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Biomedical subjects

Peter Fonagy

Publications and source records attributed to Peter Fonagy.

46 records · Page 3Linked to original sources
PubMed2002

Adolescents murderers: abuse and adversity in childhood.

With rising rates of juvenile violence, an improved understanding of its causes is much needed. The relative absence of controlled studies based on British populations of murderers further increases the need for information in this area. This case control study examines a group of 21 imprisoned males, convicted of murder whilst aged 18 years or less, and compares them on a range of psychosocial variables to 21 convicted non-violent burglars. The groups were matched for age at interview and race. Results showed that lower socio-economic status, harsh parenting from both mother and father, and exclusion from school were significantly more common for murderers. Harsh parenting from the mother than from the father appeared to contribute more strongly. When factors were combined in a general adversity index, a significant difference was found between the two groups. The study confirms that multiple environmental factors are associated with murderous behaviour in young men.

Adolescent↗
PubMed2002

Assessing adolescents who threaten homicide in schools.

Psychoanalytic and psychiatric perspectives on children who threaten to kill others are reviewed in the context of the need for an interdisciplinary approach to the problem. Converging technologies derived from a psychoanalytically informed social systems model are compared to law enforcement approaches, psychoanalytic understanding of the individual dynamics of the child, and empirical research on conduct disordered adolescents. The interdisciplinary orientation of a broadly trained community psychoanalyst allows a unique contribution when trying to distinguish adolescents who make a threat from those who pose a threat. Case vignettes are used to illustrate the hypotheses.

Adolescent↗
PubMed2002

The history and current status of outcome research at the Anna Freud Centre.

In past decades there have been impressive systematic studies of the outcome of the psychoanalysis across groups of patients and analysts, but the studies carried out to date have almost all been with adult patients. There is very little information even on the short-term outcome of psychoanalytic treatment for children. The information that does exist has largely emerged from the research tradition of the Anna Freud Centre (formerly the Hampstead Clinic) in London. The paper surveys the early studies and details the current program of research at the AFC, providing a review of fifteen years of work on the outcomes of child psychoanalytic therapy.

England↗
PubMed2002

General and relationship-specific models of social cognition: explaining the overlap and discrepancies.

BACKGROUND: This study examined the degree of overlap and sources of discrepancies between two alternative models of social cognition in early adolescence, a general model based on 'theory of mind' and a relationship-specific model rooted in attachment theory. METHODS: We administered newly developed, age-appropriate measures of advanced theory of mind or 'mentalising' and child-parent attachment, indexed by the coherence of children's narratives about attachment relationships, to a sample of 70 early adolescents (mean age 12.6 years). RESULTS: The central findings were that, as expected, there was significant overlap between the mentalising and attachment indices of social cognition (r(70) = .35, p < .01). The overlap was not significantly mediated by verbal ability or general measures of parenting. There were also substantial discrepancies in children's performance on these measures that were conceptually interesting and statistically reliable. Specifically, adolescent reports of parenting discriminated between measures of mentalising and attachment coherence. In addition, those children who exhibited a less coherent model of attachment than was predicted from performance on a mentalising task were more likely to be rated as exhibiting a 'Dismissing/Avoidant' style in the attachment interview. CONCLUSIONS: Findings support a connection between mentalising and attachment in early adolescence, and further suggest that social cognitive processes may be context and relationship-specific.

Adolescent↗
PubMed2002

The Target Symptom Rating: a brief clinical measure of acute psychiatric symptoms in children and adolescents.

Describes the development and psychometric properties of the Target Symptom Rating (TSR), a brief, multi-informant measure of commonly observed symptoms in child and adolescent clinical work. In a large sample of children and adolescents in inpatient and residential treatment, the 13 TSR items fell into 2 subscales: Emotional Problems and Behavior Problems, which were associated in expected ways with the Internalizing and Externalizing factors of the Achenbach scales and the Child and Adolescent Functional Assessment Scale (CAFAS). The measure was sensitive to change in brief and extended treatment, as rated by parents, patients, primary clinicians, and family therapists, and shows promise as a tool for outcome research in applied settings.

Acute Disease↗
PubMed2002

Adult attachment: what are the underlying dimensions?

Using a community sample of 115 young adults, this study applied a range of statistical techniques to five measures of adult attachment to gain a better understanding of what they assess. First, we determined comparability of measures, using both categorical and dimensional approaches to model the association. Agreement among classifications was modest. Next, we examined the relation of attachment classifications and attachment measure subscale scores to criterion variables (i.e. dyadic adjustment, interpersonal sensitivity and severity of psychiatric symptoms). Classification predicted severity of psychological symptoms better than it predicted other measures of adjustment. Finally, using a principal components analysis, we mapped the relationship among underlying constructs, the subscales of the five measures and three criterion measures of psychological adjustment. We discuss our findings from the perspective of underlying constructs of attachment insecurity and strategy for coping with insecurity in relationships, noting implications for further research.

Adaptation, Psychological↗
PubMed2002

Health service use costs by personality disorder following specialist and nonspecialist treatment: a comparative study.

The impact of specialist psychosocial treatment on health service use costs by patients with personality disorder is not yet sufficiently documented. In this prospective study we compare patterns of health service costs by three groups of people with personality disorder treated in a hospital-based program (IPP), a step down program (SDP), and a general psychiatric program (GPP). Total service use costs at follow up, compared with intake costs, showed that significantly higher savings were achieved by SDP and IIP compared with GPP. Cost reductions in SDP were significantly greater than in IPP. Significant cost reductions were found between treatment programs in social worker and community psychiatric nursing and psychotherapy. The cost-effectiveness of the two specialist treatment programs was indicated by the significant association between total cost reduction and clinical outcome in GPP and IPP, but not in GPP. The effect of Major Depression and Borderline Personality Disorder on health service use alone and in combination was also investigated. The finding that Major Depression was found to be more significantly associated with higher health service use costs than Borderline Personality Disorder is discussed.

Adult↗
PubMedDate not supplied

The importance of shared environment in mother-infant attachment security: a behavioral genetic study.

In a sample of 157 monozygotic and dizygotic twins, genetic and environmental influences on infant attachment and temperament were quantified. Only unique environmental or error components could explain the variance in disorganized versus organized attachment as assessed in the Ainsworth Strange Situation Procedure. For secure versus nonsecure attachment, 52% of the variance in attachment security was explained by shared environment, and 48% of the variance was explained by unique environmental factors and measurement error. The role of genetic factors in attachment disorganization and attachment security was negligible. Genetic factors explained 77% of the variance in temperamental reactivity, and unique environmental factors and measurement error explained 23%. Differences in temperamental reactivity were not associated with attachment concordance.

Female↗