Função reflexiva e capacidade de vinculação em mães de crianças com Transtorno de Déficit de Atenção e Hiperatividade - TDAH

Abstract

Based on the premise that early attachment experiences with the primary caregiver (mother) may have an influence on the emergence or worsening of psychopathological conditions such as Attention Deficit Hyperactivity Disorder - ADHD, two studies were developed, one theoretical and one empirical. which gave rise to three articles. The first article reviews the existing literature on children's ADHD and attachment theory, based on searches for theoretical and empirical studies in international and national literature. In Brazil, no article was found. The review indicates that childhood ADHD may be associated with instability in early attachment relationships. The second article presents an exploratory, quantitative, cross-sectional and comparative study of the case-control type that found differences in a group of 30 mothers of children with ADHD and 30 mothers of children with typical development in terms of Reflective Function, mentalization and maternal attachment. The instruments used were Reflective Functioning Questionnaire (RFQ) and Multidimensional Scale of Interpersonal Reactivity (EMRI) to assess Reflective Function and Perception Inventory of Maternal (IPVM ) to assess maternal bonding. It was found that the group of mothers of children diagnosed with ADHD showed a significant difference in relation to the control group regarding uncertainty regarding mental states, reflecting low mentality in relation to the compared group. The mothers of children with ADHD, therefore, had less capacity for reflexive function than mothers of children with typical development. The third article was a qualitative approach through a multiple case study with five dyads composed of children with ADHD and their mothers, the samples derived for convenience from the first empirical study. The mental representations of the children in relation to their mothers and of them in relation to their history and bond with the child were evaluated. The instruments were: mentalization interview and mental representations of life history with the mothers, the Global Scale and the Specific Signal Frequency Scale applied to Family Design and the MacArthur Story Stem Battery (MSSB) applied to children. It was found that transgenerational aspects are present in the internal representations of attachment and that traumatic situations of excessive stress, abandonment or instability in bonds with caregivers in childhood are associated with insecurity of attachment and difficulties in development. Such findings suggest that early situations of stress and abandonment, experienced in childhood, can establish transgenerational transmission of representation of unsafe attachment, interfering in the mother-child bond and causing impairment in development. Together, the findings of the present thesis allow us to conclude that there are indications that good conditions of reflexive function and mentalization in mothers may be essential in the development of representation of safe attachment in the child. This being a protective condition, given the difficulties in the development and emergence of diverse Psychopathologies, such as ADHD. Despite the vast international literature on the repercussions of attachment on childhood ADHD, studies in Brazil are still scarce, which represents a need to expand research on this topic.