Pia Risholm Mothander

Parental Rearing, Attachment, and Social Anxiety in Chinese Adolescents.

This cross-sectional study investigated associations between perceived parental rearing, attachment, and social anxiety. 510 Chinese middle school students, aged 12 to 20 years, completed a set of questionnaires including “Egna Minnen Beträffande Uppfostran” for Children (EMBU-C), Inventory for Parent and Peer Attachment (IPPA) and Social Anxiety Scale for Adolescents (SAS-A). The results showed that intercorrelations between adolescents’ rated attachment to parents were stronger than betweenparental and peer attachment. Girls scored higher on attachment to mother and peer than boys. Lack of parental rejection and presence of emotional warmth were strongly related to parental attachment. The rated level of total anxiety was not related to gender or age, but it was lower than what has earlier been reported from China. Perceived rejection from fathers and mothers’ as well as attachment to peer and mother acted as predictors; together they explained 19% of the variance in social anxiety.

Patient Attachment to Therapist Rating Scale: development and psychometric properties.

Abstract Objective: To report on the development and initial psychometric properties of a new rating scale for patent-therapist attachment. Method: Seventy interviews from the Young Adult Psychotherapy Project (YAPP) were rated. Results: Excellent internal consistency (Cronbachs α > .90) was observed for all four subscales (Security, Deactivation, Hyperactivation, and Disorganization). Three subscales showed good inter-rater reliability (ICC > .60), while one (Hyperactivation) had poor (ICC < .40). Correlations with measures of alliance, mental representations, and symptom distress support the construct validity of the reliable subscales. Exploratory factor analysis indicated three underlying factors explaining 82% of the variance. Conclusions: The Patient Attachment to Therapist Rating Scale is a promising approach for assessing the quality of attachment to therapist from patient narratives. Future development should focus on improving the discrimination of the insecure subscales.

Secure Attachment to Therapist, Alliance, and Outcome in Psychoanalytic Psychotherapy With Young Adults

Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression effect indicating that secure attachment to therapist predicted continued improvement in global functioning, whereas the alliance predicted deterioration when both variables were modeled together. Although limited by the correlational design, this study suggests that the development of a secure attachment to therapist is associated with treatment gains as well as predictive of posttreatment improvement in functioning. Future research should investigate the temporal development of attachment to therapist and its interaction with alliance and outcome more closely. To ensure differentiation from patient-rated alliance, observer-based measurement of attachment to therapist should be considered.

DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD (DC:0-5): IMPLEMENTATION CONSIDERATIONS AND CLINICAL REMARKS.

The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0–3) gave infant mental health specialists a tool to describe behavioral symptoms during infancy, earlier often ignored as minor or transient baby problems. In a new form, called the DC: 0–5, the tool now aims to describe mental health problems during the first 6 years of life. In my commentary, I discuss some implications of the proposed changes. First, I address the never-ending question regarding why a specific diagnostic classification system for young children is at all needed. The answer remains unchanged. Clinicians need to tell the world that mental health problems in young children do exist and that it is our responsibility to reduce their negative influence on early development. When DC: 0–3 was launched, it was described as a complement to other diagnostic systems; clinicians were encouraged to refer to the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases (ICD) when possible. The DC: 0–3 focused on specific characteristics of infant problems that other systems had not described, and also acknowledged that some of these were early manifestations of problems also described among older children. The DC: 0–5 is meant to be the general single source for describing infant mental health problems in children under 6 years of age, including disorders also described in other systems. While attractive as an aim, the implementation of DC: 0–5 depends on how it is received by healthcare organizations around the world. In a society where healthcare is financed by governmental sources, as in Scandinavia, a classification system has to provide guidance on where resources are most effectively used. Today, the ICD-10 is used to register mental health disorders in all age groups, including infancy and early childhood, despite poor criteria for younger ages. In those

Parent-rated socio-emotional development in children with language impairment in comparison with typically developed children

Children with language impairment (LI) and children with typical development (TD) were assessed by their respective parents using The MacArthur Communicative Development Inventories (Swedish version SECDI) and Greenspan Socio Emotional Growth Chart (GSEGC). The aim was to investigate socio-emotional and language development in children with LI and TD with respect to possible differential patterns and relations between the groups. The results highlight a clear association between language and socio-emotional development. Children with LI were rated similar to young language-matched children with TD, but significantly lower relative to age-matched TD children, particularly concerning symbolic stages of development: the use of linguistic symbols as well as related areas such as symbol play and symbolic mental ability. The results are discussed in light of presumable background factors and possible consequences for children or sub-groups of children with LI.