Parenting quality in drug-addicted mothers in a therapeutic mother–child community: the contribution of attachment and personality assessment

Abstract

Growing evidence shows that attachment is a key risk factor for the diagnosis and treatment of clinical diseases in Axis I, such as drug addiction. Recent literature regarding attachment, psychiatric pathology, and drug addiction demonstrates that there is a clear prevalence of insecure attachment patterns in clinical and drug addicted subjects. Specifically, some authors emphasize that the anxious-insecure attachment pattern is prevalent among drug-addicted women with double diagnosis (Fonagy et al., 1996). The construct of attachment as a risk factor in clinical samples of drug-addicted mothers needs to be studied more in depth though. The present explorative study focused on the evaluation of parenting quality in a therapeutic mother–child community using attachment and personality assessment tools able to outline drug-addicted mothers’ profiles. This study involved 30 drug addicted mothers, inpatients of a therapeutic community (TC). Attachment representations were assessed via the Adult Attachment Interview; personality diagnosis and symptomatic profiles were performed using the Structured Clinical Interview of the DSM-IV (SCID-II) and the Symptom Check List-90-R (SCL-90-R), respectively. Both instruments were administered during the first six months of residence in a TC. Results confirmed the prevalence of insecure attachment representations (90%), with a high presence of U patterns, prevalently scored for dangerous and/or not protective experiences in infanthood. Very high values (>5) were found for some experience scales (i.e., neglect and rejection scales). Data also showed very low values (1–3) in metacognitive monitoring, coherence of transcript and coherence of mind scales. Patients’ different profiles (U vs. E vs. Ds) were linked to SCID-II diagnosis, providing insightful indications both for treatment planning and intervention on parenting functions and for deciding if to start foster care or adoption proceedings for children.

Influence of adult attachment insecurities on parenting self-esteem: the mediating role of dyadic adjustment

“…To conclude, our findings are consistent with attachment theory and the related literature. They confirm the importance of using implicit dimensions of attachment, as well as global attachment classifications, to better understand an adult’s psychological functioning ( Salcuni, 2015 ), and better define their parenting profile ( De Palo et al, 2014 ), particularly when considering such complex psychological traits as parenting self-esteem.…”

Attachment Representations and Early Interactions in Drug Addicted Mothers: A Case Study of Four Women with Distinct Adult Attachment Interview Classifications

“…Another consideration should be addressed specifically to the need of assuming a multi-level perspective when assessing parenting (De Palo et al, 2014 ). One of the major aspects emphasized by attachment theorists, in fact, concerns maternal sensitivity and responsivity, the two main ingredients considered as necessary to fulfill a secure attachment relationship (Ainsworth, 1969 ; Bowlby, 1984 ).…”

La dipendenza da sostanze come modalità di disattivazione del sistema dell'attaccamento: una ricerca su un campione di pazienti degenti in comunità terapeutica

“…Anche in questo caso non viene presa in considerazione la presenza del pattern disorganizzato. Al contrario, in uno studio su 30 madri tossicodipendenti degenti in una struttura residenziale di cura (De Palo et al, 2014), la somministrazione dell'AAI (oltre alla SCID II per la diagnosi con il DSM-IV e alla SCL-90-R) conferma l'ipotesi della presenza di attaccamento insicuro che si riscontra nel 90% dei casi, ma con una presenza elevata di pattern U (Unresolved), la categorizzazione dell'attaccamento adulto disorganizzato, con i più alti punteggi relativi ad esperienze di esperienze pericolose o non protette in età infantile. Valori molto elevati sono stati riscontrati nelle scale della trascuratezza e del rifiuto.…”