Fostering secure attachment in infants in maltreating families through preventive interventions

University of Rochester, Rochester, New York, United States
Development and Psychopathology (Impact Factor: 4.4). 02/2006; 18(3):623-49. DOI: 10.1017/S0954579406060329
Source: PubMed

ABSTRACT The malleability of insecure and disorganized attachment among infants from maltreating families was investigated through a randomized preventive intervention trial. Findings from research on the effects of maltreatment on infant attachment were incorporated into the design and evaluation of the intervention. One-year-old infants from maltreating families (N = 137) and their mothers were randomly assigned to one of three intervention conditions: (a) infant-parent psychotherapy (IPP), (b) psychoeducational parenting intervention (PPI), and (c) community standard (CS) controls. A fourth group of infants from nonmaltreating families (N = 52) and their mothers served as an additional low-income normative comparison (NC) group. At baseline, mothers in the maltreatment group, relative to the nonmaltreatment group mothers, reported greater abuse and neglect in their own childhoods, more insecure relationships with their own mothers, more maladaptive parenting attitudes, more parenting stress, and lower family support, and they were observed to evince lower maternal sensitivity. Infants in the maltreatment groups had significantly higher rates of disorganized attachment than infants in the NC group. At postintervention follow-up at age 26 months, children in the IPP and PPI groups demonstrated substantial increases in secure attachment, whereas increases in secure attachment were not found for the CS and NC groups. Moreover, disorganized attachment continued to predominate in the CS group. These results were maintained when intent to treat analyses were conducted. The findings are discussed in terms of the utility of translating basic research into the design and evaluation of clinical trials, as well as the importance of preventive interventions for altering attachment organization and promoting an adaptive developmental course for infants in maltreating families.

  • [Show abstract] [Hide abstract]
    ABSTRACT: There are still important gaps in our knowledge regarding the intergenerational transmission of attachment from mother to child, especially in mothers with childhood histories of abuse and neglect (CA&N). This study examined the contributions of reflective function concerning general attachment relationships, and specifically concerning trauma, as well as those of maternal attachment states of mind to the prediction of infant attachment disorganization in a sample of mothers with CA&N and their infants, using a 20-month follow-up design. Attachment and reflective functioning were assessed during pregnancy with the Adult Attachment Interview. Infant attachment was evaluated with the Strange Situation Procedure. The majority (83%) of infants of abused and neglected mothers were classified as insecure, and a significant proportion (44%) manifested attachment disorganization. There was a strong concordance between mother and child attachment, indicative of intergenerational transmission of attachment in parents with CA&N and their infants. Both unresolved trauma and trauma-specific reflective function made significant contributions to explaining variance in infant attachment disorganization. The findings of this study highlight the importance of trauma-specific mentalization in the intergenerational transmission of attachment by mothers with a history of childhood maltreatment, and provide new evidence of the importance of the absence of mentalization regarding trauma for infant attachment. © 2015 Michigan Association for Infant Mental Health.
    Infant Mental Health Journal 02/2015; DOI:10.1002/imhj.21499 · 0.61 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Risk for committing child abuse is frequently attributed to an intergenerational “cycle of violence” through which abuse as a child increases risk for committing abuse as a parent. While this hypothesis has support, more research is needed to understand the factors that account for this pattern of risk. Given literature suggesting that adults with a history of child maltreatment have increased risk for a wide range of psychopathology, this study examined the role of two behavioral endophenotypes, emotional dysregulation and negative affect, in the association between maternal experiences of childhood maltreatment and maternal child abuse potential among 83 low-income, primarily African-American mothers of elementary school age children. Results indicate that a mother’s experience of abuse as a child predicts later risk for abusive parenting as measured by child abuse potential scores. However, our data also indicate that the relationship between maternal experience of child abuse and later child abuse potential is mediated by maternal emotional dysregulation and negative affect.
    Journal of Family Violence 07/2014; 29(5):483-494. DOI:10.1007/s10896-014-9606-5 · 1.17 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: this pilot study examined the potential impact of a perinatal adaptation to Child-Parent Psychotherapy (CPP), an evidence-based treatment for traumatized moth-er–child dyads, on maternal functioning 6 months post-partum among women with history of complex trauma and current intimate partner abuse. Pregnant women (n = 64) enrolled during the third trimester of their pregnancy (Mean gestational age = 27.48 weeks, range of 12 to 42) and participated in weekly perinatal CPP sessions until their infant was 6 months old. Women completed measures of trauma history, depression, posttraumatic stress symptoms (PtSS), and child-rearing attitudes at pre-and post-treatment. results showed decreases in depression and PtSS from pre-to post-treatment assessments, as well as an increase in positive child-rearing attitudes. as hypothesized, women with low maternal-fetal attachment demonstrated the greatest improvement in depression, PtSS, and child-rearing attitudes compared to women with high maternal-fetal attachment. the current study provides promising results indicating that a perinatal † deceased. This study was conducted with the generous grant from the Hedge Funds Care Foundation and was supported by the European Commission Marie Curie International Outgoing Fellowship awarded to the first author.
    Journal of Social and Clinical Psychology 01/2015; 34(1):64-82. · 1.36 Impact Factor

Full-text (2 Sources)

Available from
Jul 11, 2014