David Geffen School of Medicine, University of California Los Angeles Northridge, CA, USA.
Front Psychol. 2014 Sep 23;5:1049. doi: 10.3389/fpsyg.2014.01049. eCollection 2014.
There is now a strong if not urgent call in both the attachment and autism literatures for updated, research informed, clinically relevant interventions that can more effectively assess the mother infant dyad during early periods of brain plasticity. In this contribution I describe my work in regulation theory, an overarching interpersonal neurobiological model of the development, psychopathogenesis, and treatment of the early forming subjective self system. The theory models the psychoneurobiological mechanisms by which early rapid, spontaneous and thereby implicit emotionally laden attachment communications indelibly impact the experience-dependent maturation of the right brain, the "emotional brain." Reciprocal right-lateralized visual-facial, auditory-prosodic, and tactile-gestural non-verbal communications lie at the psychobiological core of the emotional attachment bond between the infant and primary caregiver. These affective communications can in turn be interactively regulated by the primary caregiver, thereby expanding the infant's developing right brain regulatory systems. Regulated and dysregulated bodily based communications can be assessed in order to determine the ongoing status of both the infant's emotional and social development as well as the quality and efficiency of the infant-mother attachment relationship. I then apply the model to the assessment of early stages of autism. Developmental neurobiological research documents significant alterations of the early developing right brain in autistic infants and toddlers, as well profound attachment failures and intersubjective deficits in autistic infant-mother dyads. Throughout I offer implications of the theory for clinical assessment models. This work suggests that recent knowledge of the social and emotional functions of the early developing right brain may not only bridge the attachment and autism worlds, but facilitate more effective attachment and autism models of early intervention.
现在，在依恋和自闭症文献中，都强烈呼吁更新研究信息、具有临床相关性的干预措施，以便更有效地评估大脑可塑性早期的母婴对子。在本贡献中，我描述了我在调节理论方面的工作，这是一个涵盖性的人际神经生物学模型，用于研究早期形成的主观自我系统的发展、心理发病机制和治疗。该理论模拟了心理神经生物学机制，通过这些机制，早期快速、自发且因此隐含情感的依恋交流不可磨灭地影响右脑（“情绪脑”）的经验依赖性成熟。互惠的右侧视觉-面部、听觉韵律和触觉-手势非言语交流是婴儿和主要照顾者之间情感依恋联系的心理生物学核心。这些情感交流反过来可以由主要照顾者进行互动调节，从而扩展婴儿正在发育的右脑调节系统。可以评估调节和失调的基于身体的交流，以确定婴儿的情感和社会发展的持续状态，以及婴儿-母亲依恋关系的质量和效率。然后，我将该模型应用于自闭症的早期评估。发展神经生物学研究记录了自闭症婴儿和幼儿早期发育右脑的重大改变，以及自闭症婴儿-母亲对子中严重的依恋失败和主体间缺陷。在整个过程中，我都提供了该理论对临床评估模型的影响。这项工作表明，对早期发育右脑的社会和情感功能的最新认识不仅可能弥合依恋和自闭症领域之间的差距，还能促进更有效的依恋和自闭症早期干预模型。
