Parental beliefs, infant temperament, and marital quality: Associations with infant–mother and infant–father attachment.

The present research examined parental beliefs about the importance of the paternal caregiving role, mothers’ and fathers’ reports of infant temperament, and observed marital quality as predictors of infant–mother and infant–father attachment security, over and above the effects of parental sensitivity. Infants’ attachment security to mothers and fathers were observed in the Strange Situation at 12 and 13 months, respectively (N = 62 two-parent families). Hierarchical regression models revealed that mothers who viewed the paternal caregiving role as important were less likely to have securely attached infants, but only when infant fussiness was high. In addition, fathers who viewed the paternal caregiving role as important were more likely to have securely attached infants, but only when infants’ fussiness or marital quality was high. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcomes from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program for bereaved caregivers.

Although preventive efforts for bereaved individuals have not been shown to be particularly effective in past studies, it has been suggested that intervention effects might be underestimated due to methodological issues such as short follow-up assessments. Thus, the present study aimed to assess the efficacy (as whole intervention packages and as component parts) of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) interventions in preventing complicated grief, normal grief, and depressive symptoms at a longer term follow-up assessment among bereaved caregivers (N = 224). On average, active interventions showed a statistically significant effect on normal grief symptoms (d = 0.28), exhibited a trend toward improvement on complicated grief symptoms (d = 0.25), and demonstrated little impact on depressive symptoms (d = 0.09). Interestingly, the examination of intervention components revealed differential effects, whereby cognitive and behavioral strategies were most effective at reducing levels of complicated grief, information and emotional support were most effective for addressing normal grief, and environmental modifications were most effective for ameliorating depressive symptoms. These findings suggest that different preloss interventions might be warranted depending on a caregiver's unique clinical presentation and combination of risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Relation Between Maternal State of Mind and Sensitivity in the Prediction of Infant Attachment Security.

Attachment theorists assume that maternal mental representations influence responsivity, which influences infant attachment security. However, primary studies do not support this mediation model. The authors tested mediation using 2 mother-infant samples and found no evidence of mediation. Therefore, the authors explored sensitivity as a moderator, studying the (a) interaction of mental representation and sensitivity as it predicts infant attachment security and (b) level of sensitivity in mothers whose infants' attachment security is either concordant or discordant with their own. The interactional analyses were not significant. But the match-mismatch data showed that when mother-infant attachment strategies were discordant, maternal sensitivity was more consistent with infant than maternal attachment strategy. These findings are congruent with an interpretation of sensitivity as a moderator that can block transmission of attachment strategy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parenting education with expectant and new parents: A meta-analysis.

The present meta-analysis integrates the effects of randomized controlled trials that focus on promoting effective parenting in the transition to parenthood. We included 142 papers on interventions which started during pregnancy or in the first 6 months after birth. Computations were based on random-effects models. On average, interventions had small to very small significant effects on parenting (d = .35 SD units), parental stress (d = .20), child abuse (d = .13), health-promoting behavior of parents (d=.15), cognitive development (d = .24), social development (d = .30), motor development of the child (d = .15), child mental health (d = .40), parental mental health (d = .31), and couple adjustment (d = .13). Most of the effects were maintained at follow-up. Effects varied by onset of the intervention, delivery mode, qualification of the intervener, length of intervention, intervention goals, and gender distribution. In addition, we found that older studies reported greater effect sizes. We conclude that parenting-focused interventions are effective and should be made accessible to more expectant and new parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Where is the infant in infant intervention? A review of the literature on changing troubled mother-infant relationships.

Four intervention models that aim to reduce problematic caregiver–infant relationships are reviewed within the context of attachment theory. These models include support, guidance, psychotherapy, and infant-led psychotherapy. All of the models are consistent with attachment theory in that they aim to enhance maternal sensitivity and responsiveness. Only infant-led psychotherapy focuses primarily on the mother–infant relationship and directly includes the infant in treatment instead of focusing and working primarily with the more verbal partner, the caregiver. Thus, of the 4 interventions, infant-led psychotherapy is most consistent with the current empirical and theoretical understanding of infants as active contributors to their relationships and development. However, there is little empirical research on this intervention; the bulk of studies evaluate support and guidance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Post-partum employment patterns, family-based care arrangements, and the mother–infant relationship at age two.

This longitudinal study examined the relations of postpartum maternal employment profiles with infant–mother attachment security, maternal sensitivity, and concurrent child and maternal characteristics in Canada. Ss were 57 mothers (aged 21–37) and their 23–27 mo-old children. Contrary to expectations, dyads where mothers returned to outside work after 6 mo postpartum showed higher Q-sort scores on attachment security than other dyads, and higher sensitivity scores than dyads in which women were not employed outside the home in the 1st 2 yrs. Post 6-mo returners also reported less child domain parental stress, less avoidant coping, and less child externalizing behavior problems than other mothers. Results emphasize the importance of a process-oriented approach to understanding early relationships in a family context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early intervention in adoptive families: supporting maternal sensitive responsiveness, infant-mother attachment, and infant competence

Results from adoption studies suggest that adoptive families may experience special impediments with respect to the developmental progress and outcome of their children. Based on attachment theory, two early intervention programs were designed to support families in the Netherlands with an internationally adopted child. The intervention aimed at promoting maternal sensitive responsiveness, secure infant-mother attachment relationships, and infant exploratory competence. Ninety families with an interracially adopted infant (71 from Sri Lanka and 19 from Korea) were assigned to either a control group or one of two intervention groups. All of the children, 44 boys and 46 girls, were placed for adoption under the age of 5 months (M = 8 weeks). The first intervention group (N = 30) received a personal book, which focused on sensitive parenting. The second intervention group (N = 30) was provided with the same book as well as with three video-feedback sessions at their home. The control group (N = 30) did not receive intervention. In the control group sensitive responsiveness and security of attachment were comparable to outcomes from normative samples. The least intensive program, the personal book, did not bring about change in mothers or infants. In contrast, intervention effects were established upon maternal sensitive responsiveness, infant competence, and infant-mother attachment in the group that received both the book and video feedback.     

Another Look Inside the Gap: Ecological Contributions to the Transmission of Attachment in a Sample of Adolescent Mother-Infant Dyads.

Ecological contributions to attachment transmission were studied in a sample of 64 adolescent mother-infant dyads. Maternal sensitivity was assessed when infants were 6 and 10 months old, and infant security was assessed at 15 and 18 months. Maternal attachment state of mind was measured with the Adult Attachment Interview (AAI) after the 1st assessment. Ecological variables considered were maternal education and depression, paternal support, and infant maternal grandmother support. Results indicated that when the contribution of ecological variables was statistically controlled for, sensitivity was a significant mediator and state of mind no longer contributed to infant security. Sensitivity also mediated an association between maternal education and infant attachment, suggesting that attachment transmission is embedded in a more global process of infant attachment development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of attachment-based interventions on maternal sensitivity and infant attachment: Differential susceptibility of highly reactive infants.

The current intervention study aimed at breaking the potential intergenerational cycle of insecure attachment. The authors randomly assigned 81 first-time mothers to one of two intervention groups or a control group. The interventions involved four home visits when the infants were between 7 and 10 months old. The first intervention, VIPP, consisted of video-feedback and brochures to enhance sensitive parenting. The second intervention, VIPP-R, involved additional discussions of mothers' childhood attachment experiences in relation to their current caregiving. After the intervention, intervention mothers were more sensitive than control mothers. The interventions were most effective for highly reactive children and their mothers, providing experimental support for Belsky's (1997) hypothesis of highly reactive versus less reactive children's evolutionary based differential susceptibility to rearing influences. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of psychotherapy training and intervention use on session outcome.

Objective: This study was an investigation of the relationships among therapist training variables, psychotherapy process, and session outcome in a psychotherapy training clinic. The aims were to assess the relationship between “training as usual” and intervention use in individual psychotherapy, to investigate the relationship between therapist intervention use and session outcome, and to test whether training variables moderate this relationship. Method: Graduate student therapists (n = 19; mean age = 27 years; 79% women; 84% White) provided information about their training and completed a measure of intervention use (Multitheoretical List of Therapeutic Interventions; McCarthy & Barber, 2009) and clients (n = 42; mean age = 33 years; 64% women; 95% White) completed a measure of session outcome (Session Progress Scale; Kolden, 1991) after each session of individual psychotherapy. Results: With regard to intervention use and session outcome, no main effects were found for the training variables. Consequently, tests of moderation were not performed. The final model for intervention use and session outcome yielded main effects for time-varying interpersonal therapy and time-varying common factor use, and a 3-way interaction among time-varying cognitive–behavioral (CBT) intervention use, between-patient common factor use, and between-therapist common factor use. Patients who received more common factor interventions on average rated sessions as less helpful when more CBT interventions were employed; this finding was stronger for patients who were being treated by therapists with higher average levels of common factor use. Conclusions: Implications for training are discussed, with particular attention paid to the importance of clinical decision making and the complex interaction between common and unique technical factors in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment, maternal sensitivity, and infant temperament during the first year of life.

Families were examined at 6, 9, and 12 months in an intensive longitudinal study that included Home Behavior Attachment Q-sorts, laboratory Strange Situation assessment, home observations of infant temperament behavior on 24 occasions, observations of maternal parenting sensitivity on 12 occasions, and maternal reports of infant temperament. Maternal sensitivity was modestly related to Q-sort security and unrelated to Strange Situation classification. In contrast, observed infant temperament was more strongly related to both maternal sensitivity and Q-sort security. The relation between home and laboratory assessment of attachment security, which was at the level found in prior work ( e.g., B. E. Vaughn & E. Waters, 1990 ), remained after the effects of observed and mother reported infant temperament were partialed. Our data highlight the need to consider other factors besides maternal sensitivity in the explanation of variability in the attachment status of l-year-olds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Establishing family foundations: Intervention effects on coparenting, parent/infant well-being, and parent-child relations.

This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment-based intervention for enhancing sensitive discipline in mothers of 1- to 3-year-old children at risk for externalizing behavior problems: A randomized controlled trial.

The home-based intervention program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) was tested in a randomized controlled trial with 237 families screened for their 1- to 3-year-old children's relatively high scores on externalizing behavior. VIPP-SD, based on attachment theory and coercion theory, focuses on mirroring and discussing actual parent-child interactions in six 1.5-hr sessions with individual families at home. VIPP-SD proved to be effective in enhancing maternal attitudes toward sensitivity and sensitive discipline and in promoting sensitive discipline interactions in the intervention group as compared with the control group. Moreover, in families with more marital discord and in families with more daily hassles, the intervention resulted in a decrease of overactive problem behaviors in the children. The authors conclude that VIPP-SD should become an important module in attachment-based interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attending to the exploration side of infant attachment: Contributions from self-determination theory.

Understanding the intergenerational transmission of attachment patterns has been a main focus of attachment research for many years. Most of the empirical work conducted on this question has addressed maternal sensitivity to infants’ attachment needs. Given that security of attachment is defined as an attachment/exploration balance, some researchers have stressed the need to explore maternal behaviours in the context of infant exploration. The authors propose that self-determination theory (SDT) could contribute to attachment work in this respect given that it has clearly operationalized parental exploration-related behaviours and has related them to numerous child outcomes. This article highlights conceptual, empirical, and methodological parallels that can be drawn between SDT and attachment theory, thus suggesting that they could be complementary on many levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief treatment for young substance abusers: A pilot study in an addiction treatment setting.

The present study evaluated a motivationally based, 4-session outpatient intervention for young substance abusers presenting for addiction treatment. Follow-up interviews were conducted 6 months after assessment on (a) clients who sought additional help (n = 22) and (b) clients who did not seek additional help (n = 28). Results indicated that (a) participating in an assessment and brief intervention was associated with reduced use and consequences and increased confidence in high-risk situations up to 6 months after entry into the program, and (b) clients who participated in additional treatment showed less of a decrease in substance-related consequences. These findings suggest that brief interventions can serve as either a stand-alone intervention for individuals who need short-term assistance or a first-step intervention for those with more specialized or long-term needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Influence of Decreased Parental Resources on the Efficacy of a Responsive Parenting Intervention.

To understand whether a responsive parenting intervention for socially disadvantaged mothers was related to preintervention parenting resources, the authors examined both of these conditions as moderators of behavior change in 264 participating families (term, n = 120; very low birth weight, n = 144). Families were randomly assigned to an intervention that targeted responsive behaviors or received developmental information. Limited internal resources, particularly higher levels of anger/hostility, were related to less positive change for the broadest range of responsive behaviors for mothers in the information-only condition but not those in the intervention. Decreased social support moderated less change in provision of rich language input. A systematic session format and parent facilitator may be keys to understanding why a responsive parenting intervention can be effective in spite of limited parental resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In search of shared and nonshared environmental factors in security of attachment: A behavior-genetic study of the association between sensitivity and attachment security.

The current article presents results from a twin study of genetic and environmental components of maternal sensitivity and infant attachment and their association. The sample consisted of 136 twin pairs from 2 sites: Leiden, the Netherlands, and London, UK. Maternal sensitivity was assessed in the home at 9-10 months, and infant attachment security was observed in the laboratory at 12 months. The study yielded little evidence that genetic factors are involved in variations between twins in maternal sensitivity ratings but did find that shared variance in maternal sensitivity was able to account for some of the similarity between twins in attachment security. Weak nonshared associations between sensitivity and attachment appeared to suppress the magnitude of the correlation between attachment and sensitivity in twin children. The results could indicate that the attachment security of one twin may depend on the relationship the parent has with the other twin. The results are brought to bear on the validity of attachment theory as a theory of primarily shared environmental effects in children's development and the continuing challenge posed to attachment theory by within-family differences in socioemotional processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analysis of cognitive-behavioral interventions on HIV-positive persons' mental health and immune functioning.

Objective: To evaluate the efficacy of cognitive-behavioral interventions (CBIs) for improving the mental health and immune functioning of people living with HIV (PLWH). Design: Comprehensive searches of electronic databases from 1988 to 2005, hand searches of journals, reference lists of articles, and contacts with researchers. Meta-analytic approaches were used in synthesizing findings. Main Outcome Measures: Intervention effects on symptoms of depression, anxiety, and anger, stress, and CD4 cell counts were assessed. Results: Data from 15 controlled trials were analyzed. Significant intervention effects were observed for improving symptoms of depression (d = 0.33), anxiety (d = 0.30), anger (d = 1.00), and stress (d = 0.43). There is limited evidence suggesting intervention effects on CD4 cell counts (d = 0.08). The aggregated effect size estimates for depression and anxiety were statistically significant in trials that provided stress management skills training and had more than 10 intervention sessions. Conclusion: CBIs are efficacious in improving various psychological states of PLWH. Future research should examine the relationship among interventions, psychological states, medication adherence, and immune functions, and identify other relevant factors associated with intervention effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mothers' emotional reactions to crying pose risk for subsequent attachment insecurity.

Links between maternal emotional reactions to crying (anger and anxiety) and infant attachment security were examined in 119 mother-infant dyads. Mothers rated the intensity of their emotional responses to videotapes of crying infants prenatally. Maternal sensitivity was observed during infant exposure to emotion eliciting tasks at six and 16 months postpartum and mothers' self-reported on their responses to their infant's negative emotions at 16 months. Infant attachment security was assessed using the Strange Situation at 16 months postpartum. Results indicated that observed sensitivity was associated with fewer avoidant and resistant behaviors and prenatal maternal anger and anxiety in response to infant crying predicted the developing attachment system independent of observed sensitivity, but in different ways. Maternal anxiety in response to crying was positively associated with resistant behaviors as a direct effect. Maternal anger in response to crying was associated with avoidant behaviors indirectly through mothers' self-reported punitive and minimizing responses to infant distress at 16 months. Theoretical, applied, and methodological implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Prediction of infant-father and infant-mother attachment.

The 1st-yr correlations of infant–father and infant–mother attachment were investigated in a longitudinal study of early family development. Mothers and fathers were observed interacting with their 1st-born, 3-mo-old infants. Parents also were interviewed individually at 3 mo child age concerning their time with the infant and their attitudes and reports about the infant and their parental role. Mothers and fathers were seen in the strange situation with their infant at 12 mo. For infants and fathers, security of attachment was predicted from the qualities of interaction at 3 mo, the father's attitudes and reports about the infant and the paternal role, and the father's time with the infant. For infants and mothers, security of attachment was predicted from the qualities of interaction at 3 mo and the mother's time with the infant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)