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We explored in a sample of clinically depressed patients the influence of attachment security and unresolved trauma on psychotherapeutic outcome as well as changes in attachment representation through psychotherapeutic intervention.
This result indicated the influence of parental attachment representation on children's attachment through mechanisms other than responsiveness; referred to as "the transmission gap" [ 21].
A dimensional diagnostic system comprising the relevant domains, such as relationship / attachment representation, assessing interpersonal trust, emotion regulation, affinity to dissociation / sensual perception, and lacking expectation of self-efficacy, could also be envisaged.
Potentially predictors and moderators of transmission of risk are a) severity and course of maternal disorder, b) maternal trauma, c) maternal attachment representation, d) father/partner characteristics, e) support from social network, f) socio-economic resources of the family and g) characteristics of the newborn child [ 5, 9].
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Furthermore, we will determine whether the distributions of securely attached children are moderated or mediated by variations in maternal sensitivity, mentalizing, attachment representations, and psychopathology obtained at baseline and at follow-up.
Maternal attachment representations 18 (corrected) months after very preterm birth and the effect of the post-discharge Infant Behavioral Assessment and Intervention Program (IBAIP) were studied.
Therefore we seek to characterize attachment representations as a baseline predictor of early risk or resilient trajectories.
According to the model of transgenerational transmission [ 51], maternal attachment representations influence the child's attachment more than maternal sensitivity does [ 52- 54].
Before analyzing the proportions of mothers whose attachment representations change during the treatment and follow-up period in both treatment arms, we will separate those mothers with a positive shift in attachment representations [i.e., insecure (-dismissing, preoccupied, unresolved) to secure) from the mothers without such a shift or with a negative one ((i.e., secure to any of the others)].
In several studies, the security of maternal attachment representations, as assessed by the Adult Attachment Interview (AAI) [ 29], has been found to be significantly related to mother-infant attachment security [ 30].
It is therefore unsurprising that a disproportionate number of mothers in prison are classified as insecure or unresolved with respect to loss or trauma in their attachment representations of their childhood relationships (Borelli, Goshin, Joestl, Clark, & Byrne, 2010).
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