Anna Maria Speranza

Internal working models of attachment during late childhood and early adolescence: an exploration of stability and change

This article addresses the question of how the transition from late childhood to early adolescence influences the organization of attachment. The applicability of a measure for attachment representations in early adolescence, the Attachment Interview for Childhood and Adolescence (AICA), was explored. The AICA is based on the Adult Attachment Interview, which was adapted in minor ways to the early adolescent age-group. It was hypothesized that attachment shows considerable stability from late childhood to early adolescence, although some changes might become manifest especially because distancing mechanisms toward the parents may be activated in this period. Also, stability may be different for the various secure and insecure attachment classifications. Lastly, because gender differences become larger during the transition from childhood to adolescence, attachment differences between boys and girls were explored. The same 31 Italian participants (14 girls, 17 boys) completed the AICA at 10 years and at 14 years of age. The AICA attachment classification distributions did not differ from Adult Attachment Interview (AAI) distributions in comparable but older adolescent or young adult samples. The stability of attachment security was considerable: 74% (k = .48). The stability of the dismissing and secure categories was somewhat higher than the stability of the (small) preoccupied and unresolved categories. The participants tended to show more dismissing strategies across the four years, and to report more rejection from their parents. It was suggested that the activation of dismissing defense mechanisms might be necessary to keep parental figures at some distance in order to achieve a more definite personal identity. Finally, no significant gender differences in attachment emerged during the transition from late childhood to early adolescence.

A prevention and promotion intervention program in the field of mother–infant relationship

The purpose of the study was to analyze the efficacy of early home-visiting intervention in enhancing the quality of mother–infant interaction in psychosocial risk and depressive risk mother–infant dyads. Thirty depressive risk, 28 psychosocial risk, and 33 low-depressed and low-risk mothers were randomly distributed between the Home Visiting Program and control groups. Attachment (Adult Attachment Interview; Main & Goldwyn, 1997) and maternal representations during pregnancy (Interview of Maternal Representations During Pregnancy; Ammaniti, Candelori, Pola, & Tambelli, 1999) and after the birth of the infant (Interview of Maternal Representations After the Birth; Ammaniti et al., 1999) were evaluated as well as depressive symptoms (Center for Epidemiological Studies-Depression Scale; Radloff, 1977) during the first year. Ratings of sensitivity, interference, affective state of the mother, cooperation, and infant self-regulation during mother–infant interactions were assessed at 3, 6, and 12 months. Results showed the efficacy of the home-visiting program in improving sensitive maternal behaviors toward the child after 6 months of intervention.

Memories of attachment hamper EEG cortical connectivity in dissociative patients

In this study, we evaluated cortical connectivity modifications by electroencephalography (EEG) lagged coherence analysis, in subjects with dissociative disorders and in controls, after retrieval of attachment memories. We asked thirteen patients with dissociative disorders and thirteen age- and sex-matched healthy controls to retrieve personal attachment-related autobiographical memories through adult attachment interviews (AAI). EEG was recorded in the closed eyes resting state before and after the AAI. EEG lagged coherence before and after AAI was compared in all subjects. In the control group, memories of attachment promoted a widespread increase in EEG connectivity, in particular in the high-frequency EEG bands. Compared to controls, dissociative patients did not show an increase in EEG connectivity after the AAI. Conclusions: These results shed light on the neurophysiology of the disintegrative effect of retrieval of traumatic attachment memories in dissociative patients.

Modifications of EEG power spectra in mesial temporal lobe during n-back tasks of increasing difficulty. A sLORETA study

The n-back task is widely used to investigate the neural basis of Working Memory (WM) processes. The principal aim of this study was to explore and compare the EEG power spectra during two n-back tests with different levels of difficulty (1-back vs. 3-back). Fourteen healthy subjects were enrolled (seven men and seven women, mean age 31.21 ± 7.05 years, range: 23–48). EEG was recorded while performing the N-back test, by means of 19 surface electrodes referred to joint mastoids. EEG analysis were conducted by means of the standardized Low Resolution brain Electric Tomography (sLORETA) software. The statistical comparison between EEG power spectra in the two conditions was performed using paired t-statistics on the coherence values after Fishers z transformation available in the LORETA program package. The frequency bands considered were: delta (0.5–4 Hz); theta (4.5–7.5 Hz); alpha (8–12.5 Hz); beta (13–30 Hz); gamma (30.5–100 Hz). Significant changes occurred in the delta band: in the 3-back condition an increased delta power was localized in a brain region corresponding to the Brodmann Area (BA) 28 in the left posterior entorhinal cortex (T = 3.112; p < 0.05) and in the BA 35 in the left perirhinal cortex in the parahippocampal gyrus (T = 2.876; p < 0.05). No significant differences were observed in the right hemisphere and in the alpha, theta, beta, and gamma frequency bands. Our results indicate that the most prominent modification induced by the increased complexity of the task occur in the mesial left temporal lobe structures.

Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: A hdEEG study

Eye Movement Desensitization and Reprocessing (EMDR) therapy has been proven efficacious in restoring affective regulation in post-traumatic stress disorder (PTSD) patients. However, its effectiveness on emotion processing in children with complex trauma has yet to be explored. High density electroencephalography (hdEEG) was used to investigate the effects of EMDR on brain responses to adults’ emotions on children with histories of early maltreatment. Ten school-aged children were examined before (T0) and within one month after the conclusion of EMDR (T1). hdEEGs were recorded while children passively viewed angry, afraid, happy, and neutral faces. Clinical scales were administered at the same time. Correlation analyses were performed to detect brain regions whose activity was linked to children’s traumatic symptom-related and emotional-adaptive problem scores. In all four conditions, hdEEG showed similar significantly higher activity on the right medial prefrontal and fronto-temporal limbic regions at T0, shifting toward the left medial and superior temporal regions at T1. Moreover, significant correlations were found between clinical scales and the same regions whose activity significantly differed between pre- and post-treatment. These preliminary results demonstrate that, after EMDR, children suffering from complex trauma show increased activity in areas implicated in high-order cognitive processing when passively viewing pictures of emotional expressions. These changes are associated with the decrease of depressive and traumatic symptoms, and with the improvement of emotional-adaptive functioning over time.

Alterations of EEG functional connectivity in resting state obese and overweight patients with binge eating disorder: A preliminary report

Alterations in brain functional connectivity have been detected in patients with eating disorders, but have not been studied in binge eating disorder (BED). We have investigated electroencephalographic (EEG) functional connectivity in thirteen overweight and obese patients with BED and thirteen overweight and obese patients without BED during RS condition. EEG analyzes were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). Compared to patients without BED, patients with BED demonstrated an increase of lagged phase synchronization in the beta frequency band among the cortical areas explored by FC1-T3 (left superior frontal gyrus-left middle temporal gyrus), T5-O1 (left inferior temporal gyrus-left middle occipital gyrus), and C4-O1 (right postcentral gyrus-left middle occipital gyrus) electrodes (T=4.861, p<0.05). EEG connectivity values were also significantly related to binge eating symptomatology after controlling for depressive symptoms. Our results may reflect the impairment of frontal control network and visual processing networks, which lead patients with BED to be more vulnerable to food cues and lack of control with regards to over eating.

Change in heart rate variability after the adult attachment interview in dissociative patients.

The aim of this study was to assess heart rate variability (HRV) in individuals with dissociative disorders (DD) before and after the Adult Attachment Interview (AAI). Electrocardiograms were recorded before, during, and after the AAI in 13 individuals with DD and 13 healthy participants matched for age and gender. Significant change in HRV was observed only in the DD group. After the AAI, those with DD showed significant increases in the low frequency/high frequency ratio (pre-AAI = 1.91 ± 1.19; post-AAI = 4.03 ± 2.40; Wilcoxon test = –2.76, p = .005). Our results suggest that the retrieval of childhood attachment experiences in individuals with DD is associated with a change in HRV patterns that could reflect the emotion dysregulation of dissociative psychopathological processes.

Mothers with depressive symptoms display differential brain activations when empathizing with infant faces

Maternal care during the first year of life provides the foundation for the infants emotional and cognitive development. Depressive symptoms in mothers can undermine their early dyadic interaction, which may lead to various psychopathological disorders with long-term consequences. During this period, the mother-child interaction is exclusively preverbal and is based on the mothers ability to understand her infants needs and feelings (i.e., empathy) and on reciprocal imitation of facial expressions that promote a social dialog that influences the development of the infant self. To study the effects of maternal depressive symptoms on neural circuits underlying these processes, we studied 16 healthy mothers (H) and 14 mothers with depressive symptoms (D), as assessed by the Center for Epidemiologic Studies Depression Scale. Subjects underwent functional magnetic resonance during observation/empathizing (OE) and imitation (IM) of the faces of both their own child and of that of an unknown child aged between 6 and 12 months. During OE, D deactivated the orbital and medial prefrontal cortex to a greater extent (compared with H), thus pointing to an increased internally focused cognitive style during rest. Moreover, D, in respect to H, displayed a greater reactivity of the right amygdala, which may be an expression of emotional dysregulation.

is the Dissociative experiences scale able to identify detachment and compartmentalization symptoms? Factor structure of the Dissociative experiences scale in a large sample of psychiatric and nonpsychiatric subjects

Background In this study, we explored the ability of the Dissociative Experiences Scale (DES) to catch detachment and compartmentalization symptoms. Participants and methods The DES factor structure was evaluated in 768 psychiatric patients (546 women and 222 men) and in 2,403 subjects enrolled in nonpsychiatric settings (1,857 women and 546 men). All participants were administered the Italian version of DES. Twenty senior psychiatric experts in the treatment of dissociative symptoms independently assessed the DES items and categorized each of them as follows: “C” for compartmentalization, “D” for detachment, and “NC” for noncongruence with either C or D. Results Confirmatory factor analysis supported the three-factor structure of DES in both clinical and nonclinical samples and its invariance across the two groups. Moreover, factor analyses results overlapped with those from the expert classification procedure. Conclusion Our results showed that DES can be used as a valid instrument for clinicians to assess the frequency of different types of dissociative experiences including detachment and compartmentalization.

Personality and Attachment in Transsexual Adults.

The main aim of this study was to investigate the associations between personality features and attachment patterns in transsexual adults. We explored mental representations of attachment, assessed personality traits, and possible personality disorders. Forty-four individuals diagnosed with gender identity disorder (now gender dysphoria), 28 male-to-female and 16 female-to-male, were evaluated using the Shedler–Westen assessment procedure-200 (SWAP-200) to assess personality traits and disorders; the adult attachment interview was used to evaluate their attachment state-of-mind. With respect to attachment, our sample differed both from normative samples because of the high percentage of disorganized states of mind (50% of the sample), and from clinical samples for the conspicuous percentage of secure states of mind (37%). Furthermore, we found that only 16% of our sample presented a personality disorder, while 50% showed a high level of functioning according to the SWAP-200 scales. In order to find latent subgroups that shared personality characteristics, we performed a Q-factor analysis. Three personality clusters then emerged: Healthy Functioning (54% of the sample); Depressive/Introverted (32%) and Histrionic/Extroverted (14%). These data indicate that in terms of personality and attachment, GD individuals are a heterogeneous sample and show articulate and diverse types with regard to these constructs.