SUBSTANCE-ABUSING MOTHERS IN RESIDENTIAL TREATMENT WITH THEIR BABIES: IMPORTANCE OF PRE- AND POSTNATAL MATERNAL REFLECTIVE FUNCTIONING

A residential treatment program has been developed specifically for substance-abusing pregnant and parenting women in Finland, focusing on simultaneously supporting maternal abstinence from substances and the mother-baby relationship. The aims of the study are to explore maternal pre- and postnatal reflective functioning and its association with background factors, maternal exposure to trauma, and psychiatric symptoms, postnatal interaction, child development, and later child foster care placement. Participants were 34 mother-baby pairs living in three residential program units during the pre- to postnatal period. We employed self-report questionnaires on background, trauma history, and psychiatric symptoms (Brief Symptom Inventory: L.R. Derogatis, 1993; Edinburgh Postnatal Depression Scale: J.L. Cox, J.M. Holden, & R. Sagovsky, 1987; Traumatic Antecedents Questionnaire: B. Van der Kolk, 2003), videotaped mother-child interactions coded for sensitivity, control, and unresponsiveness (Care Index for Infants and Toddlers: P. Crittenden, 2003); a standardized test of child development (Bayley Scales of Infant Development-II: N. Bayley, 1993); and semistructured interviews for maternal reflective functioning (Pregnancy Interview: A. Slade, E. Bernbach, J. Grienenberger, D.W. Levy, & A. Locker, 2002; Parent Development Interview: A. Slade et al., 2005). Pre- and postnatal maternal reflective functioning (RF) was on average low, but varied considerably across participants. Average RF increased significantly during the intervention. Increase in RF level was found to be associated with type of abused substance and maternal trauma history. Mothers who showed lower postnatal RF levels relapsed to substance use more often after completing a residential treatment period, and their children were more likely to be placed in foster care. The intensive focus on maternal RF is an important direction in the development of efficacious treatment for this very high risk population.     

Maternal representations and emotional availability among drug‐abusing and nonusing mothers and their infants

Both negative and idealized maternal prenatal representations may constitute a risk for mother–infant interaction. This study analyzed the role of maternal prenatal representations and pre‐ to postnatal representational change in predicting mother–infant emotional availability (EA) among 51 drug‐abusing mothers and their infants who participated in either psychodynamic group therapy (PGT) or received psychosocial support (PSS) and among 50 nonusing comparison dyads. Maternal representations of her child, the child's father, her own mother, self‐as‐mother, and self‐as‐woman were measured during pregnancy and at 4 and 12 months' postpartum with the Interview of Maternal Representations (M. Ammaniti et al., 1992 ; M. Ammaniti, R. Tambelli, & P. Perucchini, 1998). EA was measured with the Emotional Availability Scales, fourth edition (Z. Biringen, 2008 ) at 4 and 12 months. The results showed that drug‐abusing mothers had more negative prenatal representations of the self‐as‐woman and of the child's father. Postnatally, PSS mothers tended to first idealize their child, but later to experience disillusionment of idealization. Both negative and idealized prenatal representations of the self‐as‐mother predicted mother–infant EA problems, but only among the PGT mothers. For all mothers, negative representational change was detrimental for the mother–infant EA whereas for drug‐abusing mothers, also increasing idealization from the prenatal period to the postnatal period was harmful. Clinicians working with drug‐abusing mothers should aim at supporting the development of a realistically positive view of motherhood.     

The ambivalence of challenge stressors: Time pressure associated with both negative and positive well-being

According to the challenge–hindrance model, challenge stressors contain both stressful and challenging aspects, hindrance stressors only stressful aspects. Typically, negative outcomes of challenge stressors refer to well-being (strain), positive outcomes to so-called work outcomes (e.g., productivity, intention to quit). As both effects occur simultaneously, the positive outcomes often emerge only when controlling for the negative effects. We suggest that the negative and the positive effects of challenge stressors may refer to well-being. Specifically, we propose challenge to indicate competence, thus fostering organization-based self-esteem (OBSE), which, in turn, should enhance more general indicators of positive well-being. We explored the effect of time pressure (a prototypical challenge stressor) on a general well-being variable (positive attitude towards life; PAL). We postulated challenge stressors to be associated with PAL positively via OBSE and negatively via strain. These processes should (a) result in a non-significant bivariate association, which should (b) become significant once strain is controlled (suppression), but (c) become insignificant again once OBSE is controlled (mediation). Using structural equation modeling, we could confirm our hypotheses in a cross-sectional study. Results confirm the inherently ambivalent nature of time pressure, containing both positive and negative variance. In line with our theoretical position, results suggest that the negative and the positive outcomes may be conceived in terms of different aspects of well-being, in addition to “work outcomes” that do not refer to well-being. This concept of challenge stressors may help to explain why many people do not reduce challenge stressors even when they could: Feeling good about themselves and their lives may, at least temporarily, outweigh the strain.     

Construction and validation of the South African version of the Fear Survey Schedule for Children: an exploratory factor analysis

The Fear Survey Schedule for Children-Revised (Ollendick, 1983) is an 80-item self-report instrument that has been used internationally to asses the number of fears and general level of fearfulness among children. Despite its widespread use, this instrument has not been adapted to the South African context. The present study addressed this gap by means of a 2-phase investigation aimed at developing a South African version of the instrument. In Phase 1, semistructured interviews were conducted with 40 children (7 to 13 years of age). Qualitative data obtained from these interviews were used to construct additional items for inclusion in the South African Fear Survey Schedule for Children-Revised. The modified scale, consisting of 97 items, was then administered to a sample of 646 children between the ages of 7 and 13 years. Further psychometric considerations resulted in the final version of the scale consisting of 74 items with high internal consistency (α=.97). The factor structure was explored by means of principal component analysis with varimax rotation and a 5-factor solution was found to provide the best conceptual fit. The factors identified were as follows: Fear of Death and Danger; Fear of the Unknown; Fear of Small Animals and Minor Threats to Self; Large Animal Fears; and Situational Fears. Differences between the South African version and the original Fear Survey Schedule for Children-Revised are noted and implications for the study of fear in South Africa and other countries are discussed.     

Subliminal priming and effects of hand dominance

In the masked priming paradigm, motor responses to targets are influenced by previously presented subliminal primes, and are guided by facilitatory and inhibitory mechanisms that depend on prime-target compatibility/duration. In this study, we evaluate subliminal-driven priming in right- and left-handers during unimanual as well as bimanual tasks. The data from the unimanual tasks confirmed that prime-target compatibility affects performance as a function of prime-target duration. In a bimanual setting, the preferred hand benefitted from facilitation in both handedness groups whereas the non-preferred hand showed a positive priming effect only in left-handers. This denotes that left-handers are more susceptible to response activation of either hand. In addition, inhibitory priming had a stronger effect on the non-preferred than preferred hand, independent of handedness group. Overall, the findings suggest that subliminal-driven mechanisms that assist adaptive motor behavior are sensitive not only to extrinsic (task-related) factors such as prime-target compatibility but also to intrinsic (performer-related) factors such as hand dominance. The data further provide support for handedness-specific effects in motor functions and underline a significant role of hand dominance in the control of bimanual actions.     

How Does Neurobiological Research Influence Psychoanalytic Treatments?—Clinical Observations and Reflections From a Study on the Interface of Clinical Psychoanalysis and Neuroscience

One of the counterarguments against empirical research in psychoanalysis is that research negatively influences the treatment situation. In this paper, the impact of a neurobiological study on psychoanalytically oriented treatments is presented from three different perspectives: patients' views, a study group of participating psychoanalysts and a clinical case example. Twenty chronically depressed patients, 20 healthy controls and 16 psychoanalysts participated in the project on research. Results show a clear influence of the neurobiological study on the course of treatments. Patients consistently reported that study participation had a positive impact on their treatment experiences. However, study participation was conflictual for the psychoanalysts and forced them to carefully reflect on their unconscious and conscious involvement to establish a psychoanalytic stance independent from empirical research.     

Dopaminergic and prefrontal contributions to reward-based learning and outcome monitoring during child development and aging

In many instances, children and older adults show similar difficulties in reward-based learning and outcome monitoring. These impairments are most pronounced in situations in which reward is uncertain (e.g., probabilistic reward schedules) and if outcome information is ambiguous (e.g., the relative value of outcomes has to be learned). Furthermore, whereas children show a greater sensitivity to external outcome information, older adults focus less on a rapid differentiation of rewarding outcomes. In this article, we review evidence for the idea that these phenomenologically similar impairments in learning and outcome monitoring in children and older adults can be attributed to deficits in different underlying neurophysiological mechanisms. We propose that in older adults learning impairments are the result of reduced dopaminergic projections to the ventromedial prefrontal cortex, which lead to less differentiated representations of reward value. In contrast, in children, impairments in learning can be primarily attributed to deficits in executive control, which may be due to a protracted development of the dorsal medial and lateral prefrontal cortices. We think that this framework maps well onto recent neurophysiological models of reward processing and is plausible from a broader developmental perspective.     

Empathy, values, morality and Asperger's syndrome

The aims of this study were, first, to re-address the issue of empathy among people with autism conditions; second, to explore the relationships between empathy and values among autistic populations and controls; and third, to explore the capacity for moral agency among those affected by autism. We compared responses of an Asperger group (N = 41) and a control group (N = 139) to measures of self-reported empathy (Davis's IRI) and value priorities (Schwartz's PVQ). Control group results were largely in line with previous studies, such that empathy subscales of perspective taking and empathic concern showed their strongest positive and negative relations to the Schwartz self-transcendence/self-enhancement dimensions. Results for the Asperger group showed that although on the one hand there were self-reported difficulties in perspective taking and the cognitive recognition of affect, and that on the other hand there were less connections between the empathy and value measures, there was nevertheless a comparable prioritization of moral values. Conclusions suggest that different people may acquire moral values through different mechanisms.