This chapter begins with Bowlby’s theoretical work in the 1940s and 1950s and the evolution of attachment theory. Ainsworth’s seminal empirical research in the 1960s and 1970s, introducing the concepts of attachment security and caregiver sensitivity, is then discussed. This early theoretical and empirical research on infant attachment is evaluated in light of key findings published in the intervening years. Current views on factors predicting attachment security are presented, focusing on parental state of mind with regard to attachment, the quality of infant–parent interaction, aspects of the social environment, and child-centered factors. The chapter concludes with a summary of important questions on attachment that remain unanswered.
Kelly C. Allison and David B. Sarwer
Body image disturbances are common among women in the general population. Less is known about their prevalence and impact during pregnancy. This chapter examines the history of body image theory and research. Next, we examine issues related to body image during pregnancy, such as pregravid weight, gestational weight gain, and the unique ways women think about the changes to their body during pregnancy. The role of physical activity, mood, and eating disorders in relation to peripartum body image disturbance is also discussed. Finally, assessment of body image disturbance and existing treatments are presented. Future research is needed to develop peripartum-specific body image assessment tools and to assess the impact of psychosocial interventions during and after pregnancy on body image dissatisfaction.
Laura J. Miller
Becoming pregnant and giving birth can lead to considerable psychological, behavioral, and cognitive transformation. The nature and scope of change varies a great deal from woman to woman. This chapter summarizes qualitative and quantitative research on normal psychological adaptation to pregnancy, including recognition and acceptance of the pregnant state, experience of the boundary between self and fetus, and body image changes. It reviews research on internal representations of the fetus and fetal and neonatal attachment. Perinatal changes in stress reactivity and coping style are reviewed. The chapter explains the influence of women’s prenatal expectations about labor and delivery on subsequent experiences and reactions and describes normative postpartum mood reactivity. Perinatal effects on sleep, physical activity, sexual activity, and eating patterns are described. Controversies about the effects of pregnancy on cognition are examined. The chapter also covers topics related to the transition to motherhood, including influences on maternal self-esteem and self-efficacy.
Relational Agents in Health Applications: Leveraging Affective Computing to Promote Healing and Wellness
Timothy W. Bickmore
This chapter is from the forthcoming The Oxford Handbook of Affective Computing edited by Rafael Calvo, Sidney K. D'Mello, Jonathan Gratch, and Arvid Kappas. Computer agents can emulate the best practices of human healthcare providers in automated health education and health behavior change systems designed to promote healthy behavior such as diet, exercise, medication adherence, and self-care management. By simulating face-to-face counseling with a healthcare provider who is attuned to patients’ affective state, and simulating empathy and other emotions in turn, patient–agent rapport, trust, and therapeutic alliance can be established. These qualities of working relationships are known to be significant determiners of health outcomes in human–human counseling. This chapter surveys research in building such agents and clinical trials of their efficacy.