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      INTERGENERATIONAL TRANSMISSION OF ATTACHMENT IN ABUSED AND NEGLECTED MOTHERS: THE ROLE OF TRAUMA-SPECIFIC REFLECTIVE FUNCTIONING : Attachment, Reflective Function, and Trauma

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          Abstract

          There are still important gaps in our knowledge regarding the intergenerational transmission of attachment from mother to child, especially in mothers with childhood histories of abuse and neglect (CA&N). This study examined the contributions of reflective function concerning general attachment relationships, and specifically concerning trauma, as well as those of maternal attachment states of mind to the prediction of infant attachment disorganization in a sample of mothers with CA&N and their infants, using a 20-month follow-up design. Attachment and reflective functioning were assessed during pregnancy with the Adult Attachment Interview. Infant attachment was evaluated with the Strange Situation Procedure. The majority (83%) of infants of abused and neglected mothers were classified as insecure, and a significant proportion (44%) manifested attachment disorganization. There was a strong concordance between mother and child attachment, indicative of intergenerational transmission of attachment in parents with CA&N and their infants. Both unresolved trauma and trauma-specific reflective function made significant contributions to explaining variance in infant attachment disorganization. The findings of this study highlight the importance of trauma-specific mentalization in the intergenerational transmission of attachment by mothers with a history of childhood maltreatment, and provide new evidence of the importance of the absence of mentalization regarding trauma for infant attachment.

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          Most cited references72

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          The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology.

          Childhood maltreatment has been linked to a variety of changes in brain structure and function and stress-responsive neurobiological systems. Epidemiological studies have documented the impact of childhood maltreatment on health and emotional well-being. After a brief review of the neurobiology of childhood trauma, we use the Adverse Childhood Experiences (ACE) Study as an epidemiological "case example" of the convergence between epidemiologic and neurobiological evidence of the effects of childhood trauma. The ACE Study included 17,337 adult HMO members and assessed 8 adverse childhood experiences (ACEs) including abuse, witnessing domestic violence, and serious household dysfunction. We used the number of ACEs (ACE score) as a measure of cumulative childhood stress and hypothesized a "dose-response" relationship of the ACE score to 18 selected outcomes and to the total number of these outcomes (comorbidity). Based upon logistic regression analysis, the risk of every outcome in the affective, somatic, substance abuse, memory, sexual,and aggression-related domains increased in a graded fashion as the ACE score increased (P <0.001). The mean number of comorbid outcomes tripled across the range of the ACE score. The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.
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            A Parental Bonding Instrument

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              Childhood Experience of Care and Abuse (CECA): a retrospective interview measure.

              The development of a retrospective, investigator-based interview measure of Childhood Experience of Care and Abuse (CECA) used with two community samples of adults in London is described. The component ratings are shown to have satisfactory inter-rater reliability and also validity as determined by agreement between sisters' independent accounts. The association between the different childhood scales is explored as well as the relationship of childhood experiences to adult depression. Methodological issues concerning investigator-based versus respondent-based measures of childhood are discussed and a case made for use of the former. Advantages of using the CECA, a retrospective, time-based measure of childhood, are outlined.
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                Author and article information

                Journal
                Infant Mental Health Journal
                Infant Ment. Health J.
                Wiley
                01639641
                March 2015
                March 2015
                February 18 2015
                : 36
                : 2
                : 200-212
                Affiliations
                [1 ]Université de Québec à Trois-Rivières and Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec and Center of Interdisciplinary Studies and Research on Child and Family Development
                [2 ]Université Laval, Québec and Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse
                [3 ]Université de Montréal
                [4 ]Université Laval and Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse
                [5 ]Katholieke Universiteit Leuven and University College London
                [6 ]University College London and Anna Freud Center; United Kingdom
                Article
                10.1002/imhj.21499
                25694333
                b3aa1bb4-c7d8-4b4e-936a-37861243d120
                © 2015

                http://doi.wiley.com/10.1002/tdm_license_1.1

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