Clinical Neuropsychiatry最新文献_第6页

Grasping and Treating Attachment Trauma: A Work in Progress. 抓握与治疗依恋创伤：一项正在进行的工作。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250512

Ellert R S Nijenhuis

{"title":"Grasping and Treating Attachment Trauma: A Work in Progress.","authors":"Ellert R S Nijenhuis","doi":"10.36131/cnfioritieditore20250512","DOIUrl":"10.36131/cnfioritieditore20250512","url":null,"abstract":"Farina and Schimmenti detail and define the potential consequences for their health when children meet and cannot escape from primary caretakers who neglect, maltreat, and abuse them. They define attachment trauma in this frame and thereby overcome some of the limitations of previous formulations. Inspired by their important work, I try to make a few points. Being ecosystems, we must long and strive to get the useful, to avoid and get rid of the harmful, and to leave alone what is useless. Part of the complexity of our being and becoming is that we include multiple longings and strivings, and that these can be contradictory. Per our very nature, and particularly as children, we long and strive to attach to our primary caretakers, defend against threat, and gain power to act. What to feel, think, and do when caretakers we depend on and must learn from are in fact harmful or useless to us, and the rest of our environment does not care or intervene? What is useful, harmful, and meaningless? Attachment trauma, then, is an ecological injury that evolves when harmful powers of caretakers and others far exceed our own power to act. Being ecosystems, the form the injury takes depends on this reciprocal causing. While it is an injury, it also is a creative effort to live and make sense of a mostd difficult life.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"412-416"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic Inclusion of Attachment Trauma: A Commentary on Farina and Schimmenti (2025). 依恋创伤的诊断包括：Farina和Schimmenti（2025）的评论。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250506

Constance J Dalenberg, Kenneth J Thompson

{"title":"Diagnostic Inclusion of Attachment Trauma: A Commentary on Farina and Schimmenti (2025).","authors":"Constance J Dalenberg, Kenneth J Thompson","doi":"10.36131/cnfioritieditore20250506","DOIUrl":"10.36131/cnfioritieditore20250506","url":null,"abstract":"Farina and Schimmenti (2025) offer an intriguing reconceptualization of attachment trauma as a developmental process arising from relational failures, even in the absence of identifiable traumatic events. We support their emphasis on clinical symptom constellations-such as dissociation, emotional dysregulation, and interpersonal detachment-as markers of attachment-related dysfunction. However, we suggest a change in emphasis. We argue that any diagnostic change might target dysfunction in the attachment system itself, rather than infer the presence of trauma. This distinction aligns with diagnostic frameworks that prioritize functional patterns over historical assumptions. We also encourage the development of trauma-informed principles specific to attachment disruptions. These refinements, we believe, would increase diagnostic clarity and better support treatment planning. We believe that the enhanced focus on attachment-related psychopathologies, as proposed by Farina and Schimmenti, is of value but would benefit from further attention to the issue of reliable measurement.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"392-393"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Attachment Trauma to Traumatic Attachment: Invisible Injuries of Early Childhood and Subtle Relational Codes of Self-Regulation. 从依恋创伤到创伤性依恋：幼儿隐性伤害与自我调节的微妙关系编码。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250513

Vedat Şar

{"title":"From Attachment Trauma to Traumatic Attachment: Invisible Injuries of Early Childhood and Subtle Relational Codes of Self-Regulation.","authors":"Vedat Şar","doi":"10.36131/cnfioritieditore20250513","DOIUrl":"10.36131/cnfioritieditore20250513","url":null,"abstract":"Building on recent contributions by Farina and Schimmenti (2025a), this paper advances a more nuanced framework for their concept of attachment trauma focusing on the underlying mechanisms. The injury of attachment trauma, often concealed within ostensibly ordinary family systems, may leave no explicit memory trace yet manifest as enduring patterns of dysregulation. Instead, it becomes apparent through its clinical consequences such as Complex PTSD, borderline phenomena, dissociative disorders and their various complications. Central to the framework presented in this paper are the concept of relational encryption, in which interpersonal signals are coded to establish a balanced interpersonal dependency, and internal moderation, defined as the capacity for flexible regulation between affective and relational extremes, which is needed to overcome trauma-related paradoxes. Encryption vulnerability due to deficient or excessive relational coding, on the other hand, leads to \"traumatic attachment\" which is one of the consequences of attachment trauma. In accordance with these concepts, Implicit Psychotherapy, as a technique of communication, provides a clinical framework for safely engaging with these pre-reflective, unspoken wounds through pacing, symbolic containment, and embodied relational experience. Dialectical Dynamic Therapy (DDT), as a conceptual framework, facilitates the re-establishment of internal moderation. The paper points toward transformative therapeutic pathways grounded in embodied relational repair, epistemic trust, and dynamic therapeutic engagement. Ultimately, the paper advocates for a post-linear model of trauma, one that embraces complexity, dialectical thinking, and the reparative potential of therapeutic relationships, while insisting on the need to \"unpack\" the overloaded construct of attachment trauma.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"417-422"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conceptualizing Attachment Trauma: A Developmental Trauma Perspective. 依恋创伤的概念化：一个发展性创伤的视角。

IF 2.4

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250508

Julian D Ford

{"title":"Conceptualizing Attachment Trauma: A Developmental Trauma Perspective.","authors":"Julian D Ford","doi":"10.36131/cnfioritieditore20250508","DOIUrl":"10.36131/cnfioritieditore20250508","url":null,"abstract":"Attachment trauma, as cogently formulated by Farina and Schimmenti (2025), involves traumatic experiences that fundamentally disrupt attachment bonding with primary caregivers and result in impairments in core self and relational capacities that include but extend beyond the symptoms of formal psychiatric nosology. An overview is provided of a clinical framework that similarly is grounded in clinical and scientific evidence of the adverse effects of a combination of traumatic victimization and attachment disruption, Developmental Trauma Disorder (DTD). Six domains of self-dysregulation are identified by DTD, including affective, somatic, attention/ memory, behavioral, interpersonal, and self-identity coherence, and evidence linking the features of DTD with attachment trauma is summarized. This commentary concludes that attachment trauma, as formulated by Farina and Schimmenti, offers an important framework to enable providers, theorists, and researchers to develop clinical formulations and approaches to treatment that explicitly recognize and directly address the all too often overlooked alterations in core self-regulatory capacities that result from coping with the traumatic disruption or loss of attachment security.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"397-399"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12614175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overcoming the Brain-Body Disconnect Following Attachment Trauma: A Comment on Farina and Schimmenti. 克服依恋创伤后脑-体分离：法里纳和施门提的评论。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250510

Ruth A Lanius

{"title":"Overcoming the Brain-Body Disconnect Following Attachment Trauma: A Comment on Farina and Schimmenti.","authors":"Ruth A Lanius","doi":"10.36131/cnfioritieditore20250510","DOIUrl":"10.36131/cnfioritieditore20250510","url":null,"abstract":"Farina and Schimmenti's (2025) model of Attachment Trauma (AT) reframes early relational adversity as a transdiagnostic, developmentally rooted process that disrupts emotional regulation, identity formation, and relational functioning. Rather than viewing trauma as a single catastrophic event, their model emphasizes chronic, inescapable relational disruptions, particularly in protection, attunement, and repair as core pathogenic mechanisms. This relationally situated view positions AT as a primary etiological force behind a range of clinical conditions, including complex PTSD, borderline personality disorder, and dissociative disorders. To strengthen this compelling framework, the current paper proposes the integration of somatosensory processing models, which offer neurobiologically grounded mechanisms for how AT becomes embedded neurobiologically. Dysregulation in vestibular and somatosensory systems, critical to bodily orientation, interoception, affect regulation, and social connection, may underlie the fragmentation and dissociation central to AT. A hierarchical neurobiological model is proposed, mapping disruptions from brainstem sensory circuits through limbic and cortical systems. A key implication of this model is the need to prioritize physiological regulation before initiating higher-order cognitive or relational interventions. Bottom-up approaches, including sensorimotor psychotherapy, somatic experiencing, and Deep Brain Reorienting (DBR) target shock, autonomic dysregulation and sensory fragmentation that can compromise traditional talk-based therapy. By stabilizing the nervous system and restoring sensorimotor integration, these methods prepare clients for deeper therapeutic work and support the reorganization of disrupted self and relational patterns inherent in attachment trauma.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"403-405"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Attachment Trauma: What has been Missing in Trauma Treatment. 依恋创伤：创伤治疗中缺失的东西。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250514

Roger Solomon

引用次数: 0

Conducting Effective Therapy for Attachment Trauma Requires Skill in Being Human. 对依恋创伤进行有效的治疗需要人类的技巧。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250502

Jon G Allen

{"title":"Conducting Effective Therapy for Attachment Trauma Requires Skill in Being Human.","authors":"Jon G Allen","doi":"10.36131/cnfioritieditore20250502","DOIUrl":"10.36131/cnfioritieditore20250502","url":null,"abstract":"Benedetto Farina and Adriano Schimmenti have synthesized the burgeoning literature on attachment trauma to draw attention to its prevalence and pervasive role in the development of diverse forms of severe and chronic psychopathology. These sequelae call for a multidimensional approach to treatment that is evidenced by a spate of trauma-related psychotherapies as well as biological interventions. While respecting the sheer complexity of attachment trauma, this commentary offers an integrative perspective for therapists of different orientations. Relying on decades of research on contributors to the effectiveness of psychotherapy, the author provides a distinctive view of the role of common factors that cut across the wide varieties of therapy. These factors pertain largely to qualities of patient-therapist relationships that are especially crucial in the treatment of attachment trauma. This commentary highlights five such common factors: attachment, mentalizing, trust, care, and-not least-the therapist. As Farina and Schimmenti's review attests, understanding the complexity and severity of illness associated with trauma requires a great deal of knowledge; concomitantly, establishing therapeutic relationships requires an exceptional level of interpersonal skill: skill in being human, to put it simply.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"374-378"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Attachment Trauma and its Psychopathological Domains Through the Neuropsychodynamic Model of Self and Trauma. 依恋创伤及其精神病理领域：自我与创伤的神经心理动力学模型。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250511

Andrea Scalabrini, Clara Mucci

引用次数: 0

Attachment Trauma Re-Viewed: A Commentary on Farina and Schimmenti (2025a). 依恋创伤的回顾：Farina和Schimmenti的评论（2025a）。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250503

Ken Benau, Onno van der Hart

{"title":"Attachment Trauma Re-Viewed: A Commentary on Farina and Schimmenti (2025a).","authors":"Ken Benau, Onno van der Hart","doi":"10.36131/cnfioritieditore20250503","DOIUrl":"10.36131/cnfioritieditore20250503","url":null,"abstract":"Farina and Schimmenti (2025a) have made a major contribution to furthering our understanding of early developmental trauma and its serious, long-term, psychosocial effects, while pointing toward therapeutic approaches deeply informed by their rich conceptualization of attachment trauma (AT) and clinical acumen. The authors' impressive review and integration of a wealth of developmental and clinical research has led them to propose a sophisticated yet clear definition of AT, as well as important notions on its relationship with disorganized attachment (DA) and a helicopter view on its treatment. We identify several appreciations of the authors' conceptualization and applications to clinical practice; offer suggestions for further clarification and expansion of ideas; and finally propose how we might \"continue the conversation\" with an emphasis on clinical theory and practice, past, present, and future. Farina and Schimmenti are to be strongly commended for providing a solid foundation from which to pursue, with greater clarity and intention, our field's ever-deepening and hope-engendering understanding and treatment of survivors of AT, for patients, therapists, and concerned loved ones.","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 5","pages":"379-383"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuing the Conversation for a Clinical Conceptualization of Attachment Trauma. 继续探讨依恋创伤的临床概念。

IF 3.8

Clinical Neuropsychiatry Pub Date : 2025-10-01 DOI: 10.36131/cnfioritieditore20250516

Adriano Schimmenti, Benedetto Farina

引用次数: 0