Attachment among Adoptive Families: Two Emipirical Studies in an International Context

The present dissertation analyzed the construct of attachment at different time points, specifically focusing on two phases of adoptive family life that have so far received little attention from investigators. Study 1 focused on the first months of adoption, and analyzed the development of the attachment relationship to new caregivers. The sample was composed of a small but homogeneous group (n=6) of Korean-born children, adopted by Italian parents. The Parent Attachment Diary (Dozier & Stovall, 1997) was utilized to assess the child's attachment behavior. We assessed these behavior for the first 3 months after placement into adoption. Results showed a double variability of attachment behavior: within subjects during the 3-months, and between subjects, with just half of the children developing a stable pattern of attachment. In order to test the growth trajectories of attachment behavior, Hierarchical Linear Models (Bryk & Raudenbush, 1992) were also applied, but no significant population trend was identified. Study 2 analyzed attachment among adoptees during the sensitive period of adolescence. Data was derived from an international collection (n= 104, from Belgium Italy, and Romania) of semi-structured clinical interviews (with adolescents and with their adoptive parents), as well as from questionnaires. The purpose of this study was to detect the role played by risk and protective factors on the adoptee's behavioral and socio-emotional outcomes. In addition, we tested the possible interactions between the different attachment representations within the adoptive family. Results showed that pre-adoptive risk predicted the adolescent's adjustment; however, parental representations constituted an important moderator of this relationship. Moreover, the adolescent's security of attachment partially mediated the relationship between age at placement and later behavioral problems. In conclusion, the two present attachment studies highlighted the notable rate of change of attachment behavior over time, which showed its underlying plasticity, and thus the possible reparatory value of the adoption practice. Since parents have been proven to play an important role, especially in adolescence, the post-adoption support acquires even more importance in order to help parents promoting a positive and stable relational environment over time. - L'objectif de cette thèse est de décrire la formation des relations d'attachement chez les enfants et les adolescents adoptés, lors de deux phases particulières de la vie de la famille adoptive, qui ont été relativement peu étudiées. L'Étude 1 analyse les premiers mois après l'adoption, avec le but de comprendre si, et comment, une relation d'attachement aux nouveaux parents se développe. L'échantillon est composé d'un petit groupe (n = 6) d'enfants provenant de Corée du Sud, adoptés par des parents Italiens. A l'aide du Parent Attachment Diary (Dozier & Stovall, 1997), des observations des comportements d'attachement de l'enfant ont été recueillies chaque jour au cours des 3 premiers mois après l'arrivée. Les résultats montrent une double variabilité des comportements d'attachement: au niveau inter- et intra-individuel ; au premier de ces niveaux, seuleme la moitié des enfants parvient à développer un pattern stable d'attachement ; au niveau intra-individuel, les trajectoires de développement des comportements d'attachement ont été testées à l'aide de Modèles Linéaires Hiérarchiques (Bryk et Raudenbush, 1992), mais aucune tendance significative n'a pu être révélée. L'Étude 2 vise à analyser l'attachement chez des enfants adoptés dans l'enfance, lors de la période particulièrement sensible de l'adolescence. Les données sont issues d'un base de données internationale (n = 104, Belgique, Italie et Roumanie), composée d' entretiens cliniques semi-structurées (auprès de l'adolescents et des ses parents adoptifs), ainsi que de questionnaires. Les analyses statistiques visent à détecter la présence de facteurs de risque et de protection relativement à l'attachement et aux problèmes de comportement de l'enfant adopté. En outre, la présence d'interactions entre les représentations d'attachement des membres de la famille adoptive est évaluée. Les résultats montrent que les risques associés à la période pré-adoptive prédisent la qualité du bien-être de l'adolescent, mais les représentations parentales constituent un modérateur important de cette relation. En outre, la sécurité de l'attachement du jeune adopté médiatise partiellement la relation entre l'âge au moment du placement et les problèmes de comportement lors de l'adolescence. En conclusion, à l'aide de multiples données relatives à l'attachement, ces deux études soulignent son évolution notable au fil du temps, ce qui sous-tend la présence d'une certaine plasticité, et donc la possible valeur réparatrice de la pratique de l'adoption. Comme les parents semblent jouer un rôle important de ce point de vue, surtout à l'adolescence, cela renforce la notion d'un soutien post-adoption, en vue d'aider les parents à la promotion d'un environnement relationnel favorable et stable. - Il presente lavoro è volto ad analizzare l'attaccamento durante le due fasi della vita della famiglia adottiva che meno sono state indagate dalla letteratura. Lo Studio 1 aveva l'obiettivo di analizzare i primi mesi che seguono il collocamento del bambino, al fine di capire se e come una relazione di attaccamento verso i nuovi genitori si sviluppa. Il campione è composto da un piccolo gruppo (n = 6) di bambini provenienti dalla Corea del Sud e adottati da genitori italiani. Attraverso il Parent Attachment Diary (Stovall e Dozier, 1997) sono stati osservati quotidianamente, e per i primi tre mesi, i comportamenti di attaccamento del bambino. I risultati hanno mostrato una duplice variabilità: a livello intraindividuale (nell'arco dei 3 mesi), ed interindividuale, poiché solo la metà dei bambini ha sviluppato un pattern stabile di attaccamento. Per verificare le traiettorie di sviluppo di tali comportamenti, sono stati applicati i Modelli Lineari Gerarchici (Bryk & Raudenbush, 1992), che però non hanno stimato una tendenza significativa all'interno della popolazione. Obiettivo dello Studio 2 è stato quello di esaminare l'attaccamento nelle famiglie i cui figli adottivi si trovavano nella delicata fase adolescenziale. I dati, provenienti da una raccolta internazionale (n = 104, Belgio, Italia e Romania), erano costituiti da interviste cliniche semi-strutturate (con gli adolescenti e i propri genitori adottivi) e da questionari. Le analisi hanno indagato il ruolo dei fattori di rischio sullo sviluppo socio-emotivo e sugli eventuali problemi comportamentali dei ragazzi. Inoltre, sono state esaminate le possibili interazioni tra le diverse rappresentazioni di attaccamento dei membri della famiglia adottiva. I risultati hanno mostrato che il rischio pre-adottivo predice l'adattamento dell'adolescente, sebbene le rappresentazioni genitoriali costituiscano un importante moderatore di questa relazione. Inoltre, la sicurezza dell'attaccamento dell'adolescente media parzialmente la relazione tra età al momento dell'adozione e problemi comportamentali in adolescenza. In conclusione, attraverso i molteplici dati relativi all'attaccamento, i due studi ne hanno evidenziato il cambiamento nel tempo, a riprova della sua plasticità, e pertanto sottolineano il possibile valore riparativo dell'adozione. Dal momento che i genitori svolgono un ruolo importante, soprattutto in adolescenza, il supporto nel post- adozione diventa centrale per aiutarli a promuovere un ambiente relazionale favorevole e stabile nel tempo.

Steering Group Report on a National Substance Misuse Strategy February 2012

Alcohol plays a complex role in Irish society. It is associated with many aspects of Irish social and cultural life and is generally consumed for enjoyment, relaxation and sociability. The pub often plays an important role in community life and is an attraction for tourists. More broadly, alcohol plays a signifi cant role in the Irish economy by generating employment, tax income and export income.However, alcohol is no ordinary commodity. It has major public health implications and it is responsible for a considerable burden of health and social harm at individual, family and societal levels. Steering Group Report on a National Substance Misuse Strategy February 2012 Click here to download PDF 2.7mb

Sixth Annual Report of the Independent Monitoring Group for A Vision for Change - the Report of the Expert Group on Mental Health Policy - July 2012

Sixth Annual Report of the Independent Monitoring Group for A Vision for Change – the Report of the Expert Group on Mental Health Policy – July 2012 This is the 6th Annual Report of the Independent Monitoring Group for A Vision for Change (IMG) and the final report of the Second Group. It is clear to the IMG that the implementation of A Vision for Change (AVFC) to date including 2011 has been slow and inconsistent. There is a continued absence of a National Mental Health Service Directorate with authority and control of resources. Such a body has the potential to give strong corporate leadership and act as a catalyst for change. Click here to download HSE National and Regional Progress ReportsHSE – 6th Annual Report HSE – National and Regional Progress Report Progress Reports from Government DepartmentsDepartment of Children and Youth AffairsDepartment of Education and SkillsDepartment of Health Department of Justice and Equality Department of Social ProtectionDepartment of Environment, Community & Local Government National Mental Health Programme Plan Consultation Document What We Heard Submissions Received by the IMGAmnesty International Ireland submission Association of Occupational Therapists submission College of Psychiatry of Ireland submissionCollege of Psychiatry of Ireland – Press Release regarding Social Psychiatry and Recovery Conference College of Psychiatry of Ireland – regarding Psychotherapy Training for Psychiatric TraineesCollege of Psychiatry of Ireland – regarding relationship with Pharmaceutical Industry College of Psychiatry of Ireland – Mental Health in Primary CareDisability Federation of IrelandHealth Research Board submission Irish Association of Social Workers – Adult Mental Health Irish Association of Social Workers – Child and Adolescent Mental Health Irish College of General PractitionersMental Health CommissionMental Health ReformPharmaceutical Society of IrelandIrish Advocacy Network Childrens Mental Health CoalitionNational Disability AuthorityNational Service Users ExecutiveNational Service Users Executive – Second Opinions ReportNational Federation of Voluntary BodiesHeadstrong  

Report of the Expert Group on the Judgment in A, B and C V Ireland

In December 2009 the European Court of Human Rights (ECtHR) heard a case brought by three women in respect of the alleged breach of their rights under the European Convention for the Protection of Human Rights and Fundamental Freedoms (the Convention) in regard to abortion in Ireland (the A, B and C v Ireland case).   Click here to download PDF 929kb

Interim Report of the Steering Group on the Review of the Mental Health Act 2001

Interim Report of the Steering Group on the Review of the Mental Health Act 2001 There is a commitment in the Programme for Government to review the Mental Health Act 2001. In line with this, Minister Lynch appointed a Steering Group to review the Mental Health Act 2001. Their report is now with an Expert Group. The review takes accounts of the significant changes in thinking about the delivery of mental health services that have taken place in the last ten years (including the introduction of the UN Convention on the Rights of People with Disabilities (CRPD), the shift to community based services, the adoption of a recovery approach in every aspect of service delivery and the involvement of service users as partners in their own care and in the development of the service). Click here to download PDF 471kb

Annual Output Statement 2012 For Health Group of Votes - 38 and 39

The overall aim of this Vote Group is to provide health and personal social services to improve the health and well being of the people of Ireland in a manner that promotes better health for everyone, fair access, responsive and appropriate care delivery and high performance. The money voted goes to the Department of Health (Vote 38), and the Health Service Executive (Vote 39). The Department of Health has responsibility for the overall organisational, legislative, policy and financial accountability framework for the health sector. The Health Service Executive is responsible for the management and delivery of health and personal social services within available resources. Click here to download

Report of the Pandemic Review Group

Report of the Pandemic Review Group This Report gives an overview of the response to Pandemic (H1N1) 2009 and will inform Pandemic Planning into the future. Click here to download PDF 262KB

Value for Money & Policy Review: Allocation & Utilisation of Funding in Acute Services in the Southern Hospitals Group in 2006 - Final ReportRelated Documents

This report is a Value for Money (VFM) evaluation, conducted by the National Hospitals Office (NHO) of the Health Service Executive (HSE) on the allocation and utilisation of funding for expenditure in the Southern Hospitals Group (SHG) in 2006. The SHG consists of nine hospitals in the HSE South region. The 2006 expenditure for the SHG covered by the evaluation was 590.1 million. Performance trends were studied over the period 2004 to 2006. Download document here Value for Money & Policy Review of Allocation & Utilisation of Funding in Acute Services in the Southern Hospitals Group (in 2006) – Department of Health and Children Response & Implementation Plan

Review of the Recommendations of Protecting Our Future: Report of the Working Group on Elder Abuse

Protecting Our Future: Report of the Working Group on Elder Abuse (DOHC, 2002) was a seminal document setting out a framework and programme of work in relation to elder abuse. Prior to Protecting Our Future, the issue of elder abuse had not been explicitly articulated as a priority of health and social policy. The report included recommendations in 13 wide-ranging areas: the link to wider policy; policy on elder abuse; staff structure; legislation; impaired capacity; carers; awareness, education and training; financial abuse; advocacy; implementation; research and education; reporting abuse. It also recommended that progress in implementing Protecting Our Future should be reviewed. Download document here Download Action Plan here

Trypanosoma cruzi: genetic group with peculiar biochemical and biological behavior

Thirty-two Trypanosoma cruzi strains, isolated from chronic chagasic patients in the northwest of the state of Paraná (Brazil), were analyzed using molecular, biochemical and biological characteristics. Genotypic analysis using randomly amplified polymorphic DNA and simple sequence repeat-anchored polymerase chain reaction amplified profiles showed a large, genetically well-correlated group that contained the majority of the strains and a divergent group that included the PR-150 strain. For glycoconjugate composition, the PR-150 strain was different from the other strains considering the absence or presence of specific bands in aqueous or detergent phases. This strain was also totally different from the others in one out of the six parameters related to in vitro and in vivo biological behavior. We highlight the fact that the PR-150 was totally resistant to benznidazole. For the other biological parameters this strain was not totally distinct from the others, but it showed a peculiar behavior.

Report of the Review Group on the National Children's Hospital

The Review Group, led by Chairman Dr Frank Dolphin was appointed in March 2012 to advise the Minister for Health on the options for a new childrenâ?Ts hospital, following the refusal by An Bord Pleanála to give planning permission for the proposed National Childrenâ?Ts Hospital at a site on Eccles Street. Read the Report (PDF, 4MB) Read the Appendices Document (PDF, 11MB)

Mid Ulster Locality Group

To improve the pharmaceutical care in the community for older people and their carers working towards giving carers support and raising their awareness of the support which is on offer to them.

Rasharkin Women's Group

This is a Level 3 project. The partnership have worked together for over 6 years through BCPP projects. They have worked on a number of issues and with a range of groups including young people, older people and more recently carers and farmers. This Level 3 project seeks to build skills and capacity in the area and bring different elements off the project together. For example, advance work with farmers and combine target groups through a range of events. The project focuses on a capacity building programme. At the end of the first year, each group will identify key health issues that they would like to address over years 2 & 3.

Respiratory syncytial virus infections during an epidemic period in Salvador, Brazil: viral antigenic group analysis and description of clinical and epidemiological aspects

Acute respiratory infections (ARI) caused by respiratory syncytial virus (RSV) were studied in 482 children from Salvador, BA, Brazil, over a period of 12 months. The epidemic period of RSV infections in Salvador occurred from February (summer) to August (winter), with peaks in May, June, and July. The grouping characteristics of 84 RSV present in nasopharyngeal secretions of children seen at a reference university hospital were analyzed. RSV represented 17.4% of all cases and 54.5% of the positive samples. Sixty-four RSV strains were assigned to group A and 14 to group B. Both groups circulated in the five months of the epidemic period studied. Infections by both groups of RSV were more frequent in children up to one year of age. The incidence of RSV ARI was slightly more frequent in males, although group B had more infected females.

Portglenone Enterprise Group (PEG)

PEG and the pharmacist have been working through BCPP projects for a few years and have worked with a range of groups (young and older people) on a range of health issues. This project seeks to continue to build on this work. The lay health worker will be present in the pharmacy and more emphasis will be placed on co-delivery with young people and in schools. Relationships with young vulnerable and isolated teenagers are developing and the pharmacist will continue to engage with them to identify and work to tackle health issues they are facing.