L9-CCP-Attachment and empathy

Attachment

Predisposition to become attached to others, a deep and enduring emotional bond that connects one person to another. We develop internal working models (IWM) of ourselves and significant others.

Attachment characteristics

1. Secure base

2. Safe haven

3. Efforts to maintain proximity

4. Reactions to separation and reunification

Secure attachment

IWM of others as safe, helpful, and supportive + IWM of self as worthy of affection. Positive evaluation of attachment experiences, high self-esteem. View others as warm and accepting, high levels of intimacy. Associated with sensitive and responsive parenting

Insecure attachment (and antisocial behavior)

Focus on the power of others to control or reject them. Early belief (1940s) that antisocial behavior is predated by attachment difficulties (but insecure attachment alone does not lead to antisocial behavior)

Preoccupied/anxious attachment

Preoccupation with past attachment experiences, inability to report coherent representation. Risk of social withdrawl and rejection, feelings of incompetence. Associated with inconsistent parenting style (interference with autonomy).

Dismissive/avoidant attachment

Emphasis on achievement and self-reliance at the expenses of intimacy. Deactivation of attachment system, self-preservative behavior, self absorbed, reluctant to approach others for support, hostile, casual intimate relations. Related to rejecting/interfering parenting, remote, cold or controlling.

Disorganized attachment

Child is caught in a conflict: source of security also source of fear. Passive-aggressive, inconsistent fear of rejection/seeking intimacy. Associated with child maltreatment, frightened/frightening caregivers.

The Minnesota study

Longitudinal study examining the stability and predictive power of attachment across a thirty-year timespan.

• attachment security and insecurity fairly stable across time

• some influences of positive (more favorable and flexible attachment system) and traumatic experiences

• childhood insecurity linked to adult personality dysfunction

Attachment and Mental Health

• insecure dismissive attachment linked to violence to self and others, depression

• insecure preoccupied show ptsd of abuse and also depression. also degree of violent family.

Disorganized attachment and personality pathology

Connected to severe mental disorders, such as BPD, and ASPD. Problems with; reflection on their own mental state, understanidng mind of others, regulation of mood and arousal, maintenance of good mental function.

Attachment Insecurity as Violence Risk Factor

John Bowlby stated that offending has a psychological soothing function. Unconsciously, individual has insecure attachment → unresolved distress and anger→ delinquency. Offenders need a secure base in therapy.

Attachment insecurity as a risk factor for offending

Insecure attachment styles vastly over-represented in populations of offenders. Only in the presence of other risk factors do insecure attachment styles also present risk for offending. Type of attachment insecurity relevant for type of violence (e.g. Male perpetrators of IPV: preoccupied or ambivalent)

Attachment differences child molesters

Examining differences in attachment styles between child molesters and matched-controls. Differences in secure attachment but not avoidance or anxiety. Low secure and high avoidant attachment related to Schizoid, Schizotypal and Avoidant PD, High anxious attachment related to borderline and histrionic.

Disorganized attachment and violence risk

Disorganized attachment most relevant for violence perpetration when mental illness is present. Reality-distorting experiences (psychosis) may lead to severe violence against close others if attachment is disorganized (switching between avoidant and anxious tendencies).

Disorganized attachment and study filicide

Filicidal mothers more likely to have a combination of hostile-helpless attachment (disorganized) and lack of reflective functioning. Also experienced abuse or neglect in childhood themselves→ combination of risk factors.

Affect dysregulation linking attachment to offending

Affect dysregulation may be a mechanism linking attachment insecurity to violence. Strong violent-supporting emotions (anger, panic) lead to externalizing actions.

• Attachment Avoidance→ Deactivation or avoidance of feelings

• Attachment Anxiety→ Hyperactivating emotional response

Childhood maltreatment and attachment on aggression

Adverse childhood experience lead to disorganized attachment, which dysregulated affect systems leading to externalizing aggression. Adverse childhood experiences very prevalent in prison population.

Treatment for offenders with PD

Treatment needs to focus on mechanisms that link PD to violence. Goals include more prosocial state of mind, support mentalizing and affect regulation. Attachment to a ‘secure’ place of care. More attention needs to be paid to the attachment relationships correctional clients and forensic patients form with their places of care.

Relationship with staff

Relational security concerns matrix of relationships between detainees and those who oversee their detention and care. Therapy often involves characteristics of parent-child relations (disparities in power and control, therapists attempt to re-parent). However, problematic if patients experienced maltreatment from attachment figures, reliving toxic attachment experiences.

Attachment-informed assessment and intervention

Extended assessment with focus on early childhood attachment experiences (developmental history, early adversities, relationships, experiences of other carers). Attachment perspective can help offenders understand the meaning of the violence to the victim and them. (Why was the victim a target, knowledge can be used in collaborative risk management plan)

What does attachment styles inform therapist?

• Attachment perspective can help the therapist make sense of the patient’s narratives; e.g. Avoidant → lack of concern for past, idolizing past figures, Preoccupied → talk a lot about past or present attachments, illusion of emotional intelligence.

• Attachment perspective can help anticipate difficulties; e.g. Avoidant→ unaware feelings or describe them, struggle to trust therapist. Preoccupied→ appear trusting and cooperative but may disengage.

Risk assessment & attachment

Attachment should be considered if violence occurred within close relationships. Problems can arise in conflict situations. Assessment may include HCR-20 and PAS.

• How did their past attachment experiences inform their offending pattern?

• Which attachment role do the people at risk play?

Empathy

Includes different perspectives an mechanisms

• Motor response → mirroring of someones motor response or activity

• Cognitive response → Taking perspective of others (theory of mind), understanding how or why a person feels the way they feel

• Emotional response → Own emotional response to another individual’s emotional state

Affective/emotional empathy vs cognitive

• Impairment in both types of empathy linked to callous-unemotional traits and conduct problems in children

• In boys with psychopathic traits, deficits in cognitive empathy might fade away with older age, while the affective deficits persist

Relationship of psychopathic traits to deficits in empathy across childhood (study)

Parent report (may be unreliable) on psychopathic traits and affective and cognitive empathy.

• Link between psychopathic traits and deficits in affective empathy stronger in male compared to female children

• No sex difference in the link between psychopathic traits and cognitive empathy. High psychopathic traits, less cognitive empathy.

Male vs female study on empathy and psychopathic traits

• Males: Deficits in cognitive empathy disappeared in the preteens, deficits in affective empathy persisted across age groups.

• Females: Differences in cognitive empathy stronger among older girls, no consistent differences in affective empathy.

3 perspectives on the neuro-cognitive architecture of emotional empathy

1. Mirror neuron

2. Mirror neuron analogy

3. Emotional response

Mirror neurons and emotional empathy.

1992: Seminal study with primates. Neurons that were activated both when performing an action and when observing one. In a study by Carr, participants viewed facial stimuli passively or viewed facial stimuli and were asked to internally generate the target emotion. In both condititions, similar network of brain areas activated.

Problems with Carr et al. 2003

1. The extent of the similarity in brain network is difficult to estimate

2. Overlap due to watching face stimuli across conditions?

3. Finding not replicated in a subsequent study, which found dissociation in neural systems for passive viewing and imitation

More general problems with the mirror neuron perspective

1. Most studies found neural activity also outside mirror neuron system

2. Fallacy in the emotional congruence hypothesis

Emotional empathy – Mirror neuron analogy

Similar account: brain regions instead of single neurons. Instead of perception-based, there is a specific mirror neuron system for emotional expression (but same concept).

Problem mirror neuron analogy

• Does not explain empathy when the target individual is not observed (e.g., story telling)

• Does not account for emotional incongruence in Prisoner’s Dilemma (Singer et al., 2006). Thus: Clearly not automatic process.

• Role of APPRAISAL → 2 mechanisms (de Vignemont & Singer, 2006)

1.Late appraisal model: Appraisal modulates automatic response

2.Early appraisal model: Appraisal occur on both emotional cues and context to generate response

Emotional empathy – Emotional response

• Empathy is simply a form of emotional reaction

• Same mechanisms in responding to a tiger or an electric shock, or to a target individual scared at the sight of a tiger

• Response is modulated by causal reasoning/conscious experience of the observer

Behaviorist approach empathy and emotions

Emotional States elicited by rewards and punishments (event-related experiences). Emotional expressions are reinforcers that modulate the likelihood of future behavior. NOT automatic, but under the influence of top-down attentional control. Can be triggered by non-social (tiger) and social stimuli (fearful expressions)

Pain empathy

Measured by testing what people understand if they observe other people experiencing pain and whether they can share and mirror their feelings

Pain recognition in youth (study)

Anger recognition better in youth with CU (callousness) traits but pain recognition worse.

Psychopathy and pain tolerance

If people with psychopathy can tolerate more pain, less sensitive to developing empathic response for someone else in pain. Brislin study on when participants will say stop to increasing pressure on dominant hand. Pain tolerance higher among students scoring higher on the Meanness subscore of the Triarchic Psychopathy Measure. Other ways of assessing pain tolerance (electric shocks or cold temp) show links to psychopathy and antisocial beheviors

Empathy for stangers

Empathy requires effort and comes with the cost of regulating one’s emotions. Empathy is more likely for a person you like or that you are familiar with. Do people with callous traits choose to not empathize because they find it too taxing? Being more selective with whom to emphasize. Psychopathic offenders showed reduced spontaneous empathic response when observing emotional implicit hand movements, but group differences markedly reduced when participants were asked to “feel with the actors in the video”.

Developmental task for empathy

Children more likely to exhibit empathy if encouraged by parents to consider other people’s viewpoints, role of parents important.

Mind-mindedness

The extent to which a caregiver is attuned to, and interacts with the child in a way that responds to a child’s mind, thoughts and feelings. Empathy-related abilities might be fostered by mind related talk.

Study; appropriate mind-related talk at T1 (8 months), predicts better emotion understanding and theory of mind abilities at T2 (51 months). Emotion understanding capability at T2 linked to lower callous-unemotional traits at T4 (10 years). Theory of Mind (taking persepctives of others) linked to lower impulsivity at 10 years.

Disengagement from empathy as emotion regulation

People with callous-unemotional traits may lack the ability to regulate their emotions properly. Disengaging from empathic response as a way of emotion regulation if resulting emotions cannot be managed. Impairment in emotion regulation abilities may contribute to lack of empathic responding.