May 28th, 2017

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Новейшие исследования привязанности: мигрень

https://www.ncbi.nlm.nih.gov/pubmed/28058729

Headache. 2017 Feb;57(2):266-275. doi: 10.1111/head.13007. Epub 2017 Jan 6.

Role of the Attachment Style in Determining the Association Between Headache Features and Psychological Symptoms in Migraine Children and Adolescents. An Analytical Observational Case-Control Study.

Tarantino S1, De Ranieri C2, Dionisi C2, Gagliardi V2, Paniccia MF2, Capuano A1, Frusciante R1, Balestri M1, Vigevano F1, Gentile S2, Valeriani M1,3.
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Abstract
OBJECTIVE:
We aimed to study the role of attachment style on headache severity and psychological symptoms in migraineurs children/adolescents. Moreover, we investigated the association between attachment style, migraine severity, and psychological symptoms.

BACKGROUND:
Attachment theory suggests that early interpersonal relationships may be important determinants of psychopathology and pain management. In particular, individuals with insecure attachment styles have been shown to experience more pain than people with secure attachment style. Few studies focused on headache and data on attachment style in pediatric headache are scarce.

METHODS:
We studied 90 migraineurs (mean age 12.2 ± 2.6 years; female: 54, male: 36). Patients were divided in two groups according to headache attack frequency: (1) high frequency (HF) patients, having from weekly to daily episodes and (2) low frequency (LF) patients, showing ≤3 episodes per month. According to headache attack intensity, patients were classified in two groups: (1) mild pain (MP), allowing the patient to continue his/her daily activities and (2) severe pain (SP), leading to interruption of patient activities or forcing the child to go to bed. The psychological screening was assessed by SAFA Anxiety, Depression, and Somatization questionnaires. Attachment style was measured by the semi-projective test Separation Anxiety Test. Patients were divided into "secure," "avoidant," "ambivalent," and "disorganized/confused" attachment patterns.

RESULTS:
We found a significant relationship between the attachment style and migraine features. The ambivalent attachment was the most common style among patients reporting high attack frequency (51%) and severe pain intensity (50%). Anxiety (SAFA-A Tot: F = 23.3, P < .001), depression (SAFA-D Tot: F = 11.8, P < .001), and somatization (SAFA-S Tot: F = 10.1, P < .001) were higher in patients with ambivalent attachment style. Moreover, our results showed an association between high attack frequency and high anxiety levels, in children with ambivalent attachment style (F = 6.7, P < .002).

CONCLUSIONS:
Ambivalent attachment style may be a common vulnerability factor that impacts on pain severity, anxiety, depression, and somatization symptoms in young migraineurs. In particular, the present study provides the first evidence of the role of insecure attachment on the relationship between pain severity and psychological symptoms in migraine children.

© 2017 American Headache Society.
KEYWORDS:
attachment style; children; migraine severity; psychological factors
PMID: 28058729 DOI: 10.1111/head.13007
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Новейшие исследования привязанности у взрослых

https://www.ncbi.nlm.nih.gov/pubmed/27548462

Psychopathology. 2016;49(4):236-246. Epub 2016 Aug 23.
Mentalization Mediates the Relationship between Early Maltreatment and Potential for Violence in Adolescence.
Taubner S1, Zimmermann L, Ramberg A, Schröder P.
Author information
1
Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany.
Abstract
AIM:
The present study investigates the role of attachment representation and mentalization as possibly protective factors in the relationship between early maltreatment and potential for violence in adolescence.

METHODS:
For the current study, 161 adolescents, aged 14-21 years, were recruited from high schools and youth psychiatry. Early maltreatment was assessed by the Childhood Experiences of Care and Abuse Questionnaire, attachment was assessed using the Adult Attachment Projective Picture System, and mentalization was coded with the Reflective Functioning Scale from Adult Attachment Interviews. Potential for violence was operationalized using the Reactive-Proactive Aggression Questionnaire, and the presence of conduct disorder was assessed by the Structured Clinical Interview. Using structural equation modeling, reflective functioning and attachment were tested as mediators on the direct effect of early maltreatment on potential for violence.

RESULTS:
There was a direct effect of early maltreatment on potential for violence. Furthermore, this direct effect was partially mediated by reflective functioning but not by attachment representations.

DISCUSSION:
The results contribute to the idea that mentalization serves as a protective factor that may suspend the pathway from early maltreatment to violence in adolescence. Because of the transformation of attachment patterns into generalized cognitive models of attachment, attachment in adolescence may have a less pronounced effect on violence in this specific developmental phase. Future studies should test for further group differences in community and clinical groups, which was not possible in the present study due to the limited sample size.

© 2016 S. Karger AG, Basel.
PMID: 27548462 DOI: 10.1159/000448053