Conceptual Analysis: A Social Neuroscience Approach to Interpersonal Interaction in the Context of Disruption and Disorganization of Attachment (NAMDA).

Lars O White,Margerete J S Schoett,Jan Keil,Charlotte C Schulz,Melanie T Kungl,Pascal Vrtička,Jessica L Borelli

doi:10.3389/fpsyt.2020.517372

Abstract

Humans are strongly dependent upon social resources for allostasis and emotion regulation. This applies especially to early childhood because humans—as an altricial species—have a prolonged period of dependency on support and input from caregivers who typically act as sources of co-regulation. Accordingly, attachment theory proposes that the history and quality of early interactions with primary caregivers shape children's internal working models of attachment. In turn, these attachment models guide behavior, initially with the set goal of maintaining proximity to caregivers but eventually paving the way to more generalized mental representations of self and others. Mounting evidence in non-clinical populations suggests that these mental representations coincide with differential patterns of neural structure, function, and connectivity in a range of brain regions previously associated with emotional and cognitive capacities. What is currently lacking, however, is an evidence-based account of how early adverse attachment-related experiences and/or the emergence of attachment disorganization impact the developing brain. While work on early childhood adversities offers important insights, we propose that how these events become biologically embedded crucially hinges on the context of the child–caregiver attachment relationships in which the events take place. Our selective review distinguishes between direct social neuroscience research on disorganized attachment and indirect maltreatment-related research, converging on aberrant functioning in neurobiological systems subserving aversion, approach, emotion regulation, and mental state processing in the wake of severe attachment disruption. To account for heterogeneity of findings, we propose two distinct neurobiological phenotypes characterized by hyper- and hypo-arousal primarily deriving from the caregiver serving either as a threatening or as an insufficient source of co-regulation, respectively.

Highlights

Both the approach and aversion modules are deemed to be activated by, and represent more automatic, bottom-up biological and neural mechanisms and are summarized as affective evaluation or emotional mentalization processes [76]
Within NAMA, we propose a prototypical initial attachment pathway and its translation into four fundamental biological and neural building blocks of human attachment—the four aversion, approach, emotion regulation, and mental state representation modules
Our aim is to extend NAMA—the model of organized attachment outlined in the previous section— to disrupted and disorganized attachment in the context of maltreatment and adverse attachment-related experiences

Summary

Introduction

Both the approach and aversion modules are deemed to be activated by, and represent more automatic, bottom-up biological and neural mechanisms and are summarized as affective evaluation or emotional mentalization processes [76]. It should be noted here that we view the approach and aversion modules as two rather independent—albeit complementary— neurobiological systems that can be de- or hyper-activated to varying degrees in attachment-relevant situations as a function of inter-individual differences in secure vs insecure attachment orientations (even in opposing directions), that is, we do not equate de- or hyper-activation of the approach module with attachment security and de- or hyper-activation of the aversion module with insecurity as two diametrically opposing ends of one single attachment dimension. We believe that, except during the initial moment of approach module involvement, to motivate a social approach response of support seeking under distress (i.e., during simultaneous aversion module activation), for typical (or organized) attachment patterns, the two emotional modules should not be activated concomitantly for an extensive time period/chronically, as this would lead to conflicting social emotional states

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Conclusion