The Mentalizing Approach to Psychopathology: State of the Art and Future Directions
In: Annual Review of Clinical Psychology, Band 16, S. 297-325
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In: Annual Review of Clinical Psychology, Band 16, S. 297-325
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In: Social policy and society: SPS ; a journal of the Social Policy Association, Band 18, Heft 3, S. 415-424
ISSN: 1475-3073
There is strong evidence linking adverse childhood experiences (ACEs) and poor outcomes in adulthood both in terms of mental and physical health. Gaps in both the evidence base and research priorities still exist. These include understanding how to identify and assess risk in children who have experienced ACEs, and also the development and, importantly, the evaluation of interventions. Outstanding gaps include whether there are sensitive periods during childhood, the role of resilience/protective factors, the causal relationships, biological mechanisms and relative risk of ACEs for particular negative outcomes. ACEs affect individual children differently and chronic exposure appears to increase the risk of poor outcomes in adulthood, meaning interventions should also be tailored to the individual children, families and communities. Generally, there needs to be better evaluation of interventions and dissemination of this information to ensure that their use is evidence based. More input from affected communities, clinicians, funding bodies and Government departments is required to identify research priorities and ensure gaps in the evidence base are addressed.
In: Adoption & fostering: quarterly journal, Band 42, Heft 3, S. 234-248
ISSN: 1740-469X
Looked after children represent a vulnerable group in society, many of whom are exposed to maltreatment, particularly in the form of relational trauma, prior to placement with a foster family. Challenging behaviours can place foster placements at risk and looked after children often confront the possibility of placement breakdown. A carer's capacity to retain a robust understanding of the children in their care as autonomous individuals with needs, feelings and thoughts can be important in enabling them to respond more effectively to the worrying or disruptive behaviour they may encounter. The Reflective Fostering Programme (RFP) is a new group-based programme aiming to support foster carers of children aged 4–11. This innovative development follows calls by the National Institute for Health and Care Excellence (NICE) and other organisations to help improve outcomes for children in care by improving resources for their carers. The RFP is rooted in evidence drawn from the field of contemporary attachment and mentalizing research, which indicates that children who have a carer high in reflective functioning tend to have more favourable outcomes in terms of social-emotional well-being. It also draws on the evidence that looking after a child who has impaired capacity to mentalize as a result of early relational trauma affects the carer's capacity to mentalize and respond sensitively to the child (Ensink, et al., 2015). This article sets out the rationale for the RFP, outlines its key elements and concludes by indicating future service implementation and a planned feasibility study examining this approach.
Available online: 22 November 2017 ; Assessing and analysing individual differences in change over time is of central scientific importance to developmental neuroscience. However, the literature is based largely on cross-sectional comparisons, which reflect a variety of influences and cannot directly represent change. We advocate using latent change score (LCS) models in longitudinal samples as a statistical framework to tease apart the complex processes underlying lifespan development in brain and behaviour using longitudinal data. LCS models provide a flexible framework that naturally accommodates key developmental questions as model parameters and can even be used, with some limitations, in cases with only two measurement occasions. We illustrate the use of LCS models with two empirical examples. In a lifespan cognitive training study (COGITO, N = 204 (N = 32 imaging) on two waves) we observe correlated change in brain and behaviour in the context of a high-intensity training intervention. In an adolescent development cohort (NSPN, N = 176, two waves) we find greater variability in cortical thinning in males than in females. To facilitate the adoption of LCS by the developmental community, we provide analysis code that can be adapted by other researchers and basic primers in two freely available SEM software packages (lavaan and Omega nyx). ; Sir Henry Wellcome Trust [107392/Z/15/Z] ; UK Medical Research Council Programme [MC-A060-5PR61] ; Wellcome Trust [095844/Z/11/Z] ; European Union's Horizon 2020 research and innovation programme [732592]
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