Case–contrast study about parent–infant interaction in a Brazilian sample of siblings of children with autism spectrum disorders

Siblings of children with autism spectrum disorders (ASD) present greater susceptibility to developmental problems, in comparison with siblings of typically developing children. The greater prevalence of mental health disorders among parents of children with ASD increases younger siblings’ vulnerability to emotional problems. The aim of this study is to compare the interaction between carers and babies aged 2 to 26 months (M = 11.7, SD = 6.9) who are siblings of children with ASD (ASD dyads) with the interaction of dyads of siblings of typically developing children (TD dyads). The protocol of Clinical Indicators of Risk for Child Development and the Coding Interactive Behaviour measures were used to evaluate interaction. ASD dyads presented higher scores of constriction in their interaction, P = .024, with babies presenting higher scores of withdrawal behavior, P = .003, and carers presenting higher scores of depressive mood, P = .008, when compared to TD dyads. The ASD dyads have interactive impairments more frequently than do the TD dyads.     

Caregiving representations in war conditions: Associations with maternal trauma,mental health,and mother–infant interaction

Risk features in mothers’ caregiving representations remain understudied in dangerous environments where infants most urgently need protective parenting. This pilot study examines the feasibility of a novel coding system for the Parent Development Interview (PDI) interview (ARR, Assessment of Representational Risk) in assessing 50 war-exposed Palestinian mothers’ caregiving representations. First, we explored the content and structure of risks in the representations. Second, we examined associations between the high-risk representations, mothers’ pre- and postnatal exposure to traumatic war events (TWE), depressive and post-traumatic stress disorder (PTSD) symptoms, and self-rated emotional availability (EA) with their 1-year-old infants. Following three dimensions of high-risk caregiving representations were identified: self/dyadic dysregulation, unavailable, and fearful. Mothers’ prenatal depressive symptoms were associated with dysregulating and fearful representations, and their postnatal PTSD with fearful representations. TWE were not associated with the high-risk representations. Moreover, mothers of boys reported more fearful representations, and mothers with financial difficulties reported more unavailable representations. TWE and high-risk representations were not associated with EA. However, qualitative analysis of the representations indicated risks in the mother–infant relationship. Further, older mothers and mothers with postnatal PTSD reported lower EA. Cultural variance in caregiving representations and the use of self-report measures among traumatized mothers are discussed.     

Community-delivered infant–parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting

The current study evaluated the effectiveness of a home-based psychotherapeutic Infant Mental Health Home Visiting (IMH-HV) intervention for enhancing parenting sensitivity; a secondary aim was to evaluate whether the use of video feedback was associated with greater treatment response. Participants were N = 78 mothers and their children (age at entry ranged from prebirth to 24-month old (M = 9.8, SD = 8.4), who were initiating IMH-HV services with community mental health-based therapists (N = 51). Dyads were assessed during extended home visits via standardized interviews and observational and questionnaire methods within the first month of treatment (baseline), and again 6 and 12 months thereafter. Following each of these extended home visits, study evaluators completed a standard Q-sort to capture observations of maternal sensitivity during the visit. Therapists completed fidelity checklists used to derive the total number of IMH-HV sessions received (i.e., dosage) and frequency with which therapists provided video feedback. Results indicated a dose–response relationship between number of sessions and maternal sensitivity, and that video review with parents independently contributed to improved maternal sensitivity. Discussion focuses on the effectiveness of this community-based psychotherapeutic home visiting model for enhancing parenting, as well as the value of video feedback as a specific therapeutic strategy.     

Studying the process of psychoanalytic parent–infant psychotherapy: Embodied and discursive aspects

This paper presents findings from an intensive, mixed methods case study of one session of psychoanalytic parent–infant psychotherapy (PPIP) addressing early relational trauma, and aims to shed light on the multimodal interactive processes that take place in the moment-to-moment exchanges comprising the therapeutic encounter. Different research methods were used on video material from PPIP sessions, including microanalysis of adult–infant interactions, discourse analysis of talk, and coding systems developed to study parent–infant interaction. These different perspectives were brought together with the clinical narrative to illuminate the complex, dynamic processes of parent–infant–therapist interaction. More specifically, the detailed analysis of one interactive episode revealed brief behavioral manifestations of fearful and disoriented states of mind, reflecting dysregulated interaction between mother and infant, which also powerfully affected the therapist. The processes through which the therapist gradually resolves this rupture are also described in detail. Through this pilot study, we were able to show that it is possible to systematically study the process of PPIP. The study contributes to the growing psychotherapy research literature that takes into account both the verbal domain and implicit, interactional processes in therapeutic practice, and underscores the therapist's comprehensive engagement in the therapeutic process.     

Relational trauma in infancy. Psychoanalytic,attachment and neuropsychological contributions to parent–infant psychotherapy

Abstract

The paper argues that residential projects working mainly with those diagnosed schizophrenic are specialized work groups, in Bion's terms, operating upon the assumption of pairing, and illustrates this with reference to a period of organizational change at one such project. The reasons why this might be so are discussed, and are related to the central issue of hope and despair in work with those who are unlikely to recover.     

Mutual touch during mother–infant face-to-face still-face interactions: Influences of interaction period and infant birth status

Contact behaviours such as touch, have been shown to be influential channels of nonverbal communication between mothers and infants. While existing research has examined the communicative roles of maternal or infant touch in isolation, mutual touch, whereby touching behaviours occur simultaneously between mothers and their infants, has yet to be examined. The present study was designed to investigate mutual touch during face-to-face interactions between mothers and their 5½-month-old fullterm (n = 40), very low birth weight/preterm (VLBW/preterm; n = 40) infants, and infants at psychosocial risk (n = 41). Objectives were to examine: (1) how the quantitative and qualitative aspects of touch employed by mothers and their infants varied across the normal periods of the still-face (SF) procedure, and (2) how these were associated with risk status. Mutual touch was systematically coded using the mother–infant touch scale. Interactions were found to largely consist of mutual touch and one-sided touch plus movement, highlighting that active touching is pervasive during mother–infant interactions. Consistent with the literature, while the SF period did not negatively affect the amount of mutual touch engaged in for mothers and their fullterm infants and mothers and their infants at psychosocial risk, it did for mothers and their VLBW/preterm infants. Together, results illuminate how both mothers and infants participate in shaping and co-regulating their interactions through the use of touch and underscore the contribution of examining the influence of birth status on mutual touch.     

Mother–infant interactions with firstborns and secondborns: A within-family study of European Americans

Given the large numbers of families with more than one child, understanding similarities and differences in siblings’ behaviors and in parents’ interactions with their sibling infants is an important goal for advancing more representative developmental science. This study employed a within-family design to examine mean-level consistency and individual-order agreement in 5-month-old sibling behaviors and maternal parenting practices with their firstborns and secondborns (ns = 61 mothers and 122 infants). Each infant was seen independently with mother. Firstborn infants were more social with their mothers and engaged in more exploration with objects than secondborn infants; firstborn and secondborn infants’ behaviors were correlated for smiling, distress communication, and efficiency of exploration. Mothers engaged in more physical encouragement, social exchange, didactic interaction, material provisioning, and language with their firstborns than with their secondborns. Notably, only maternal nurturing (e.g., feeding, holding) did not differ in mean level when mothers were with their two infants. However, mean differences in mothers’ social exchange and material provisioning with their two children attenuated to nonsignificance when controlling for differences in siblings’ behaviors. Individual-order agreement of mothers’ behaviors with firstborn and secondborn infants (across an average of almost 3 years) was only moderate. These findings suggest that mother–firstborn interactions may differ from mother–secondborn interactions. Future research should move beyond studying mother–firstborn dyads to understand broader family and developmental processes.     

Eating patterns and disorders in a college population: Are college women's eating problems a new phenomenon?

This paper examines the relationship between gender differences in eating patterns among college students and the disorders as clinically defined. A considerable number of college women but few men in our sample show behavioral patterns associated with an eating disorder (anorexia or bulimia). Our findings for women are in the moderate to high range for these symptoms, compared with other university populations. Results indicate that the eating difficulties of college women may be an eating problem, which only partially resembles clinical eating disorders. Although our female college sample displays the behavioral symptoms associated with anorexia and bulimia, they exhibit few of the constellation of psychological traits associated with these disorders. Some evidence suggests that the etiology of eating problems may be partly related to women wanting to be thinner than is medically desirable and may represent a response of normal women to the new, more demanding cultural and supercultural standards for thinness. Diagnosis and treatment issues as well as sociocultural implications of these results are discussed.The author wishes to thank Alan Clayton-Matthews, Larry Zaborski, John Downey, Larry Ludlow, the Editor, and an anonymous reviewer for their helpful comments. This research was supported, in part, from a grant from the Office of Research Administration, Boston College.     

Hypno-Operant therapy–A capsule description of a new approach in the mental health field

Abstract

The principles of behavior modification techniques, based mainly on Skinner's operant conditioning, me combined with hypnotic suggestion to create this new therapeutic technique. However, the assumption that learning is not mechanical (the S-R model) is an important element of this method, leaving an opening for the consideration of unconscious factors, especially in the management of sexual dysfunction.     

From ‘Intersex’ to ‘DSD’: a case of epistemic injustice

Synthese - The 2005 International Consensus Conference on Intersex resulted in a substantive revision of the lexicon and guidelines for treating intersex conditions. The speed with which the new...     

Profiles of competence and adaptation in preschoolers as related to the quality of parent–child interaction

In a sample of 107 five-year-olds, cluster analysis was used to identify groups of children with similar profiles of competence and adaptation. A comprehensive set of child characteristics was included in the analysis, together covering the most important aspects of five-year-olds’ development and functioning. Three groups of children emerged, which were labeled Well-adapted/Competent, Underachieving/Internalizing, and Maladapted/Externalizing. Well-adapted/Competent children (59%) were competent and well-adjusted in all domains. The Maladapted/Externalizing children (22%) scored low in almost all domains of competence and functioning, and the Underachieving/Internalizing children (22%) showed a mixed profile of competence and adaptation. The differences in the quality of parent–child interaction that were observed between the groups provide clues as to how the different profiles of competence and adaptation are shaped and maintained in the interactions with parents.     

Maternal perinatal representations and their associations with mother–infant interaction and attachment: A longitudinal comparison of Portuguese and Brazilian dyads

Prior research in Western countries (mostly the US, Canada and northern Europe) indicates that mothers' representations are associated with mother–infant interaction quality and their child's attachment security later in the first year. Fewer studies, however, have evaluated whether these associations hold for mother–infant dyads in other countries, such as Brazil and Portugal. Although these countries share a similar language and culture, they differ on societal dimensions that may affect parenting attitudes and mother–infant relationships, such as economic stress, social organisation, social policy, and the availability of services for young families. In this longitudinal study, we followed two independent samples of Brazilian and Portuguese mother–infant dyads from the perinatal period to 12 months post-partum. We assessed mothers' perinatal representations using semi-structured interviews in the first 48 hours after the infant's birth, and evaluated the associations of these representations with mother interaction quality at 9 months and infant attachment at 12 months. Results were similar in each country, corroborating prior research in single Western countries: Mothers with more positive perinatal representations were more sensitive to their infants during free play at 9 months and were more likely to have infants classified as securely attached at 12 months.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

Finding focus in a difficult landscape: Therapists’ experiences with challenging video guidance processes for parent–infant dyads

Marte Meo video guidance uses filmed interaction of the actual parent–infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent–infant dyads may illuminate important aspects of the method itself as well as the therapists’ role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent–infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent–infant dyads where child protective issues arise, where caregivers’ insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists’ role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.     

From multimodal programs to a new cognitive–interpersonal approach in the rehabilitation of offenders

A considerable amount of meta-analytic research supports the effectiveness of cognitive–behavioral psychoeducational programs in reducing recidivism rates, in youths and adults with antisocial behavior. These same studies suggest that programs including a cognitive component are as twice as more effective in reducing recidivism rates. This paper reviews outcome studies sustaining the use of structured interventions in forensic settings. It introduces a new program, Growing Pro-Social (GPS), currently in use in several Portuguese youth rehabilitation centers and prisons. GPS is a multimodal structured group program designed for the rehabilitation of individuals with antisocial behavior. It includes 40 weekly sessions, organized into 5 sequential modules. Based on a cognitive–interpersonal theoretical framework, GPS focuses on cognitive, emotional, and behavioral change, assuming as an ultimate goal the modification of dysfunctional core beliefs underlying antisocial behavior.     

Maternal romantic attachment,and antenatal and postnatal mother–infant attachment in a sample of Polish women

In this exploratory study, we evaluated the relationship between a woman's self-reported romantic attachment style (as measured with The Attachment Styles Questionnaire), her experience of pregnancy, antenatal (The Maternal–Fetal Attachment Scale) and postnatal (Postpartum Bonding Questionnaire) attachment with her baby, and depressive symptomatology (The Edinburgh Postnatal Depression Scale). In the first stage of the study 162 pregnant females participated; of these, 64 were followed up in the second stage. The maternal romantic attachment style predicted attachment with the baby in the antenatal, but not in the postpartum period. The anxious-ambivalent romantic attachment style predicted more interaction with and attributing more characteristics to the foetus, secure attachment style was positively correlated with role taking, and avoidant—with attributing more characteristics to the foetus. In the postpartum period, the correlation between antenatal and postnatal attachment was only moderate; role taking during pregnancy correlated with anxiety about care for an infant. However, our study shows the association of the profile of anxious-ambivalent romantic attachment with postpartum depression, which heightens the risk of postnatal mother–infant bonding impairments.     

Plato and Socrates: From an Educator of Childhood to a Childlike Educator?

This paper deals with two forms of education—Platonic and Socratic. The former educates childhood to transform it into what it ought to be. The latter does not form childhood, but makes education childlike. To unfold the philosophical and pedagogical dimensions of this opposition, the first part of the paper highlights the way in which philosophy is presented indirectly in some of Plato’s dialogues, beginning with a characterisation that Socrates makes of himself in the dialogue Phaedrus. The second part details Plato’s condemnation of writing in the Phaedrus, and draws on the critique by Jacques Derrida and Gilles Deleuze to establish what is at stake in this condemnation. In the third part, the pedagogical and political implications of this condemnation are reviewed, and Plato is placed in a surprising position in relation to his own teacher, Socrates. Finally, through a comparison between childhood and philosophy, the educational value of putting childhood and philosophy together is questioned. Through a number of questions, the paper ends problematising the pedagogical, political and philosophical value of placing the practice of philosophy in the realm of childhood citizenship education. It also recovers the value of philosophy—as a form of questioning and unlearning what we know and affirming the value of not knowing—in a childlike education.     

Fatal violence – from trauma to offence: A case study in forensic psychotherapy and trauma therapy with a migrant patient

Abstract

That persons who are objects of violence and traumatisation become offenders themselves is a typical feature of ill-fated cycles of violence in countries torn by fierce political, ethnic, and religious conflicts. Some refugees and migrants with this background present a challenge to forensic psychotherapy when they continue such patterns of physical force and criminal behaviour in a host country like Germany, and are found to be either not responsible or of diminished responsibility for their criminal acts by reason of mental disorders or addictions. Their offences create a critical legal situation for them, since they are threatened with deportation. At the same time, their clinical condition is critical, for they were possibly subjected to traumatic experiences by authorities in their past; their cooperation in the treatment can seriously affect their legal status. Finding a way out of these complications has to take these special factors into account. Our paper focuses on the case study of a refugee from North Africa, illustrating a model of cooperation in forensic inpatient treatment, special trauma therapy (narrative exposure therapy), and expert testimony.