Expanding the concept of unresolved mental states: Hostile/Helpess states of mind on the Adult Attachment Interview are associated with disrupted mother-infant communication and infant disorganization

Department of Psychiatry, Harvard Medical School at Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139, USA.
Development and Psychopathology (Impact Factor: 4.89). 02/2005; 17(1):1-23. DOI: 10.1017/S0954579405050017
Source: PubMed


In a recent meta-analysis, only 53% of disorganized infants were predicted by parental Unresolved states of mind on the Adult Attachment Interview (AAI). The goal of this study was to identify additional predictors of infant disorganization on the AAI by developing and validating an interview-wide coding system for Hostile/Helpless (H/H) parental states of mind with respect to attachment. Maternal AAls were collected from 45 low-income mothers with high rates of childhood trauma when their children were age 7; Strange Situation assessments had been collected at 18 months of age. AAIs were independently coded using both the Main and Goldwyn coding system and newly developed codes for H/H states of mind. Results indicated that the H/H coding system displayed discriminant validity in that it did not overlap substantially with the Unresolved, Cannot Classify, or Fearfully Preoccupied by Traumatic Events categories in the Main and Goldwyn coding system. Second, H/H states of mind accounted for variance in disorganized infant behavior not associated with the Unresolved classification. Third, H/H states of mind were significantly related to maternal disrupted affective communication as coded by the Atypical Maternal Behavior Instrument for Assessment and Classification coding system, and maternal disrupted communication mediated the relations between H/H states of mind and infant disorganization.

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    • "Considering the unbalanced victim/aggressor representational patterns characterizing HH mothers (Lyons-Ruth et al., 2005), it is essential for the therapist to establish a secure therapeutic alliance as a stepping stone for healing past attachment experiences (Lyons-Ruth & Spielman, 2004). Treatments such as Transference-Focused "
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    ABSTRACT: This study aimed to assess disorganized states of mind in a sample of neglecting and at-risk of neglecting mothers using the recently developed Hostile-Helpless (HH) coding system (Lyons-Ruth et al., 2006) for the Adult Attachment Interview (Main & Goldwyn, 1998). The relation between HH states of mind and mothers’ childhood traumas was also examined. Participants were 70 neglecting mothers and at-risk of neglecting mothers. Childhood traumas were assessed using the Childhood Trauma Questionnaire. HH states of mind were coded from Adult Attachment Interview transcripts by two reliable coders. Results revealed a high prevalence of disorganized states of mind in this sample. Forty-five mothers were classified HH, representing 64% of the entire sample. Most mothers reported at least one form of childhood trauma, with a mean of 2.9 different forms of trauma. Mothers classified HH reported having been emotionally abused, sexually abused and physically neglected more frequently than non-HH mothers. There was no difference between neglecting and at-risk of neglect mothers on HH states of mind and childhood experiences of trauma. These findings are in line with theorization on maltreating mothers’ psychological background and they provide further empirical support to the validation of the HH classification system with at-risk populations.
    Child abuse & neglect 08/2014; 38(8). DOI:10.1016/j.chiabu.2014.02.015 · 2.34 Impact Factor
    • "The concept of mentalization postulates that one's understanding of others depends on whether one's own mental states were adequately understood by caring, attentive, nonthreatening adults. Problems in affect regulation, attentional control , and self-control stemming from dysfunctional attachment relationships (Agrawal et al. 2004; Lyons-Ruth et al. 2005; Sroufe et al. 2005) are mediated through a failure to develop a robust mentalizing capacity (Bateman and Fonagy 2010). Mental disorders in general can be seen as the mind misinterpreting its own experience of itself and therefore of others (Bateman and Fonagy 2010). "
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    ABSTRACT: http://books.google.co.uk/books?id=TlKTAwAAQBAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false
    The American Psychiatric Publishing Textbook of Personality Disorders, 2 edited by John Oldham, Andrew Skodol, Donna Bender, 05/2014: chapter Development, Attachment, and Childhood Experiences: pages 55-78; American Psychiatric Publishing., ISBN: 978-1-58562-456-0
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    • "The classification of unresolved trauma, as derived from the Adult Attachment Interview (AAI; George et al., 1985), relies on relatively subtle and transient signs of absorption in past trauma (Hesse and van Ijzendoorn, 1999), and taps into the degree to which past trauma exerts an ongoing influence on the present socioemotional experiences (Fearon and Mansell, 2001; Crittenden and Landini, 2011). Two decades of longitudinal and cross-sectional research (van IJzendoorn, 1995; Hesse and Main, 1999; Schuengel et al., 1999; Lyons-Ruth et al., 2005) has shown that mothers with unresolved trauma are more likely to have infants who display profoundly disorganized attachment. These infants tend to show striking difficulties using the mother for comfort when distressed, and appear frightened and alarmed (e.g., showing immobilized behavior and dazed appearance) in the presence of their traumatized mothers. "
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    ABSTRACT: While the neurobiology of post-traumatic stress disorder has been extensively researched, much less attention has been paid to the neural mechanisms underlying more covert but pervasive types of trauma (e.g., those involving disrupted relationships and insecure attachment). Here, we report on a neurobiological study documenting that mothers' attachment-related trauma, when unresolved, undermines her optimal brain response to her infant's distress. We examined the amygdala blood oxygenation level-dependent response in 42 first-time mothers as they underwent functional magnetic resonance imaging scanning, viewing happy- and sad-face images of their own infant, along with those of a matched unknown infant. Whereas mothers with no trauma demonstrated greater amygdala responses to the sad faces of their own infant as compared to their happy faces, mothers who were classified as having unresolved trauma in the Adult Attachment Interview (Dynamic Maturational Model) displayed blunted amygdala responses when cued by their own infants' sadness as compared to happiness. Unknown infant faces did not elicit differential amygdala responses between the mother groups. The blunting of the amygdala response in traumatized mothers is discussed as a neural indication of mothers' possible disengagement from infant distress, which may be part of a process linking maternal unresolved trauma and disrupted maternal caregiving.
    Social neuroscience 03/2014; 9(4). DOI:10.1080/17470919.2014.896287 · 2.66 Impact Factor
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