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Annual Report

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Book (chapter)
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Referens:Risholm Mothander, P. (2005). Förord till svenska upplagan. [Foreword to Swedish edition.] In D.N. Stern Ögonblickets psykologi. Om tid och förändring i psykoterapi och vardagsliv. [The present moment in psychotherapy and everyday life.] Natur och Kultur.
Abstract:The foreword introduces the author D.N. Stern and discusses his new book in relation to earlier work. It focuses on how theory of intersubjectivity, based on infant research, can be of help in clinical and therapeutic work.
Nyckelord:psykoterapi, intersubjektivitet


Journal
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Referens:Risholm Mothander, P. (2005). Behövs de barnpsykiatriska diagnoserna? [Are childpsychiatric diagnoses needed?] Mellanrummet, 12, 49-61.
Abstract:The paper draws a line from the historical use of diagnoses in infant psychiatry to how diagnostic work can be used in an infant mental health setting today. A clinical procedure model and a classification system, Diagnostic Classification, DC:0-3, are introduced and discussed.
Nyckelord:spädbarnspsykologi, DC:0-3


Report
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Referens:Risholm Mothander, P., & Grette Moe, R. (in press). Diagnostic Classification, DC:0-3. Utpröving og implementering i en klinisk setting. Regionsenter for Barn og Unges Psykiske Helse, Helseregion Öst og Sör, R.BUP
Abstract:This report presents the results of an implementation of DC:0-3, a multiaxial infant psychiatry classification system, at Nic Waals Institute, (NWI), in Oslo, Norway. During a two-year period 138 (68%) all children under four who were referred to the parent-infant clinic were assessed and independently classified within both DC:0-3 and ICD-10 frameworks. Of the assessed children 59% were given DC:0-3, Axis I classifications, with regulatory disorders, disorders of affect and traumatic stress disorders as most common diagnoses, 48 % received a DC:0-3 Axis II classification of relationship disorder and 27% were given classifications in both DC:0-3 Axes I and II. The profiles of ICD-10 and DC:0-3 classifications were similar but detailed comparisons were made difficult because of the use of many different ICD-10 categories. A validity test was made by using four different parental questionnaires, CES-D, SPSQ, CBCL and ITSC, in a smaller number of families. The results indicate that mothers had a higher degree of self reported depression than fathers. Mothers’ CBCL reports were significantly related to infants’ regulatory and affect disorders as classified with DC:0-3. The value of a classification system developed specifically for mental health problems during infancy with both categorical and dimensional descriptions is discussed. Although more emphasis on validity and reliability issues has to be encouraged DC:0-3 is seen as a valuable complement to already existing diagnostic systems like DSM and ICD.
Nyckelord:infant mental health, späd- och småbarnspsykologi, DC:0-3


Journal
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Referens:Risholm Mothander, P., & Grette Moe, R. (2007). Småbarnspykiatrisk diagnostik med DC 0-3. Socialmedicinsk tidskrift, 1, 66-77.
Abstract:The growing understanding of the importance of early development for later functioning has led to an increased need for methods to assess infant mental health problems. This paper describes Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3) a descriptive classification system designed to address the need for descriptions of mental health difficulties in the first 4 years of life. DC: 0-3 was implemented in a Psychiatric Program for Infants and Toddlers (Nic Waals Institute) in Norway. DC: 0-3 was used in parallel with earlier established clinical routines and ICD 10 classifaction. A group of 138 children was classified according to DC: 0-3, Axes I and II. 59% of the children were classified with a Primary Diagnosis according to Axis I, and 48 % with a Relationship Classifcation according to Axis II. The clinicians found DC: 0-3 criteria to be more clinically relevant for this age group than the ICD 10, and they appreciated the use of Axis II to describe the relationship. However, the clinical use of DC: 0-3 is depending on a thorough familiarity with both normal and pathological infant development.
Nyckelord:infant mental health, psychiatry, assessment


Journal
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Referens:Risholm Mothander, P., & Grette Moe, R. (in press). Infant Mental Health Assessment: The use of DC 0-3 in an outpatient child psychiatric clinic in Scandinavia. Scandinavian Journal of Psychology.
Abstract:The study focuses on Infant Mental Health data from an outpatient psychiatric clinic using the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3) and parental questionnaires, CBCL and ITSC. In total, 138 infants (aged 0-3) went through the diagnostic procedure. Sixty eight per cent were diagnosed within Axis I, with regulatory disorder, disorder of affect and traumatic stress disorder being the most frequent diagnoses. In addition, 48 % were classified as having a relationship disorder according to Axis II, with another 40 % being considered to be at risk of developing a relationship disorder. The mothers´ and fathers´ ratings of their children´s extrernalised and sensitivity problems were in agreement with the clinicians, but the ratings of internalised problems as well as relationship problems presented a more complex pattern.
Nyckelord:infant mental health, psychiatry, assessment


Journal
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Referens:Risholm Mothander, P., & Grette Moe, R. (2008). Infant Mental Health Assessment: The use of DC 0-3 in an outpatient child psychiatric clinic in Scandinavia. Scandinavian Journal of Psychology, 49, (3), 259-267.
Abstract:The study focuses on Infant Mental Health data from an outpatient psychiatric clinic using the “Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood” (DC 0-3) and parental questionnaires, CBCL and ITSC. In total, 138 infants (aged 0–3) went through the diagnostic procedure. Sixty-eight per cent were diagnosed within Axis I, with regulatory disorder, disorder of affect and traumatic stress disorder being the most frequent diagnoses. In addition, 48% were classified as having a relationship disorder according to Axis II, with an additional 40% being considered to be at risk of developing a relationship disorder. The mothers’ and fathers’ ratings of their children’s externalized and sensitivity problems were in agreement with the clinicians, but the ratings of internalized problems as well as relationship problems presented a more complex pattern.
Nyckelord:DC 0-3, infant mental health, infant psychiatry, diagnostic procedure, mothers’ assessments, fathers’ assessments


Book (chapter)
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Referens:Broberg, A., Risholm Mothander, P., Granqvist, P., & Ivarsson, T. (2008). Anknytning i praktiken. Tillämpningar av anknytningsteorin. Stockholm: Natur & Kultur.
Abstract:The book presents basic knowledge of attachment theory, research and clinical applications. It includes chapters of Infant Mental Health, parenting and family life, as well as descriptions of methods to assess attachment security in children, teenagers and adults. Further, it includes chapters on psychopathology and psychotherapy.
Nyckelord:anknytning, omvårdnad, psykoterapi, ISBN: 978-91-27-11484-5


Book (chapter)
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Referens:Broberg, A., Granqvist, P., Ivarsson, T., & Risholm Mothander, P. (2006). Anknytningsteori. Betydelsen av nära känslomässiga relationer. Stockholm: Natur och Kultur.
Abstract:This book gives a broad picture of the development of the attachment theory and research related to attachment theory. It presents the links to evolutionary biology, ethology, systems theory as well as to psychoanalytic theory and cognitive psychology.
Nyckelord:attachment, omvårdnad, utveckling , ISBN: 91-27-10975-5


Book (chapter)
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Referens:Risholm Mothander, P. (2008). Utvecklingspsykologi [Developmental psychology]. I P.A. Granhag & S.Å. Christianson (Eds.), Handbok i Rättspsykologi [Handbook of forensic psychology]. Stockholm: Liber.
Abstract:The chapter presents different aspects of child development. The discussion of nature and nurture is brought forward. Theories of cognitive and emotional development are presented. Applications of developmental theory in the pre-school and school environment is discussed as well as abuse, neglect and children in non-optimal environments.
Nyckelord:emotionell utveckling, kognitiv utveckling, omsorgsbrist, ISBN: 978-91-47-05287-5


Journal
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Referens:Moe, R., & Mothander, P.R. (2009). Kartlegging av vansker hos sped- og småbarn. [Infant mental health assessment.] Tidsskrift for Norsk Psykologforening, 46(8), 749-756.
Abstract:This paper presents the results of a study where disorders were diagnosed using the Diagnostic Classification of Mental Health and the Developmental Disorders of Infancy and Early Childhood (DC: 0–3) at Nic Waals Institute (NWI), in Oslo, Norway. During a three-year period 138 children under four who were referred to a parent-infant clinic, and were assessed and independently classified using both the DC: 0–3 and the ICD-10 systems. Fifty nine per cent of the children received a DC 0–3, Axis I classification. Regulatory disorders, disorders of affect and traumatic stress disorders were the most common diagnoses. Forty eight per cent received a DC: 0–3 Axis II classification of relationship disorder and 27 % received classifications in both DC: 0–3 Axes I and II.
Nyckelord:DC: 0-3, ICD-10, child, health assessment, ISSN: 0332-6470


Book (chapter)
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Referens:Havnesköld, L., & Risholm Mothander, P. (2009). Utvecklingspsykologi [Developmental psychology] (3rd ed). Liber utbildning.
Abstract:I denna nya och helt omarbetade upplaga av Utvecklingspsykologi redovisas aktuell teori och forskning inom modern utvecklingsteori. Boken belyser individens utveckling ur både ett psykodynamiskt och kognitivt synsätt. De kompletterande perspektiven befruktar varandra och tydliggör bilden av människans psykiska utveckling, för att visa hur de tidiga psykiska utvecklingsprocesserna påverkar individens beteende och utveckling under barndomen, från fostertiden fram till puberteten. Boken tar upp minne och informationsprocessande, intersubjektivitetsteori, självets utveckling, känslans psykologi, den emotionella hjärnan, anknytningsteori, mentaliseringsteori samt barnets utveckling från fostertiden till puberteten.
Nyckelord:utvecklingspsykologi, ISBN: 978-91-47-09338-8


Proceedings
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Referens:Smedler, A.-C., Böhm, B., Lundequist, A., & Risholm Mothander, P. (2009). Born preterm: Socioemotional adjustment in relation toneruopsychological functioning at age 18. Symposium presentation, International Neuropsychological Society, Mid-Year Meeting 2009, Helsinki, Finland and Tallin, Estonia.
Abstract:Objective: The Stockholm Neonatal Project is a prospective longitudinal study of children born prematurely in 1988-93, with very low birth weight (<1500 g, VLBW). Currently, all children with VLBW (n=182) and matched controls born at term (n=125), who participated in the previous follow-up at age 5 1/2 years, are invited to a psychological assessment at age 18.

Participants and methods: The assessment involves neuropsychological tests as well as self-report measures of health and adjustment, interpersonal relations, school performance, interests and quality of life. As a complement, parents are asked to complete a rating scale of their child’s health, adjustment and educational record, as well as self-report measures of their own well-being and possible parental stress.

Results: Half-way through the data collection, preliminary neuropsychological results suggest that at age 18, the preterm group tends to score >1 SD below the controls on tests of visuo-spatial ability, executive functions, and speed, whereas no systematic group differences have been observed in the verbal domain. According to self-reports from SDQ and YSR/CBCL, the preterm group has a higher incidence of peer problems and lower self-rated competence than controls, a picture that is supported by the parental reports. Qualitative data indicate that the preterm group may be less socially active and more home-bound. When controlling for overall cognitive functioning, most group differences in socio-emotional adjustment disappear, although parents of prematurely born adolescents still tend to report more concerns.

Conclusions: Our findings suggest that socio-emotional adjustment may be closely linked to long-term neuropsychological outcome in adolescents with a history of premature birth.
Nyckelord:neuropsych*, development, preterm birth


Journal
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Referens:Brandtzaeg, I., Moe, R., & Mothander, P.R. (2009). Hva kjennetegner de minste barna uten akse 1-diagnose i DC:0-3 systemet? Tidsskrift for Norsk Psykologforening, 46(9), 850-856.
Abstract:Characteristics of children with no Axis 1 diagnosis in the DC 0-3 system. This investigation forms part of a more extensive Norwegian study of the diagnostic system DC:0-3. 75 children aged 0-4 years participated in the investigation. Of these, 45 received an axis 1 diagnosis. Our aim was to establish whether children with and without a primary diagnosis differ in regard to age, gender, maternal age, living conditions, parents' educational status, relational difficulties and maternal depression. No significant differences were found between the groups. However, the investigation did find that mothers of children with no primary diagnosis displayed a significantly higher level of depression than mothers of children with a primary diagnosis. The authors discuss these results and the implications they might have for clinical practice.
Nyckelord:DC 0-3, axis 1, maternal depression, transactional model, ISSN: 0332-6470


Journal
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Referens:Risholm Mothander, P., & Moe, R.G. (in press). Self-reported Depressive Symptoms and Parental Stress in Mothers and Fathers who bring their Infants to an Infant Mental Health Clinic. Nordic Journal of Psychiatry.
Abstract:Background: The parental functioning and its influence upon infant mental health development have been extensively studied but there are few clinical studies investigating less severe psychiatric problems among mothers and fathers in the same family.

Aim: This study focuses on the emotional well-being of mothers’ and fathers’ who bring their infants to an Infant Mental Health Clinic.

Methods: The studied sample is comprised of 63 families with 0-47 month old infants where the mothers completed the Center for Epidemiological Study - Depression Scale (CES-D), including 43 families in which the CES-D was completed by both parents. In 44 families, the mothers also filled in the Swedish Parental Stress Questionnaire (SPSQ), including 32 where the SPSQ was completed by both parents. The children were independently classified with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3).

Results: Altogether, 54 % of the mothers and 11 % of the fathers reported depressive symptoms above the CES-D clinical cut-off. Self-rated depressive symptoms and parental stress were strongly related. The mothers’ self-rated depressive symptoms were associated with the severity of their infant’s problems, but the association was not specific to the DC 0-3 Axis I classification. The mothers’ stress level was marginally related to DC 0-3 Axis II relationship classification.

Conclusion: The results indicate that the inclusion of systematic parental self-ratings in infant mental health assessments could add clinical information facilitating the planning of family oriented interventions.
Nyckelord:DC 0-3, infant mental health, infant psychiatry


Proceedings
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Referens:Risholm Mothander, P., & Grette Moe, R. (2010). Why use DC 0-3? Experiences from DC 0-3 in Scandinavia. Symposium presentation. World Association for Infant Mental Health, WAIMH, 10th World Congress, Leipzig, Germany.
Abstract:Clinicians both in Norway and Sweden have for years framed infant mental health problems in a parent-infant relationship context. Parents are considered to be the experts of their own infants and their needs have guided the planning of interventions. However, changes in the psychiatric and primary health care systems have increased the demand of evidence based infant assessments and family intervention methods.

Many Scandinavian infant-parent programs are today organized within bigger child and adolescent psychiatric clinics. When diagnostic systems are introduced, the systems already in use for the older children, like DSM or ICD, are also applied for the younger age groups.

The aim of the Norwegian study was to explore the value of DC 0-3 and compare it to the ICD 10 system. Data was drawn from a parent-child program serving families with pre-school children at Nic Waals Institute (NWI), an outpatient child and adolescent psychiatric clinic in Oslo. DC 0-3 was introduced as part of the assessment procedure for referred families with infants below 4 years of age during a period of 3,5 years. The diagnostic information was described within the frame of DC 0-3 Axes I and II. Independent diagnoses were made following ICD 10 criteria.

During the research period, 203 infants and their parents were referred to the parent-child program; 40 families (20 %) did not go through the diagnostic procedure and 23 families (23 %) were referred to other clinics. The remaining 138 infants and their parents went through the diagnostic procedure, including home and day care visits and videotaping of a free play situation.

68 % of the infants were diagnosed within DC 0-3 Axis I, with regulatory disorder, disorder of affect and traumatic stress disorder being the most frequent diagnoses. In addition, 48 % of the infants were classified as having a relationship disorder according to DC 0-3 Axis II, with an additional 40 % being considered to be at risk for developing a relationship disorder. 63 % of the infants were diagnosed with ICD 10, where the non-specific ICD-diagnoses were mostly used. The predominant diagnoses were Mixed conduct and emotional disorder, Emotional disorder or Mental disorder, NOS.

The burning issue is how to balance the cost of introducing an alternative diagnostic system with benefit of getting a better tool for describing the mental health problems of the youngest children. Are the DC 0-3 classification criteria clear and is DC 0-3 user-friendly enough to fulfil this?
Nyckelord:DC 0-3


Proceedings
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Referens:Fransson, E., Hjelmstedt, A., Lind, A., Böhm,B., & Risholm Mothander, P. (2010). Parents’ experiences of preterm birth. Poster presentation, World Association for Infant Mental Health, 10th World Congress, Leipzig, Germany.
Abstract:Background: The development and wellbeing of infants born preterm have been extensively studied but the experiences of parents of preterm infants have been quite overlooked. Previous studies have shown that mothers of preterm infants are at greater risk of depressed mood and anxiety. Research on the relationship between mothers and infants born preterm have shown that maternal factors such as educational level could have a stronger impact than infant variables on the relationship. However, previous studies on mothers of preterm infants have almost exclusively focused on mothers with infants born early preterm. The health and experiences of mothers and fathers with infants born near term (at 34-36 weeks) are less studied.

Aim: To describe how mothers and fathers experience preterm birth and transition to parenthood.

Material and methods: 20 mothers and 20 fathers of preterm infants were interviewed separately during the first week after delivery and at infant age four months (corrected age) at the Karolinska Hospital, Sweden. Narratives from parents who experienced early PTB (before 31 weeks of completed gestation) and late PTB (in 34-35 weeks of completed gestation) will be analyzed and contrasted and factors contributing to a positive or negative experience will be illustrated using a qualitative content analysis.

Preliminary results: Being emotionally prepared for childbirth seemed to be an important positive factor in the narratives and for the transition to parenthood. This was not exclusively related to gestational length, but also due to how sudden or predictable the delivery process was perceived. Another theme in the narratives was the ability or not to attribute importance to one’s own parent capacity and to attribute emotional response from the infant. Aggravating circumstances in transition to parenthood included avoidance and fear to see or touch the baby and perceptions of the baby as indifferent to contact. The process of analysing the narratives is still ongoing.
Nyckelord:preterm birth, parents


Book (chapter)
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Referens:Grette Moe, R., & Risholm Mothander, P. (2010). Kartlegging og diagnostisering av vansker hos sped- og småbarn. I V. Moe, K. Slinning & M. B. Hansen (red). Håndbok i sped- og småbarns psykiske helse. (Kap 31, sid 610 – 635). Oslo: Gyldendal.
Abstract:For å øke vår forståelse av de symptomene på mistilpasning og emosjonelle problemer vi møter hos de yngste barna, har det lenge vært et behov for å utvikle spesielle kartleggingsverktøy og diagnostiske beskrivelser. Det diagnostiske kartleggingssystemet «Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood» (DC: 0–3) er utviklet spesielt for å fange opp problemer hos de minste barna, det vil si fra fødselen og opp til fireårsalderen, og gir en referanseramme for å kunne forstå og utveksle kunnskap om disse vanskene. I dette kapittelet ser vi på begrunnelsene for å ha et eget kartleggings- og diagnosesystem for de yngste barna. Vi går igjennom oppbyggingen av DC 0–3 R (revidert utgave kom i 2005) og tar for oss kartleggingsverktøy som vi mener bør brukes for å kvalitetssikre de diagnostiske vurderingene og de behandlingsplanene som legges ved hjelp av systemet. Kartleggings- og diagnostiseringsprosessen belyses ved et klinisk eksempel. Til slutt tar vi for oss noen erfaringer fra bruk av systemet.
Nyckelord:missanpassning, emotionella problem, spädbarn, småbarn, ISBN: 9788205390713


Journal
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Referens:Risholm Mothander, P., & Grette Moe, R. (2010). Self-reported depressive symptoms and parental stress in mothers and fathers who bring their infants to an infant mental health clinic. Nordic Journal of Psychiatry, 64(5), 310-316.
Abstract:Background: The parental functioning and its influence upon infant mental health development have been extensively studied but there are few clinical studies investigating less severe psychiatric problems among mothers and fathers in the same family. Aim: This study focuses on the emotional well-being of mothers' and fathers' who bring their infants to an Infant Mental Health Clinic. Methods: The studied sample is comprised of 63 families with 0-47-month-old infants where the mothers completed the Center for Epidemiological Study-Depression Scale (CES-D), including 43 families in which the CES-D was completed by both parents. In 44 families, the mothers also filled in the Swedish Parental Stress Questionnaire (SPSQ), including 32 where the SPSQ was completed by both parents. The children were independently classified with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3). Results: Altogether, 54% of the mothers and 11% of the fathers reported depressive symptoms above the CES-D clinical cut-off. Self-rated depressive symptoms and parental stress were strongly related. The mothers' self-rated depressive symptoms were associated with the severity of their infant's problems, but the association was not specific to the DC 0-3 Axis I classification. The mothers' stress level was marginally related to DC 0-3 Axis II relationship classification. Conclusion: The results indicate that the inclusion of systematic parental self-ratings in infant mental health assessments could add clinical information facilitating the planning of family oriented interventions.
Nyckelord:DC 0-3, depression, infant mental health, infant psychiatry, parental stress, ISSN: 0803-9488


Book (chapter)
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Referens:Risholm Mothander, P. (2010). Förord till den andra utgåvan. I Bowlby, J., En trygg bas. Kliniska tillämpningar av anknytningsteorin. Stockholm: Natur och Kultur.
Abstract:The foreword introduces central concepts of attachment theory and discusses how the theory has developed during the 30 years since the first edition of the book was published. Three areas are focused; the changing family roles with fathers being more actively present in the life of their small children, the attachment relationship as an on-going relationship where mis-match and repair can strengthen the quality of the relationship and finally the acceptance of attachment theory both as a scientific and a clinical theory.
Nyckelord:attachment theory, ISBN: 978-91-27-12141-6


Journal
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Referens:Risholm Mothander, P., & Wang, M. (in press). Parental Rearing, Attachment, and Social Anxiety in Chinese Adolescents. Youth & Society.
Abstract:This cross-sectional study investigated associations between perceived parental rearing, attachment, and social anxiety. 510 Chinese middle school students, aged 12 to 20 years, completed a set of questionnaires including “Egna Minnen Beträffande Uppfostran” for Children (EMBU-C), Inventory for Parent and Peer Attachment (IPPA) and Social Anxiety Scale for Adolescents (SAS-A). The results showed that intercorrelations between adolescents’ rated attachment to parents were stronger than betweenparental and peer attachment. Girls scored higher on attachment to mother and peer than boys. Lack of parental rejection and presence of emotional warmth were strongly related to parental attachment. The rated level of total anxiety was not related to gender or age, but it was lower than what has earlier been reported from China. Perceived rejection from fathers and mothers’ as well as attachment to peer and mother acted as predictors; together they explained 19% of the variance in social anxiety.
Nyckelord:parenting, peers, anxiety, ISSN: 0044-118X


Journal
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Referens:Risholm Mothander, P., & Wang, M. (in press). Parental Rearing, Attachment, and Social Anxiety in Chinese Adolescents. Youth & Society.
Abstract:This cross-sectional study investigated associations between perceived parental rearing, attachment, and social anxiety. 510 Chinese middle school students, aged 12 to 20 years, completed a set of questionnaires including “Egna Minnen Beträffande Uppfostran” for Children (EMBU-C), Inventory for Parent and Peer Attachment (IPPA) and Social Anxiety Scale for Adolescents (SAS-A). The results showed that intercorrelations between adolescents’ rated attachment to parents were stronger than betweenparental and peer attachment. Girls scored higher on attachment to mother and peer than boys. Lack of parental rejection and presence of emotional warmth were strongly related to parental attachment. The rated level of total anxiety was not related to gender or age, but it was lower than what has earlier been reported from China. Perceived rejection from fathers and mothers’ as well as attachment to peer and mother acted as predictors; together they explained 19% of the variance in social anxiety.
Nyckelord:parenting, peers, anxiety, ISSN: 0044-118X


Journal
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Referens:Risholm Mothander, P., & Wang, M. (in press). Parental Rearing, Attachment, and Social Anxiety in Chinese Adolescents. Youth & Society.
Abstract:This cross-sectional study investigated associations between perceived parental rearing, attachment, and social anxiety. 510 Chinese middle school students, aged 12 to 20 years, completed a set of questionnaires including “Egna Minnen Beträffande Uppfostran” for Children (EMBU-C), Inventory for Parent and Peer Attachment (IPPA) and Social Anxiety Scale for Adolescents (SAS-A). The results showed that intercorrelations between adolescents’ rated attachment to parents were stronger than betweenparental and peer attachment. Girls scored higher on attachment to mother and peer than boys. Lack of parental rejection and presence of emotional warmth were strongly related to parental attachment. The rated level of total anxiety was not related to gender or age, but it was lower than what has earlier been reported from China. Perceived rejection from fathers and mothers’ as well as attachment to peer and mother acted as predictors; together they explained 19% of the variance in social anxiety.
Nyckelord:parenting, peers, anxiety, ISSN: 0044-118X


Journal
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Referens:Lilliengren, P., Werbart, A., Risholm Mothander, P., Ekström, A., Susanna Sjögren, S., & Ögren, M.-L. (in press). Patient Attachment to Therapist Rating Scale: Development and psychometric properties. Psychotherapy Research.
Abstract:This paper reports on the development and psychometric properties of a new rating scale for patent-therapist attachment. Excellent internal consistency (Cronbach’s α > .90) was observed for all four subscales (Security, Deactivation, Hyperactivation and Disorganization). Three subscales showed good inter-rater reliability (ICC > .60), while one (Hyperactivation) had poor (ICC < .40). Correlations with measures of alliance, mental representations, and symptom distress generally support the construct validity of the reliable subscales. Exploratory factor analysis indicated three underlying factors explaining 82% of the variance. The Patient Attachment to Therapist Rating Scale is a promising approach for assessing the quality of attachment to therapist from patient narratives. Future development should focus on improving the discrimination of the insecure subscales.
Nyckelord:attachment to therapist; rating scale, reliability, construct validity, ISSN: 1050-3307


Journal
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Referens:Aarne, P., Almkvist, O., Risholm Mothander, P., & Tallberg, I.M. (2014). Parent-rated socio-emotional development in children with language impairment in comparison with typically developed children. European Journal of Developmental Psychology, 11(3), 279-291.
Abstract:Children with language impairment (LI) and children with typical development (TD) were assessed by their respective parents using The MacArthur Communicative Development Inventories (Swedish version SECDI) and Greenspan Socio Emotional Growth Chart (GSEGC). The aim was to investigate socio-emotional and language development in children with LI and TD with respect to possible differential patterns and relations between the groups. The results highlight a clear association between language and socio-emotional development. Children with LI were rated similar to young language-matched children with TD, but significantly lower relative to age-matched TD children, particularly concerning symbolic stages of development: the use of linguistic symbols as well as related areas such as symbol play and symbolic mental ability. The results are discussed in light of presumable background factors and possible consequences for children or sub-groups of children with LI.
Nyckelord:language impairment, socio emotional development, parent ratings, ISSN: 1740-5629


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Referens:Lilliengren, P., Falkenström, F., Sandell, R., Risholm Mothander, P., & Werbart, A. (in press). Secure attachment to therapist, alliance, and outcome in psychoanalytic psychotherapy with young adults. Journal of Counseling Psychology.
Abstract:Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression effect indicating that secure attachment to therapist predicted continued improvement in global functioning, whereas the alliance predicted deterioration when both variables were modeled together. Although limited by the correlational design, this study suggests that the development of a secure attachment to therapist is associated with treatment gains as well as predictive of posttreatment improvement in functioning. Future research should investigate the temporal development of attachment to therapist and its interaction with alliance and outcome more closely. To ensure differentiation from patient-rated alliance, observer-based measurement of attachment to therapist should be considered.
Nyckelord:attachment to therapist, therapeutic alliance, outcome, psychoanalytic, psychodynamic, psychotherapy, young adults, ISSN: 0022-0167


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