Características generales del tracto respiratorio humano

The first set of nine-point rating scales is designed to assess the individual’s likely childhood experience, and together they constitute the Probable Past Experience Scales. Every second point is anchored with an operational definition. Mary Main delineated five separate scales which cover distinctive but related areas of experience, which include the following areas: the degree to which, during their childhood, interviewees experienced parents who were loving; rejecting; neglecting; role-reversing; and pressuring to achieve. The UCL manual includes a sixth scale, that is a rating of the extent to which the parenting provided was overprotective. The six Probable Experience Scales may be considered ‘parent-specific’ as each of the scales is separately applied to consideration of the parenting provided by the subject’s mother, and father. What follows are definitions of each of these Probable Experience Scales, with descriptions of interview material that would indicate low, moderate or high scores on each of the scales.

LOVING

The Loving Scale assesses the extent to which the adult is likely to have experienced a supportive childhood. The rating is based both on the global assessments the adult provides, and on the presentation of specific incidents which support a picture of a loving relationship. It is not imperative that the adult describe the parent using the adjective "loving", but rather that the overall picture conveys this experience.

At the low end of this scale, the interview content is judged as unloving where a parent is deemed to have provided only physical or even educational care, without affection, emotional support or interest. In the middle range, there are some indications of affection and adequate parenting was probably provided, but there is a distinct paucity of special memories to support a view of a loving childhood. There may be a consistent set of moderate signs of love, but these are balanced by negative signs (e.g. parent was at times absent or frightening). At the high end of the scale, the individual is rated as having experienced a firm sense of emotional support from the parent. Furthermore, the parent was someone who could be trusted in times of trouble and was actively loving. These transcripts provide consistent evidence (i.e. memories of physical affection, comfort) of loving experiences which outweigh negative aspects. Direct statements such as those below, especially when "volunteered" rather than given as a response to a question, are clear indicators of high

ratings on the Loving Scale:

- "I always knew she/he was there for me"; - "No matter what, I could depend on him/her."

REJECTION

The Rejection Scale addresses the issue of a parent having actively engaged in rejecting the child. It is designed to assess the degree to which the parent is likely to have rebuffed and avoided the child.

At the low end of the scale the individual presents some evidence of mildly rejecting experience. For example, memories of parents who stressed early or inappropriate independence, or memories of quarrels involving the child. At the moderate level there is evidence of a parent having been reserved, cool, stem or inexpressive with a conspicuous absence of overt encouragement. At the high end of this scale there is evidence for a real and pervasive turning away from the child. Parent seems to have wanted to be rid of the child. Subjects scoring high on this scale recall active rejection by the parent, having been the recipient of degrading or abusive treatment, being told to leave, or receiving an unusually unsympathetic response when hurt.

NEGLECT

This scale allows for the possibility that neglect may be independent of rejection. For example, a parent may give little or no attention to a child without being actively and highly rejecting. Neglect due to parental illness or professional preoccupations need not involve active rejection. Conversely, a highly rejecting parent need not also be highly neglecting. A child who is highly rejected will often not be completely neglected, as attention and responsiveness may be negative. Neglect may involve physical absence and/or psychological unresponsiveness.

The Neglect Scale assesses the extent to which the parent was inattentive, inaccessible or otherwise occupied. Reasons for the parental neglect may have included a large household; time-consuming professional activity on the part of the parent; parent being away for long periods; parent depressed or ill. At the low end of the scale, the child missed out on play, interaction, or conversation. The parent was, in a limited way, preoccupied with work or household; absent for brief or intermittent periods. At the middle of the scaleA there was definitely insufficient parental attentiveness. The parent was extensively preoccupied with work or household. However, there were interruptions to this pattern: the parental failure was consistent but only partial, or there was a brief period of complete parental failure (e.g. prolonged absence but reunited). At the high end of the scale, the child’s needs, interests, failures

and achievements were unnoticed. The parent and child were unknown to one another, because of repeated parental absences and/or because of a profound lack of connection. The highly neglecting parent was either not physically present or present but emotionally inaccessible to the child.

INVOLVING/ROLE REVERSING

The involving/role-reversing scale is designed to assess the degree to which the parent-child relationship was reversed so that it was the child who felt responsible for the parent and not vice versa. Indications for this scale include memories of parental incompetence, conspicuous worrying by the child, and feeling responsible toward the parent.

At the low end of this scale the individual presents a picture of the parent as slightly incompetent and/or the child having been worried about or having, in slight ways, protected the parent. The parent may at times have been disorganised or confused, and the child may have had to take on some adult­ like responsibilities (such as caring for younger siblings) but the child was not called upon to care for the parent. At the moderate end of the scale, the individual’s experience seems to have been of having a parent who may have been clearly incompetent but could be relied upon in emergencies. The subject expresses having felt some responsibility for the parent but this did not become an outstanding feature of the relationship. At the high end of the scale the

individual presents a childhood history where the parent either manifested (or was seen to manifest) such a degree of incompetence that the child could not avoid having the parent’s welfare as their primary concern or, for reasons which may not be clear, the child continuously appeared to take responsibility for the parent. It is important to note that severe signs may co-exist with evidence that the parent provided physical care/warmth.

PRESSURING TO ACHIEVE

This scale is designed to assess the degree to which the individual experienced pressure to achieve some particular status or position, or was pushed to exceed other children or family members during childhood.

At the low end of the scale, the individual presents a picture of the parent as having been overly but not unreasonably concerned with grades or school performance, but this was limited to exam time. Failure to achieve was not connected to punishment and the child was not continuously pushed. At the moderate level, the pressure to achieve was a consistent feature of the parent-child relationship, but did not wholly determine it. The parent was clearly invested in the child’s performance, but did not withdraw from the child if this was not achieved. At the high end of the scale, the child’s achievements were the basis for the parent-child relationship and little or no concern was shown for the deleterious effects this would have on the child.

OVERPROTECTION

An addition made to the Main system is the UCL Overprotection Scale. This scale assesses the extent to which the subject experienced excessively over-protecting parenting, such that it greatly restricted the individual’s freedom to enjoy ordinary childhood pleasures.

At the low end of the scale, the parent was mildly overprotective in general, perhaps overconcemed about safety issues. The parent was somewhat excessive in his/her worries for the child’s welfare, but this had a limited influence on behaviour; e.g. was restricted to a single issue such as crossing the street alone. At the mid-range of this scale the individual seems to have had parents who consistently worried about the child’s welfare in a variety of situations; and, while this had a wide influence on the parent’s behaviour toward the child, there was an appreciation of the child’s need for independence. At the high end of this scale, the individual conveys a picture where the parent restricted the child’s behaviour in definite ways; e.g. routine prohibition to join peers on outings considered by the parent as "too dangerous." The parent’s overwhelming worries severely restricted the child and the overprotectiveness took the form of cruel or highly unreasonable interference, where the child’s freedom to explore was severely restricted.

PRESENT STATE OF MIND ABO U T ATTACHMENT

The second set of ratings focuses on the degree to which the individual has an objective and affectively appropriate account of their childhood history and current thinking about attachment The ratings are based on nine-point scales, with the mid-point marking moderate levels of the mental state being considered. This set of ratings is meant to describe the way in which subjects organise and understand their attachment-related experiences, the probable nature of which was the focus of the first set of ratings. More than the Probable Experience ratings, the State of Mind ratings are crucial to the overall classification decision. Mary Main’s original manual contains nine nine-point scales designed to assess the individual’s current state of mind with regard to attachment. Some of these scales are parent-specific (e.g. Idealization), i.e. rated separately with respect to the individual’s representation of mother, and father. Other of these scales are not parent-specific, i.e. rated with respect to the quality of the individual’s general attitude (e.g. Passivity of Thought) toward attachment-related topics evidenced by the narrative quality of their answers to the AAI questions. The UCL version includes, in addition to those scales enumerated by Main et al., one global scale (Aggression) and two parent-specific scales (Guilt and Quality of the Present-day Relationship with Parents). What follows are definitions and descriptions of each of the 12 State of Mind Scales.

PARENT-SPECIFIC STATE O F MIND SCALES•

IDEALIZATION

The Idealization Scale focuses on the degree to which the individual’s account of his or her childhood experience is objective and consistent. Specifically, this scale assesses the amount of distance in the transcript between generalized or semantic representations (e.g. "my parents were loving") and actual memories (e.g. "I was afraid to talk to them when I was upset"). High idealization is rated where there is evidence of praise which is out of context, unsupported or extreme, or the subject is unable to acknowledge any difficulties in the parent-child relationship.

At the low end of the Idealization Scale the individual seems aware of slight faults/difficulties with their parents, and presents one or two only partially supported adjectives or statements of praise, or at least one instance of praise which is extreme or out of context. This kind of evidence may be expected in the early part of the interview when subject is "settling in." Moderate ratings of idealization are assigned when there is a lack of acknowledgement or normalizing of at least one significant negative experience. There are indications of an inability to allow for realistic and expectable difficulties, in conjunction with extreme or out of context praise. At the high end of the scale, the individual normalizes extreme negative

experiences, or makes no allowance for expectable difficulties, in conjunction with extreme positive statements. Idealization at this high level appears to the reader as a sign of irrational thought processes.

ACTIVE DISMISSAL/DEROGATION OF ATTACHMENT EXPERIENCES OR RELATIONSHIPS

The Derogation Scale assesses the extent to which the individual presents evidence which understates the importance and influence of their childhood history and of attachment relationships.

At the low end of the scale there is evidence of a cool dismissal belied by an underlying valuing of attachment. There may also be a lack of full acknowledgement of the significance of attachment-related experiences. In the moderate range of the scale, there are signs of a dismissing attitude towards attachment experiences or loss, with some limited acknowledgement of the influence upon the self of attachment-related experiences. At the high end of the scale, the individual shows an active, cool dismissal, without any mitigating acknowledgement of the effects (either positive or negative) of attachment-related experiences. In the extreme case, there is evidence of thematic, continued reference to how little value is attached by the individual to the representation of the parent.

CURRENT PREOCCUPYING ANGER

The Preoccupying Anger Scale is designed to assess the degree to which the individual expresses anger toward attachment figures within the interview context. The presence of unmodulated affect is often indicated by incoherencies and contradictions in the discourse.

At the low end of this scale is the expression of anger towards the parent in a form which indicates some current preoccupation such as recalling incidents of unfavourable parenting, but these are clearly placed in the past. Recent examples of anger are either dismissed, or described with reflection, humour and self-containment. There may also be instances where the subject shows irritation or surprise at still sensing anger about the past, or a continuing offence, but the anger is acknowledged and the effort to gain interviewer agreement, where present, is momentary. In the moderate range, there is expression of anger but it is contained, perhaps accompanied and mitigated by humour. Involving anger towards the parent is not a theme of the interview. At the high end of the scale, strong anger may run throughout the interview or suddenly make a brazen appearance. In extreme cases, subjects are only able to discuss the offending parent in terms of their preoccupying anger, and make implicit efforts to elicit interviewer agreement with an emotionally charged denigration of the parent.

PRESENT GUILT

This UCL scale assesses the extent to which the individual carries a sense of blame, deserved punishment or being culpable with respect to attachment-related experiences or relationships.

At the low end of the scale, the subject expresses some regrets/concerns in relation to attachment figures. The subject may share a feeling of an irrational sense of responsibility, which they recognize as excessive, and convey the sense that the burden of responsibility lies with the parent. In the moderate range of the scale, the subject offers self-reproachful comments or repeated reference to the role of the self in attachment-related difficulties; importantly, the subject does not seem to recognize that this sense of personal responsibility for the parent’s behaviour is excessive. At the severe end of the scale, the subject indicates an oppressive sense of having carried the burden of responsibility both for difficulties in the relationship to the parent and, overall, for maintaining the relationship.

QUALITY OF PRESENT-DAY RELATIONSHIP WITH PARENT

The motivation for developing this UCL scale comes from a recent article by Ainsworth (1989) in which she notes that attachment research has yet to establish the extent to which parent-child relationships develop over time into symmetrical relationships. This scale was thus designed to assess the extent to which the adult has entered into a symmetrical relationship with the parent. Symmetry in this context means that each person, in some ways and at some times, views the other as stronger and wiser, so that each can gain security in the relationship and can give care to the other.

At the low end of the scale, there is little pleasure in interactions with the parent and these interactions occur infrequently, if at all. When the parent requests help from the child (e.g. parent is weak, old or otherwise in need of care) the subject resents the role of parenting the parent. In the moderate range, the subject is aware that ‘old’ dispositions exist and actively seeks to achieve a more symmetrical relationship. There is some pleasure derived from interactions with the parent. In cases where the adult must care for the parent, they may do so but with some resentment. At the high end of the scale the individual and their parent seem to share equally in a sense of pleasure and security derived from interactions, which tend to occur frequently. Both subject and parent serve as sources of support and understanding to one another. If the parent needs to be parented, the subject performs this duty without excessive

NON-PARENT-SPECIFIC STATE OF MIND SCALES:

INABILITY TO RECALL CHILDHOOD ATTACHMENT EXPERIENCES

Inability to recall in the context of the AAI appears to have two distinct dimensions. The first was identified in the Main system in terms of the Insistence upon an Inability to Recall Scale. This scale assesses the degree to which an individual repeatedly, and strenuously, reports difficulties with the recollection of childhood attachment experiences. The UCL manual has added a further assessment of recall to allow for those cases where, objectively, memory is noticeably impoverished, but the subject is not distressed and does not insist on an inability to remember. Thus, actual or objective inability to recall may merit distinction from the subjective insistence upon an inability to recall.

ACTUAL OR OBJECTIVE INABILITY TO RECALL

At the low end of the scale, the subject offers relevant memories including ones from early childhood, often with vivid, perceptual detail. These memories are central to the general feeling of the individual’s childhood. In the moderate range of the scale, individual offers only somewhat relevant memories (more of adolescence than of childhood), or a number of childhood

memories, many of which are only incidental to attachment. At the high end of this scale, there is an absence of relevant memories. Where there are