Psychodynamic Research
Empirical evidence for basic assumptions of psychodynamic developmental approaches
A developmental perspective has been central in psychoanalytic approaches from their inception. Psychodynamic developmental psychopathology approaches share a number of key assumptions in this regard about the role of developmental processes in both normal and disrupted psychological development. These have been the focus of considerable research efforts over the past decades (Fonagy et al., 2006; Knight, 2022; Luyten et al., in press; Warshaw, 2023).
The importance of early developmental experiences. One of the major assumptions of psychodynamic approaches is that early developmental experiences, in interaction with biological and environmental factors, play an important role in predicting both normal and disrupted psychological development throughout the life span (Fonagy et al., 2006; Luyten et al., in press). Psychoanalytic approaches particularly emphasize the role of the early caregiving environment as an important factor in determining both typical and atypical development.
Three major sets of findings have emerged in this context. The first set of findings has largely confirmed the emphasis in psychodynamic approaches on the importance of early experiences. Developmental research has amply demonstrated the major role of early adversity plays in both physical and mental health across the life span (Hogg et al., 2023; Madigan et al., 2023; McCrory et al., 2012; McCrory et al., 2022; Pollak, 2015; Smith & Pollak, 2021a, 2021b). For instance, population-attributable fractions of early adversity (the degree to which psychopathological outcomes could be reduced if early adversity were prevented) typically range from 20% to 50% (Dragioti et al., 2022). A second set of findings, again consistent with psychoanalytic assumptions concerning psychological development, concerns the enduring influence of the quality of interpersonal relationships (e.g., maternal sensitivity, the quality of attachment relationships with early caregivers) on both psychosocial and physical health across the life span, as demonstrated by research in humans and non-human animals (Fraley, 2019; Kunkel et al., 2022; Raby et al., 2015; Raby et al., 2019), and the intergenerational transmission of attachment and mentalizing or reflective functioning in particular (Verhage et al., 2018; Verhage et al., 2016; Zeegers et al., 2017).
Finally, notwithstanding the above-mentioned findings, early psychoanalytic developmental theories were often overspecified in that they overvalued the role of specific factors (e.g., experiences of separation or loss) in predicting developmental outcomes. As a result, they underestimated the complex interplay of developmental factors in psychological development. In this regard it is also important to note that the ubiquitous nature of psychological resilience (Bonanno & Diminich, 2013; Denckla et al., 2020; Masten et al., 2021), and thus the human potential for plasticity and change, has been underestimated by early psychoanalytic developmental theories (Hauser et al., 2006; Luyten et al., in press; Varvin, 2021). The predictive effects of many developmental factors are therefore smaller than expected based on early developmental theories, including early psychodynamic developmental theories. For instance, meta-analyses suggest that the association between insecure attachment and the development of psychopathology across the life span, on average, represent only small to moderate effect sizes (Fearon et al., 2010; Groh et al., 2012). Similarly, meta-analyses suggest that the stability of attachment from childhood to adulthood is lower than expected by early theories (with r’s around r=.30 - .40) (Fraley & Brumbaugh, 2004; Opie et al., 2021; Pinquart et al., 2013). Furthermore, the substantially greater impact of attachment on development in adolescence and adulthood, and its remarkably greater stability from adolesence onwards (with r’s ranging from r=.50 to r=.70) (Fraley & Brumbaugh, 2004; Jones et al., 2018), is probably largely due to genetic factors and the stability of the environment in which most humans grow up (Fearon et al., 2014; Fraley & Roberts, 2005), rather than reflecting stable personality features that are relatively impervious to environmental influences. As discussed further below, this has led to an increasing consensus that attachment, and personality more generally, is best seen as an adaptation strategy to a given environment (Simpson & Belsky, 2016). More contemporary psychodynamic developmental approaches have incorporated these findings, with important implications for intervention and prevention.
The role of biological factors. Contrary to popular belief, from the earliest formulations to present, most psychodynamic approaches have a strong emphasis on the role of neurobiological factors, including genetics, and interactions between developmental experiences and neurobiological development, in explaining psychological development (Fonagy et al., 2006; Luyten et al., in press; McWilliams, 2011). Consistent with these assumptions, there is increasing evidence from both studies in humans and non-human animals for the role of the early caregiving environment in the development of key neural systems, such as those involved in stress regulation, reward, social cognition and cognitive development (Caspi et al., 2014; Fehlbaum et al., 2021; Feldman, 2015, 2017; Frith & Frith, 2021). Similary, considerable heritability has been found for many psychological disorders and personality traits (Giangrande et al., 2022). Findings for the role of gene–environment correlations, interactions, and epigenetics have been more difficult to replicate and their precize role in psychological development remains unclear (Bleys et al., 2018; Golds et al., 2020; Leighton et al., 2017; Martins et al., 2022; Picardi et al., 2020; Smeeth et al., 2021).
Latent vulnerability, deferred action and the enduring legacy of early experiences. It is a central tenet of psychodynamic developmental theories that psychological development involves a continuous need to adapt to ever changing circumstances (Fonagy et al., 2006; Gilmore & Meersand, 2013; Luyten et al., in press). On the one hand, there is the inevitable confrontation with adversity throughout the life cycle (e.g., experiences of loss, aging, death). On the other hand, different developmental phases (such as the transition to adulthood or old age) bring different challenges (e.g., the transition to adolescence is associated with increased expectations with regard to achievement and romantic relationships).
Psychodynamic developmental approaches assume in this context that (a) individuals differ in the extent to which they are able to successfully adapt and negotiate these challenges and that latent and hitherto “invisible” vulnerabilities reflecting problems with negotiating certain developmental tasks, may be reactivated later in life by new challenges (e.g., relationship difficulties, loss of a spouse), which might also negatively influence the negotiation of later developmental challenges, and (b) new life challenges my render problematic what in the past had not been problematic, referred to as “deferred action” (i.e., that prior events take on a new meaning depending on later experiences).
Overall, research has supported these assumptions. Erik Erikson (1950) was among the first psychodynamic developmental theorists who proposed a life span perspective on psychosocial development, outlining 8 different stages across the life span, each involving different psychosocial challenges. These theoretical views played a seminal role in the development of comprehensive theoretical and empirical approaches concerning the interplay between psychological and cultural factors across the life cycle, which continues to inspire developmental research, particulary in the area of identity development (Branje et al., 2021) and personality (Sharp & Wall, 2021). Anna Freud (1981) was another important pioneer in this regard by emphasizing the importance of simultaneously considering different developmental lines and their interactions over time (e.g, the developmental line from complete dependency on caregivers to the capacity to develop and maintain adult object relationships). Her views continue to influence the field of developmental psychopathology. For instance, the notions of equifinality and multifinality, which are central guiding principles in developmental psychopathology research, first coined by Dante Cicchetti and Fred Rogosch’s (1996) in a ground-breaking paper in the mid-1990s, can be traced directly to Anna Freud’s work. The principle of equifinality refers in this context to how a single developmental outcome may be influenced by multiple risk or protective factors, while multifinality implies that one particular risk or protective factor may result in multiple outcomes.
There is now also considerable evidence that different developmental phases, such as the transition to middle childhood, adolescence, adulthood and late life, not only involve major psychosocial challenges, but also involve the need for a major reorganization of psychological capacities (Knight, 2022; Warshaw, 2023). Particularly in those who have grown up in a context of (early) adversity, impairments in the capacity for psychological reorganization have been associated with increased vulnerability for maladaptation (Borelli et al., 2019; Ensink et al., 2016; Luyten et al., 2020; Lyons-Ruth & Brumariu, 2021; Roisman et al., 2002; Swerbenski et al., 2023). There is also good evidence to suggest that the psychosocial reorganization that is typical of major developmental transitions influences and is influenced by important changes in the structural and/or functional organization of the brain (Lupien et al., 2009; Sisk & Gee, 2022). Most research from a psychoanalytic perspective in this context has focused on the transition to adolescence and young adulthood (Luyckx et al., in press), parenthood (Rutherford & Mayes, 2018; von Mohr et al., 2017), and old age (Van Assche et al., 2013), with a strong interdisciplinary and multidisciplinary focus aimed at unravelling the interplay between biological and psychosocial factors.
The assumption that latent vulnerabilities may be reactivated by later experiences has also received broad support. Findings in this regard, consistent with psychoanalytic assumptions, again stress the role of early adversity and attachment trauma in particular in predicting maladaptation in interaction with adverse experiences later in life (Lupien et al., 2009; McCrory & Viding, 2015; Stanton et al., 2020; Van Assche et al., 2020).
These latter findings can be seen as a particular case demonstrating, as reviewed above, how early experiences, and early attachment experiences in particular, give rise to internal mental representations or internal working models of self and others that serve as templates to organize later experiences that continue to influence psychosocial development thorughout the life span, for better or worse. Consistent with these assumptions, evidence suggests that internal working models of self and others, despite being malleable to change over time, contain a prototypic set of expectations regarding the self and others that are formed early in life and that are relatively resistant to change (Fraley, 2019; Fraley et al., 2011).
Personality and psychopathology as attempts at adaptation. Psychoanalytic approaches assume that psychological development involves an ongoing series of attempts by the individual to find a balance between biological endowment and developmental experiences (Blatt, 2008; Luyten & Fonagy, 2022; McWilliams, 2011). From this perspective, personality and psychopathology are thus seen as developmentally determined adaptation strategies or conflict-defense constellations, rather than stable intrapsychic personality traits and discrete disorders, respectively. Empirical research is consistent with these assmuptions. For instance, empirical evidence is most consistent with the view that attachment styles reflect adaptations to a particular environment (Ein-Dor et al., 2010; Ellis et al., 2011; Mikulincer & Shaver, 2017). For example, fearful-avoidant attachment appears to represent a response to the (perceived) unavailability of attachment figures early in life in that these individuals have learned not to rely on others; and have developed the belief that they have to be able cope with adversity on their own. These individuals show a tendency to deny distress, but both priming and physiological studies suggest that this is a defensive strategy to ward off underlying feelings of distress, insecurity, and inferiority (Mikulincer & Shaver, 2017). Perfectionism, a personality feature that has been implicated in both resilience and vulnerablity to psychopathology, similarly seems to reflect an adaptation strategy to a caregiving environment characterized by a an emphasis on achievement (Luyten, 2017). Likewise, research findings suggest that most types of psychopathology can also be conceptualized as attempts to find a balance, however distorted, between biological endownment and psychosocial challenges (Luyten & Fonagy, 2022). For instance, patients with narcissistic personality disorder features present with high self-esteem, but this reflects a defensive compensation strategy to deal with underlying feelings of inferiority and emptiness (Kampe et al., 2021; Russ et al., 2008).
The importance of the internal world. Psychodynamic developmental approaches have a two-fold focus on the developing internal world or mind of the child. On the one hand, they stress the influence of both biological factors and developmental experiences on the development of the content of mental representations or internal working models of self and others. On the other hand, they also focus on the importance of the development of the capacity to reflect on subjective internal mental states which constitutes the mental process focus in psychoanalytic developmental approaches (Fonagy et al., 1993).
A wide variety of methods to assess the content of representations of self and others (also referred to as internal working models of self and others, cognitive affective schemas with regard to self and others, and object relations) have been developed and empirically validated over the past decades (Huprich et al., 2016; Verhage et al., 2016). This has also resulted in considerable dialogue and overlap with both social psychology and cognitive-behavioral approaches, as is for instance shown in the influence of psychodynamic approaches on mainstream attachment approaches. Similarly, these formulations have played a key role in the development of schema therapy, a cognitive-behavioral approach to the conceptualization and treatment of personality disorders that is to a large extent rooted in psychoanalytic object relations theory. Research in this context has shown significant differences between non-clinical and clinical participants in the content of mental representations, and prospective relationships between impairments in mental representations as well as therapeutic change (Fraley, 2019; Huprich et al., 2016; Mikulincer & Shaver, 2017).
A focus on the content of mental representations has also given rise to a research tradition distinguishing between different levels of personality functioning (i.e., neurotic, borderline, and psychotic), largely influenced by the theoretical formulations of Otto Kernberg and Nancy McWilliams (Kernberg & Caligor, 2005; McWilliams, 2011). This approach has provided a developmentally-informed and increasingly empirically validated approach that complements more descriptive, multivariate models of personality and personality pathology (Cierpka et al., 2007; Lingiardi & McWilliams, 2017; Zettl et al., 2020).
Psychodynamic process-oriented approaches, in turn, have demonstrated the role of the capacity for parental mentalizing or parental reflective functioning, and specifically caregivers’ ability to reflect on their own adverse experiences, as a protective factor in child development (Berthelot et al., 2022; Borelli et al., 2019; Ensink, Begin, Normandin, & Fonagy, 2017; Luyten et al., 2017; Meins et al., 2013; Sharp & Fonagy, 2008; Slade, 2005; Slade et al., 2023; Zeegers et al., 2017). Mentalizing, or reflective functioning, refers to the human capacity to understand the self and others in terms of intentional mental states such as feelings, desires, wishes, attitudes, and goals. Parental mentalizing entails the capacity of parents to reflect on their child’s mind and the impact of their own attachment history on their capacity to be a parent. Studies suggest that the capacity for parental reflective functioning fosters the development of a broad array of socio-emotional capacities in children, including the child’s own capacity for mentalizing, emotion regulation, and attachment (Luyten et al., 2020; Luyten et al., 2017; Slade, 2023), particularly in the context of early adversity (Ensink, Begin, Normandin, Godbout, et al., 2017).
The following questions are open to further research
Despite the considerable advances in the scientific testing of psychodynamic developmental theories, more research is needed in the following areas:
The legacy of early experiences: consensus and controversy
Although there is increasing consensus that early experiences have an enduring influence on psychosocial development throughout life, psychosocial development is determined by a complex interplay of biological, social and psychological factors. Hence, it has been notably difficult to predict psychological development, as most associations between developmental factors and later outcomes are typically small to modest (Fearon et al., 2010; Groh et al., 2012; Luyten et al., 2021; Zeegers et al., 2017). More research is therefore needed to unravel the complexity of developmental pathways. These studies are particularly important with regard to the role of early prevention and intervention. For instance, more research is needed to distinguish the normal upheaval and distress associated with adolescence and signs of emerging psychopathology (Fonagy et al., 2015; Hutsebaut et al., 2020). In this context, it is also not clear whether early prevention and intervention should primarily focus on presumed specific vulnerability factors or on broader transdiagnostic factors involved in equifinality and multifinality in psychological development (Leichsenring et al., 2022; Norton & Paulus, 2016; Weisz et al., 2019).
Untested theories and assumptions
A number of theories and concepts within psychodynamic developmental approaches need further empirical investigation. For instance, many psychodynamic approaches to psychological development stress the importance of oedipal issues (broadly defined as problems related to the identification with primary caregivers, which are assumed to influence both the development of a sense of identity and the capacity to develop and maintain interpersonal relationships, and romantic relationships in particular). Although there is a substantial body of research that supports some assumptions of formulations concerning the role of oedipal dynamics (e.g., concerning the role of primary caregivers in the development of internal working models of self and others and their influence on romantic relationships) (Biton-Bereby et al., 2020), high quality research testing other key predictions that can be derived from formulations concerning oedipal dynamics is largely lacking. Similarly, although much research on self-esteem and dynamics related to both adaptive and maladaptive narcissism has been inspired by Kohut’s self psychology, with some notable exceptions (Banai et al., 2005; Reininger et al., in press), more research testing self psychology’s key assumptions is needed.
Psychodynamic developmental psychopathology and our changing world
There is an urgent need for more research concerning psychodynamic views of psychological development related to the major sociocultural changes that have taken place over the past few decades. These include changing views on gender and sexuality, the hyperconnected world in which we live and its potential impact on psychological development, and the threat of war, pandemics, and climate change. Psychodynamic developmental theories are often still characterized by a heteronormative bias and are largely based on studies in so-called individuals in “WEIRD” (Western, Educated, Industrialized, Rich, and Democratic) countries, who constitute only slightly more than 10% of the global population (Henrich, 2020). This is a more general problem which the field of developmental psychology is increasingly addressing. For example, less than 10% of studies investigating gene–environment interactions in psychological development are based on non-Western samples (Leighton et al., 2017).
In the past few years, an increasing number of studies from a psychodynamic developmental perspective have emerged in this area (Campbell et al., 2021; Locati et al., 2023; Shahar & Henrich, 2019; Tanzilli et al., 2022), yet more research is needed.
Effectiveness of psychodynamic interventions
The evidence base for psychodynamic interventions for young people and their caregivers has dramatically increased in the past decades (Abbass et al., 2013; Barlow et al., 2021; Midgley et al., 2017; Midgley et al., 2021). Yet, much work remains to be done in this area. There is a particular need for high quality research of longer-term psychodynamic interventions for young people and their caregivers, given the paucity of empirically-supported treatments in this area (Weisz et al., 2017).
References
Abbass, A. A., Rabung, S., Leichsenring, F., Refseth, J. S., & Midgley, N. (2013). Psychodynamic psychotherapy for children and adolescents: a meta-analysis of short-term psychodynamic models. Journal of the American Academy of Child and Adolescent Psychiatry, 52(8), 863-875. https://doi.org/10.1016/j.jaac.2013.05.014
Banai, E., Mikulincer, M., & Shaver, P. R. (2005). "Selfobject" Needs in Kohut's Self Psychology: Links With Attachment, Self-Cohesion, Affect Regulation, and Adjustment. Psychoanalytic Psychology, 22(2), 224-260.
Barlow, J., Sleed, M., & Midgley, N. (2021). Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta-analysis [https://doi.org/10.1002/imhj.21896]. Infant Mental Health Journal, 42(1), 21-34. https://doi.org/https://doi.org/10.1002/imhj.21896
Berthelot, N., Savard, C., Lemieux, R., Garon-Bissonnette, J., Ensink, K., & Godbout, N. (2022). Development and validation of a self-report measure assessing failures in the mentalization of trauma and adverse relationships. Child Abuse and Neglect, 128, 105017. https://doi.org/10.1016/j.chiabu.2021.105017
Biton-Bereby, L., Mikulincer, M., & Shaver, P. R. (2020). Attachment and the Oedipus complex: Attachment orientations moderate the effects of priming Oedipal representations on the construal of romantic relationships. Psychoanalytic Psychology, 37(4), 324-334. https://doi.org/10.1037/pap0000290
Blatt, S. J. (2008). Polarities of experience: Relatedness and self definition in personality development, psychopathology, and the therapeutic process. American Psychological Association.
Bonanno, G. A., & Diminich, E. D. (2013). Annual Research Review: Positive adjustment to adversity—trajectories of minimal-impact resilience and emergent resilience. Journal of Child Psychology and Psychiatry, 54(4), 378-401. https://doi.org/10.1111/jcpp.12021
Borelli, J. L., Cohen, C., Pettit, C., Normandin, L., Target, M., Fonagy, P., & Ensink, K. (2019). Maternal and child sexual abuse history: An intergenerational exploration of children's adjustment and maternal trauma-reflective functioning. Front Psychol, 10, 1062. https://doi.org/10.3389/fpsyg.2019.01062
Branje, S., de Moor, E. L., Spitzer, J., & Becht, A. I. (2021). Dynamics of Identity Development in Adolescence: A Decade in Review. J Res Adolesc, 31(4), 908-927. https://doi.org/10.1111/jora.12678
Campbell, C., Tanzer, M., Saunders, R., Booker, T., Allison, E., Li, E., O'Dowda, C., Luyten, P., & Fonagy, P. (2021). Development and validation of a self-report measure of epistemic trust. PLoS ONE, 16(4), e0250264. https://doi.org/10.1371/journal.pone.0250264
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, M. H., Ramrakha, S., Shalev, I., Poulton, R., & Moffitt, T. E. (2014). The p factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2(2), 119-137. https://doi.org/10.1177/2167702613497473
Cicchetti, D., & Rogosch, F. A. (1996). Equifinality and multifinality in developmental psychopathology. Development and Psychopathology, 8, 597-600.
Cierpka, M., Grande, T., Rudolf, G., von der Tann, M., & Stasch, M. (2007). The Operationalized Psychodynamic Diagnostics System: Clinical relevance, reliability and validity. Psychopathology, 40(4), 209-220. http://www.karger.com/DOI/10.1159/000101363
Denckla, C. A., Cicchetti, D., Kubzansky, L. D., Seedat, S., Teicher, M. H., Williams, D. R., & Koenen, K. C. (2020). Psychological resilience: An update on definitions, a critical appraisal, and research recommendations. Eur J Psychotraumatol, 11(1), 1822064. https://doi.org/10.1080/20008198.2020.1822064
Ein-Dor, T., Mikulincer, M., Doron, G., & Shaver, P. R. (2010). The attachment paradox: How can so many of us (the insecure ones) have no adaptive advantages? Perspectives on Psychological Science, 5(2), 123-141. https://doi.org/10.1177/1745691610362349
Ellis, B. J., Boyce, W. T., Belsky, J., Bakermans-Kranenburg, M. J., & van Ijzendoorn, M. H. (2011). Differential susceptibility to the environment: An evolutionary–neurodevelopmental theory. Development and Psychopathology, 23(1), 7-28. https://doi.org/10.1017/S0954579410000611
Ensink, K., Begin, M., Normandin, L., & Fonagy, P. (2017). Parental reflective functioning as a moderator of child internalizing difficulties in the context of child sexual abuse. Psychiatry Research, 257, 361-366. https://doi.org/10.1016/j.psychres.2017.07.051
Ensink, K., Begin, M., Normandin, L., Godbout, N., & Fonagy, P. (2017). Mentalization and dissociation in the context of trauma: Implications for child psychopathology. Journal of Trauma & Dissociation, 18(1), 11-30. https://doi.org/10.1080/15299732.2016.1172536
Ensink, K., Normandin, L., Plamondon, A., Berthelot, N., & Fonagy, P. (2016). Intergenerational pathways from reflective functioning to infant attachment through parenting. Canadian Journal of Behavioural Science, 48(1), 9-18. https://doi.org/10.1037/cbs0000030
Erikson, E. H. (1950). Childhood and Society. Norton.
Fearon, P., Shmueli-Goetz, Y., Viding, E., Fonagy, P., & Plomin, R. (2014). Genetic and environmental influences on adolescent attachment. Journal of Child Psychology and Psychiatry, 55(9), 1033-1041. https://doi.org/10.1111/jcpp.12171
Fearon, R. P., Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., Lapsley, A. M., & Roisman, G. I. (2010). The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study. Child Development, 81(2), 435-456. https://doi.org/10.1111/j.1467-8624.2009.01405.x
Fehlbaum, L. V., Borbás, R., Paul, K., Eickhoff, S. B., & Raschle, N. M. (2021). Early and late neural correlates of mentalizing: ALE meta-analyses in adults, children and adolescents. Social Cognitive and Affective Neuroscience, 17(4), 351-366. https://doi.org/10.1093/scan/nsab105
Feldman, R. (2015). The adaptive human parental brain: implications for children's social development. Trends in Neurosciences, 38(6), 387-399. https://doi.org/10.1016/j.tins.2015.04.004
Feldman, R. (2017). The neurobiology of human attachments. Trends Cogn Sci, 21(2), 80-99. https://doi.org/10.1016/j.tics.2016.11.007
Fonagy, P., Edgcumbe, R., Moran, G. S., Kennedy, H., & Target, M. (1993). The roles of mental representations and mental processes in therapeutic action. The Psychoanalytic Study of the Child, 48, 9-48.
Fonagy, P., Speranza, M., Luyten, P., Kaess, M., Hessels, C., & Bohus, M. (2015). ESCAP Expert Article: borderline personality disorder in adolescence: an expert research review with implications for clinical practice. European Child & Adolescent Psychiatry, 24(11), 1307-1320. https://doi.org/10.1007/s00787-015-0751-z
Fonagy, P., Target, M., & Gergely, G. (2006). Psychoanalytic perspectives on developmental psychopathology. In D. Cicchetti & D. J. Cohen (Eds.), Developmental Psychopathology (2nd ed., Vol. 1, pp. 701-749). John Wiley & Sons.
Fraley, R. C. (2019). Attachment in adulthood: Recent developments, emerging debates, and future directions. Annual Review of Psychology, 70(1), 401-422. https://doi.org/10.1146/annurev-psych-010418-102813
Fraley, R. C., & Brumbaugh, C. C. (2004). A dynamical systems approach to conceptualizing and studying stability and change in attachment security. In W. S. Rholes & J. A. Simpson (Eds.), Adult attachment: Theory, research, and clinical implications (pp. 86-132). Guilford Press.
Fraley, R. C., & Roberts, B. W. (2005). Patterns of continuity: A dynamic model for conceptualizing the stability of individual differences in psychological constructs across the life course. Psychological Review, 112(1), 60-74. https://doi.org/10.1037/0033-295X.112.1.60
Fraley, R. C., Vicary, A. M., Brumbaugh, C. C., & Roisman, G. I. (2011). Patterns of stability in adult attachment: an empirical test of two models of continuity and change. Journal of Personality and Social Psychology, 101(5), 974-992. https://doi.org/10.1037/a0024150
Freud, A. (1981). The concept of developmental lines: Their diagnostic significance. Psychoanalytic Study of the Child, 36, 129-136. https://doi.org/10.1080/00797308.1981.11823333
Frith, C. D., & Frith, U. (2021). Mapping Mentalising in the Brain. In M. Gilead & K. N. Ochsner (Eds.), The Neural Basis of Mentalizing (pp. 17-45). Springer International Publishing. https://doi.org/10.1007/978-3-030-51890-5_2
Giangrande, E. J., Weber, R. S., & Turkheimer, E. (2022). What Do We Know About the Genetic Architecture of Psychopathology? Annual Review of Clinical Psychology, 18(1), 19-42. https://doi.org/10.1146/annurev-clinpsy-081219-091234
Gilmore, K. J., & Meersand, P. (2013). Normal child and adolescent development: A psychodynamic primer. American Psychiatric Association.
Groh, A. M., Roisman, G. I., van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., & Fearon, R. P. (2012). The significance of insecure and disorganized attachment for children's internalizing symptoms: A meta-analytic study. Child Development, 83(2), 591-610. https://doi.org/10.1111/j.1467-8624.2011.01711.x
Hauser, S., Allen, J., & Golden, E. (2006). Out of the woods. Tales of resilient teens. Harvard University Press.
Henrich, J. (2020). The WEIRDest people in the world: How the West became psychologically peculiar and particularly prosperous. Farrar, Straus and Giroux.
Hogg, B., Gardoki-Souto, I., Valiente-Gómez, A., Rosa, A. R., Fortea, L., Radua, J., Amann, B. L., & Moreno-Alcázar, A. (2023). Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta-analysis. European Archives of Psychiatry and Clinical Neuroscience, 273(2), 397-410. https://doi.org/10.1007/s00406-022-01495-5
Huprich, S. K., Auerbach, J. S., Porcerelli, J. H., & Bupp, L. L. (2016). Sidney Blatt's Object Relations Inventory: Contributions and Future Directions. Journal of Personality Assessment, 98(1), 30-43. https://doi.org/10.1080/00223891.2015.1099539
Hutsebaut, J., Debbané, M., & Sharp, C. (2020). Designing a range of mentalizing interventions for young people using a clinical staging approach to borderline pathology. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 6. https://doi.org/10.1186/s40479-020-0121-4
Jones, J. D., Fraley, R. C., Ehrlich, K. B., Stern, J. A., Lejuez, C. W., Shaver, P. R., & Cassidy, J. (2018). Stability of attachment style in adolescence: An empirical test of alternative developmental processes. Child Development, 89(3), 871-880. https://doi.org/10.1111/cdev.12775
Kampe, L., Bohn, J., Remmers, C., & Hörz-Sagstetter, S. (2021). It's Not That Great Anymore: The Central Role of Defense Mechanisms in Grandiose and Vulnerable Narcissism [Original Research]. Front Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.661948
Kernberg, O. F., & Caligor, E. (2005). A psychoanalytic theory of personality disorders. In M. F. Lenzenweger & J. F. Clarkin (Eds.), Major theories of personality disorder (2nd ed. ed., pp. 114-156). The Guilford Press.
Knight, R. (2022). Reconsidering Development in Psychoanalysis. The Psychoanalytic Study of the Child, 75(1), 215-232. https://doi.org/10.1080/00797308.2021.1996123
Kunkel, J. J., Magro, S. W., Bleil, M. E., Booth-LaForce, C., Vandell, D. L., Fraley, R. C., & Roisman, G. I. (2022). Early maternal sensitivity and markers of physical health: Enduring or transient associations from childhood to adulthood? [doi:10.1037/dev0001430].
Leichsenring, F., Steinert, C., Rabung, S., & Ioannidis, J. P. A. (2022). The efficacy of psychotherapies and pharmacotherapies for mental disorders in adults: an umbrella review and meta-analytic evaluation of recent meta-analyses. World Psychiatry, 21(1), 133-145. https://doi.org/10.1002/wps.20941
Leighton, C., Botto, A., Silva, J. R., Jimenez, J. P., & Luyten, P. (2017). Vulnerability or sensitivity to the environment? Methodological issues, trends, and recommendations in gene-environment interactions research in human behavior [Review]. Front Psychiatry, 8(106), 106. https://doi.org/10.3389/fpsyt.2017.00106
Lingiardi, V., & McWilliams, N. (2017). Psychodynamic diagnostic manual: PDM-2. Guilford Press.
Locati, F., Milesi, A., Conte, F., Campbell, C., Fonagy, P., Ensink, K., & Parolin, L. (2023). Adolescence in lockdown: The protective role of mentalizing and epistemic trust. Journal of Clinical Psychology, 79(4), 969-984. https://doi.org/10.1002/jclp.23453
Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews. Neuroscience, 10(6), 434-445. https://doi.org/10.1038/nrn2639
Luyckx, K., Vanderhaegen, J., Raemen, L., & Claes, L. (in press). Identity formation in adolescence and emerging adulthood: a process-oriented and applied perspective. European Journal of Developmental Psychology. https://doi.org/10.1080/17405629.2023.2250128
Luyten, P. (2017). Personality, psychopathology, and health through the lens of interpersonal relatedness and self-definition. Journal of the American Psychoanalytic Association, 65(3), 473-489. https://doi.org/10.1177/0003065117712518
Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020). The mentalizing approach to psychopathology: State of the art and future directions. Annual Review of Clinical Psychology, 16, 297-325. https://doi.org/10.1146/annurev-clinpsy-071919-015355
Luyten, P., Campbell, C., & Fonagy, P. (2021). Rethinking the relationship between attachment and personality disorder. Current Opinion in Psychology, 37, 109-113. https://doi.org/10.1016/j.copsyc.2020.11.003
Luyten, P., & Fonagy, P. (2022). Integrating and differentiating personality and psychopathology: A psychodynamic perspective [https://doi.org/10.1111/jopy.12656]. Journal of Personality, 90(1), 75-88. https://doi.org/https://doi.org/10.1111/jopy.12656
Luyten, P., Malcorps, S., Mayes, L. C., Target, M., & Fonagy, P. (in press). Developmental research. In G. O. Gabbard, B. Litowitz, & P. Williams (Eds.), Textbook of psychoanalysis (3rd ed.). American Psychiatric Press.
Luyten, P., Nijssens, L., Fonagy, P., & Mayes, L. C. (2017). Parental reflective functioning: Theory, research, and clinical applications. Psychoanalytic Study of the Child, 70(1), 174-199. https://doi.org/10.1080/00797308.2016.1277901
Lyons-Ruth, K., & Brumariu, L. E. (2021). Emerging child competencies and personality pathology: toward a Developmental Cascade model of BPD. Current Opinion in Psychology, 37, 32-38. https://doi.org/10.1016/j.copsyc.2020.07.004
Madigan, S., Deneault, A. A., Racine, N., Park, J., Thiemann, R., Zhu, J., Dimitropoulos, G., Williamson, T., Fearon, P., Cénat, J. M., McDonald, S., Devereux, C., & Neville, R. D. (2023). Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry, 22(3), 463-471. https://doi.org/10.1002/wps.21122
Masten, A. S., Lucke, C. M., Nelson, K. M., & Stallworthy, I. C. (2021). Resilience in development and psychopathology: Multisystem perspectives. Annual Review of Clinical Psychology, 17(1), 521-549. https://doi.org/10.1146/annurev-clinpsy-081219-120307
McCrory, E., De Brito, S. A., & Viding, E. (2012). The link between child abuse and psychopathology: A review of neurobiological and genetic research [Research Support, Non-U.S. Gov't
Review]. Journal of the Royal Society of Medicine, 105(4), 151-156. https://doi.org/10.1258/jrsm.2011.110222
McCrory, E., Foulkes, L., & Viding, E. (2022). Social thinning and stress generation after childhood maltreatment: a neurocognitive social transactional model of psychiatric vulnerability. Lancet Psychiatry, 9(10), 828-837. https://doi.org/10.1016/s2215-0366(22)00202-4
McCrory, E. J., & Viding, E. (2015). The theory of latent vulnerability: Reconceptualizing the link between childhood maltreatment and psychiatric disorder. Development and Psychopathology, 27(2), 493-505. https://doi.org/10.1017/s0954579415000115
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press.
Meins, E., Centifanti, L. M., Fernyhough, C., & Fishburn, S. (2013). Maternal Mind-Mindedness and Children’s Behavioral Difficulties: Mitigating the Impact of Low Socioeconomic Status. Journal of Abnormal Child Psychology, 41(4), 543-553. https://doi.org/10.1007/s10802-012-9699-3
Midgley, N., O’Keeffe, S., French, L., & Kennedy, E. (2017). Psychodynamic psychotherapy for children and adolescents: an updated narrative review of the evidence base. Journal of Child Psychotherapy, 43(3), 307-329. https://doi.org/10.1080/0075417X.2017.1323945
Midgley, N., Sprecher, E. A., & Sleed, M. (2021). Mentalization-Based Interventions for Children Aged 6-12 and Their Carers: A Narrative Systematic Review. Journal of Infant, Child, and Adolescent Psychotherapy, 1-21. https://doi.org/10.1080/15289168.2021.1915654
Mikulincer, M., & Shaver, P. R. (2017). Attachment in adulthood: Structure, dynamics and change (2nd ed.). Guilford Press.
Norton, P. J., & Paulus, D. J. (2016). Toward a unified treatment for emotional disorders: Update on the science and practice. Behavior Therapy, 47(6), 854-868. https://doi.org/10.1016/j.beth.2015.07.002
Opie, J. E., McIntosh, J. E., Esler, T. B., Duschinsky, R., George, C., Schore, A., Kothe, E. J., Tan, E. S., Greenwood, C. J., & Olsson, C. A. (2021). Early childhood attachment stability and change: a meta-analysis. Attachment and Human Development, 23(6), 897-930. https://doi.org/10.1080/14616734.2020.1800769
Pinquart, M., Feußner, C., & Ahnert, L. (2013). Meta-analytic evidence for stability in attachments from infancy to early adulthood. Attachment and Human Development, 15(2), 189-218. https://doi.org/10.1080/14616734.2013.746257
Pollak, S. D. (2015). Developmental psychopathology: Recent advances and future challenges. World Psychiatry, 14(3), 262-269. https://doi.org/10.1002/wps.20237
Raby, K. L., Roisman, G. I., Fraley, R. C., & Simpson, J. A. (2015). The Enduring Predictive Significance of Early Maternal Sensitivity: Social and Academic Competence Through Age 32 Years. Child Development, 86(3), 695-708. https://doi.org/https://doi.org/10.1111/cdev.12325
Raby, K. L., Roisman, G. I., Labella, M. H., Martin, J., Fraley, R. C., & Simpson, J. A. (2019). The Legacy of Early Abuse and Neglect for Social and Academic Competence From Childhood to Adulthood. Child Development, 90(5), 1684-1701. https://doi.org/https://doi.org/10.1111/cdev.13033
Reininger, K. M., Biel, H. M., Hennig, T., Moritz, S., Briken, P., & Löwe, B. (in press). Testing Heinz Kohut’s thoughts on narcissism and narcissistic rage: narcissistic injury paves the way for radicalization and subclinical paranoid states – an experimental study. Psychoanalytic Psychotherapy. https://doi.org/10.1080/02668734.2023.2274450
Roisman, G. I., Padron, E., Sroufe, L. A., & Egeland, B. (2002). Earned secure attachment in retrospect and prospect. Child Development, 73, 1204-1219.
Russ, E., Shedler, J., Bradley, R., & Westen, D. (2008). Refining the construct of narcissistic personality disorder: Diagnostic criteria and subtypes. American Journal of Psychiatry, 165(11), 1473-1481. https://doi.org/10.1176/appi.ajp.2008.07030376
Rutherford, H. J., & Mayes, L. C. (2018). Minds shaped through relationships: The emerging neurobiology of parenting. In R. Emde & M. Leuzinger-Bohleber (Eds.), Early parenting and prevention of disorder (pp. 50-69). Routledge.
Shahar, G., & Henrich, C. C. (2019). Role of adolescent exposure to rockets in the links between personality vulnerability and psychopathology. Development and Psychopathology, 31(4), 1367-1380. https://doi.org/10.1017/s0954579418000792
Sharp, C., & Fonagy, P. (2008). The parent's capacity to treat the child as a psychological agent: Constructs, measures and implications for developmental psychopathology. Social Development, 17(3), 737-754. https://doi.org/10.1111/j.1467-9507.2007.00457.x
Sharp, C., & Wall, K. (2021). DSM-5 level of personality functioning: Refocusing personality disorder on what it means to be human. Annual Review of Clinical Psychology, 17(1), 313-337. https://doi.org/10.1146/annurev-clinpsy-081219-105402
Simpson, J. A., & Belsky, J. (2016). Attachment theory within a modern evolutionary framework. In J. Cassidy & P. R. Shaver (Eds.), Handbook of Attachment: Theory, Research and Clinical Applications (3rd ed., pp. 91-116). The Guilford Press.
Sisk, L. M., & Gee, D. G. (2022). Stress and adolescence: vulnerability and opportunity during a sensitive window of development. Curr Opin Psychol, 44, 286-292. https://doi.org/https://doi.org/10.1016/j.copsyc.2021.10.005
Slade, A. (2005). Parental reflective functioning: An introduction. Attachment and Human Development, 7(3), 269-281. https://doi.org/10.1080/14616730500245906
Slade, A. (2023). Enhancing Attachment and Reflective Parenting in Clinical Practice. A Minding the Baby Approach. The Guilford Press.
Slade, A., Sadler, L. S., Eaves, T., & Webb, D. L. (2023). Enhancing Attachment and Reflective Parenting in Clinical Practice: A Minding the Baby Approach. The Guilford Press. https://books.google.be/books?id=wOzAEAAAQBAJ
Smith, K. E., & Pollak, S. D. (2021a). Rethinking concepts and categories for understanding the neurodevelopmental effects of childhood adversity. Perspectives on Psychological Science, 16(1), 67-93. https://doi.org/10.1177/1745691620920725
Smith, K. E., & Pollak, S. D. (2021b). Social relationships and children's perceptions of adversity. Child Dev Perspect, 15(4), 228-234. https://doi.org/10.1111/cdep.12427
Stanton, K. J., Denietolis, B., Goodwin, B. J., & Dvir, Y. (2020). Childhood Trauma and Psychosis: An Updated Review. Child and Adolescent Psychiatric Clinics of North America, 29(1), 115-129. https://doi.org/10.1016/j.chc.2019.08.004
Swerbenski, H. G., Sturge-Apple, M. L., Messina, G., Toth, S. L., Rogosch, F., & Cicchetti, D. (2023). Maternal childhood maltreatment trauma resolution: Development of a novel narrative coding measure and implications for intergenerational parenting processes. Development and Psychopathology, 1-16. https://doi.org/10.1017/S0954579423001256
Tanzilli, A., Cibelli, A., Liotti, M., Fiorentino, F., Williams, R., & Lingiardi, V. (2022). Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model. International Journal of Environmental Research and Public Health, 19(21). https://doi.org/10.3390/ijerph192114290
Van Assche, L., Luyten, P., Bruffaerts, R., Persoons, P., van de Ven, L., & Vandenbulcke, M. (2013). Attachment in old age: Theoretical assumptions, empirical findings and implications for clinical practice. Clinical Psychology Review, 33(1), 67-81. https://doi.org/10.1016/j.cpr.2012.10.003
Van Assche, L., Van de Ven, L., Vandenbulcke, M., & Luyten, P. (2020). Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life. Aging and Mental Health, 24(6), 898-905. https://doi.org/10.1080/13607863.2019.1571017
Varvin, S. (2021). Psychoanalysis in Social and Cultural Settings: Upheavals and Resilience. Taylor & Francis. https://books.google.be/books?id=s9M7EAAAQBAJ
Verhage, M. L., Fearon, R. M. P., Schuengel, C., van, I. M. H., Bakermans-Kranenburg, M. J., Madigan, S., Roisman, G. I., Oosterman, M., Behrens, K. Y., Wong, M. S., Mangelsdorf, S., Priddis, L. E., Brisch, K. H., & Collaboration on Attachment Transmission Synthesis. (2018). Examining ecological constraints on the intergenerational transmission of attachment via individual participant data meta-analysis. Child Development, 89(6), 2023-2037. https://doi.org/10.1111/cdev.13085
Verhage, M. L., Schuengel, C., Madigan, S., Fearon, R. M., Oosterman, M., Cassibba, R., Bakermans-Kranenburg, M. J., & van, I. M. H. (2016). Narrowing the transmission gap: A synthesis of three decades of research on intergenerational transmission of attachment. Psychological Bulletin, 142(4), 337-366. https://doi.org/10.1037/bul0000038
von Mohr, M., Mayes, L. C., & Rutherford, H. J. V. (2017). The Transition to Motherhood: Psychoanalysis and Neuroscience Perspectives. The Psychoanalytic Study of the Child, 70(1), 154-173. https://doi.org/10.1080/00797308.2016.1277905
Warshaw, S. C. (2023). Middle Childhood and Beyond: Evolving Psychoanalytic Perspectives on Developmental Tasks and Clinical Work, Post Classical Theoretical Contributions, Neurobiology, and Our Changing Culture. Journal of Infant, Child, and Adolescent Psychotherapy, 22(2), 93-94. https://doi.org/10.1080/15289168.2023.2210047
Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., Jensen-Doss, A., Hawley, K. M., Krumholz Marchette, L. S., Chu, B. C., Weersing, V. R., & Fordwood, S. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice [Meta-Analysis]. American Psychologist, 72(2), 79-117. https://doi.org/10.1037/a0040360
Weisz, J. R., Kuppens, S., Ng, M. Y., Vaughn-Coaxum, R. A., Ugueto, A. M., Eckshtain, D., & Corteselli, K. A. (2019). Are psychotherapies for young people growing stronger? Tracking trends over time for youth anxiety, depression, attention-deficit/hyperactivity disorder, and conduct problems. Perspectives on Psychological Science, 14(2), 216-237. https://doi.org/10.1177/1745691618805436
Zeegers, M. A. J., Colonnesi, C., Stams, G. J. M., & Meins, E. (2017). Mind matters: A meta-analysis on parental mentalization and sensitivity as predictors of infant-parent attachment. Psychological Bulletin, 143(12), 1245-1272. https://doi.org/10.1037/bul0000114
Zettl, M., Volkert, J., Vögele, C., Herpertz, S. C., Kubera, K. M., & Taubner, S. (2020). Mentalization and criterion a of the alternative model for personality disorders: Results from a clinical and nonclinical sample. Personal Disord, 11(3), 191-201. https://doi.org/10.1037/per0000356