Rivista per le Medical Humanities

Lavinia Barone
rMH 22, 2012, 11-16

Attachment in infancy: building a secure basis in typical and atypical contexts

This paper describes the relation between the caregiver and her child as basis for the definition of individual differences. Different caregiving practices correspond to different children’s attachment pattern: secure, insecure-avoidant, insecure-ambivalent and insecure-disorganised. Each pattern implies a strategy for emotion regulation, which has to be learned through affective relationship with the caregiver. Attachment pattern tend to represent a reliable and stable way for coping with emotions across the whole life cycle. Adoption experience is presented as an atypical family context where attachment is indeed affecting the caregiver-child relationship; even if “learned” in the new adoptive family context, parents’ attachment patterns affect those of the children in a similar way than in the biological families. Adoption thus represents a key situation for studying attachment in its broad effects on emotion regulation and socioemotional adjustment. 

Rita B. Ardito
Mauro Adenzato
rMH 22, 2012, 24-28

Psycho-neurobiological aspects of attachment: the contribution of cognitive neurosciences to clinical psychology

Attachment theory can be considered by all means a prototypical theory in the most recent research in the neurosciences of mind. Given the focus of this theory on the interaction between the biological, psychological and social dimensions, it is not surprising that in recent years a growing number of scientists have studied the neural bases of the attachment system, and of the way the functioning of these cerebral structures is influenced by the quality of interpersonal relations experienced in the earliest years of life. This paper explores the main contributions of this research field. Special attention is given to neuroimaging approaches, which allowed study of the neural correlates of the attachment system and of the complementary caring system, as well as to the works focusing on the effects of early attachment experiences on cerebral development. Taken together, these works demonstrate how the quality of interpersonal experiences with the attachment figure is critical in influencing the child’s cerebral and mental development since the beginning. 

Rita B. Ardito
rMH 22, 2012, 29-33

Research on attachment in the adult: the Adult Attachment Interview

Attachment theory is essential in the understanding of the way human beings represent knowledge of the self and of the world. This theory has advanced the psychological disciplines both in theoretical development and in clinical practice, thanks to systematic and consistent high-quality research. The most important instrument for the experimental analysis of attachment in the adult is the Adult Attachment Interview (AAI). AAI is a semistructured clinical interview that explores the state of mind of the interviewee, while the latter is asked to reflect on her early attachment experiences. In a recent review of the measuring instruments of attachment in adults, AAI has been given the highest rank in terms of psychometric qualities, reliability and validity. The state of mind relative to attachment that emerges from AAI (the way the subjects construct and narrate their primary experiences, relate and clarify them in the course of the interview) can be classified as Free, Dismissing, Entangled and Unresolved. Longitudinal studies of attachment behaviour observed in children through the Strange Situation is predictive of the kind of mental state that they will associate to attachment in adult age through AAI. 

Rita Pezzati
rMH 22, 2012, 34-39

Attachment theory and ageing

Attachment theory places in the dimension of intersubjectivity the emotional tuning between the subject seeking a protective closeness (and related feeling of safeness) and the subject offering it. Early studies have shown how the tuning between the child and the reference figure is dependent on the latter’s specific modalities of relational construction, as well as on the child’s specific features. The ensuing attachment styles will in turn influence the construction of each person’s sense of self and of the world. This entails that in other periods of life, like in ageing, in which individuals experience massive somatic, psychological and social change, often accompanied by a perception of increased fragility, the need for an available attachment figure may reappear with a greater urgency than in productive adult age. If much has been done in the study of attachment in early childhood and in part of adult life, however, very little is known on attachment in the elderly. This paper will summarize the existing literature with regard to the impact of attachment theory on the understanding and planning of interventions on elderly people undergoing physiological and pathological ageing and on their formal and informal caregivers. 

Bernardino Fantini
rMH 22, 2012, 67-84

Death ascertainment and its history

The debate over the criteria for ascertaining the death of a person has a long history, and has always been linked to the fear of burying or cremating people only erroneously believed to be dead. In different ages, religious and medical practices found empirical solutions to solve these problems and, in the 19th Century, the birth of scientific medicine multiplied the clinical and instrumental methods for ascertaining death. In the second half of the 20th century, the problem of ascertaining death has been completely reframed: from the association with fear of being buried alive to that of being stuck in a state of non-life and non-death.