Interpersonal Relations

Of all the theories purporting to uncover the roots of childhood behaviour and its extension into adult behaviour, the most cogent relates to the physical and psychological bonds of attachment between infant and mother. It is helpful to divide the human lifespan into three periods, each of which has alternating phases of attachment and detachment.

OBJECTIVES: To investigate the psychosocial impact of lipodystrophy on the lifestyles of HIV positive patients on highly active antiretroviral therapy (HAART). METHODS: In-depth interviews were conducted with 14 HIV positive patients on HAART at an outpatient sexually transmitted infections (STI) and HIV clinic in central London. Qualitative data from interview transcripts were analysed using grounded theory to elicit key categories and subcategories.

We compared how evaluations by out-group members and evaluations by in-group members affected participants' stress responses--their neuroendocrine reactivity, cognitive appraisals, and observed anxiety--and how participants' implicit racial bias moderated these responses. Specifically, White participants completed measures of racial bias prior to the experiment. During the experiment, participants performed speech and serial subtraction tasks in front of White or Black interviewers.

The inadequate nature of research into group psychotherapy stems from the lack of a satisfactory general theory that accounts for the group as a social system as well as for the functioning of the individual. A critique is presented of the group-as-whole tradition and a brief introduction given to social system concepts, particularly as they relate to group developmental stages. The idea that groups progress through a series of stages implies the notion of the group as a single entity with its own organizational structure.

Early life stress (child and adolescent abuse, neglect and trauma) induces robust alterations in emotional and social functioning resulting in enhanced risk for the development of psychopathologies such as mood and aggressive disorders. Here, an overview is given on recent findings in primate and rodent models of early life stress, demonstrating that chronic deprivation of early maternal care as well as chronic deprivation of early physical interactions with peers are profound risk factors for the development of inappropriate aggressive behaviors.

Accumulating evidence points to severe relationship dysfunction as the core epigenetic expression of borderline personality disorder (BPD). In adulthood, BPD is typified by disorganization within and across interpersonal domains of functioning. When interacting with their infants, mothers with BPD show marked withdrawal and frightening or frightened behavior, leading to disorganized infant-mother attachments. Linked to both infant disorganization and BPD is a maternal state of mind typified by unresolved mourning regarding past loss or trauma.

This article provides a selective review of the neuroscience and child-psychoanalytic literature, focusing on areas of significant overlap and emphasizing comprehensive theories in developmental neuroscience and child psychoanalysis with testable mechanisms of action.

LEARNING OBJECTIVES: After participating in this educational activity, the physician should be better able to 1. Identify the biological role of oxytocin in forming attachments. 2. Evaluate the relationship between various neuropsychiatric disorders and oxytocin. 3. Identify clinical implications of using oxytocin to treat various neuropsychiatric disorders. Oxytocin is a peptide hormone integral in parturition, milk letdown, and maternal behaviors that has been demonstrated in animal studies to be important in the formation of pair bonds and in social behaviors.

Social relationships and attachment are core developmental elements of human existence and survival that evolve over the lifetime of an individual. The internal and external factors that influence them include the presence of illness in the individual or in their immediate environment. The developmental aspects of attachment and social relationships have become increasingly of interest and relevance in light of early developmental epigenetic modification of gene expression patterns that may influence subsequent behavioral patterns and outcomes.