Wound-related pain is complex, integrating the experience of noncyclic acute wound pain, cyclic acute wound pain, and chronic wound pain (Krasner 1995). More than 80% of chronic wound patients report pain during wound dressing change. A constellation of physical and psychological factors may be involved in the mediation of pain during wound dressing change. A burgeoning body of evidence suggests the intricate relationship between anxiety and pain. In this study, the attachment framework was examined to determine how personal views of self (attachment anxiety) and others (attachment avoidance) may affect pain during dressing change. Attachment styles are systematic patterns of expectations, emotional reactivity, strategies for distress management and social behaviour that are based on an individual’s belief about the self and others. Internal working models are cognitive-affective schemas that guide the attachment patterns. Purpose: The purpose of this study was to explore the relationship of attachment style and pain during dressing change in an older population. In particular the study focussed on the role that anxiety, anticipatory self reported pain, and behavioural expression of pain play in this relationships. Method: A questionnaire was used in this cross-sectional study to classify 96 older subjects into four different categories of attachment styles. Subjects were asked to rate their levels of anticipatory pain and actual pain levels at different times during wound care using a numerical rating scale. Results: The results indicated that subjects experienced more pain during dressing change than at baseline. Secure subjects reported less pain and anxiety than subjects with other attachment styles. Results of regression analysis indicated that anxiety mediated the relationship between attachment and pain. Conclusion: The results of this study also support the role that attachment plays in the experience of pain in older adults. Clinicians must be cognizant of the impact of personality, anxiety, and anticipation of pain on the actual pain experience.

Wound-related pain is complex, integrating the experience of noncyclic acute wound pain, cyclic acute wound pain, and chronic wound pain (Krasner 1995). More than 80% of chronic wound patients report pain during wound dressing change. A constellation of physical and psychological factors may be involved in the mediation of pain during wound dressing change. A burgeoning body of evidence suggests the intricate relationship between anxiety and pain. In this study, the attachment framework was examined to determine how personal views of self (attachment anxiety) and others (attachment avoidance) may affect pain during dressing change. Attachment styles are systematic patterns of expectations, emotional reactivity, strategies for distress management and social behaviour that are based on an individual’s belief about the self and others. Internal working models are cognitive-affective schemas that guide the attachment patterns. Purpose: The purpose of this study was to explore the relationship of attachment style and pain during dressing change in an older population. In particular the study focussed on the role that anxiety, anticipatory self reported pain, and behavioural expression of pain play in this relationships. Method: A questionnaire was used in this cross-sectional study to classify 96 older subjects into four different categories of attachment styles. Subjects were asked to rate their levels of anticipatory pain and actual pain levels at different times during wound care using a numerical rating scale. Results: The results indicated that subjects experienced more pain during dressing change than at baseline. Secure subjects reported less pain and anxiety than subjects with other attachment styles. Results of regression analysis indicated that anxiety mediated the relationship between attachment and pain. Conclusion: The results of this study also support the role that attachment plays in the experience of pain in older adults. Clinicians must be cognizant of the impact of personality, anxiety, and anticipation of pain on the actual pain experience.

Made available in DSpace on 2014-06-11T19:28:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-03-30Bitstream added on 2014-06-13T19:16:57Z : No. of bitstreams: 1 gomes_aa_me_bauru.pdf: 1351547 bytes, checksum: cec8e0d89dc0cc29f7588e1ad48f7887 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A teoria do apego, elaborada por John Bowlby, baseia-se na premissa de que os seres humanos, assim como outros animais, apresentam uma inclinação natural para construir e para manter vínculos com os outros que, ao longo do tempo, podem tornar-se insubistituíveis. Em suas pesquisas, desenvolvidas principalmente no período marcado pela Segunda Guerra Mundial, Bowlby descreveu os efeitos da separação de pessoas significativas na tenra infância, procurando especificar quais experiências afetivas seriam essenciais para a criança desenvolver habilidades para lidar com os desafios que a vida coloca a cada ser humano. No decorrer de praticamente meio século, a Teoria do Apego tornou-se um importante modelo psicológico que, na atualidade, possibilita elucidar tanto o desenvolvimento normal quanto condições psicopatológicas. Nesse contexto de transformações paulatinas, a dimensão emocional presente nos vínculos de apego constitui hoje, um componente fundamental de um quadro teórico bem mais extenso e diversificado. Em vista disso, o presente trabalho objetivou identificar os avanços da Teoria do Apego na Psicologia contemporânea, por meio de análise de material bibliográfico publicado no período de 2005 a 2010, na modalidade de resumos de artigos científicos e no formato de textos completos indexados nas bases de dados PsycInfo, Eric, Lilacs e Scielo. Foram encontrados 194 trabalhos, com maior volume de produção no ano de 2007. Nesse contexto, a pesquisadora chilena Maria Pía Santelices destacou-se como a autora com maior frequencia de publicações na atualidade. O inglês foi o idioma mais utilizado nos artigos encontrados, sendo que os Estados Unidos constituiu no país com maior volume de publicações. Observou-se um predomínio de estudos teóricos e, no caso dos estudos empíricos... / The attachment theory, developed by John Bowlby, is based on the premise that humans, like other animals, have a natural inclination to build and maintain links with others who, over time, may become irreplaceable. In this research, developed mainly in the period market by World War II. Bowlby described the effects of separation from significant others in early childhood, seeking to specify which affective experiences would be essential for the child develop skills to cope the challenges that life poses to every human being. During nearly half a century, the Attachment. Theory has become an important psychological model that currently enables elucidate both normal development and psychopathological conditions. In this context of gradual changes, the emotional dimension of attachment bonds is now a key component of a theoretical framework much more extensive and diversified. Taking this into account, the present study aimed to identify the progress of the Attachment Theory in the Contemporary Psychology, through analysis of papers published in the period 2005 to 2010, in the form of abstracts of scientific articles and in full text format indexed in databases PsyInfo, Eric, Lilacs and Scielo. The research found 194 studies and revealed a higher volume of production in 2007. In this context, the Chilean researcher Maria Pia Santelices stood out a the author of publications more frequently nowadays. Enghish was the language most used in the articles found, and the United States was the country with the greatest volume of publications. There was predominate of theoretical works and, in the case of empirical research, a greater number of studies investigating attachment in adulthood was detected. Studies on human development prevailed. Psychology was the field of knowledge that received the most... (Complete abstract click electronic access below)

“Non-affective” psychotic disorders are in fact associated with a high rate of emotional disorders. A number of attachment-based models of impairments in emotion regulation and mentalization in psychosis have been put forward. The present thesis aimed to explore psychobiological markers of emotion regulation in order to develop and pilot a novel psychological intervention. The portfolio consists of six peer-reviewed published articles. Four studies were conducted involving 167 psychosis patients and 66 community controls resulting in four original articles, a theory paper and a metaanalysis. Paper 1- 3 explored emotion regulation using different methods (self-report, hormonal, attachment-based narrative). Paper 4 lays out a compassion-focused model for promoting emotional recovery from psychosis. Paper 5 presents data from a feasibility trial of Group Compassion Focused Therapy. Paper 6 presents an updated attachment- and compassion-focused model of emotion regulation and mentalization in the context of a meta-analysis of effects of intranasal oxytocin on symptoms and social cognition in psychosis. Childhood trauma – especially emotional abuse - was strongly associated with dissociation in psychosis patients compared to non-psychotic community controls – most strongly in chronic patients (Paper 1). Psychosis patients with childhood trauma showed significantly lower basal cortisol levels indicative of impaired stress regulation than those without childhood trauma (Paper 2). Impaired emotion regulation operationalised as attachment-based mentalisation was associated with problematic adolescent development and emotional and interpersonal adaptation to a first episode of psychosis in qualitative interviews. A novel attachment-based model for improving emotion regulation in psychosis by way of strengthening the caregiving/ receiving and affiliation system through Compassion Focused Therapy (CFT) was put forward (Paper 4). A feasibility trial showed that group CFT was safe, well-accepted and associated with greater clinical improvement and greater increases in compassion compared to treatment as usual. Increases in compassion in CFT were associated with reductions in shame, perceived social marginalisation, fear or relapse and depression (Paper 5). A metaanalysis of oxytocin administration as a biological way of strengthening the care-giving/receiving and affiliation system in psychosis was conducted yielding medium effects despite significant heterogeneity (Paper 6). Findings replicated the strong association between childhood trauma and dissociation in psychosis patients relative to controls highlighting the importance of emotional abuse and suggesting underlying difficulties with regulating distress related to early interpersonal trauma. Lower basal cortisol in patients with childhood trauma appeared to support the presence of emotion regulation difficulties due to early interpersonal trauma on a physiological level. Qualitative findings helped to generate hypotheses about inhibitors and facilitators of recovery and targets for intervention including the moderating role of mentalization. A novel attachment- and compassion-focused model was outlined and successfully piloted yielding important signals of change such as increases in compassion, which appear to reduce depression and social marginalisation in particular. This model helped account for inconsistencies in oxytocin studies of psychosis. In summary, findings extend existing research on emotion regulation in psychosis by supporting links to early interpersonal trauma and attachment and offer a promising novel attachment-and compassion-focused psychological intervention and a comprehensive biopsychosocial framework for further improving emotion regulation and mentalization in people with psychosis.

Introduction: Research indicates that children with an intellectual disability [ID] are at an increased risk of developing attachment difficulties and subsequent affect regulation difficulties. Attachment theory may further understanding of the risk factors for individuals with an ID experiencing mental health problems, challenging behaviour and emotional difficulties. However, there is a paucity of research into attachment and adults with ID and there is a lack of valid and reliable measures for assessing attachment security for this group. The Manchester Attachment Scale-Third Party Observational Measure [MAST] was developed to assess degree of secure attachment behaviour for adults with ID and the current study examined the psychometric properties of the MAST. Method: Professional carers [N=40] supporting individuals with an ID completed the MAST and other measures related to the construct of attachment theory (subscales of the Edward Zigler-Yale Personality Questionnaire[EZPQ] and Emotional Rating Scale [ERS] as well as the Learning Disability Casemix Scale [LDCS) regarding individuals with an ID they were supporting [N=57]. Individuals with an ID [N=14] completed the Self-report Assessment of Attachment Security [SRAAS]. Results: The MAST was found to have good internal consistency and test-retest reliability. The convergent validity of the MAST was indicated by positive correlation with the EZPQ subscales (negative reaction tendency, obedience, positive reaction tendency and outerdirectedness) and scores on the SRAAS. The MAST was found to be correlated with both levels of ID and presence of challenging behaviour as measured by LDCS scores. Conclusion: These current results provide preliminary support for the reliability and validity of the MAST as a measure of secure attachment behaviour for adults with ID. The results provide support for previous research that indicates a relationship between attachment security and level of ID and challenging behaviour. The results of the study and the implications of attachment theory for adults with ID are discussed.

The poor outcomes of young people leaving foster care are well documented and demand a focus on placement permanency and interventions that encourage stability (Rubin et al, 2007). The need for better support for foster carers is widely acknowledged (Warman, Pallet & Scott, 2006; Morgan & Baron, 2011). To provide effective support an understanding of foster carers support needs is required. A qualitative approach explored the support needs of foster carers who look after young people perceived to have emotional and behavioural difficulties. Semi- structured interviews were undertaken with 17 foster carers employed by a local authority or an Independent Fostering Agency. A grounded theory methodology within a social constructionist framework was used to develop a new theoretical understanding from the data. A central storyline of ‘keeping your head above water’ emerged and appeared to encapsulate daily struggles and ways of managing. Categories which contributed to this were ‘becoming isolated’ from other professionals, ‘role ambiguity’ regarding the multiple meanings attached to being a foster carer, ‘making sense of emotional and behavioural difficulties’ highlighting a need to understand the children cared for, ‘a focus on behaviours’ illuminating approaches to parenting and ‘unmet emotional needs’ which is a possible consequence of focussing on children’s behaviours. The emergent theory may hold potential for developing psychological formulations, interventions and training programmes for foster carers. Suggestions for future support are put forward based on the new theoretical framework. Applications of the findings to Counselling Psychology are discussed in detail.

The psychological concept of attachment began to take hold in the 1950s and 1960s. This time period also began a significant period of social and legislative change impacting on the field of child protection. These social science and legal developments have been mutually reinforcing and this thesis examines those developments over the course of the 60 years since Attachment Theory first emerged from the work of John Bowlby. This examination will include a review of the fundamentals of Attachment Theory with a particular focus on the implications of those developmental lessons on the circumstances of children removed from the care of their families due to risk or maltreatment. Following a review of the fundamentals of Attachment Theory, this examination will review the influence of those principles on the laws of child protection in Ontario – through changes in the legislation and through decisions of the Supreme Court of Canada and the Courts of Ontario. Finally, this thesis will examine some of the ways in which the attachment needs of Ontario’s children are being served or failed with regard to both the need for early establishment of permanency for children as well as the continuity of the care arrangements for children up to and including the point at which permanent plans are established. This examination of the legislation and the case law will demonstrate that Ontario has seen a progressive shift away from family reunification as a fixed priority and toward the examination of each child’s individual developmental needs. This includes an acceptance of the application of Attachment Theory and its principles as one significant means of describing those needs and assessing the best interests of children. / Thesis (Master, Law) -- Queen's University, 2013-04-29 01:15:06.929

Background/Aims: Children and young people in residential care often exhibit complex emotional and behavioural needs. Attachment theory is frequently used to explain these difficulties, whereby a young person's early experience can influence their internal representations of relationships and their subsequent interactions within the residential milieu. Thus, residential childcare staff have a fundamental role supporting young people, to facilitate therapeutic change and mitigate poor long-term outcomes. Policy and research often recommend staff training and attachment-informed care, yet there is very limited understanding of how this translates into practice or influences outcomes. Therefore, this thesis aimed to systematically review literature on the types, measurement and effectiveness of residential staff training, focussed upon psychosocial outcomes. It also aimed to construct an explanatory theory of how residential staff make sense of, and use, attachment theory in practice. Methods: Research aims are addressed in two studies. Literature on residential staff training was systematically reviewed in Journal Article 1. This was conducted through a search of electronic databases, quality assessment of included studies, and subsequent narrative synthesis. Journal Article 2 used qualitative methodology in the form of constructivist grounded theory. Semi-structured interviews were conducted with twenty residential staff members through an iterative process of data collection and analysis, and theoretical sampling, until theoretical saturation was achieved. Results: Eighteen studies were included in the systematic review. Results highlight heterogeneous staff training, often evaluated through measurement of staff knowledge, skills and/or attitudes, and/or child behaviour frequency. Findings offer tentative support for the positive impact of training upon staff skills but other outcomes remain unclear. Results from Journal Article 2 indicate that staff had difficulty articulating attachment theory and often did not have a coherent narrative to describe attachment theory to practice links. Instead, they focussed upon a natural process of building relationships within a challenging context, with attachment theory only coming to the forefront when deemed relevant. Conclusions: The effectiveness of residential staff training remains unclear due to the methodological limitations of included studies. Significant improvements are identified for future evaluations of training to address this issue. Future staff training may benefit from limiting jargon, developing theory to practice links, and facilitating staff reflective function. Recommendations of attachment-informed care must also recognise the complexity of the residential system; and the current disparity between attachment theory narrative within policy and research, and practice.

This research developed two best-fitting structural equation models of risk factors for adolescent depression and suicidality: a core model, which included parenting factors, gender, depression, and suicidality, and an extended model, which also encompassed personality traits (Introversion and Impulsivity) and mood factors (Anxiety and Anger). Further, this research investigated the consistency of model fit across time (Le., 1 month & 12 months) and samples, and explored the effectiveness of the ReachOut! Internet site as a psychoeducational prevention strategy for adolescent depression and suicidality. Gender, age, and location differences were also explored. Participants were 185 Year-9 students and 93 Year-10 students aged 14 - 16 years, from seven secondary schools in regional and rural Victoria. Students were given a survey which included the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Profile of Mood States Inventory (McNair & Lorr, 1964), items on suicidal behaviour including some questions from the Revised Adolescent Suicide Questionnaire (Pearce & Martin, 1994), and questions on loss and general demographics. Results supported an indirect model of risk factors, with family factors directly influencing personality factors, which in turn influenced mood factors, including depression, which then influenced suicidality. At the theoretical level, results supported Attachment Theory (Bowlby, 1969), demonstrating that perceived parenting styles that are warm and not overly controlling are more conducive to an adolescent's emotional well-being than are parenting styles that are cold and controlling. Further, results supported Millon's theory of personality (1981), demonstrating that parenting style influences a child's personality. Short-term intervention effects from the internet site were a decrease in Introversion for the full sample, and decreased Inhibition and Suicidality for a high-risk subgroup. Long-term age effects were decreased Inhibition and increased Anxiety for the fall sample. There was also a probable intervention effect for Depression for the high-risk subgroup. No location differences for the risk factors were found between regional and rural areas.

The main purpose of this study is to investigate if bloggers¡¦ attachment style would affect their self-disclosure. In addition, the study also examines if bloggers¡¦ social support would affect blogger¡¦s self-efficacy to self-disclose, if self-disclosure would affect Internet interpersonal satisfaction. The results show that social support has positive effect on blogger¡¦s self-efficacy to self-disclosure, and blogger¡¦s self-efficacy to self-disclose has positive effect on self-disclosure and Internet interpersonal satisfaction. The results also show that bloggers of the secure attachment style have higher score than avoidant and anxious attachment styles on self-efficacy, self-disclosure, and Internet interpersonal satisfaction.