Aggression and Suicidal Behavior During Latency

1
Aggression and Suicidal Behavior During Latency

• What is latency?
• Follows conflicts produced by Oedipus Complex
• Sexual and aggressive drives become latent or
  dormant, becoming sublimated in industrious
  activities (e.g., hobbies, sports)
• Peer relationships assume greater importance

2
Problems during Latency

• Conflicts from the Oedipal period as well as
  earlier periods (oral, anal periods) are poorly
  resolved or not resolved at all
• Attachment insecurities assume different forms
• secure confidence in relationships,
  goal-corrected partnership, autonomy
• Casual minimizing or dismissing of attachment
  needs
• Busy distracting oneself from affective
  components of attachment through activity or
  displacement of fears onto others (projection,
  reaction formation)
• Controlling
• Punitive
• Caregiving

3

• Resulting symptomatologyaggression or depression
• Possible etiologies
• Wants to hurt others because not Oedipal victor,
  not in control of parents (anal), or not getting
  basic security needs met (oral)
• Wants to hurt self because of guilty feelings
  over being Oedipal victor, fantasies of having
  destroyed mother (oral), need to destroy internal
  representation of mother or father, need to
  activate caregivers concern

4
Attachment Disorganization In Prepubertal
Psychiatric Inpatients

• Three traditional patterns of attachment (A, B,
  C)
• Fourth category (D)
• Four proposed subtypes of Dlooking for
  organization within disorganization
• Direct-aggressive outward
• Direct-aggressive inward
• Indirect-aggressive pseudosecure
• Indirect-aggressive displaced

5

• Each attachment pattern subtype is coherently
  related to both psychiatric diagnosis and
  clinical symptomatology, as well as to what we
  know about the relationship to the mother (but
  diagnosis and symptomatology can imply other
  pathways)
• Each child had experienced significant separation
  from a significant or primary caregiver

6

• Psychotic features could be related to
  disturbances in the attachment relationship
  (difficulties with separation)
• Is the disorganization attachment-relevant, or
  more global psychosis?
• Is the disorganization attachment-relevant, or
  more neurologically based?
• Could florid psychotic features (in subtype 1 and
  2) develop into more reality-based
  disorganization (in subtypes 3 and 4)?

7
Effects of Attachment Disorganization during
Latency I (Solomon et al.)

• Children who appear controlling upon reunion
  appear frightened (chaotic or inhibited) in story
  completions
• Frightened children appear more aggressive at
  home and more hostile at school then children
  with organized attachment strategies
• Development of coding system related to
  development sample (p. 460, 2nd column)

8

• 6/13 D, 4/27 non-D fell into highest quartile on
  CBCL
• 7/11 D, 4/29 non-D fell into lowest quartile of
  ISCS

9
Effects of Attachment Disorganization During
Latency II (Easterbrooks et al.)

• Do attachment security and verbal intelligence
  moderate the effects of psychosocial risk on
  behavioral adaptation (aggression in classroom)?
• How psychosocial risk is measured
• Family income
• AFDC status (welfare)
• Maltreatment reports to DSS
• Law enforcement problems during past two years
• Serious injuries or hospitalization of child
  during past two years
• Maternal depression (CES-D) 16 (clinical
  cutoff)
• Sum sum of yes scores to all six areas
  (composite risk)

10

• Correlation matrix
• Risk related to attachment security (p lt .05)
• Risk not related to attachment avoidance (n.s.)
• Risk marginally related to verbal intelligence (p
  lt.10)
• Attachment security related to verbal
  intelligence (p lt.05)
• Attachment avoidance related to verbal
  intelligence (p lt.05)
• Attachment security related to attachment
  avoidance (p lt.001)
• Risk related to externalizing, total behavior
  problems
• Attachment security related to internalizing,
  externalizing, total behavior problems
• Attachment avoidance related to internalizing,
  externalizing, total behavior problems
• Verbal intelligence not related to behavior
  problems

11

• Predictions (RAVRARV ? behavior problem)
• Risk predicted externalizing and total problems
  in both mother and father reports
• Attachment security predicted internalizing,
  externalizing, and total problems, but only in
  teacher reports
• No interaction effects in behavior-problems
  analyses
• Verbal intelligence did not predict behavior
  problems
• Insecure attachments more likely to appear in
  clinical range than secure attachments (88 vs.
  45, 100 controlling)

12
Suicidal Behavior During Latency

• Maternal suicidal ideas and gestures (severity)
  related to childs treatment status (p lt .01)
• Prevalence of diagnosis
• Inpatient conduct disorder, MDD, Organic Brain
  Syndrome, PDD, Schizophrenia, BPD
• Outpatient adjustment disorder
• Nonpatient anxiety disorder

13

• Variables associated with suicidal behavior
• Recent general psychopathology
• Preoccupation with death
• Recent and past depression
• Introjection (inpatient, nonpatient)
• Past general psychopathology
• Recent aggression (outpatient)

14
(No Transcript)