Papers by Alicia Lieberman
Prevention and intervention programs for supporting early attachment security
Ghosts and Angels in the Nursery
Wiley-Blackwell eBooks, Jul 21, 2010
On the Verge of Motherhood and Mental Illness: Prenatal Mental Health Service Utilization among Women at Highest Risk
Zero to Three, May 1, 2019
DC:0-3" to "DC:0-3R" to "DC:0-5": A New Edition
Zero to Three, 2015
Still Searching for the Best Interests of the Child
Psychoanalytic Study of The Child, 2007
This article describes recent developments in theory and clinical practice with traumatized child... more This article describes recent developments in theory and clinical practice with traumatized children in the birth to five age range. It revisits the treatment of an abused two-year-old girl and her mother from the perspective of the child's reappearance in the clinic twenty years later to ask about her past. The early treatment of the child and the mother is re-examined from the perspective of the advances in theory and practice about early childhood trauma in the intervening decades. These advances are contrasted with the persistent gap between the urgent needs of maltreated children and their families and the availability of services designed to support their mental health.
Contributions of attachment theory to infant–parent psychotherapy and other interventions with infants and young children
... Citation. Database: PsycINFO. [Chapter]. Contributions of attachment theory to infant-parent ... more ... Citation. Database: PsycINFO. [Chapter]. Contributions of attachment theory to infant-parent psychotherapy and other interventions with infants and young children. ... The third section describes other programs and approaches influenced by attachment theory. ...
Infant mental health journal, Aug 30, 2016
Infant mental health is explicitly relational in its focus, and therefore a diagnostic classifica... more Infant mental health is explicitly relational in its focus, and therefore a diagnostic classification system for early childhood disorders should include attention not only to within-the-child psychopathology but also between child and caregiver psychopathology. In this article, we begin by providing a review of previous efforts to introduce this approach that date back more than 30 years. Next, we introduce changes proposed in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood DC:0-5 (ZERO TO THREE, in press). In a major change from previous attempts, the DC:0-5 includes an Axis I "Relationship Specific Disorder of Early Childhood." This disorder intends to capture disordered behavior that is limited to one caregiver relationship rather than cross contextually. An axial characterization is continued from the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood DC:0-3R (ZERO TO THREE, 2005), but two major changes are introduced. First, the DC:0-5 proposes to simplify ratings of relationship adaptation/maladaptation, and to expand what is rated so that in addition to characterizing the child's relationship with his or her primary caregiver, there also is a characterization of the network of family relationships in which the child develops. This includes coparenting relationships and the entire network of close relationships that impinge on the young child's development and adaptation.
Attachment Disorders of Infancy
Springer eBooks, 2000
... Citation. Database: PsycINFO. [Chapter]. Attachment disorders of infancy. Handbook of develop... more ... Citation. Database: PsycINFO. [Chapter]. Attachment disorders of infancy. Handbook of developmental psychopathology (2nd ed.). Zeanah, Charles H.; Boris, Neil W.; Lieberman, Alicia F. Sameroff, Arnold J. (Ed); Lewis, Michael (Ed); Miller, Suzanne M. (Ed), (2000). ...
Zero to Three, 2017
This article introduces the revised and updated DC:0-5™: Diagnostic Classification of Mental Heal... more This article introduces the revised and updated DC:0-5™: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. The authors describe the past and current efforts to create a developmentally based classification system for very young children. DC:0-3, published in 1994 by ZERO TO THREE, was created to address the significant need for a systematic, developmentally based approach to the classification of mental health and developmental difficulties in the first 4 years of life (i.e., birth through 3 years old). Based on advances in knowledge, ZERO TO THREE decided to revise DC:0-3 and published DC:0-3R in 2005. The current revision, DC:0-5, was substantial, expanding the age range from 3 years old to 5 years old and expanding the number of diagnostic categories and clinical disorders from previous versions. The authors describe the new features of DC:0-5, detail three levels of the training model, highlight other DC:0-5 resources, and discuss the future of DC:0-5.
Development and Psychopathology, Feb 1, 2019
This replication study examined protective effects of positive childhood memories with caregivers... more This replication study examined protective effects of positive childhood memories with caregivers ("angels in the nursery") against lifespan and intergenerational transmission of trauma. More positive, elaborated angel memories were hypothesized to buffer associations between mothers' childhood maltreatment and their adulthood posttraumatic stress disorder (PTSD) and depression symptoms, comorbid psychopathology, and children's trauma exposure. Participants were 185 mothers (M age ¼ 30.67 years, SD ¼ 6.44, range ¼ 17-46 years, 54.6% Latina, 17.8% White, 10.3% African American, 17.3% other; 24% Spanish speaking) and children (M age ¼ 42.51 months; SD ¼ 15.95, range ¼ 3-72 months; 51.4% male). Mothers completed the Angels in the Nursery Interview (Van Horn, Lieberman, & Harris, 2008), and assessments of childhood maltreatment, adulthood psychopathology, children's trauma exposure, and demographics. Angel memories significantly moderated associations between maltreatment and PTSD (but not depression) symptoms, comorbid psychopathology, and children's trauma exposure. For mothers with less positive, elaborated angel memories, higher levels of maltreatment predicted higher levels of psychopathology and children's trauma exposure. For mothers with more positive, elaborated memories, however, predictive associations were not significant, reflecting protective effects. Furthermore, protective effects against children's trauma exposure were significant only for female children, suggesting that angel memories may specifically buffer against intergenerational trauma from mothers to daughters.
Infant mental health journal, Aug 29, 2016
Child Abuse & Neglect, Jul 1, 2011
Objective-This study involves a reanalysis of data from a randomized controlled trial to examine ... more Objective-This study involves a reanalysis of data from a randomized controlled trial to examine whether child-parent psychotherapy (CPP), an empirically based treatment focusing on the mother-child relationship as the vehicle for child improvement, is efficacious for children who experienced multiple traumatic and stressful life events (TSEs). Methods-Participants comprised 75 preschool-aged children and their mothers referred to treatment following the child's exposure to domestic violence. Dyads were randomly assigned to CPP or to a comparison group that received monthly case management plus referrals to community services and were assessed at intake, posttest, and 6-month follow-up. Treatment effectiveness was examined by level of child TSE risk exposure (<4 risks versus 4+ TSEs). Results-For children in the 4+ risk group, those who received CPP showed significantly greater improvements in PTSD and depression symptoms, PTSD diagnosis, number of co-occurring diagnoses, and behavior problems compared to those in the comparison group. CPP children with <4 risks showed greater improvements in symptoms of PTSD than those in the comparison group. Mothers of children with 4+ TSEs in the CPP group showed greater reductions in symptoms of PTSD and depression than those randomized to the comparison condition. Analyses of 6-month follow-up data suggest improvements were maintained for the high risk group. Conclusions-The data provide evidence that CPP is effective in improving outcomes for children who experienced four or more TSEs and had positive effects for their mothers as well. Practice Implications-Numerous studies show that exposure to childhood trauma and adversity has negative consequences for later physical and mental health, but few interventions have been specifically evaluated to determine their effectiveness for children who experienced multiple TSEs. The findings suggest that including the mother as an integral participant in the child's treatment may be particularly effective in the treatment of young children exposed to multiple risks.
Psychodynamic therapy for child trauma
Adversity and Resilience Science, Jun 1, 2020
The present study examined developmental antecedents of angels and ghosts in the nursery during t... more The present study examined developmental antecedents of angels and ghosts in the nursery during the pregnancy and postnatal periods. Higher levels of benevolent childhood experiences (BCEs) were hypothesized to predict higher levels of angels in the nursery at both periods, whereas higher levels of adverse childhood experiences (ACEs) were expected to predict higher levels of ghost in the nursery at both periods. Participants were 101 low-income, ethnically diverse pregnant women (M = 29.10 years, SD = 6.56, range = 18-44; 37% Latina, 22% African American, 20% White, 13% biracial/multiracial, 8% other) planning to deliver at an urban general hospital. During their second or third trimester, they reported on ACEs, BCEs, and demographic information. During pregnancy and 3-4 months of postnatal, they completed the Angels in the Nursery Interview (Van Horn, Lieberman, & Harris, 2008), coded by trained raters for quality of loving memories with childhood caregivers (angel memories) and traumatic intrusions of childhood adversity (ghost memories). Results revealed moderate stability of angel and ghost memories across the perinatal period. Higher levels of BCEs directly predicted higher levels of angel memories during pregnancy, and indirectly predicted higher levels of angel memories during the postnatal period through angel memories during pregnancy. Higher levels of ACEs directly predicted higher levels of ghost memories during both periods. BCEs did not predict ghost memories and ACEs did not predict angel memories. Findings support independent pathways of risk and resilience through the pregnancy period with distinct origins in women's childhood adversity versus positive childhood experiences. Implications for promoting intergenerational resilience by linking and leveraging BCEs and angel memories and recovering from ACEs and ghost memories are discussed.
Disorders of Attachment in Infancy
Child and Adolescent Psychiatric Clinics of North America, Jul 1, 1995
ABSTRACT Proposes a monology of attachment disorders that includes categories for disorders of no... more ABSTRACT Proposes a monology of attachment disorders that includes categories for disorders of nonattachment, disordered attachments, and lost or broken attachments. Current diagnostic classifications such as Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) address only disorders of nonattachment. The article also explicates briefly the concept of attachment and its behavioral and representational manifestations; describes normative variations in the quality of attachment in nonclinical populations; elucidates when relationship disturbances become disorders of attachment; and describes infant-parent psychotherapy as the most comprehensive method currently available for treating disorders of attachment. Case examples of 6 infants (aged 16–30 mo) with disorders of attachment are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Papers by Alicia Lieberman