Mentalization Mediates the Relationship between Early Maltreatment and Potential for Violence in Adolescence.

AIM: The present study investigates the role of attachment representation and mentalization as possibly protective factors in the relationship between early maltreatment and potential for violence in adolescence. METHODS: For the current study, 161 adolescents, aged 14-21 years, were recruited from high schools and youth psychiatry. Early maltreatment was assessed by the Childhood Experiences of Care and Abuse Questionnaire, attachment was assessed using the Adult Attachment Projective Picture System, and mentalization was coded with the Reflective Functioning Scale from Adult Attachment Interviews. Potential for violence was operationalized using the Reactive-Proactive Aggression Questionnaire, and the presence of conduct disorder was assessed by the Structured Clinical Interview. Using structural equation modeling, reflective functioning and attachment were tested as mediators on the direct effect of early maltreatment on potential for violence. RESULTS: There was a direct effect of early maltreatment on potential for violence. Furthermore, this direct effect was partially mediated by reflective functioning but not by attachment representations. DISCUSSION: The results contribute to the idea that mentalization serves as a protective factor that may suspend the pathway from early maltreatment to violence in adolescence. Because of the transformation of attachment patterns into generalized cognitive models of attachment, attachment in adolescence may have a less pronounced effect on violence in this specific developmental phase. Future studies should test for further group differences in community and clinical groups, which was not possible in the present study due to the limited sample size.

[Attachment Quality of Young Children with Mentally Ill Parents on the Example of the Munchausen by Proxy Syndrome]. / Bindungsqualität von Kleinstkindern psychisch kranker Eltern am Beispiel des Münchhausen by Proxy Syndroms/ Attachment Quality of Young Children with Mentally Ill Parents on the Example of the Munchausen by Proxy Syndrome.

One of the most discussed questions in clinical literature concerns the impact of child abuse by mentally ill parents (cf. Mattejat, 1998). It's obvious that most children cannot understand such a parental behaviour and that this lack of understanding along with the lack of knowledge about their parents' emotional disorder results in childrens' fear, disorientation and uncertainty. The consequences are massive interferences in the relationship between parents and children, who could develop an anxious-resistant insecure or even a disorganized/disoriented attachment. But how does a child react, if the behaviour of its parents is ambivalent itself and alternates from abuse to care? Such a parental behaviour is described as the "Munchausen by Proxy Syndrome". This article regards the effects of a "Munchausen by Proxy Syndrome" on the childrens' attachment development. After discussing the basic assumptions about the "Munchhauen by Proxy Syndrome" and the attachment theory we draw conclusions about the syndrome's effect on childrens' attachment behaviour.