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Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression effect indicating that secure attachment to therapist predicted continued improvement in global functioning, whereas the alliance predicted deterioration when both variables were modeled together. Although limited by the correlational design, this study suggests that the development of a secure attachment to therapist is associated with treatment gains as well as predictive of posttreatment improvement in functioning. Future research should investigate the temporal development of attachment to therapist and its interaction with alliance and outcome more closely. To ensure differentiation from patient-rated alliance, observer-based measurement of attachment to therapist should be considered.

. Adding "Circle of Security -Parenting" to treatment as usual in three Swedish infant mental health clinics. Effects on parents' internal representations and quality of parent-infant interaction. Scandinavian Journal of Psychology, 59,[262][263][264][265][266][267][268][269][270][271][272] This study presents effects of adding Circle of Security-Parenting (COS-P) to an already established comprehensive therapeutic model for early parentchild intervention in three Swedish infant mental health (IMH) clinics. Parents' internal representations and quality of parent-infant interaction were studied in a clinical sample comprised of 52 parent-infant dyads randomly allocated to two comparable groups. One group consisted of 28 dyads receiving treatment as usual (TAU) supplemented with COS-P in a small group format, and another group of 24 dyads receiving TAU only. Assessments were made at baseline (T1), 6 months after inclusion (T2) and 12 months after inclusion (T3). Changes over time were explored in 42 dyads. In the COS-P group, the proportion of balanced representations, as assessed with Working Model of the Child Interview (WMCI), significantly increased between T1 and T3. Further, the proportion of emotionally available interactions, as assessed with Emotional Availability scales (EA), significantly increased over time in the COS-P group. Improvements in the TAU-group were close to significant. Limitations of the study are mainly related to the small sample size. Strength is the real world character of the study, where COS-P was implemented in a clinical context not otherwise adapted to research. We conclude by discussing the value of supplementing TAU with COS-P in IMH treatment.

The Patient Attachment to Therapist Rating Scale is a promising approach for assessing the quality of attachment to therapist from patient narratives. Future development should focus on improving the discrimination of the insecure subscales.

This cross-sectional study investigated associations between perceived parental rearing, attachment, and social anxiety. 510 Chinese middle school students, aged 12 to 20 years, completed a set of questionnaires including “Egna Minnen Beträffande Uppfostran” for Children (EMBU-C), Inventory for Parent and Peer Attachment (IPPA) and Social Anxiety Scale for Adolescents (SAS-A). The results showed that intercorrelations between adolescents’ rated attachment to parents were stronger than betweenparental and peer attachment. Girls scored higher on attachment to mother and peer than boys. Lack of parental rejection and presence of emotional warmth were strongly related to parental attachment. The rated level of total anxiety was not related to gender or age, but it was lower than what has earlier been reported from China. Perceived rejection from fathers and mothers’ as well as attachment to peer and mother acted as predictors; together they explained 19% of the variance in social anxiety.