Parental behaviour as origin of maladaptive core beliefs and differences in brain functioning among normal young adults

Running head:

Parental behaviour as origin of maladaptive core beliefs and

differences in brain functioning among normal young adults

Master thesis, December 2009 Annemijn van der Veek, BA

Abstract

Maternal and paternal behaviour during childhood may influence a persons’ core beliefs and brain development. For this study we used 49 normal young adults (mean age 22.3 years) to test the association between their representations about mothers’ and fathers’ behaviour, conceptualized as in whether or not they met certain needs during participants’ childhood, and developed core beliefs, as well as alternations in grey matter density of brain areas.

The results showed that the representations about behaviour of mothers and fathers affected the young adults’ core beliefs. However, maternal behaviour affected in a wider way than the behaviour of fathers. Further, participants that reported more negatively on their mothers’ behaviour show alternate formations in gray matter volume of certain areas in the brain: anterior medial temporal, parahippocampal gyrus, cerebellum, PMA, occipital and frontal pole areas.

We concluded that negative parental behaviour, as in not meeting important emotional needs, can be viewed as the origin of certain maladaptive core beliefs, and have an influence on brain functioning. The affected areas are associated in integration and emotional semantic processing of information, as well as a past and future thinking. The results of this study give more information about the origins of pathology related to early parent-child relationships.

Introduction

1.1 Experiences with caregivers and the development of core beliefs

Early in life, children develop a bond with their caregiver. More specifically, through interactions with primary caregivers, children develop expectations about their caregivers’ availability, which serve as the basis for internal working models of the self and the other (Bretherton, 1985; Bowlby & Ainsworth, 1992; Cichetti & Toth, 1995).

The basis for theories about the influence of caregivers on peoples’ core beliefs, is set by attachment theorists and psychoanalysts, like John Bowlby. They have been drawn to the term ‘internal working models’ and were greatly concerned with the relationship between outer reality and individual’s inner world. Bowlby (1973) build his constitutions on Craik’s (1943) definition of internal working models, who describes as follows that:

‘Thought models, or parallels, reality… If the organism carries a ‘small-scale-model’ of external reality and of its own possible actions within its head, it is able to try out various alternatives, conclude which is the best of them, react to future situations before they arise, utilize the knowledge of past events in dealing with the present

future, and in every way to react in a fuller, safer and more competent manner to the emergencies which face it.’ (p.61)

Children’s image of reality about themselves arises from experiences that lead to the expectation that either they are loved and valued, and confident to seek out caregivers when distressed or in need, with the expectation that their needs will be met, or that they are unloved and rejected, expecting that caregivers will not be available when needed and develop insecure coping strategies for their distress (Bretherton, 1985; Bowlby & Ainsworth, 1992; Cichetti & Toth, 1995).

Emotions associated with meeting a child’s needs leads to positive self image and confidence in the ability to cope successfully with problems as they arise (Bretherton & Munholland, 1999). As a consequence, discovering and succeeding in what one can do plays a central role in the mental picture of reality about self-definition and self worth.

Alongside, primary caregivers can also use their bond with children to serve as models for emotion regulation, as in the ability to monitor, evaluate, and modify one’s emotional reactions in order to accomplish one’s goals. Emotion regulation requires the capacity to identify, to understand, and, when appropriate, temper one’s feelings (Thompson, 1994). It has been stated that this may contribute to empathy and moral development (Laible & Thompson, 2000).

It is not hard to imagine that research on childrens’ experiences with primary caregivers show that it is related to psychology and psychopathology in childhood and adolescence. For instance, research shows that experiences for instance that lead to insecure attachment between children and their caregiver, results more frequently in anxiety disorders (e.g., generalized anxiety disorder, separation anxiety disorder, social phobia) (Warren, Huston, Egeland, and Sroufe, 1997). In addition, studies have also linked an insecure attachment to internalizing problem behaviour during childhood and adolescence (Muris, Meesters and Van den Berg, 2003; Lafreniere et al., 2006; Allen et al., 1998). On the contrary, research among adults shows that when people had experiences that lead to secure attachment, they are better able to display effortful control and self differentiality, i.e. greater ability to take ‘I’ positions in relationships, than whether they had formed an insecure attachment with their caregiver (Laible & Thompson, 2000).

However, the relationship between a formed attachment and development is not straightforward. For example, when predicting externalizing symptoms, parental rearing behaviours only, but not the formed attachment, declare a significant proportion of the

variance. Further, it also appears that different relationships with maternal and paternal figures may produce differential outcomes both in childhood and in later interpersonal relationships (Carranza & Kilmann, 2000).

It can be concluded that experiences of children with their caregivers’ parenting behaviour has an effect on the way they will perceive themselves, as in they develop internal working models, or core beliefs. Early maladaptive core beliefs are self-defeating beliefs about the self that they keep repeating throughout our lives. These core beliefs can be related to basic emotional needs of a child. When these needs are not met in childhood, core beliefs develop that lead to unhealthy life patterns (Harris & Curtin, 2002; Leung, Thomas, & Waller, 2000; Shah & Waller, 2000). Caregivers’ behaviour as meeting a child’s basic emotional needs is what we focus on when we speak about origins in the development of childrens’ core beliefs and, yet to discuss, brain development.

1.2Experiences with caregivers and the development of the brain

To address long term effects of social experiences with caregivers on thoughts about the self and others, a recently highlighted neural network may be very interesting. In line with previously described impact of care giving experiences on current, past and future self definition and the formation of a strong and healthy personality, neural substrates underlying momentary self-reference and narrative self-reference, or self awareness by linking subjective experiences across time can theoretically be linked to each other (Farb et al., 2007; Fair et al., 2007; Buckner et al., 2008; D’Argembeau et al., 2008).

This neural network is a specific, anatomically defined brain system preferentially active when individuals are not focused on the external environment. Studies have shown that activity is associated with engaging in internally focused tasks, which include autobiographical memory retrieval, self-reflection across time, envisioning the future, and conceiving the perspectives of others (Buckner, Andrews-Hanna, & Schacter, 2008; d’Archembeau et al., 2008; Farb et al., 2007).

To illustrate this so called default network’s role more specifically, Farb et al. (2007) have investigated neural modes of both self awareness, and, in opposition, momentary consciousness among adults through fMRI. The former supports an array of self-related capacities, including memory for self-traits, traits of similar others, reflected self knowledge, and aspirations for the future. The results show that self reference is marked by a coupling between vmPFC, right insula and IPL. The authors suggest that self reference is habituated through past experiences and is associated with cortical midline activity, which underlies

narrative-generating mind wandering (Mason et al., 2007) and is very similar to activity associated with the ‘default mode’ of resting attention (Buckner, Andrews-Hanna, & Schacter, 2008). Greene (2007) also suggests the role of vMPFC (and dlPFC) in moral reasoning and subsequent emotional responses. In addition, Buckner et al (2008) review that the default network has associations with the hippocampus and cingulated, in relation to autobiographical/episodic memory.

An overview of this network is being presented in Figure 1 and 2.

Figure 1. Figure 2.

Figure 1. Hubs and subsystems within the default network are mapped using functional connectivity analysis.

This map was produced by seeding three separate regions (dMPFC, vMPFC, HF+) and plotting the overlap of the functional correlations across the three regions. Data are high-resolution rest data (2mm voxels) from 40 participants (mean age=22 years; 16 male) (data from Andrews-Hanna et al. 2007b). Three observations are notable. First, the combined map is remarkably similar to the original estimate of the default network from PET task-induced deactivation (see Figure 2, which shows the medial and lateral surface of the left hemisphere; blue represents regions most active in passive task settings). Second, PCC/Rsp, IPL, and vMPFC represent anatomic hubs in the default network to which all other regions are correlated. Third, dMPFC and HF+, which are both strongly correlated with the hub regions, are not correlated with each other, indicating that they are part of distinct subsystems. A further interesting feature is that area 7m within the precuneus (indicated by asterisk) is not part of the default network. The black line near the asterisk represents the approximate boundary between areas 7m and 23/31 (estimated boundary based on Vogt & Laureys 2005).

The default network might apply here for several reasons. Empirical reviews have examined the links between attachment formations and four aspects of information processing: memory, feedback seeking, perceptions of others, and secure base scripts, which all comprise the

mentioned internally focused tasks (Dykas & Cassidy, 2007). Although we are not focussing on attachment styles, due to care giving experiences that are directed towards meeting a child’s needs, a secure attachment may be formed. As described earlier, this has consequences for developed core beliefs as having a stronger sense of self esteem, self concept, and emotional control which allows them to differentiate their personality and, meanwhile, effectively act upon the external surrounding.

It is interesting to note that the default regions are not functionally connected until young adulthood (Fair et al., 2007). In addition, other research has shown that young adults have more activity in this default network than do older adults during so-called passive conditions where they are not given any particular task to think about (Persson et al., 2007). Therefore, if there can be found an influence of parenting experiences during childhood to such a network that is not functionally connected until, and very well noticeable during, late development, we understand much more about the pervasiveness of social-emotional development.

To explain further why there would be a relationship between brain development and early social life experiences, it has been found that environmental influences affect the growth and survival of dendrites, axons, synapses, interneurons, neurons and glia. To illustrate, as first discovered by Joseph (1992; 1998) different phases of social emotional development and the formation of loving attachments correspond to the differential maturation rates of parts of the limbic system: amygdala, septal nuclei and cingulate gyrus. This developmental process also involves the orbital frontal lobes, which are an evolutionary derivative of the amygdala and cingulated.

These limbic system nuclei, as well as the later to mature neocortex, require considerable social, emotional, perceptual, and cognitive stimulation during the first several months and years of life in order to develop normally. Norepinephrine (NE) neurotransmitters may decrease in response to even mildly adverse early experiences (including temporary separation from the mother; Joseph, 1979). This may lead to the formation of abnormal neural networks, for NE serves a neuronal protective function and promotes maturation (Joseph, 1999).

As a consequence, tendency for displaying behavioural problems during social situations could be the result from an abnormal network between amygdala, cingulated gyrus, septal nuclei, hypocampus, hypothalamus, pituitary and (orbito-) frontal regions. To illustrate, Rots et al. (1996) found that maternal separation among rats and enduring stress were related to increased levels of stress hormones, which resulted in dysfunction of the hippocampus,

hypothalamus and pituitary. Further, lesions in areas involved in attachment are behaviourally noticeable in fear, disability to identify motivational and social-emotional nuances, social bullying, disability of emotion regulation or acting in an appropriate emotional fashion, isolation seeking or social withdrawal (LeDoux, 1992; Halgren, 1996; Izard & Harris, 1999).

To explain further, in particular importance to social interaction and stress regulation, is the influence of adverse social-emotional experiences to the internal emotion regulation system, i.e. connection between visceral nuclei, amygdale, cingulated gyrus and orbito-frontal cortex. The cingulated gyrus and higher order orbitofrontal lobe represent the ‘social interaction’ system. It allows us to make rapid and subtle changes in our visceral state, especially of our heart rate and breath, as we create social contact. Such immediate changes correlate with approach or distancing social behaviour. However, an excessively intense and prolonged reaction to stress results in chemicals being mobilized for the defence reaction, and not just the immediate fine-tuned bio-electrical neuronal patterns. The disadvantage is that the chemical mechanism does not stop as rapidly as the neuronal, higher order mechanism. Thus, the over sensitized fight or flight system creates a response that hampers normal social and psychological responses to the environment.

The influence of social experiences with caregivers may therefore be expected to affect brain and personality development simultaneously.

We assume that people differ when it comes to representations about their caregivers in whether they succeeded to meet certain emotional needs during childhood. This study will address the following hypothesis:

1) We investigated the representations and linked them to the development of core beliefs. The measured core beliefs are supposed to be related to the measured representations (Young, Klosko & Weishaar, 2003). We expect to find that when people report having representations that certain needs were not met in childhood, they also report high on maladaptive core beliefs that lead to unhealthy life patterns. We expect to find that the representations will be statistically predictive of unhealthy core beliefs.

2) We also expect to find differences in this relationship when looking at representations about mothers and fathers.

3) In addition, with the use of MRI scanning we test the hypothesis that the density in nerve cells of brain regions differs for people who report more negatively on

representations about their parents’ behaviour, in that did they not meet certain emotional needs during childhood.

Method

Participants

A group of 80 normal Dutch psychology students of the University of Amsterdam was scanned using a 3T Philips Intera MRI scanner with a 6 channel head coil. Two high resolution scans (3D T1, Turbo Field Echo, TE 4.6 ms, TR 9.6 ms, FA 8°, 182 sagittal slices of 1.2 mm, FOV 2502 mm, reconstruction matrix 2562) were recorded of the brain, while the participants were watching a movie.

Two years later, 49 people were found being willing to participate to complete questionnaires for this study. The mean age of the group is 22.29 (SD = 1.87) and consists of 34 women. The participants filled in the questionnaires in groups of maximum 4 people at the time, which took them on average 45 minutes. Thirteen people requested to digitally receive the questionnaires at home, and sent a completed score form back through e-mail. Although the questionnaires are originally in English and have not been translated, all participants master English sufficiently well to study psychology at degree level, and have been asked after completion whether they had difficulties with the language, which none of them reported. Also right after, all participants received 14 Euros.

Materials and procedures – Questionnaires

For the investigation of core beliefs the short version of the Young Schema Questionnaire (YSQ-Short) (Young, 1998) has been used. This is a 75-item self-report questionnaire, which examines an individual’s maladaptive core beliefs. The items of the YSQ-S are grouped into 15 scales. For example, the following statements about people themselves measure together the scale ‘Dependence/ Incompetence’: ‘I do not feel capable of getting by on my own in everyday life’, ´I think of myself as a dependent person, when it comes to everyday functioning´, ´I lack common sense’, ‘My judgment cannot be relied upon in everyday situations’ and ‘I don't feel confident about my ability to solve everyday problems that come up’.

Respectively, the Young Parenting Inventory (YPI) has been used to measure representations about paternal and maternal behaviour separately during childhood. This questionnaire consists of 72 items and 17 scales for mothers and fathers respectively, and identifies the most likely origins of each scale in the YSQ-S on core beliefs for a particular

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person. For example, the following statements about mothers and fathers measure together the scale ‘Dependence/ Incompetence’: My mother and father ‘made me feel I couldn't rely on my decisions or judgment’, ‘did too many things for me instead of letting me do things on my own’, and ‘treated me as if I were younger than I really was’. This scale is, along with 4 other ones, part of the domain ‘Impaired autonomy and performance’.

The scales of both questionnaires are further grouped into 5 same domains. However, the YSQ-S measures these domains in the form of asking about maladaptive core beliefs, which are self-defeating, core themes or patterns that we keep repeating throughout our lives. The 5 domains of the YPI relate to the basic emotional needs of a child. When these needs are not met in childhood, core beliefs develop that lead to unhealthy life patterns. By linking the domains of the core beliefs to the representations about parents behaviour in meeting emotional needs, we can see which representations about not having met core needs could be the basis of developed core beliefs. This means that the questionnaires are constructed in such a way that only the questions are posed differently.

The domains of the grouped items in the questionnaires are (Young, 1999):

1. Disconnection and rejection. Expectation that one's needs for security, safety, stability, nurturance, empathy, sharing of feelings, acceptance, and respect will not be met in a predictable manner. Typical family origin is detached, cold, rejecting, withholding, lonely, explosive, unpredictable, or abusive.

2. Impaired autonomy and performance. Expectations about oneself and the environment that interfere with one's perceived ability to separate, survive, function independently, or perform successfully. Typical family origin is enmeshed, undermining of child's confidence, overprotective, or failing to reinforce child for performing competently outside the family. 3. Other-directedness. An excessive focus on the desires, feelings, and responses of others, at the expense of one's own needs -- in order to gain love and approval, maintain one's sense of connection, or avoid retaliation. Usually involves suppression and lack of awareness regarding one's own anger and natural inclinations. Typical family origin is based on conditional acceptance: children must suppress important aspects of themselves in order to gain love, attention, and approval. In many such families, the parents' emotional needs and desires -- or social acceptance and status -- are valued more than the unique needs and feelings of each child.

4. Overvigilance and inhibition. Excessive emphasis on suppressing one's spontaneous feelings, impulses, and choices OR on meeting rigid, internalized rules and expectations about performance and ethical behavior -- often at the expense of happiness, self-expression,

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Highlight

relaxation, close relationships, or health. Typical family origin is grim, demanding, and sometimes punitive: performance, duty, perfectionism, following rules, hiding emotions, and avoiding mistakes predominate over pleasure, joy, and relaxation. There is usually an undercurrent of pessimism and worry---that things could fall apart if one fails to be vigilant and careful at all times.

5. Impaired limits. Deficiency in internal limits, responsibility to others, or long-term goal-orientation. Leads to difficulty respecting the rights of others, cooperating with others, making commitments, or setting and meeting realistic personal goals. Typical family origin is characterized by permissiveness, overindulgence, lack of direction, or a sense of superiority -- rather than appropriate confrontation, discipline, and limits in relation to taking responsibility, cooperating in a reciprocal manner, and setting goals. In some cases, child may not have been pushed to tolerate normal levels of discomfort, or may not have been given adequate supervision, direction, or guidance.

Each item of the YSQ-S and YPI is scored on a six point scale, with high scores reflecting unhealthy, maladaptive core beliefs, and their likely origins. According to the regulations for the use of the YSQ-S and YPI, the score of each scale is then simply computed by counting only the extremely high item scores that comprise the particular scale. Thus, for example the scale emotional deprivation will have a score of 2 when 2 items measuring emotional deprivation have been reported with either a 5 or 6. Finally, the scores of the scales that form together a domain are summed. Although some items and clusters of the YPI and YSQ-S are not equally included, the clusters and domains of both questionnaires have been found to correspond well to each other (Young, 1998; Sheffield, 2006).

The YSQ-S and YPI have been demonstrated to have good clinical and empirical reliability and validity (Cecero et al., 2004; Welburn et al., 2002), with empirical support for the hypothesized factors (Cecero et al., 2004). In addition to showing good construct validity in its ability to predict psychopathological and psychiatric symptoms (Welburn et al., 2002), the YSQ-S is also used in non-clinical groups (Cecero et al., 2004; Waller et al., 2001).

In this study, the reliability of questionnaires on domain level is .70 for the YSQ, and for the scale on representations about mothers of the YPI .80 and .54 for the scale of fathers. According to the results, we will attempt to theorize why and whether this is an issue. Although the reliability on item level for all three questionnaires is higher, we direct ourselves to the reduction of data in domains, because the analyses will be easier to interpret. In addition, for the brain analyses it is required to have as less predictive variables as possible,

which is why we will carry out a component factor analyses on the clusters, to see if we can derive to one single factor for mothers and fathers separately.

To establish the relationship on scale and cluster level between maternal and paternal representations during childhood and developed core beliefs, and whether core belief can be predicted by the parental representations, we carried out a series of exploratory multiple regression analyses. Stepwise methods were used, as these are suited to exploratory model building (Field, 2000), and allow us to establish which subset of origins explains the greatest amount of variance in the core beliefs measures. The amount of variance explained (R2) is presented to allow interpretation of the relative contribution of each of the origins to the explanation of variance in unhealthy beliefs. Furthermore, the standardized regression coefficients (beta values) are provided to indicate the relationships between the standard deviations of each variable. To ensure the assumptions of regression were not violated, we assessed the intercorrelations between the parental origins/representation subscales, and between the YSQ subscales. Whilst the subscales of the questionnaires were often significantly correlated with one another, no correlation coefficient was greater than 0.7, a cut-off point recommended for tolerance within regression analysis (Field, 2000).

We also controlled for paternal and maternal origins in their separate prediction to core beliefs by calculating the partial correlations. Further, we carried out a Mann-Whitney test to see if there were gender differences in participants’ report on maternal, paternal and core beliefs.

Brain imaging

Voxel-based morphometry analyses were carried out with FSL-VBM, part of the FSL package (Smith et al., 2004). For the analyses, two independent VBM sets were generated, the first consisted of the all first T1 scans, and the second all second T1 scans. Data preprocessing consisted of brain extraction using BET (Smith, 2002), averaging of the two co registered images per participant, segmentation of the resulting brain-only images using FAST4 (Zhang et al., 2001), alignment to standard space, and nonlinear registration. All images were averaged in a single file, to which the original grey matter images were re-registered. The registered images were modulated by dividing by the Jacobian of the warp field and smoothed using a Gaussian kernel of 4 millimeters. A voxelwise General Linear Model (GLM) analysis was conducted using permutation-based non-parametric testing on the first VBM set using the demeaned maternal factor. This factor was established by conducting a component factor analysis on the 5

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domains of representations about maternal behaviour, which resulted in one single factor. The GLM analysis resulted in depiction of anterior medial temporal and parahippocampal gyrus, cerebellum, PMA, occipital and frontal pole areas. Next, clusters were extracted from the voxel-based thresholded positive and negative t-statistic images using cortical and a subcortical masks. Subcortical regions were extracted using a minimum cluster size of 50 voxels (p threshold <.01) and cortical regions were extracted with a minimum cluster size of 100 voxels (p threshold <.01). Next, these regions served as weighted masks to extract individual grey matter values from the second set. These grey matter values were used to correlate back to the questionnaire data. Excluding some participants who did not had a second brain scanning, which we used to compare the significant brain regions of the first set of scannings, we arrived at a number of 42 participants that could be used for further analyses. Lastly, we tested our final hypothesis that negative representations about maternal behaviour during childhood will be statistically predictive to the amount of gray matter density, by correlating the density with the 5 domains that are measured by the questionnaires. This means we do not have subgroup comparisons, but a continuous scale for assessing the relationship.

Results

Descriptive Statistics

Besides the five cases on father report during childhood, the data contained no missing values. The Mann-Whitney test on gender differences showed a significant difference between male and female report on only one scale, that is women report more that their mothers have unrelented standards than man t(49) = -2.01, p = .05. However, since this effect is only just significant, we will further report on the group as a whole.

Table 1 gives the mean and standard deviation scores of scales and clusters for paternal and maternal representations, and core beliefs respectively.

Table 1. Mean and standard deviation scores of domains for negative representations on mother and father components as measured by the YPI (Young, 1999), and unhealthy core beliefs measured by the YSQ-S (Young, 1999)

Mean Standard deviation

Domains

YPI

Mother (N=49)

Disconnection and rejection Impaired autonomy and performance

.53 1.00

2.1 1.8

Other directedness

Overviligance and inhibition Impaired limits

Father (N=44)

Disconnection and rejection Impaired autonomy and performance Other directedness

Overviligance and inhibition Impaired limits

YSC-S

Core beliefs (N=49) Disconnection and rejection Impaired autonomy and performance Other directedness

Overviligance and inhibition Impaired limits 1.16 2.73 .43 .25 .43 .75 .27 .45 .79 .18 .59 1.12 .76 1.5 3.4 .9 .5 .8 1.0 2.5 .9 2.1 .6 1.2 1.8 1.1

This table shows that the mean scores for rapport on fathers’ behaviour is quite low compared to those on mothers’ behaviour. Also, the standard deviations of the domains in the father scale are small, which indicates that people reported similarly about their fathers.

Prediction of Core Beliefs from Representations about Parents during Childhood

We used a series of stepwise regression analyses to establish whether the representation of parents during childhood can predict core beliefs. For each domain of core beliefs we investigated which origin(s) predicted them significantly (see Table 2). The predictors are the representations about mother’s and father’s behaviour during childhood, and described in the most left column. The supposed outcomes are the core beliefs, described in the second left column.

Table 2. Significant predictors of core beliefs identified by 10 stepwise regression analyses

Predictors Outcomes Beta R² F <p

Mother’s behaviour Core Beliefs

Overvigilance and inhibition Overvigilance and inhibition .208 .456 12.357 .001

Overvigilance and inhibition Impaired limits .140 .334 5.919 .019

Impaired limits Impaired autonomy and performance

.112 .374 7.647 .008

Impaired autonomy and performance

Disconnection and rejection Impaired limits

Disconnection and rejection .645

.692 .723 .417 .479 .532 33.562 21.163 16.455 .000 .000 .000

Disconnection and rejection Impaired autonomy and performance Other directedness .644 .697 .414 .486 33.237 21.755 .002 .015 Father’s behaviour Core Beliefs

Other directedness Overviligance and inhibition .456 .208 12.357 .001

Other directedness Impaired limits .441 .194 10.118 .003

Other directedness Impaired autonomy and performance

.409 .167 8.414 .006

Impaired limits Disconnection and rejection .174 .417 8.817 .005

- Other directedness

Prediction of core beliefs by mothers

Overvigilance and inhibition among mothers predicted core beliefs on overvigilance and inhibition and on impaired limits. Impaired limits among mothers predicted core beliefs on impaired autonomy and performance. Impaired autonomy and performance among mothers, together with disconnection and rejection and impaired limits predicted core beliefs on disconnection and rejection. And disconnection and rejection together with impaired autonomy and performance predicted core beliefs about other directedness.

Prediction of core beliefs by fathers

Other directedness among fathers predicted core beliefs on overvigilance and inhibition, on impaired autonomy and performance, and on impaired limits. Impaired limits among fathers predicted core beliefs on disconnection, and rejection.

Confounding factors taken into account

Table 3 shows the correlations of the overall representation about mothers’ behaviour during childhood with developed core beliefs. We arrived at a single variable for maternal behaviour by simply summing up the 5 domains. As can be seen in the table, a negative representation about mother’s behaviour has a significant relationship with increase in all developed unhealthy core beliefs, except for autonomy and performance. The representation about mothers also shows a significant correlation with the participants’ representation about fathers

r(44) = .32, p < .05. Formatted: English (U.S.), Not

In addition, table 3 shows that the correlation between the participants’ representation about mothers’ behaviour and the developed core beliefs, is still significant after controlling for the representation about fathers’ behaviour.

Table 3. Correlations between representations about mothers and developed core beliefs, before and after controlling for representations about fathers.

Variables Core beliefs Disconnection and rejection Impaired limits Autonomy and performance Overvigilance and inhibition Other directedness Mother’s behaviour .579(**) .351(*) .173 .409(**) .548(**) Mother’s behaviour while controlling for father’s behaviour

.554(*) .326(*) -.068 .393(*) .568(*)

* Correlation is significant at the 0.05 level (2-tailed). ** Correlation is significant at the 0.01 level (2-tailed).

The fact that the impact of representations about mothers on core beliefs still hold its significant relationship, states that mothers and fathers truly have a separate effect on developing core beliefs. It also implies that both questionnaires indeed measured two different aspects, which indicates good internal validity of the YPI.

Brain analyses

The reliability of the questionnaire about representations on maternal behaviour is better compared to the representations on paternal behaviour. Representations about maternal behaviour also hold significant associations with developed core beliefs after controlling for representations about fathers. Further, given that the component analysis on the representations about mothers’ behaviour resulted in one factor, and a component analysis on representations about fathers’ behaviour in two, we expected that we could better use this single factor about mothers for regression analyses on VBM MRI-images. This turned out to be an accurate choice, for when we actually did use representations about fathers’ behaviour in the GLM analysis, we did not find any depicted brain areas. Herewith we describe the results on representations about mothers for not succeeding in meeting emotional needs and gray matter density of brain areas.

Results of the regression analyses based on the computed single factor for representations about maternal behaviour show significant differences in gray matter density when people report more negatively on their mothers’ behaviour during childhood. This was depicted in the following areas: right cerebellum, right temporal/ parahippocampal gyrus, left

parahippocampal gyrus, right anterior middle temporal gyrus, right lateral occiptical area, left frontal pole, and right precentral gyrus.

Although this sounds promising, we checked whether there are confounding factors when correlating the computed factor for representations about maternal behaviour to the statistic scores of these brain areas. All the results are similarly obtained in both weighted and unweighted images.

It showed, that only after controlling for gender all associations were significant, which can be seen in Table 4. This means that apparently gender has a relationship to the representations about mothers, density in brain areas, or both. Without controlling for gender, the factor for representations about mothers’ behaviour was only significantly associated with the right anterior middle temporal gyrus, and left cerebellum. To note, a negative correlation between maternal behaviour and a brain area means that not meeting the emotional needs of children by mothers is associated with less nerve cell density in this area. Respectively, a positive correlation between maternal behaviour and a brain area means that not meeting the emotional needs of their children by mothers is associated with more nerve cell density in this area.

Table 4. The significant relationships between representations about mothers and brain areas, after controlling for gender

* correlation is significant at the 0.05 level (2-tailed)

We decided to check whether gender is correlated to the representations about mothers. The results showed no significant correlation between gender and representations about maternal behaviour during childhood.

In addition, we checked whether gender correlated with the brain areas. The results showed that gender has a significant association between right temporal/ parahippocampal gyrus r= +.368, n= 42 p < .05, and right lateral occiptical area r= -.308, n= 42 p < .05. Women Variables Brain areas Right cerebellum Right parahippocampal gyrus Left parahippocampal gyrus Right anterior middle temporal gyrus Right LO Left frontal pole Right precentral gyrus Maternal behaviour -.398* .357* .453* -.592* -.342* -.292* .347*

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apparently display more gray matter density in right temporal/ parahippocampal gyrus than men, and less in right lateral occipital area.

To be sure that left and right temporal/ parahippocampal gyrus indeed differ, and should therefore be viewed as two separate areas that are effected, we compared the two. There was in fact a significant difference in the scores for left (M=.46, SD=.05) and right temporal/ parahippocampal gyrus (M=.59, SD=.11); t(41)=7.45, p = .000.

We decided to keep controlling for gender while correlating the 5 domains of representations about maternal behaviour to the obtained gray matter density-values. Table 5 shows the significant associations between the 5 domains of representations about maternal behaviour and the obtained values of gray matter density in brain areas. We can see whether each domain separately is important enough to correlate with gray matter volumes.

Table 5. The correlations between representations about domains measuring mothers’ behaviour and brain areas Variables Brain areas Right cerebellum Right parahippocampal gyrus Left parahippocampal gyrus Right anterior middle temporal gyrus Right LO Left frontal pole Right precentral gyrus Maternal Behaviour Overvigilance and inhibition -.420* .306 .428* -.594* -.323* -.302 .432* Disconnection and rejection -.250 .427* .398* -.411* -.322* -.227 .158 Impaired autonomy and performance -.238 .300 .296 -.371* -.202 -.191 .014 Impaired limits -.034 .505 .337* -.432* -.047 -.155 .079

* correlation is significant at the 0.05 level (2-tailed)

Again, a negative correlation between certain maternal behaviour and a brain area means that not meeting emotional needs of their children by mothers is associated with less nerve cell density in this area. Respectively, a positive correlation between certain maternal behaviour and a brain area means that not meeting emotional needs of their children by mothers is associated with more nerve cell density in this area.

As can be seen in this table, overvigilance and inhibition among mothers is associated with more gray matter density in left parahippocampal gyrus and right precentral gyrus, and less density in right anterior middle temporal gyrus and right lateral occiptical area. Disconnection and rejection is associated with more density in right and left parahippocampal gyrus, less density in right anterior medial temporal gyrus and right lateral occipital area. Impaired autonomy and performance is associated with less density in right anterior medial temporal gyrus. Impaired limits are associated with more gray matter density in the left parahippocampal gyrus, and less density in the right anterior medial temporal gyrus. Finally, other directedness is associated with less gray matter volume in right cerebellum and right anterior middle temporal gyrus, and more volume in left parahippocampal gyrus.

The right anterior middle temporal gyrus is affected the most by negative representation about maternal behaviour during childhood. An image of the correlation is shown below in Figure 2.

A B

Other directedness

Figure 2. Images A and B shows a significant difference prediction of the factor about participants’ representations on negative maternal behaviour and grey matter density in right medial temporal gyrus.

A high score on the representation scale means that a person has a negative representation about mothers’ behaviour. The negative correlation between the medial temporal gyrus and representation about maternal behaviour is, shows maternal behaviour that does not meet certain emotional needs results in less gray matter volume in this brain area. We also found this for the right cerebellum and right lateral occipital area. Respectively, the left and right parahippocampal, and right precentral gyrus seem to be positively correlated to maternal behaviour. Therefore, maternal behaviour that does not meet emotional needs of their children is associated to more gray matter volume in these areas.

Discussion

Experiences with caregivers and the development of core beliefs

The hypothesis that negative representations about parental behaviour in meeting emotional needs during childhood predict the development of negative, destructive core beliefs, has been supported by the results in this study. Although the sample was very small compared to a previous study of Sheffield et al. (2006), who tested in a non-clinical sample of 422 students the psychometric validation of the YPI and its relationship with core beliefs, the sample of this study displayed a strong relationship with parents as being the possible origin of developed core beliefs in young adults.

To explain the influence of emotional needs that are not met by mothers through their behaviour and which core beliefs this will bring about in their children, we investigated the results of the regression analyses. It is interesting to see that, although there seems to be a one to one relationship between certain parental behaviour and development of a core belief, some core beliefs develop more then others and show a relationship with more than one predictor. This leads to the conclusion that maternal behaviour that goes at the expense of emotional needs during childhood, results mainly in feelings of being rejected, as well as believing that one must suppress important aspects of themselves in order to gain love, attention, or approval.

Differences between fathers’ and mothers’ behaviour as predictors of core beliefs

The differences in this study between fathers’ and mothers’ behaviour as predictors of core beliefs supports our hypothesis that, as Carranza & Kilmann (2000) also stated, different

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relationships with maternal and paternal figures may produce differential outcomes both in childhood and later in life.

Our results show that the effect of mothers during childhood on the development of core beliefs appeared to be quite different from the amount and content that fathers have. For instance, it is interesting to see that when fathers are the ones being very permissive to their children, adults end up having core beliefs of being unloved, and expect that others are unreliable and will not give adequate emotional support. Setting limits by fathers is thus internalized by children as a sign of affection. However when mothers set limits, besides perceiving it as a sign of affection, children also end up feeling more adequate and independent.

What is also interesting is that one single negative behavioural aspect of fathers during childhood appeared to be the predictor of almost all developed core beliefs. People in this study reported their fathers mainly as someone that values their own emotional needs and desires, or social acceptance and status, more than the unique needs and feelings of their child. This opposed to reports on maternal behaviour, where this behaviour appeared to be the lowest in presence, and predicted none of the developed core beliefs.

Experiences with caregivers and the development of the brain

The MRI results support the hypothesis that people who report negatively about their mothers behaviour during childhood have grey matter density alternations in areas of their brain. This is interesting for it supports that there is reason to believe that the functionality of the brain is influenced by environmental circumstances, that is, early parent-child experiences. Investigating the influence of an early period is very important, because the brain is then developing and specializing a lot more then in later stages of development, especially adulthood. However, the positive and negative influence by parenting behaviour on gray matter density in adult brains is hard to explain. We should keep in mind that there is a developmental aspect involved and that there is still little known about the influence of parenting and parental behaviour on brain development. For now we can therefore only conclude that there appears to be an influence, but is difficult to fully understand.

This study contributes also to brain research, because it is the first one that studies the functionality of brain areas in a developmental perspective with the use of structural data, i.e. MRI analyses. We therefore can only base theorization about the functions of the areas that we found in MRI research that is directed to current, momentary brain functioning and fMRI research.

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As mentioned, we found both positive and negative correlations between maternal behaviour and grey matter density. This means that a negative correlation between maternal behaviour and a brain area means that not meeting emotional needs of their children by mothers is associated with less nerve cell density in this area. Respectively, a positive correlation between maternal behaviour and a brain area means that not meeting emotional needs of their children by mothers is associated with more nerve cell density in this area.

The area that seems to be effected the most by maternal behaviour during childhood is the right anterior medial temporal gyrus, which seems to be ‘thinner’ in people with negative experiences with their mothers’ behaviour during childhood. fMRI studies have associated this area with emotional information processing (Okuda et al., 2003; Onitsuka et al., 2004) and semantic information processing, which implies acquirement of information across various contexts and is used across different situations; it refers to general facts and meanings we share with others (Tulving, 1990).

Other parts that appear to be ‘thinner’ in people with negative experiences with their mothers’ behaviour during childhood as well, are the right part of the cerebellum, right lateral occipital area and frontal pole area. It may be informative that we could found a correlation between the anterior medial temporal gyrus to the left frontal pole. Although this area is not associated with any of the separate domains on maternal represenations, Okuda et al. (2003) found in an fMRI study that the frontal pole and the medial temporal lobes were activated during future and past tasks, suggesting that thinking of the future by the frontal pole is closely related to retrospective memory by the anterior medial temporal gyrus.

Both left and right parahippocampal gyrus, and right precentral gyrus appear to be ‘thicker’ in people with negative experiences with their mothers’ behaviour during childhood. Especially the left parahippocampal gyrus seems to be effected. fMRI studies showed that the parahippocampal gyrus is associated with past memory retrieval (Okuda et al., 2003; Onitsuka et al., 2004).

In conclusion, these results show the possibility that functional differences in brain areas can be produced by environmental factors early in life. It gives special importance to the impact of maternal rearing behaviour as being a predictor for both psychology and brain functioning later in life.

Methodological implications

The main limitation of this study is the size and content of our sample, which makes it not very easy to conclude on some aspects. For instance, the low reliability of the father

questionnaire may be due to the fact that our sample size was just too small, given that the reliability of the paternal scale in the study of Sheffield et al. (2006), who used 422 participants, was sufficiently high. However, it may also be the case that our group of people reported very similar about their fathers behaviour, resulting in a group that is not heterogeneous enough. This was the case in our study, shown by the low standard deviations. Therefore we can not conclude with certainty whether the questionnaire is not reliable enough, or that the behaviour of mothers perhaps has influence in a more differential way, given that we also did not find any influence of paternal behaviour during childhood on brain development. However, because we did have a small sample size and our data on paternal behaviour was even smaller due to lack of reports, we recommend to investigate the influence of paternal behaviour on core beliefs and brain development again with the inclusion of more participants.

Besides a larger sample size, another recommendation would be the inclusion of more males, to investigate gender differences in reports on parental behaviour during childhood. Although we did not find any gender differences in questionnaire reports, we did find an influence of gender on brain areas that are related to maternal behaviour. Although it might be that the brain is simply different for males and females, we still should investigate with the inclusion of more male data whether perhaps men view their mothers’ behaviour differently and therefore are affected differently, not only in brain development but also in psychology.

Further, our sample consisted of a group of university students, which may have influenced our results. For example, the maternal scale in general (when we do not differentiate between 5 domains), has no relationship with impaired autonomy and performance among these participants. This may be due to the possibility that the parents of these participants themselves are highly educated, have a higher IQ, have a higher social economic status, which makes it plausible to think that other factors ruled out the relationship. This an important note, because an influence of parenting behaviour on a persons’ autonomy and performance is to be expected. Therefore, there should be controlled for these aspects when investigating the influence of parental behaviour, or include a wider range of people with different social economic and educational backgrounds.

Finally, we should have included an instrument that supports the justification of our use of the YPI for investigating parental behaviour during early childhood. Although we did not have to control for representations about behaviour of fathers when looking at the relationship of representations about behaviour of mothers and developed core beliefs, a questionnaire that measures for example a personality trait to complain in general might be

used as a controlling variable to see whether this trait has had an influence to report also more negatively on parental behaviour.

Implications for further research

The results of this study indicate the importance of parent-child relationships early in life. However, they only give an indication of an influenced brain development in young adulthood, and we can basically not conclude on the negative and positive relationships. In order to understand the influence of parent-child relationships on brain development, and the link between brain functioning and psychology, it is necessary to start measuring this relationship from an early age onward in a longitudinal study.

In addition, the use of spontaneous fMRI can be very informative, for this method can highlight the functionality of brain networks that are highly associated to personality development.

Reference

Achenbach, T.M. (1991). Manual for the Youth Self-Report. Burlington, VT: Unive rsity of Vermont, Department of Psychiatry.

Ainsworth, M. S., Blehar, M.,Waters, E.,&Wall, S. (1978). Patterns of attachment: Assessed in the strange situation and at home. Hillsdale, NJ: Lawrence Erlbaum.

Allen, J. P., Moore, C., Kuperminc, G., and Bell, K. (1998) Attachment and Adolescent Psychosocial Functioning. Child Development, 69(5) 1406–1419.

Andrews-Hanna, J. R., Snyder, A. Z., Vincent, J. L., Lustig, C., Head, D., et al. (2007a). Disruption of large-scale brain systems in advanced aging. Neuron, 56, 924–35.

Blisset, J., Walsh, J., Harris, G., Jones, C., Leung, N., & Meyer, C. (2006). Different Core Beliefs Predict Paternal and Maternal Attachment. Clin. Psychol. Psychother. 13, 163–171.

Bowlby, J., Ainsworth, M., and Bretherton I. (1992). The origins of attachment theory. Developmental Psychology, 28, 759-775.

Bretherton, I., & Munholland, K.A. (1999). Internal working models in attachment relationships: A construct revisited. In J. Cassidy, & P.R. Shaver (Eds), Handbook of Attachment. (pp. 99–111). New York: Guilford.

Brugha T, Bebington P, Tennant, C. and Hurry, J. (1985) The list of threatening experiences: A subset of 12 life events categories with considerable long-term contextual threat. Psychological medicine, 15, 189-194.

Buckner, R. L., Andrews-Hanna, J. R., and Schacter, D. L. (2008). The Brain’s Default Network Anatomy, Function, and Relevance to Disease. Annals of the New York Academy of Sciences, 1124, 1-38.

Cecero, J.J., Nelson, J.D., & Gillie, J.M. (2004). Tools and tenets of schema therapy: toward the construct of the Early Maladaptive Schema Questionnaire—Research Version (EMSQ-R). Clinical Psychology and Psychotherapy, 11, 344–357.

Cichetti, D., and Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Acadamy of Child and Adolescence Psychiatry, 34 (5) 541-565.

Dykas, M. J. and Cassidy, J. (2007). Attachment and the Processing of Social Information in Adolescence. New Directions for Child ans Adolescent Development, 117, 41-56.

Ellenbroek, B. A., Van den Kroonenberg, P.T.J.M., and Cools, A. R. (1997). The effects of an early stressful life even ton sensorimotor gating in adult rats. Schizophrenia Research, 30, 251-260.

Fair, D. A., Cohen, A. L., Dosenbach, N. U. F., Church, J. A., Miezin, F. M., Barch, D. M., Raichle, M. E., Petersen, S. E. and Schlaggar, B. L. (2007). The maturing architecture of the brain’s default network. PNAS, 105 (10) 4028-4032.

Farb, N. S. A., Segal, Z. A., Mayberg, H., Bean, J., McKeon, D., Fatima, Z. and Anderson, A. K. (2007). Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference. Social Cognitive and Affective Neuroscience, 2, 313–22.

Field, A.P. (2000). Discovering statistics using SPSS for Windows: Advanced techniques for the beginner. London: Sage.

Gilbert, S. J., Dumontheil, I., Simons, J. S., Frith, C. D., & Burgess, P. W. (2007). Comment on ‘Wandering minds: the default network and stimulus-independent thought’. Science 317, 43.

Greene, J.D. (2007) Why are VMPFC patients more utilitarian?: A dual-process theory of moral judgment explains. Trends in Cognitive Sciences. Vol 11, No. 8, 322-323.

Halgren, E. (1992). Emotional neurophysiology of the amygdala within the context of human cognition. In The Amygdala, ed. Aggleton JP. New York: Wiley.

Harter., S. (1997). Symbolic Interactionism Revisited: Potential Liabilities for the Self Constructed in the Crucible of Interpersonal Relationships. Merrill-Palmer Quarterly, 45, 15-23.

Hinderlie, H.H., & Kenny, M. (2002). Attachment, social support, and college adjustment among Black students at predominantly White universities. Journal of College Student Development, 43(3), 327–340.

Holmbeck, G.N., & Wandrei, M.L., (1993). Individual and relational predictors of adjustment in first year college students. Journal of Counselling Psychology, 40, 73–78.

Izard, C. E, and Harris, P. (1995). Emotional development and developmental psychopathology. In Developmental Psychopathology: Vol. 1. Theory and Methods, eds. Cicchetti D, Cohen C. New York: Wiley.

Joseph, R. (1982). The Neuropsychology of Development. Hemispheric Laterality, Limbic Language, the Origin of Thought. Journal of Clinical Psychology, 44, 4-33.

Joseph, R. (1979). Effects of rearing environment and sex on learning, memory, and competitive exploration. Journal of Psychology, 101, 37-43.

Joseph, R. (1992) The Limbic System: Emotion, Laterality, and Unconscious Mind. The Psychoanalytic Review, 79, 405-456.

Joseph, R. (1998). Traumatic amnesia, repression, and hippocampal injury due to corticosteroid and enkephalin secretion. Child Psychiatry and Human Development, 29, 169-186.

Joseph, R. (1999). Environmental influences on neural plasticity, the limbic system, and emotional development and attachment. Child Psychiatry and Human Development, 29, 187-203.

Kenny, M. (1987). The extent and function of parental attachment among first-year college students. Journal of Youth and Adolescence, 16(1), 17–29.

Kenny, M.E., & Rice, K.G. (1995). Attachment to parents and adjustment in late adolescent college students: Current status, applications, and future considerations. Counseling Psychologist, 23(3), 433–456.

Kenny, M., & Perez, V. (1996). Attachment and psychological well-being among racially and ethnicall diverse first-year college students. Journal of College Student Development, 37(5), 527- 535.

Kenny, M., Lomax, R., Brabeck, M.M., & Fife, (1998). Contributions of parental attachment to view of self and depressive symptoms among early adolescents. Journal of Early Adolescence, 13(4), 408–430.

Laible, D. J., & Thompson, R. A. (2000). Mother–child discourse, attachment security, shared positive affect, and early conscience development. Child Development, 71, 1424–1440.

Lafrenière P. J., Provost, M. A., and Dubeau, D. (2006). From an insecure base: Parent-child relations and internalizing behaviour in the pre-school. Early Development and Parenting, 1 (3) 173-148.

LeDoux, J. E. (1992). Emotion and the amygdala. In The Amygdala, ed. Aggleton JP. New York: Wiley.

Mason, M. F., Norton, M.I., Van Horn, J. D., Wegner, D. M., Grafton, S. T., and Macrae, C. N. (2007). Wandering Minds: The Default Network and Stimulus-Independent Thought. Science, 315, 393-395.

Moos, R., & Moos, B. (1986). Family Environment Scale manual. Palo Alto, CA: Consulting Psychologists Press.

Muris, P., Meesters, C., and Van den Berg, S. (2003) Internalizing and Externalizing Problems as Correlates of Self-Reported Attachment Style and Perceived Parental Rearing in Normal Adolescents. Journal of Child and Family Studies, 12 (2) 171–183

Persson, J., Lustig, C., Nelson, J., Reuter-Lorenz, P., (2007). Age differences in deactivation: a link to cognitive control? Journal of Cognitive Neuroscience, 19, 1021–1032.

Porges, S. W. (1995). Cardiac vagal tone: A psysiological index of stress. Neuroscience and Biocehavioural Reviews, 19, 225-233.

Porges, S.W. (2001). The polyvagal theory: phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123–146.

Porges, S.W. (2003). Social engagement and attachment: a phylogenetic perspective. Annals of the New York Academy of Sciences 1008, 31–47.

Propper, C., and Moore, G.A. (2006). The influence of parenting on infant emotionality: A multi-level psychobiological perspective. Elsevier developmental review, 26, 427-460.

Rots. N.Y., de Jong, J., Levine, S., Cools, A.R., de Kloet, E.R. (1996). Neonatal mother-deprived rats have as adult elewited basal pituitary adrenal activity lind apomorphine susceptibility. Journal of Neuroendocrinology, 8, 501-516.

Sheffield, A., Waller, G., Emanuelli, F., Murray, J. & Meyer, C. (2006). Links Between Parenting and Core Beliefs: Preliminary Psychometric Validation of the Young Parenting Inventory. Cognitive Therapy and Research, 29 (6) 787–802.

Shulman,G. L., Fiez, J. A., Corbetta,M., Buckner, R. L.,Miezin, F. M., et al. (1997). Common blood flow changes across visual tasks: II.: decreases in cerebral cortex. Journal of Cognitive Neuroscience, 9, 648–63.

Skowron, E. A., & Dendy, A. K. (2004). Differentiation of self and attachment in adulthood: Relational correlates of effortful control. Contemporary Family Therapy: An International Journal, 26, 337-357.

Smith, S. M. (2002). Fast robust automated brain extraction. Human Brain Mapping, 17(3), 143-155.

Smith S. M., Jenkinson M., Woolrich M. W., Beckmann C. F., Behrens T. E. J., Johansen-Berg H., Bannister P. R., De Luca M., Drobnjak I., Flitney D. E., Niazy R. K., Saunders J., Vickers J., Zhang Y. Y., De Stefano N., Brady J. M., Matthews P. M. (2004). Advances in functional and structural MR image analysis and implementation as FSL. NeuroImage, S208-S219.

Sroufe, L. A. (2000). Early relationships and the development of children. Infant Mental Health Journal, 21, 67-74.

Thompson, R. A. (1994). Emotional regulation: A theme in search of definition; The development of emotion regulation: Biological and behavioral aspects. Monographs of the Society for Research in Child Development, 59, 25-52.

Vance, H.B. (1998). Psychological assessment of children: Best practices for school and clinical settings. New York: Wiley.

Vogt, B. A., & Laureys, S. (2005). Posterior cingulate, precuneal and retrosplenial cortices: cytology and components of the neural network correlates of consciousness. Progressive Brain Research, 150, 205–17.

Waller, G., Meyer, C., & Ohanian, S. (2001). Psychometric properties of the long and short versions of the Young Schema Questionnaire: Core beliefs among bulimic and comparison women. Cognitive Therapy and Research, 25, 137–147.

Warren, S. L., Houston, L., Egeland, B., & Sroufe, L. A. (1997). Child and adolescent anxiety disorders and early attachment. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 637-644.

Welburn, K., Coristine, M., Dagg, P., Pontefract, A., & Jordan, S. (2002). The Schema Questionnaire—Short Form: Factor analysis and relationship between schemas and symptoms. Cognitive Therapy and Research, 26, 519–530.

Young, J.E. (1998) The Young Schema Questionnaire: Short Form. New York: Cognitive Therapy Center.

Young, J.E. (1999) Cognitive therapy for personality disorders: A schema-focused approach, 3rd ed. Sarasota, FL: Professional Resource Press.

Zhang Y. Y., Brady M., Smith S. (2001). Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Transactions on Medical Imaging, 20(1), 45-57.

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Enclosures: YSQ-S and YPI

YSQ - S2

Number ___________________________________________________Date_________________

INSTRUCTIONS:

Listed below are statements that a person might use to describe himself or herself. Please read each statement and decide how well it describes you. When there you are not sure, base your answer on what you emotionally feel, not on what you think to be true. Choose the highest rating from 1 to 6 that describes you and write the number in the space before the statement.

RATING SCALE:

1 = Completely untrue of me 2 = Mostly untrue of me 3 = Slightly more true than untrue 4 = Moderately true of me

5 = Mostly true of me 6 = Describes me perfectly

1. _____ Most of the time, I haven't had someone to nurture me, share him/herself with me, or care deeply about everything that happens to me.

2. _____ In general, people have not been there to give me warmth, holding, and affection. 3. _____ For much of my life, I haven't felt that I am special to someone.

4. _____ For the most part, I have not had someone who really listens to me, understands me, or is tuned into my true needs and feelings.

5. _____ I have rarely had a strong person to give me sound advice or direction when I'm not sure what to do.

*emotional deprivation

6. _____ I find myself clinging to people I'm close to, because I'm afraid they'll leave me. 7.______I need other people so much that I worry about losing them.

8. _____ I worry that people I feel close to will leave me or abandon me. 9. _____ When I feel someone I care for pulling away from me, I get desperate. 10. _____ Sometimes I am so worried about people leaving me that I drive them away.

*abandonment/ instability

11. _____ I feel that people will take advantage of me.

12.______I feel that I cannot let my guard down in the presence of other people, or else they will intentionally hurt me.

13.______It is only a matter of time before someone betrays me. 14. _____ I am quite suspicious of other people's motives. 15. _____ I'm usually on the lookout for people's ulterior motives.

*mistrust/ abuse

16. _____ I don't fit in.

17. _____ I'm fundamentally different from other people. 18. _____ I don't belong; I'm a loner.

19. _____ I feel alienated from other people. 20. _____ I always feel on the outside of groups. *social isolation/ alienation

21. _____ No man/woman I desire could love me one he/she saw my defects. 22. _____ No one I desire would want to stay close to me if he/she knew the real me.

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23. _____ I'm unworthy of the love, attention, and respect of others. 24. _____ I feel that I'm not lovable.

25. _____ I am too unacceptable in very basic ways to reveal myself to other people. *defectiveness/ shame

26. _____ Almost nothing I do at work (or school) is as good as other people can do. 27. _____ I'm incompetent when it comes to achievement.

28. _____ Most other people are more capable than I am in areas of work and achievement. 29. _____ I'm not as talented as most people are at their work.

30. _____ I'm not as intelligent as most people when it comes to work (or school).

*failure

31. _____ I do not feel capable of getting by on my own in everyday life.

32. _____ I think of myself as a dependent person, when it comes to everyday functioning. 33. _____ I lack common sense.

34. _____ My judgment cannot be relied upon in everyday situations.

35. _____ I don't feel confident about my ability to solve everyday problems that come up.

*dependence/ incompetence

36. _____ I can't seem to escape the feeling that something bad is about to happen.

37. _____ I feel that a disaster (natural, criminal, financial, or medical) could strike at any moment. 38. _____ I worry about being attacked.

39. _____ I worry that I'll lose all my money and become destitute.

40. _____ I worry that I'm developing a serious illness, even though nothing serious has been diagnosed by a physician.

*vulnerability to harm or illness

41. _____I have not been able to separate myself from my parent(s), the way other people my age seem to.

42. _____ My parent(s) and I tend to be overinvolved in each other's lives and problems.

43. _____ It is very difficult for my parent(s) and me to keep intimate details from each other, without feeling betrayed or guilty.

44. _____ I often feel as if my parent(s) are living through me--I don't have a life of my own. 45. _____I often feel that I do not have a separate identity from my parent(s) or partner.

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*enmeshment/ undeveloped self

46. _____ I think that if I do what I want, I'm only asking for trouble.

47. _____ I feel that I have no choice but to give in to other people's wishes, or else they will retaliate or reject me in some way.

48. _____ In relationships, I let the other person have the upper hand.

49. _____ I've always let others make choices for me, so I really don't know what I want for myself.

50. _____ I have a lot of trouble demanding that my rights be respected and that my feelings be taken into account.

*subjugation

51. _____ I'm the one who usually ends up taking care of the people I'm close to. 52. _____ I am a good person because I think of others more than of myself.

53. _____ I'm so busy doing for the people that I care about, that I have little time for myself. 54. _____ I've always been the one who listens to everyone else's problems.

55. _____ Other people see me as doing too much for others and not enough for myself. *self-sacrifice

56. _____ I am too self-conscious to show positive feelings to others (e.g., affection, showing I care). 57. _____ I find it embarrassing to express my feelings to others.

58. _____ I find it hard to be warm and spontaneous.

59. _____ I control myself so much that people think I am unemotional. 60. _____ People see me as uptight emotionally.

*emotional inhibition

61. _____ I must be the best at most of what I do; I can't accept second best. 62. _____ I try to do my best; I can't settle for "good enough."

63. _____ I must meet all my responsibilities.

64. _____ I feel there is constant pressure for me to achieve and get things done. 65. _____ I can't let myself off the hook easily or make excuses for my mistakes.

*unrelenting standards/ hypercriticalness

66. _____ I have a lot of trouble accepting "no" for an answer when I want something from other people.

67. _____ I'm special and shouldn't have to accept many of the restrictions placed on other people.

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68. _____ I hate to be constrained or kept from doing what I want.

69. _____ I feel that I shouldn't have to follow the normal rules and conventions other people do. 70. _____ I feel that what I have to offer is of greater value than the contributions of others. *entitlement/ grandiosity

71. _____ I can't seem to discipline myself to complete routine or boring tasks. 72. _____ If I can't reach a goal, I become easily frustrated and give up.

73. _____ I have a very difficult time sacrificing immediate gratification to achieve a long-range goal. 74. _____ I can't force myself to do things I don't enjoy, even when I know it's for my own good.

75. _____ I have rarely been able to stick to my resolutions. *insufficient self-controle/ self-discipline

COPYRIGHT 2003 Jeffrey Young, Ph.D., and Gary Brown, Ph.D. Unauthorized reproduction without written consent of the authors is prohibited. For more information, write: Cognitive Therapy Center of New York, 130 West 42nd St., Suite 501, New York, NY 10036.

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