Relationship between adolescent parent attachment and attempted suicide among middle school students / 中国学校卫生

Objective@#To understand the current situation of suicide attempts in middle school students and to explore its relation with adolescent parent attachment, to provide a basis for the prevention and control of middle school students suicidal behavior.@*Methods@#A total of 4 419 students from grades 7 to 12 in Ezhou City and Xiaogan City, Hubei Province were selected by stratified cluster random sampling. The Inventory of Parent and Peer Attachment, Rosenberg Self Esteem Scale, Kessler Psychological Distress Scale were used to conduct a questionnaire Survey, and evaluated the suicide attempts of middle school students.@*Results@#The detection rate of attempted suicide among middle school students was 6.8%. The detection rate of attempted suicide varies among different grades, family types, parental relation, parenting style, family income, self esteem level, and psychological distress( χ 2/ t =3.88, 10.12, 18.00, 52.54, 13.90 , 2.37, 8.99, P <0.05). The scores of paternal attachment and maternal attachment ( 14.64 ±13.45, 14.77±12.26) in the group with attempted suicide were lower than those without attempted suicide(22.05±16.08, 23.79±14.93)( t =-9.07, -12.11, P <0.05). Logistic regression analysis showed that both paternal attachment and maternal attachment were associated with lower rate of suicide attempts among middle school students(paternal attachment, OR=0.99, 95%CI = 0.98 -0.99; maternal attachment OR=0.97, 95%CI =0.96-0.98), with paternal attachment for girls only( OR=0.98, 95%CI= 0.97 -0.99)(P <0.05).@*Conclusion@#Adolescent parent attachment may be a protective factor for middle school students suicide attempts. Sex specific effects are observed in adolescent father attachment in girls. Parents should pay attention to cultivating a good attachment relationship with their children and promote the healthy growth of middle school students.

Relações de apego e Transtorno de Déficit de Atenção com Hiperatividade infantil / Attachment relationships and child Attention Deficit Hyperactivity Disorder

A insuficiência de condições seguras de apego pode estar associada a dificuldades no desenvolvimento infantil e vulnerabilidade para o surgimento de condições clínicas diversas, como o Transtorno do Déficit de Atenção com Hiperatividade (TDAH). Foi realizada uma revisão narrativa da literatura buscando contribuições da Teoria do Apego para a compreensão de fatores ambientais associados ao TDAH infantil. A revisão incluiu artigos teóricos e empíricos dos Portais do Index Psi, PubMed, Capes e Google acadêmico publicados nos idiomas português, inglês e espanhol entre 2002 a 2021. Os estudos apontaram que: crianças com TDAH apresentam em geral as mesmas dificuldades no desenvolvimento das que possuem apego primário inseguro; o apego de crianças com TDAH difere das crianças típicas, sendo predominantemente inseguro; estudos com pais dessas crianças têm encontrado dificuldades na função reflexiva destes. Conclui-se que o laço estabelecido entre criança e cuidador principal pode ser considerado um fator de proteção ou risco para o desenvolvimento infantil. A Teoria do Apego pode oferecer suporte para pensar diferentes fatores ambientais associados ao TDAH.(AU)

The insufficiency of secure attachment conditions may be associated with difficulties in child development and vulnerability to the onset of various clinical conditions, such as Attention Deficit Hyperactivity Disorder (ADHD). A narrative literature review was carried out seeking contributions from Attachment Theory to the understanding of environmental factors associated with childhood ADHD. Revision included theoretical and empirical articles from Index Psi, PubMed, Capes and Scholar Google published in Portuguese, English and Spanish between 2002 and 2021. The studies showed that: children with ADHD generally have the same difficulties in development of those with primary insecure attachment; the attachment of children with ADHD differs from typical children, being predominantly insecure; studies with parents of these children have found difficulties in their reflective function. It is concluded that the bond established between the child and the main caregiver can be considered a protective or risk factor for child development. Attachment Theory can support thinking about different environmental factors associated with ADHD.(AU)

La insuficiencia de las condiciones de apego seguro puede se asociar con dificultades en el desarrollo infantil y vulnerabilidad a la aparición de diversas condiciones clínicas, como el trastorno por déficit de atención con hiperactividad (TDAH). Se llevó a cabo una revisión de la literatura narrativa buscando contribuciones de la Teoría del Apego a la comprensión de los factores ambientales asociados con el TDAH infantil. La revisión incluyó artículos teóricos y empíricos de los portales Index Psi, PubMed, Capes y Academic Google publicados en portugués, inglés y español entre 2002 y 2021. Los estudios mostraron que: los niños con TDAH generalmente tienen las mismas dificultades de desarrollo que aquellos con inseguridad apego primario; el apego de los niños con TDAH difiere del de los niños típicos, ya que es predominantemente inseguro; Los estudios con padres de estos niños han encontrado dificultades en su función reflexiva. Se concluye que el vínculo que se establece entre el niño y el cuidador principal puede considerarse un factor protector o de riesgo para el desarrollo infantil. La Teoría del Apego puede apoyar el pensamiento sobre diferentes factores ambientales asociados con el TDAH.

Validity and reliability of the Chinese version of object attachment questionnaire in college students / 中华行为医学与脑科学杂志

Objective:To offer a revised Chinese version of the object attachment questionnaire(OAQ), and to examine its reliability and validity in Chinese college students.Methods:Totally 1 350 college students were tested with the Chinese version of OAQ, Chinese version of the saving inventory-revised scale(SI-R), experiences in close relationships inventory(ECR) and emotion attachment questionnaire(EAQ). A total of 100 college students from the sample were followed to complete the Chinese version of OAQ after 4 weeks.Item analysis, correlation analysis, exploratory factor analysis and reliability test were conducted by SPSS 24.0 software, while confirmatory factor nalaysis and convergent validity were conducted by AMOS 21.0.Results:The exploratory factor analysis showed that Chinese version of OAQ included two factors and twelve items.Confirmatory factor analysis showed that the two-factor model fitted well( χ2/ df=3.76, GFI=0.93, CFI=0.90, TLI=0.87, IFI=0.90, RMSEA=0.08). The OAQ positively correlated with SI-R, ECR and EAQ ( r=0.22, 0.34, 0.63, all P<0.01, CR=0.74-0.85, P<0.01.AVE=0.29-0.39, P<0.01). The OAQ had good internal reliability with Cronbach’s α coefficients from 0.78 to 0.83, retest reliability coefficients from 0.87 to 0.97 and split-half reliability coefficients from 0.60 to 0.76(all P<0.01). Conclusion:The Chinese version of OAQ has acceptable reliability and validity.

"Quem Não Pega, Não Se Apega"? Interações e Vínculos com Bebês Acolhidos / "Who Doesn't Pick-Up, Doesn´t Get Attached"? Interactions and Bonds with Foster Infants

Resumo Investigou-se o estabelecimento de vínculos entre cuidadores e bebês acolhidos, e como estes eram significados e (im)possibilitados em instituição de acolhimento. Utilizando videogravações semanais, por três meses, entrevistas e diários de campo, conduziu-se estudo exploratório, descritivo-qualitativo, em contexto naturalístico, acompanhando interações entre cuidadoras e 3 bebês (idade: 4 a 13 meses). Categorias observacionais foram quantificadas. Observou-se baixa responsividade às expressões dos bebês. Contatos físicos eram evitados pelas cuidadoras. Orientações institucionalizadas (como não pegue para não se apegar) mostraram-se significativos circunscritores das interações. Laços afetivos se estabeleceram apenas com determinadas crianças. Discutiu-se como a socialização emocional, a responsividade das cuidadoras e a organização do contexto relacionavam-se com o desenvolvimento socioafetivo, a construção de vínculos e os processos de aprendizagens.

Abstract This study investigated the emotional bonds between caregivers and foster infants, and how these were meant and enabled in a foster care institution. An exploratory study was conducted, following the interactions of three babies (age: 4-13 months). Video recordings were weekly made, along three months, in addition to interviews and field diaries. Observational categories were quantified. Results indicate low caregivers' responsiveness to the infants' expressions. Caregivers avoided physical contacts. Institutionalized guidelines (as "don´t pick-up the baby to not get attached") circunscribed interactions. Strong emotional bonds were established with certain children. It was discussed how emotional socialization, caregivers' responsiveness and the context organization are related to infant's socio-affective development, the construction of bonds and the process of learning.

Interaction between peer attachment, peer trust and loneliness in the first year senior high school students / 中国学校卫生

Objective@#To explore the longitudinal relationship between peer attachment, peer trust and loneliness, and to provide reference for the effective adolescent mental health promotion.@*Methods@#A convenient sampling method was used to select 1 013 first year senior high school students from 2 high schools in Guizhou Province and Shandong Province. A longitudinal design was adopted. The Revised Experiences in Close Relationships relationship Structures Scale(ECR-RS), Trust Scale and University of California at Los Angels Loneliness Scale were administered in Nov. 2020, Dec. 2021(T1), as well as in Jan. 2021 and Jan. 2022(T2).@*Results@#Peer trust at two time points was negatively correlated with attachment anxiety, attachment avoidance and loneliness( r=-0.50--0.17, P <0.01), while attachment anxiety, avoidance and loneliness were positively correlated( r=0.11- 0.41 , P <0.01). T1 attachment anxiety significantly predicted T2 loneliness( β=0.16, P <0.01), and T1 loneliness significantly predicted T2 attachment anxiety and avoidance( β=0.19, 0.15, P <0.01). Correlation between stability of loneliness was higher than attachment anxiety( CR=7.12, P <0.01). Correlation between stability of peer trust was higher than attachment avoidance( CR=2.40, P <0.01).@*Conclusion@#Loneliness affects attachment avoidance and peer trust unidirectionally. There is mutual influence between loneliness and attachment anxiety, with larger impact from loneliness. Intervention aiming for attachment promotion might consider loneliness reduction.

Mother-child bonding, environment, and motor development of babies at risk accompanied by a follow-up / Vínculo mãe-filho, ambiente e desenvolvimento motor de bebês acompanhados em seguimento de risco

Abstract Objectives: to identify factors resulting from the correlation between mother-child bonding, environment, and infant motor development (MD). Methods: a cross-sectional study was conducted with 130 mothers/guardians and their infants at risk from 3 to 12 months of age, accompanied in an outpatient clinic follow-up at a public maternity. The data were collected using a form with socioeconomic data, mother/child routine at the hospital and home environments, and three other instruments validated in Brazil: Protocolo de Avaliação do Vínculo Mãe-Filho (Mother-Child Bonding Evaluation Protocol), Affordances in the Home Environment for Motor Development - Infant Scale, and Escala Motora Infantil de Alberta (Alberta Infant Motor Scale). Pearson's chi-square test, Fisher's exact test, and a significance level of 5% was used for the correlation. Results: the data showed a predominance of preterm babies (74.5%), low-income families (86.2%), and domestic opportunities below the adequate (93.8%) for good motor development. Regarding the mother-child bonding, 60% of the mothers showed a strong bonding with their children. A total of 62.3% of the children had typical motor development. Concerning the interaction between variables, statistical significance (p˂0.05) was observed in the correlation between bonding and typical motor development. Conclusion: despite the presence of risk factors, motor development was normal in most of the babies in this study, suggesting that the mother-child bonding favored motor development even with environmental and biological adversities.

Resumo Objetivos: identificar fatores resultantes da correlação vínculo mãe-filho, ambiente e desenvolvimento motor (DM) infantil. Métodos: estudo transversal com 130 mães/responsáveis e seus lactentes de 3 a 12 meses de vida, acompanhados em ambulatório de seguimento de risco de uma maternidade pública. Os dados foram coletados através de ficha contendo dados socioeconômicos e rotina de mãe/filho no ambiente hospitalar e domiciliar, e três outros instrumentos validados no Brasil: Protocolo de Avaliação do Vínculo Mãe-Filho, Affordances in the Home Envirornent for Motor Development - Infant Scale e Escala Motora Infantil de Alberta. Para correlação utilizou-se teste de qui-quadrado de Pearson, exato de Fisher e nível de significância de 5%. Resultados: os dados mostraram predominância de bebês prematuros (74,5%), famílias de baixa renda (86,2%) e com oportunidades domésticas abaixo do adequado (93,8%) para um bom desenvolvimento motor. No que concerne a vinculação, 60% das mães apresentou forte vinculação com seu filho. O desenvolvimento motor de 62,3% das crianças apresentouse típico. Nas interações entre variáveis, observou-se significância estatística (p<0,05) na correlação entre vínculo e desenvolvimento motor típico. Conclusão: apesar dos fatores de risco, o desenvolvimento motor apresentou-se típico na maioria dos bebês desse estudo, sugerindo que a presença de vínculo favoreceu o desenvolvimento motor mesmo com a presença de adversidades ambientais e biológicas.

Relationship between peer attachment and quality of life among adolescents in Chongqing / 中国学校卫生

Objective@#To determine the relationship between peer attachment and quality of life among adolescents in Chongqing, to provide scientific basis for intervention of quality of life.@*Methods@#A total of 6 073 respondents were selected from 5 middle schools and 6 primary schools in a district of Chongqing in December 2017 by stratified cluster sampling method. The revised Chinese version of Adolescent Attachment Questionnaire (IPPA-R) Peer Attachment Subscale and Adolescent Children s Quality of Life Scale were used to conduct the survey.@*Results@#The total score of life quality of students with secure attachment type (144.97±17.39) was significantly higher than that of students with insecure attachment type(136.45±17.75)(t=18.90，P<0.01). The scores of four dimensions of life quality of students with secure attachment[(30.40±5.11)(39.42±6.42)(53.45±7.99)(21.73±3.69)] were significantly higher than those of students with insecure attachment[(29.54±5.15)(37.87±6.66)(49.02±8.69)(20.02±3.60)](P<0.05). Multivariate stepwise regression analysis showed that peer attachment was correlated with physical, psychological, social, adolescent dimensions and the total score of life quality(B=0.28，0.03，0.05，0.14，0.05，P<0.05).@*Conclusion@#Adolescent peer attachment is positively correlated with the total score and specific dimensions of life quality. Improving the safety of peer attachment is helpful to improve life quality among adolescents.

Construção do apego entre o binômio mãe e bebê pré-termo mediado pelo posicionamento canguru / Construcción del apego entre el binomio madre y bebé prematuro por medio de la posición canguro / Building the attachment between mother and preterm baby dyad mediated by kangaroo position

Objetivo: Compreender como as mães vivenciam o posicionamento canguru, na Unidade de Terapia Intensiva Neonatal e apreender a percepção sobre as relações de apego com seus bebês mediadas pelo posicionamento canguru. Método: Caráter qualitativo, descritivo e exploratório. Participaram 9 mães maiores de 18 anos com filhos internados em Unidade de Terapia Intensiva Neonatal com idade gestacional igual ou inferior a 30 semanas, que realizaram o posicionamento canguru, pelo menos duas vezes. Foram excluídas mães que já tiveram filhos internados em Unidade de Terapia Intensiva Neonatal, mães de gemelares, com diagnóstico psiquiátrico e usuárias de psicoativos. A coleta aconteceu, por meio do preenchimento de ficha para obtenção de dadossociodemográficos, entrevista semiestruturada antes e após a realização da posição canguru e o diário da participante. O encerramento da coleta deu-se por saturação e foram analisados, conforme Análise de Conteúdo, na modalidade temática. Resultados: Os dados foram agrupados por temas, emergiram as seguintes categorias: maternidade no contexto da Unidade de Terapia Intensiva Neonatal, Interação mãe-bebê, durante a gestação e após o Canguru, Expectativa e realidade materna, em relação ao Canguru. Conclusão: A posição canguru cumpre sua função conforme norma do Ministério da Saúde, tanto para benefícios clínicos para o bebê como para humanização e aumento do apego mãe-bebê.(AU)

Objective: To understand how mothers experience and perceive the attachment relationship with their babies mediated by the kangaroo position in the Neonatal Intensive Care Unit . Method: This is a qualitative, descriptive, and exploratory study. Nine mothers over 18 years of age with children admitted to the Neonatal Intensive Care Unit with gestational age equal to or less than 30 weeks, and who performed the kangaroo positioning at least twice participated in this study. Mothers who already had children hospitalized in the Neonatal Intensive Care Unit, had twins, had a psychiatric diagnosis and used psychoactive drugs were excluded. Data collection took place by filling out a form to obtain sociodemographic data, by performing semi-structured interviews before and after the kangaroo position, and by analyzing the participant's' diaries. The criterion to end data collectionwas saturation and data were analyzed according to Content Analysis. Results: The data were grouped in themes, and divided into the following categories: Maternity in the context of the Neonatal Intensive Care Unit, Mother-baby interaction during pregnancy and after the Kangaroo, Expectation and maternal reality concerning the Kangaroo. Conclusion: the kangaroo position fulfilled its function according to the Ministry of Health standard, both for clinical benefits for the baby and humanization, and increased mother-baby attachment.(AU)

Objetivo: Comprender cómo las madres experimentan la posición canguro en la Unidad de Cuidados Intensivos Neonatales y comprender la percepción de las relaciones de apego con sus bebés por medio de la posición canguro. Método: Cualitativo, descriptivo y exploratorio. Participaron nueve madres mayores de 18 años con hijos ingresados en la Unidad de Cuidados Intensivos Neonatales con edad gestacional igual o menor a 30 semanas, quienes realizaron la posición canguro al menos dos veces. Se excluyeron las madres que ya tenían hijos hospitalizados en la Unidad de Cuidados Intensivos Neonatales, madres con gemelos, con diagnóstico psiquiátrico y consumidoras de psicoactivos. La recogida se realizó mediante las respuestas de un formulario de obtención de datos sociodemográficos, entrevista semiestructurada antes y después de realizar la posición canguro y diario del participante. El cierre de la recolección de datos fue por saturación y se analizaron según Análisis de Contenido, en la modalidad temática. Resultados: Los datos fueron agrupados por temas, surgieron las siguientes categorías: Maternidad en el contexto de la Unidad de Cuidados Intensivos Neonatales, Interacción madre-bebé durante el embarazo y después del Canguro, Expectativa y realidad materna con relación al Canguro. Conclusión: La posición canguro cumple su función según el estándar del Ministerio de Salud, tanto por los beneficios clínicos para el bebé como por la humanización y el aumento del apego madre-bebé(AU)

Attachment styles of People Living with HIV/AIDS / Estilos de Apego de Pessoas vivendo com HIV/AIDS

Abstract Factors that involve the dynamics in interpersonal relationships and may have consequences in health are still little explored in people living with HIV/AIDS. The aim was to identify the evidences of literature regarding adult attachment style and HIV. It is an Integrative literature review. Seven databases were explored, using the combination of key words and Boolean connectors: "Attachment Style OR Object Attachment AND HIV". A reasonable number of articles addressed attachment among people with HIV as a mediator to post-traumatic stress disorder, depression and stress. The prevalence of insecure attachment in this group was high. Evidence was also found in relation to the attachment as an important factor to adaptation to the diagnosis of HIV, attachment and behavior in interpersonal relationships, and emphasize the possibility of changing the attachment style.

Resumo Fatores que envolvem a dinâmica nos relacionados interpessoais e podem ter consequências na saúde ainda são pouco explorados em Pessoas vivendo com HIV/AIDS. O objetivo desse estudo é identificar as evidências na literatura relacionando estilo de apego e HIV em adultos. Trata-se de uma revisão integrativa de literatura. Sete bases de dados foram exploradas, usando a combinação das palavras-chave e dos seguintes conectores booleanos em inglês: "Attachment Style OR Object Attachment AND HIV". Um número razoável de artigos abordou o vínculo entre pessoas com HIV como mediador de transtorno de estresse pós-traumático, depressão e estresse. A prevalência de apego inseguro nesse grupo foi alta. Evidências mostram ainda a relação entre apego e a adaptação ao diagnóstico de HIV, apego e estilos de comportamento nos relacionamentos, e destacam ainda a possibilidade de modificação do tipo de apego.

Effect of peer attachment and loneliness on self-esteem among children in rural area / 中国学校卫生

Objective@#To study the effects of peer attachment and loneliness on self-esteem and to provide suggestions for the development of self-esteem among children in rural area.@*Methods@#A total of 1 009 fourth to sixth graders from ten primary schools in rural area of Sichuan and Henan Provinces participated in this longitudinal study. The self-esteem, peer attachment and loneliness were assessed at baseline, and the selfesteem was assessed after 9-month follow up.@*Results@#After controlling for age, gender, whether parents migrate to work in urban area and self-esteem, peer attachment( β =0.14)and loneliness at Time 1 ( β = -0.13 ) were found to significantly predict self-esteem at Time 2. In addition, the interaction between loneliness at Time 1 and peer attachment at Time 1 on self-esteem at Time 2 was significant( β =-0.08)( P <0.01). Specifically, the relation between peer attachment at Time 1 and selfesteem at Time 2 was greater when children had low level of loneliness at Time 1.@*Conclusion@#The findings indicated that initial low level of loneliness facilitates the protective effect of initial peer attachment on later self-esteem. It reminds parents and educators that both promoting children’s secure attachment towards peers and reducing children’s sense of loneliness are needed in order to develop children’s self-esteem in rural area.

Attachment style in children with chronic diseases: a comprehensive review / Estilo de apego em crianças com doenças crônicas: uma revisão integrativa

ABSTRACT Objective: To investigate how attachment style has been studied in children with chronic disease in the scientific literature, and what repercussions this attachment has on this population. Data sources: An integrative review of the literature was carried out from a survey in the LILACS, MEDLINE and SciELO databases, including original national and international publications in Portuguese, Spanish and English from 2007 to 2018, using the descriptors "apego" and "criança" in the Health Sciences Descriptors (DeCS), and "attachment" and "children" for the Medical Subject Headings (MeSH). Sixteen (16 articles) were obtained for the sample analysis. Data synthesis: The chronic diseases found in the research were neurobehavioral disorders such as attention deficit hyperactivity disorder (ADHD) and autism, childhood obesity, and chronic migraine. The predominant attachment style was insecurity, which could compromise the biopsychosocial development of the child. Conclusions: The type of attachment between child and primary caregiver may be considered a protective or risk factor for child development. Considering this premise, it is important to equip/inform families based on dialogic educational practices, in which professionals create opportunities and means for families to develop their skills and competencies, and acquire resources which meet the child's needs. It is important that this professional helps the family to build secure bases for their child with chronic disease, understanding that the main focus for promoting child development is in the family unit.

RESUMO Objetivo: Investigar, na literatura científica, de que forma o estilo de apego tem sido estudado nas crianças com doença crônica e as repercussões dessa vinculação nessa população. Fonte de dados: Realizou-se uma revisão integrativa da literatura por meio de um levantamento nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE) e Biblioteca Eletrônica Científica Online (SciELO) incluindo publicações originais nacionais e internacionais, em português, espanhol e inglês, no período de 2007 a 2018, utilizando-se os descritores apego e criança nos Descritores em Ciências da Saúde (DeCS) e attachment e children para o Medical Subject Headings (MeSH). Foi obtida uma amostra de 16 artigos para análise. Síntese dos dados: As doenças crônicas encontradas na pesquisa foram os distúrbios neurocomportamentais, como transtorno do déficit de atenção e hiperatividade (TDAH) e autismo, obesidade infantil e enxaqueca crônica. O estilo de apego predominante foi o inseguro, o que pode comprometer o desenvolvimento biopsicossocial dessa criança. Conclusões: O tipo de vinculação entre criança e cuidador primário pode ser considerado um fator de proteção ou risco para o desenvolvimento infantil. Haja vista essa premissa, é fundamental a instrumentalização das famílias baseada em práticas educativas dialógicas, nas quais os profissionais criam oportunidades e meios para que os familiares desenvolvam suas habilidades e competências e adquiram recursos que atendam às necessidades da criança. É importante que esse profissional auxilie a família a construir bases seguras para a criança com doença crônica, entendendo que é na unidade familiar que está o principal foco de promoção do desenvolvimento infantil.

Aspects of the marital relationship that characterize secure and insecure attachment in men and women / Aspectos do relacionamento conjugal que caracterizam apego seguro e inseguro em homens e mulheres

The internalized attachment in childhood has consequences in the adult life, specifically in the marital life, which demands greater closeness, intimacy and interdependence. In this sense, it was analyzed whether the communication, marital adjustment, frequency, intensity and conflict resolution variables discriminate individuals with secure and insecure attachment in heterosexual relationships. It is a quantitative, descriptive and explanatory study. Data from 485 participants were collected in the south of Brazil through the following measures: Experience in Close Relationship, Marital Conflict Scale, Conflict Resolution Behavior Questionnaire, Communication Questionnaire and Revised Dyadic Adjustment Scale. The results of the discriminant analysis indicated that the variables tested characterize secure or insecure attachment. Therefore, the type of attachment is a relevant resource in the assessment of individual and marital functioning. Psychotherapy interventions are discussed considering the relational bias of the attachment theory and the results observed in the scientific literature.

O apego internalizado na infância provoca reflexos na vida adulta, especificamente na conjugalidade, a qual demanda maior proximidade, intimidade e interdependência. Nesse sentido, foi analisado se as variáveis comunicação, ajustamento conjugal, frequência, intensidade e resolução de conflitos discriminam indivíduos com apego seguro e inseguro em relacionamentos heterossexuais. Trata-se de um estudo quantitativo, descritivo e explicativo. Dados de 485 participantes foram coletados no Sul do Brasil por meio das medidas Experience in Close Relationship, Escala de Conflito Conjugal, Conflict Resolution Behavior Questionnaire, Communication Questionnaire e Revised Dyadic Adjustment Scale. Análise discriminante indicou que as variáveis testadas caracterizam apego seguro ou inseguro. Portanto, o tipo de vinculação é um recurso relevante na avaliação do funcionamento individual e conjugal. Intervenções em psicoterapia são discutidas considerando o viés relacional da teoria do apego e os resultados apontados na literatura científica.

Translation and Brazilian adaptation of the Relationship Scales Questionnaire (RSQ) / Tradução e adaptação brasileira do Relationship Scales Questionnaire (RSQ)

Abstract Objectives To describe the process of translating and adapting the Relationship Scales Questionnaire (RSQ) from English into Brazilian Portuguese and to present the results of its test-retest reliability using the version developed for interview application. Methodology The process was based on the guidelines of the International Society for Pharmaeconomics and Outcomes Research (ISPOR), which propose 10 steps for the translation and cross-cultural adaptation of self-administered instruments. The original authors of the RSQ have agreed to the translation. The interview version was applied to a sample of 43 healthy elders (≥60 years old) enrolled in a primary health care program in the city of Porto Alegre, state of Rio Grande do Sul, southern Brazil, and then reapplied. The scores of the two applications were compared using the paired sample t-test. Results Only 6 of the 30 items required the adaptation of words or expressions to maintain its conceptual and semantic equivalence. The self-administered form of the RSQ posed difficulties for elders due to visual deficiencies and lower education level, both common in this age group, demonstrating a need for the development of a version of the RSQ in a structured interview format. Only the measure for secure attachment presented significant differences after the application of the retest, indicating reliability of the version being proposed. Conclusion Translation of the RSQ is the first step towards the validation of an attachment evaluation instrument for use in the elderly population in Brazil, allowing for future studies on this topic.

Resumo Objetivos Descrever o processo de tradução e adaptação cultural do questionário Relationship Scales Questionnaire (RSQ) do inglês para o português do Brasil e apresentar os resultados de confiabilidade teste-reteste utilizando a versão desenvolvida para aplicação em entrevista. Metodologia O método utilizado teve como diretriz a proposta da International Society for Pharmaeconomics and Outcomes Research (ISPOR), de 10 passos para a tradução e adaptação transcultural de instrumentos autoaplicáveis. Os autores originais do RSQ concordaram com a tradução. A versão para entrevista dirigida foi aplicada em uma amostra de 43 idosos saudáveis (≥60 anos) cadastrados em um programa de atenção primária à saúde na cidade de Porto Alegre, RS, sendo então reaplicada. As pontuações das duas aplicações foram comparadas usando o teste t de Student para amostras pareadas. Resultados Apenas 6 dos 30 itens precisaram de adaptação cultural de palavras ou expressões para manter sua equivalência conceitual e semântica. O formato autoaplicável do RSQ mostrou-se pouco adequado entre idosos, devido à presença comum de déficits visuais e baixa escolaridade, demonstrando a necessidade do desenvolvimento de uma versão do RSQ em formato de entrevista dirigida. Apenas a medida de apego seguro apresentou diferença significativa após a aplicação do reteste, indicando a confiabilidade da versão proposta. Conclusão A tradução do RSQ é o primeiro passo para a validação de um instrumento de avaliação de apego para a população idosa no Brasil, permitindo futuros estudos sobre o tema.

The Mediating Effect of Alexithymia on the Relationship between Attachment and Depression in Early Adulthood / 정신간호학회지

PURPOSE: The purpose of this study was to examine the mediating effect of alexithmia on the relationship between attachment and depression in early adulthood. METHODS: A convenience sample of 260 young adults responded to the survey. The collected data were analyzed using descriptive statistics, independent t-test, Pearson's correlation coefficients, and path analyses using bootstrapping. RESULTS: The path analysis indicated that anxious attachment and alexithymia was positively related to depression, but there was not a significant relationship between avoidant attachment and depression. In a modified path model, alexithymia mediated the positive effects of anxious attachment and avoidant attachment on depression. CONCLUSION: Our study findings suggest that early adults who have insecure attachments are vulnerable to alexithymia and depression. Targeted interventions to improve emotional expressive ability may reduce depression in early adulthood.

Factors associated with Maternal Attachment of Breastfeeding Mothers

PURPOSE: This study aimed to identify factors associated with maternal attachment of breastfeeding mothers, with a focus on the mothers' breastfeeding characteristics. METHODS: Data were collected from 217 mothers who breastfed their healthy baby for 1 month after childbirth and had no postpartum complications. The data were analyzed by hierarchical regression analysis. RESULTS: The factors significantly associated with maternal attachment were an emotional exchange with one's baby (β=.41, p < .001), breastfeeding confidence (β=.20, p=.022), depression (‘quite a bit or more’, β= −.18, p=.005), and depression (‘a little’, β=−.14, p=.024). The model explained 38.4% of variance in maternal attachment. CONCLUSION: In order to improve attachment, nurses should be actively supported in helping mothers in the first month postpartum adapt to breastfeeding. Interventions to prevent postpartum depression should also be conducted.

Mediating role of adult attachment in childhood abuse and borderline personality disorder in college students / 中国学校卫生

Objective@#To explore the relationship between childhood abuse, adult attachment and borderline personality disorder (BPD) in college students, and to provide reference for promoting the physical and mental health of college students.@*Methods@#We selected undergraduate students from four colleges in Hefei, a total of 4 034 college students were surveyed by the childhood trauma questionnaire short form(CTQ-SF), the state adult attachment measure (SAAM) and the Personality Diagnostic Questionnaire(PDQ).@*Results@#BPD was found in 4.2% of subjects, 4.5% of males and 3.7% of females. The score of BPD in non-single-parent families was lower than that in single-parent families, in families with average family economic status was lower than that in families with poor and good family economic status, and in families with medium father education level was lower than that in fathers with low and high education level(Z=-2.30, 29.25, 9.63, P<0.05). Childhood abuse, avoidant attachment and anxious attachment positively predicted BPD(β=0.21, 0.10, 0.23, P<0.01), secure attachment negatively predicted BPD(β=-0.15, P<0.01). Adult attachment played a partial mediating role in the effects of childhood abuse on BPD, with the mediating effect accounting for 16.7% of the total effect.@*Conclusion@#Adult attachment plays a mediating role in the effects of childhood abuse on BPD.

Mediation of shame in parent-child attachment and bullying among high school students / 中国学校卫生

Objective@#To explore mediating effect of shame on parent-child attachment and bullying among high school students, and to provide the basis for school bullying prevention among high school students.@*Methods@#From September to November 2018, a total of 1 149 students’ bullying behavior from 4 high schools in Shenyang and Xinxiang, were investigated with the Inventory of Parents and Peer Attachment, Middle School Students’ Bullying Scale and Middle School Students’ Shame Scale.@*Results@#About 31.07% of the subjects involved in school bullying. The report rates of bullying among boys, high school students of second grade, only child, students from rural area were higher (P<0.01). Mother-child attachment was negatively correlated with traditional and cyber bullying(r=-0.14, -0.21, -0.20, P<0.01). Father-child attachment was negatively correlated with traditional and cyber bullying(r=-0.19, -0.21, -0.19, P<0.01). Shame was positively correlated with traditional bullying and cyber bullying (r=0.20, 0.19, P<0.01). Shame mediates mother-child attachment, traditional and cyber bullying, accounting for 11.78% and 15.70% of the total effects. Shame mediates father-child attachment, traditional and cyber bullying, accounting for 15.17% and 17.43% of the total effect.@*Conclusion@#Mother-child and father-child attachment have direct effect on school bullying, and indirect effect on school bullying through shame.

Transcultural adaptation to the Brazilian Portuguese of the Postpartum Bonding Questionnaire for assessing the postpartum bond between mother and baby / Adaptação transcultural para o português do Brasil do Postpartum Bonding Questionnaire para avaliação do vínculo no pós-parto entre mãe e bebê / Adaptación transcultural al portugués brasileño del Postpartum Bonding Questionnaire para evaluar el vínculo en el posparto entre la madre y el bebé

Abstract: The establishment of the bond between mother and baby in the postpartum period is important for ensuring the physical and psychological health of both. This short communication reports the first phase of the cross-cultural translation and adaptation to the Brazilian context of the Postpartum Bonding Questionnaire (PBQ). Four aspects of equivalence between the original scale and the Portuguese version were evaluated: the conceptual, semantic, operational and item equivalences. Literature review, the study of PBQ history, translation, expert evaluation, back-translation and pretests involving 30 mothers with children aging up to 7 months using a primary healthcare unit were conducted. Each step demonstrated the need for adjustments, which were made during the adaptation process. At the end of the study, a version of PBQ in Brazilian Portuguese equivalent to the original one was obtained, offering promise for national studies on the mother-baby bond, and its influence on health, and for use in health services.

Resumo: O estabelecimento do vínculo entre mãe e bebê no período pós-parto é importante para garantir a saúde física e psicológica de ambos. Esta artigo relata a primeira fase da tradução e adaptação transcultural ao contexto brasileiro do Postpartum Bonding Questionnaire (PBQ). Quatro aspectos de equivalência entre a escala original e a versão em português foram avaliados: as equivalências conceitual, semântica, operacional e de item. Foi realizada revisão de literatura, estudo da história do PBQ, tradução, avaliação por especialistas, retrotradução e pré-testes envolvendo 30 mães com crianças com até sete meses de idade, que utilizaram unidades básicas de saúde. Cada passo demonstrou a necessidade de ajustes, que foram feitos durante o processo de adaptação. Ao final do estudo, obteve-se uma versão do PBQ em português do Brasil equivalente à original, possibilitando estudos nacionais sobre o vínculo mãe-bebê e sua influência na saúde e uso nos serviços de saúde.

Resumen: El establecimiento del vínculo entre la madre y el bebé en el período posparto es importante para garantizar la salud física y psicológica de ambos. Este artículo informa la primera fase de la traducción y adaptación transcultural al contexto brasileño del Postpartum Bonding Questionnaire (PBQ). Se evaluaron cuatro aspectos de la equivalencia entre la escala original y la versión en portugués: las equivalencias conceptuales, semánticas, operacionales y de ítem. Se realizó una revisión de la literatura, el estudio de la historia de PBQ, la traducción, la evaluación de expertos, la retrotraducción y los exámenes previos que involucraron a 30 madres con niños de hasta siete meses que usaban una unidad de salud primaria. Cada paso demostró la necesidad de ajustes, que se realizaron durante el proceso de adaptación. Al final del estudio, se obtuvo una versión de PBQ en portugués de Brasil equivalente a la original, permitiendo estudios nacionales sobre el vínculo madre-bebé, y su influencia en la salud, y para su uso en los servicios de salud.

Sleep quality perception and romantic relationships in university students: cross-sectional study / Percepción de calidad de sueño en jóvenes universitarios y relaciones románticas: estudio de corte transversal

Abstract Introduction: Sleep in adolescence is influenced by emotional states triggered by romantic relationships, which can be determinant in sleep quality perception. Objective: This study was designed to assess the association between sleep quality perception and romantic relationships, as well as its characteristics in late adolescent/young adult university students. Materials and methods: A cross sectional study was conducted in 443 subjects. Sleep quality perception was quantified using a validated diary for young persons. Individual attachment style, romantic relationship status and its characteristics were determined using specific validated measures. Results: Sleep quality perception was determined using five multivariate models that included statistically significant characteristics of romantic relationships. Higher sleep quality perception was associated with the level of satisfaction of a subject with the relationship and liking for the partner (p=0.035). The prevalence of romantic relationships in students was 64% (95%CI: 59.4-68.9). The individuals that were not in a romantic relationship experienced significantly prolonged sleep latency (p<0.05). Conclusion: Higher sleep quality perception in university students is associated with being in a romantic relationship and the attachment style. These aspects can be identified and intervened, if support systems of educational institutions recognize their potential importance for health, wellbeing and academic performance.

Resumen Introducción. El sueño en adolescentes está influenciado de manera especial por los estados emocionales presentes en las relaciones románticas. Esto puede ser determinante en la percepción de calidad del sueño. Objetivo. Evaluar la asociación entre la percepción de la calidad del sueño y las características de las relaciones románticas en estudiantes universitarios adolescentes y adultos jóvenes. Materiales y métodos. Estudio de corte transversal realizado en 443 sujetos. La percepción de calidad del sueño, los estilos de apego, estar en una relación romántica y sus características se determinaron utilizando medidas validadas. Resultados. La percepción de calidad del sueño se determinó utilizando cinco modelos multivariados que incluyeron características estadísticamente significativas de las relaciones románticas. El nivel de satisfacción del individuo con su relación de pareja y la atracción hacia esta se asoció con su nivel de percepción de calidad del sueño (p=0.035). La prevalencia de las relaciones románticas fue del 64% (IC95%: 59.4-68.9). Los que no estaban en una relación experimentaron latencia del sueño significativamente más prolongada (p<0.05). Conclusión. Las relaciones sentimentales románticas y sus características se asocian con la calidad de sueño percibida por los individuos. Estos aspectos pueden ser identificados e intervenidos y ser útiles para los sistemas de apoyo de las instituciones educativas.

Investigação dos padrões relacionais do vínculo mãe-filha envolvidos na obesidade feminina / Investigation of the relationship patterns of the mother- daughter bond involved in female obesity

Introdução: A obesidade apresenta uma incidência elevada e gênese multifatorial, como fatores biológicos, ambientais e psicológicos. Dentre os psicológicos, os conflitos na relação mãe-filha podem contribuir para a gênese da obesidade feminina. Objetivo: O objetivo desse estudo é investigar os padrões relacionais do vínculo mãe-filha envolvidos na obesidade feminina. Materiais e Métodos: Foi realizado estudo transversal, qualitativo, com pacientes obesas do Programa de Cirurgia Bariátrica de um Hospital Escola do Sul de Minas Gerais. Todas possuíam IMC acima de 30kg/m2 e eram maiores de 18 anos. A determinação da amostra foi de 12 pacientes, número suficiente para se atingir a saturação (Field Methods). Foram realizadas as entrevistas não-diretivas, gravadas e transcritas para análise posterior segundo a Metodologia de Análise de Conteúdo de Bardin. Resultados e Discussão: Foram encontradas seis temáticas centrais relacionadas à influência do vínculo mãe-filha sobre a obesidade feminina: comida/fuga/prazer; ganho de peso após a gravidez; superproteção/dominação materna; abandono materno; abuso sexual; insegurança/baixa autoestima/depressão. Conclusão: Foi possível evidenciar uma relação entre conflitos na relação mãe-filha e condições para a gênese da obesidade.

Introduction: Obesity has a high incidence and multifactorial genesis, such as biological, environmental and psychological factors. Among the psychological factors, the conflicts in the mother-daughter bond can contribute to the genesis of female obesity. Objective: The objective of this study is to investigate the relationship patterns of the mother-daughter bond involved in female obesity. Materials and Methods: A cross-sectional, qualitative study with obese patients in the Bariatric Surgery Program in a Hospital in Minas Gerais. All them have had BMI over 30kg / m2 and were older than 18 years of age. The determination of the sample of 12 patients was sufficient for achieving saturation (Field Methods). The interviews were non-directive ones, recorded and transcribed for posterior analysis according to Bardin's content analysis methodology. Results and Discussion: Six main themes were found and related to the influence of the mother-daughter bond on female obesity: Food / escape / pleasure, Overprotection/ Maternal domination, Maternal Abandonment, Sexual abuse, low self-confidence / low self-esteem / depression, weight gain after pregnancy. Conclusion: It was possible to show a significant relationship between conflicts in the mother-daughter relationship and conditions for the genesis of obesity.