Jessica L. Borelli

Reflective functioning in mothers with drug use disorders: implications for dyadic interactions with infants and toddlers.

In this study, we examined maternal reflective functioning as a bi-dimensional construct in a sample of 47 mothers with drug use disorders caring for infants and toddlers. We first tested a two-factor solution with scale items from the Parent Development Interview and confirmed the presence of two related but distinct dimensions: self-mentalization and child-mentalization. We then tested predictions that (a) self-mentalization would be associated with overall quality of maternal caregiving and that (b) child-mentalization would be associated with (i) maternal contingent behavior and (ii) child communication. Results partially supported hypotheses (a) and (bii). Unexpectedly, self-mentalization alone was associated with maternal contingent behavior. Findings suggest that self-mentalization may be a critical first step in improving mother-child relations involving mothers with drug use disorders. Implications for theory and practice are discussed.

Attachment and emotion in school-aged children.

One of the primary functions of the attachment behavioral system is to regulate emotional experience under conditions of threat. Although research supports this association among infants and adults, few studies examine the relation between emotion and attachment in middle childhood. This study examined the concurrent associations among childrens attachment organization and three indices of emotion reactivity/regulation: self- and parent-assessments of emotion, neuroendocrine reactivity, and fear-potentiated startle response. Ninety-seven 8- to 12-year-old children completed the Child Attachment Interview (CAI) and a fear-potentiated startle paradigm on separate occasions, with salivary cortisol assessed before and after each assessment. Greater attachment security was related to greater child-reported positive trait- and state-level emotion, lower pre-CAI cortisol levels, higher initial startle magnitude during threat, and a faster decrease in startle magnitude during threat. The findings provide initial support that attachment security is related to select measures of emotion, though different methods of assessment yielded discrepant findings. The findings are discussed in terms of their contribution to theory and research examining attachment and emotion.

Attachment dismissal predicts frontal slow-wave ERPs during rejection by unfamiliar peers.

Attachment representations are thought to provide a cognitive-affective template, guiding the way individuals interact with unfamiliar social partners. To examine the neural correlates of this process, we sampled event-related potentials (ERPs) during exclusion by unfamiliar peers to differentiate insecure-dismissing from securely attached youth, as indexed by the child attachment interview. Thirteen secure and 10 dismissing 11- to 15-year-olds were ostensibly connected with two peers via the Internet to play a computerized ball-toss game. Actually, peers were computer generated, first distributing the ball evenly, but eventually excluding participants. Afterward children rated their distress. As in previous studies, distress was related to a negative left frontal slow wave (500-900 ms) during rejection, a waveform implicated in negative appraisals and less approach motivation. Though attachment classifications were comparable in frontal ERPs and distress, an attachment-related dismissal dimension predicted a negative left frontal slow wave during rejection, suggesting that high dismissal potentially involves elevated anticipation of rejection. As expected, dismissal and self-reported distress were uncorrelated. Yet, a new approach to quantifying the dissociation between self-reports and rejection-related ERPs revealed that dismissal predicted underreporting of distress relative to ERPs. Our findings imply that evaluations and regulatory strategies linked to attachment generalize to distressing social contexts in early adolescence.

Attachment organization in a sample of incarcerated mothers: Distribution of classifications and associations with substance abuse history, depressive symptoms, perceptions of parenting competency and social support

We report attachment classifications in a sample of pregnant women incarcerated in a state prison with a nursery program. Analyses were based on 69 women serving sentences for felony crimes who were followed from the birth of their child to completion of the prison nursery co-residence. They completed the Adult Attachment Interview shortly after entering the program and scales measuring depression, perceived parenting competency, and social support at study entry (Time 1) and program completion (Time 2). Incarcerated mothers had higher rates of insecure attachment than previous low-risk community samples. Compared with dismissing and secure mothers, preoccupied mothers reported higher levels of depressive symptoms, lower parenting competency, and lower satisfaction with social support at the conclusion of the nursery program. Higher scores on unresolved loss and derogation were associated with a history of substance abuse; higher scores on unresolved trauma were associated with depressive symptoms at program completion.

Assessing parental empathy: a role for empathy in child attachment

Although empathy has been associated with helping behavior and relationship quality, little research has evaluated the role of parental empathy in the development of parent–child relationships. The current study (1) establishes preliminary validity of the Parental Affective and Cognitive Empathy Scale (PACES), a method for coding empathy from parents’ narrative responses to the Parent Development Interview – Revised for School-Aged Children (PDI-R-SC), and (2) tests a theoretical model of empathy and attachment. Sixty caregivers and their children completed a battery of questionnaire and interview measures, including the PDI-R-SC and the Child Attachment Interview (CAI). Caregivers’ interview narratives were scored for empathy using PACES. PACES showed good interrater reliability and good convergent validity with a self-report empathy measure. Parent empathy was positively related to child attachment security (using a continuous score for narrative coherence) and emotional openness on the CAI, as well as to child perceptions of parental warmth. Moreover, parent empathy mediated the relation between parents’ self-reported attachment style and their children’s attachment security. Implications for attachment theory and future directions for establishing scale validity are discussed.

Heart rate variability moderates the association between attachment avoidance and self-concept reorganization following marital separation

Despite substantial evidence indicating that relationships shape peoples self-concept, relatively little is known about how people reorganize their sense of self when relationships end and whether this varies as a function of peoples beliefs about relationships. In this report, we examine the prospective association between self-report adult attachment style and self-concept recovery among 89 adults following a recent marital separation. People high in attachment avoidance are characterized by the tendency to deactivate (i.e., suppress) painful attachment-related thoughts and feelings, and, following Fagundes, Diamond, and Allen (2012), we hypothesized that highly avoidant people would show better or worse self-concept outcomes depending on their ability to successfully regulate their emotional experience during a divorce-related mental recall task. We operationalized self-regulation using respiratory sinus arrhythmia (RSA) and found that highly avoidant people who showed RSA increases across our divorce-related mental activation task (DMAT) evidenced improvements in their self-concept over three months. In contrast, highly avoidant adults who showed RSA decreases during the DMAT showed no improvement (or a worsening) in their self-concept disruptions over the subsequent three months. These results suggest that RSA, an index of heart rate variability, may provide a window into self-regulation that has the potential to shed new light on why some people cope well or poorly following the loss of a relationship. Discussion centers on the potential mechanisms of action that explain why some people are able to successfully deactivate attachment-related thoughts and feelings whereas other people are not.

Emotion-related regulatory difficulties contribute to negative psychological outcomes in active-duty Iraq war soldiers with and without posttraumatic stress disorder

Data suggest military personnel involved in U.S. military initiatives in Iraq and Afghanistan are returning from deployment with elevated rates of mental health diagnoses, including posttraumatic stress disorder (PTSD). The aim of this study was to examine difficulties with emotion regulation as a potential contributory mechanism by which soldiers have poorer psychological outcomes, such as depression, dissociation, alcohol abuse, and interpersonal difficulties. Participants were 44 active‐duty male service members who comprised three groups, including those deployed with and without diagnosed PTSD and those prior to deployment. Participants in the PTSD group scored significantly higher on measures of self‐reported depression, trauma‐related dissociation, alcohol misuse, and social adjustment difficulties than did comparison groups. Importantly, difficulties with emotion regulation were found to partially mediate the relationship between PTSD and depression, poor social adjustment, and trauma‐related depersonalization but not alcohol misuse. Emotion‐regulation difficulties are important to consider in the relationship between PTSD and additional psychological outcomes in recently deployed personnel. Implications for treatment are briefly discussed.

Dismissing child attachment and discordance for subjective and neuroendocrine responses to vulnerability

Emerging evidence suggests that as with adults, dismissing children underreport their psychological distress relative to physiological indicators of their experience (startle response, neural signals). In this report, we extend these observations to neuroendocrine reactivity. One hundred and six 8-12-year-old children completed the Child Attachment Interview and a computer-based paradigm comprised of vignettes reflecting vulnerability in interpersonal contexts. Dismissing childrens cortisol responses remained comparable from pre-to-post paradigm, while secure childrens cortisol responses decreased from pre-to-post paradigm. Furthermore, compared to secure children, dismissing children reported less distress than their cortisol response would suggest. Implications for dismissing childrens coping and self-regulation are discussed.

Dismissing Children’s Perceptions of Their Emotional Experience and Parental Care: Preliminary Evidence of Positive Bias

The tendency to perceive caregivers in highly positive terms and to perceive the self as strong and problem-free are two facets of the positive bias characteristic of a dismissing attachment classification in adulthood. However, this link has not yet been examined in children. We evaluated the association between dismissing attachment and positive bias in school-aged children’s reports of their own emotional experience and their parental care, hypothesizing that: (1) compared to secure children, dismissing children would underreport their subjective distress relative to physiological indicators of distress, and (2) dismissing children would report that their parents were warmer/more caring than would secure children. Ninety-seven children between the ages of 8 and 12 completed the Child Attachment Interview, reports of maternal and paternal care, and a psychophysiological threat paradigm. Compared to secure children, dismissing children reported less distress than their startle responses during threat would suggest. In other words, dismissing children showed a greater divergence between subjective and physiological emotional response. Dismissing children rated their parents as warmer and more caring as compared to secure children’s ratings. Results provide support for the association between dismissing attachment and inflated positivity on child-report measures of parental care and emotional experience. Implications of the study’s findings for attachment theory are discussed.

Mothering From the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment

Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering From the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of parent education (PE), a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and posttreatment and 3-month follow-up. Mother-child interaction quality was assessed again at 12-month follow-up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at posttreatment and 3-month follow-up. At 12-month follow-up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.