Postpartum depression and attachment: Is anybody here?

Abstract

The paper presents a developmental and dynamic multitheoretical overview of many dimensions of attachment-related processes activated under the conditions of maternal depression. The clinical vignette (from the analytic practice of Eva D. Papiasvili) of reconstructive anaytic work with an adult patient illustrates the profound impact of maternal depression on precocious early differentiation between the attachment styles, of the depressed parent and the substitute caregiver, at the root of early “counterdependent” self-sufficiency. Through reconstructive interpretive work, first with enactments and then dreams, pertaining to not-remembered, represented, or symbolized events of earliest infancy, the patient is able to make a series of developmentally transformative symbolic leaps, restoring the capacity for intimacy, hope, trust, and pleasure. This breaks the intergenerational mother–daughter transmission of postpartum depression and related problematic attachment.     

Can discrepancies between impulsive and reflective processes be associated with movement behavior among the elderly? The facilitating role of inhibitory control

Physical activity participation remains a global public health challenge, with 8 out of 10 older adults failing to meet the minimum physical activity recommendations, and it is also associated with an increased risk of cardiovascular disease, cognitive impairment, and mortality. Strategies to promote physical activity are primarily focused on socio-cognitive factors, and their effectiveness is limited. According to dual-process theories, physical activity is related with impulsive/implicit (i.e., emotions) and reflective/explicit (i.e., perceived advantage) processes; however, implicit-explicit discrepancy (IED) may impair movement behavior. In addition, cognitive inhibitory control may have r direct relationship with IED situations since it determines which of these processes predominates in the regulation of individual's behavior. Nonetheless, these outcomes in physical activity behavior among older adults have received little attention. In this study, we associate IED with physical activity and sedentary behavior as measured by accelerometers, and investigate the moderator role of inhibitory control in this association. In this cross-sectional study, 94 older adults were assessed for implicit and explicit attitudes, inhibitory control, and movement behavior using accelerometers over the course of seven days. A higher magnitude of the IED was linked to less moderate-to-vigorous physical activity (MVPA) and daily steps. Interestingly, a higher light physical activity was associated with a direction of the IED with more positive explicit attitudes. Furthermore, in older adults with higher inhibitory control, a direction of the IED with more positive explicit attitudes than implicit attitudes was associated with higher MVPA. Our findings suggest that IED may be important factor in the physical activity behavior of older adults. Furthermore, a higher inhibitory control appears to override an impulsive negative response, enabling a more positive reflective assessment of physical activity to serve as the main driver of an active lifestyle.