Many thanks for your post, I enjoyed reading more about attachment theory, which you explained is based on the apparent innate need of humans to form close relationships. I noted from your post, and from relevant reading materials this week that fundamentally this begins in infancy, and the forming of the relationships sets the standard for relationships in future (Euler et al., 2021). Thank you also for explaining the developmental phases of attachment. I find Darwinian evolutionary theories to be fascinating, and the studies of monkeys being separated from their mothers resulted in some interesting findings, although truth be told, I fundamentally disagree with animal testing or interfering with nature in any way. I find it interesting that the condition of Borderline Personality Disorder is often the result of poor, unstable, or insecure attachments (Calvo et al., 2020). Indeed, I have several clients/patients in my role as a FACT team RN with Borderline Personality Disorder, and after having learned about their unstable backgrounds and fragmented family relationships this makes sense to me. One of your points included that neglect or abuse from the primary caregiver can lead to the development of poor relational skills. To continue along these lines, Krause-Utz et al. (2021) noted that intimate partner violence (IPV) is another unfortunate and concerning result of childhood maltreatment or disruption to healthy attachments during development. Krause-Utz et al. (2021) explained that the features of Borderline Personality Disorder are likely to hold a significant role in the cycle of violence within adult relationships. Furthermore, violence in childhood is noted to be associated with unstable adult relationships, and the continuation of the cycle of violence (Euleret al., 2021). In conclusion, it is safe to say that poor relational skills in childhood often results in maladaptive coping skills and poor relationships in adulthood, and that disturbances to attachment in the developing years significantly predisposes patients to IPV perpetration as well as victimization. It is vital that as PMHNPs we are alert to these risks and intervene where appropriate to ensure that children have healthy developments. Many thanks again for your interesting post.ReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5). APA Press. ISBN 978-0-89042-554-1Calvo, N., Benjamin, L, Laia Serrat L., PÃ©rez-RodrÃguez, V., AndiÃ³n, O., Josep A. Ramos-Quiroga, J., & Ferrer, M. (2020). The role of environmental influences in the complex relationship between borderline personality disorder and attention-deficit/hyperactivity disorder: review of recent findings. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 1â€“7. https://doi.org/10.1186/s40479-019-0118-zEuler, S., Stalujanis, E., Lindenmeyer, H. J., Nicastro, R., Kramer, U., Perroud, N., & Weibel, S. (2021). Impact of Childhood Maltreatment in Borderline Personality Disorder on Treatment Response to Intensive Dialectical Behavior Therapy. Journal of Personality Disorders, 35(3), 428â€“446. https://doi.org/10.1521/pedi_2019_33_461Krause-Utz, A., Mertens, L. J., Renn, J. B., Lucke, P., WÃ¶hlke, A. Z., van Schie, C. C., & Mouthaan, J. (2021). Childhood Maltreatment, Borderline Personality Features, and Coping as Predictors of Intimate Partner Violence. Journal of Interpersonal Violence, 36(13/14), 6693â€“6721. https://doi.org/10.1177/0886260518817782
Thanks for your informative post on Piagetâ€™s theory of cognitive development. What I find especially interesting is the infantâ€™s achievement of object permanence, which usually occurs between 6 and 12 months. By obtaining object permanence, the infant understands that out of sight is not out of mind, and they will often develop separation anxiety and stranger anxiety at this time (Malik & Marwaha, 2021). This information can be applied to Bowlbyâ€™s attachment theory in that the infant develops the ability to differentiate between subject and object, in particular caregiver and self (Pallini & Barcaccia, 2014). They both agree that the capacity for the infant to distinguish between familiar figures and strangers occur around the age of 6 months (Pallini & Barcaccia, 2014). Bowlby applies his theory of secure attachment to this concept in that an infant with a secure attachment to his primary caregiver will develop the reassurance that the caregiverâ€™s absence will be temporarily distressing, but they will return.
Disruptions in this stage can impact the infant negatively. In the attachment theory, a loss of the primary caregiver at this age could lead to anxious or insecure attachments that may lead to future anxiety or avoidant behaviors. Cognitive developmental stages that are not met may lead the child to stagnate and can affect their ability to develop problem solving abilities and abstract thinking (Malik & Marwaha, 2021). Understanding the various developmental theories is beneficial to treating patients with physical and mental health disorders. Adverse childhood experiences have been well established in research as negatively impacting mental and physical health of adolescents and adults. Robust knowledge of the theories can help to navigate healing and treatment options for our patient population.
Malik, F. & Marwaha, R. (2021, July 31). Cognitive development. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK537095/
Pallini, S. & Barcaccia, B. (2014). A meeting of the minds: John Bowlby encounters Jean Piaget. Review of General Psychology, 18(4), 287-292.