraient être utilisés pour explorer le lien entre la capacité de mentalisation de la mère et les représentations d'attachement de l'enfant au sein d’un échantillon plus large d’enfants présentant un diagnostic de TRA.